OBJECTIVE:To explore the way for the development of E-commerce in Chinese pharmaceutical enterprises. METHODS:The successful experiences of American in developing E-commerce were studied,and problems for the develop-ment of E-commerce in China pharmaceutical enterprises were analyzed.RESULTS&CONCLUSIONS:The development of E-commerce in Chinese pharmaceutical enterprises should count on information construction in enterprises,depend on the third party E-commerce transaction platform,focus on the service and actively develop the countryside market etc.

The periods of the medical students' clinical practice is an important transition from medical theory to medical practice.According to the medical interns' expectations,such as the clinical tutor' level,hardware of the department,daily medical process and our department' s experiences,we grope for much better teaching methods that can meet medical interns' expectations and evaluate the new teaching methods.The basic clinical skills of medical students and the teaching level of gastrointestinal surgery department have been effectively improved.

Objective To investigate the changes of PPARr mRNA and protein expressions in rats with ANP. Methods 36 rats were randomly divided into sham group and ANP group. The rats were sacrificed 3 h, 6 h,12 h after ANP induction, the levels of serum amylase were measured, the pancreatic pathological changes were determined and the expressions of pancreatic PPARr mRNA and protein was examined by RT- PCR and immunohistochemistry. Results In ANP group, the level of serum amylase at 6h was (7170.83± 1635.59) U/L, the scores of pathological changes were 6.67±1.03 and 13.00±2.36, which were much higher than those of sham group (P<0.01) ; the PPARr mRNA expression was 0.18±0.05, and there were no obvious differences compared with that of sham group (0.22±0.03 ) ; PPARr protein expression was 4.17 ±0.98, which was significantly higher than that of sham group (1.83±0.71, P<0.05). Conclusions Inflammatory injury resulted in increased deactivation of pancreatic acinar PPARr, meanwhile PPARr gene expression was inhibited by feedback.

Objective To investigate the effect of pretreatment of pioglitazone on acute necrotizing pancreatitis (ANP) rats. Methods ANP was induced by retrograde injection of 5% sedinm deoxycholate into bilio-pancreatic ducts. The animals were randomly divided into ANP (n=18), sham operation (n=18) and pioglitazone pretreatment group (n=18). Pioglitazone was given 20 mg/kg in pioglitazone group before ANP was induced. The rats were sacrificed 3 h, 6 h, 12 h after ANP induction, respectively. Bblood samples were taken for serum amylase measurement. Tissue samples of pancreas were harvested for morphological observation under conventional light microscopy. Pathological change of pancreas was evaluated by Hughes and Kusske score system. Results The concentration of serum amylase and the pancreatic histological score in pioglitazone and ANP groups were significantly higher than those in sham operation group (P＜0.001 ). The concentration of serum amylase, Hughes and Kusske score in pioglitazone group at 12 h after ANP induction were (2980± 1080) U/L,4.50±2.07 and 7.50±1.05, respectively, and were lower than (7598±1072) U/L, 7.17±1.47 and 11.33±1.75 of ANP group at 12 h (P＜0.01). Conclusions Pioglitazone pretreatment could decrease the serum level of amylase and the pancreatic histological score. Pioglitazone may ameliorate the severity of ANP.

Objective To observe the effect of pioglitazone on peroxisome proliferators activated receptors (PPARγ) mRNA expression in rats with acute necrotizing pancreatitis (ANP). Methods 54 rats were randomly divided into sham group, ANP group, and pioglitazone group. ANP was induced by the retrograde injection of sodium taurocholate into pancreatic duct. The levels of serum amylase at 3 h, 6 h, and 12 h after ANP induction were determined and pancreatic pathological scores were measured, and the expression of pancreatic PPARγ mRNA was determined by RT-PCR. Results The levels of serum amylase and pancreatic pathological scores at 6 h in ANP group were (7171 ± 1636) U/L and 13.00 ±2.36; which were significantly higher than those in sham group [ (523 ± 166)U/L and 1.67 ± 234, P < 0. 01 ]. While the expressions of PPARγ mRNA were weakly expressed in ANP gyoup and sharm group(0. 18 ± 0.05 vs 0. 22 ±0. 03, P > 0. 05). The levels of serum amylase and pancreatic pathological scores at 6 h in pioglitazone group were (4504 ± 1901 )U/L and 9.00 ±0.89, which were significantly lower than those in ANP group (P <0. 05).While the expressions of PPARγ mRNA was higher than that in ANP group (0.56 ±0.05 vs 0. 18 ±0.05, P <0.05). Conclusions The protective role of pioglitazone on ANP rats was closely correlated with up-regulation of PPARγgene expression.

Coronavirus disease 2019 (COVID-19) is a new infectious disease rapidly spreading around the world, raising global public health concerns. Radiological examinations play a crucial role in the early diagnosis and follow-up of COVID-19. Cross infection among patients and radiographers can occur in radiology departments due to the close and frequent contact of radiographers with confirmed or potentially infected patients in a relatively confined room during radiological workflow. This article outlines our experience in the emergency management procedure and infection control of the radiology department during the COVID-19 outbreak.

OBJECTIVE: To investigate the clinical characteristics and prognostic factors of reoperation patients with postoperative recurrence or metastasis of gastrointestinal stromal tumor (GIST). METHODS: A retrospective case-control study was performed on the clinical data of 31 patients with GIST who had recurrence or metastasis after the first surgery and underwent one or more operations again from February 2003 to January 2016 at Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The clinical characteristics of these patients were analyzed. Kaplan-Meier survival curve was used to calculate the survival rate, Cox univariate and multivariate regression model was applied to prognosis analysis. RESULTS: Age of these 31 patients at the first operation was 35-78 (median 49) years, including 17 males (54.8%) and 14 females (45.2%). The tumors of 21 cases located in small intestines (67.7%), 2 cases in stomach (6.5%), 4 cases (12.9%) in colorectum and of 4 cases (12.9%) in other sites. According to NIH criteria, risk assessment indicated 26 cases were(83.8%) with high risk, 3 cases (9.7%) with moderate risk, and 2 cases (6.5%) with low risk. After the first operation, 15 cases received the IM (imatinib) therapy regularly based on NCCN guideline,10 cases received the therapy irregularly, and the other 6 cases did not receive the therapy. R0 resection was performed in 29 cases (93.5%) and R1/R2 resection was performed in 2 cases (6.5%). The median interval between the first operation to the recurrence was 32.3 (5.2-117.6) months and the median age of recurrence was 56 years old. Refer to the recurrent location, 28 cases (90.3%) were found in the same location or liver, 1 case in greater omentum, and 2 cases in pelvic cavity. The median diameter of the tumor in reoperation was 6.5 cm. Twenty-three cases(74.2%) received R0 excision and the other 8 cases(25.8%) received R1/R2 excision. At diagnosis of tumor recurrence, 20 cases (64.5%) received the second surgery immediately and the other 11 cases received surgery after imatinib or sunitinib treatment. Twenty-nine (93.5%) patients were followed up for 7.3 to 160.3 (median 49.5) months. After the second surgery, the relapse-free survival (RFS) of the whole group was 3.2 to 148.6(median: 29.7) months. Till the end of follow-up, 9 cases died of recurrence. Among 20 alive cases, 8 cases were living with the tumor, 1 case received the third surgery. The median overall survival (OS) time was 38.4(6.2-160.3) months. The 5-year RFS and the 5-year OS of 15 cases who received regular targeted therapy after the first operation were 73.4% and 81.7% respectively, significantly higher than those of the other 16 cases who received irregular or no targeted therapy(37.6%, P=0.015 and 38.9%,P=0.023,respectively). The 5-year RFS rate and the 5-year OS rate of the 11 patients who were diagnosed or complicated with liver metastasis were 29.8% and 32.2% respectively, which were significantly lower than those of the 20 patients without liver metastasis (79.1% and 88.1% respectively, both P<0.001). Cox model for OS, the results showed that regular targeted therapy after first surgery(HR=0.362, 95%CI:0.210-1.074, P=0.089) and the liver metastasis (HR=5.342, 95%CI: 0.902-12.580, P=0.057) were not the independent risk factors. CONCLUSIONS Regular targeted therapy according to the guideline after the first operation for GIST patients with recurrence or metastasis may improve the prognosis. Prognosis of GIST patients with postoperative liver metastasis is poor.
Case-Control Studies ; China ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Reoperation ; Retrospective Studies

Humans ; Female ; Prevalence ; Breast Neoplasms ; Cancer Survivors ; Non-alcoholic Fatty Liver Disease ; Liver