Objective To explore the diagnosis and treatment of gastrointestinal stromal tumors(GIST).Methods 26 patients with gastrointestinal stromal tumors in Ji'an Central People's Hospital from 1998 to 2006 Were retrospectively analyzed.Results All patients received operation.Of them,low malignant GIST wag in 17 eases,high malignant GIST in 9.All patients were follwod-up from 6 to 84 months.4 ofthem had local recurrence and metastasis and 5 eases died.Condusion The diagnosis of GIST Was dimcult because of the lack of clinical features.Final diagnosis should be based on IHC pathology.The main choice of treatment Was operation.Glivee could prolong the life and improve the prognosis of the patients in recurrent and metastatic cases.

Background Branch retinal vein occlusion (BRVO)often leads to macular edema as the result of elevating intravitreal VEGF level,and avastin,a anti-VEGF drug,show a good effectiveness on macular edema secondary to BRVO.ObjectiveThis study attempts to evaluate the clinical efficacy of avastin on macular edema induced by BRVO.MethodsThis is a retrospective case-observation study.The clinical data of 39 eyes from 39 patients with macular edema induced by BRVO were included in this analysis.All of the patients received intravitreal injection of 1.25mg (0.05mL)avastin without other any therapy prior to the injection of avastin.This procedure followed the Declaration of Helsinki,and written informed consent was obtained from all the patients before and initial of any management.Clinical indexes included best-corrected visual acuity(BCVA),slit-lamp examination,intraocular pressure and stereoscopic biomicroscopy examination before injection and 3,6 and 12 weeks after initial injection.Optical coherence tomography (OCT),fundus photography,fluorescein fundus angiography(FFA)were performed prior to injection and 6,12 weeks after initial injection.The follow-up period was 3-20 months.ResultsThe mean BCVA was significantly improved at 3,6,12 weeks after injection in comparison with before injection (t=-6.039,-6.182,-4.189,all P=0.000).The mean CMT showed a statistically significantly decline at 6,12 weeks after injection in comparison with before injection(t=8.684,5.019,all P=0.000).No ocular or systemic adverse events were found after intravitreal injection of avastin during the follow-up duration.The numbers of visual acuity-improved eyes were significantly increased in the patients with disease course ≤1 month duration in comparison to ones with the course ≥1 month (P<0.05)in 3 weeks after injection.CMT was obviously decreased in 12 weeks after injection in comparison to before injection between with and without macular perfusion eyes (P<0.05).ConclusionIntravitreal injection of avastin is safe and effective for macular edema induced by BRVO,especially the patients with shorter course of disease.

The system of first contact in community health institutions, as the core element of hierarchical di-agnosis and treatment system, is of great importance for reforming successfully China’ health service system. The sys-tem of first contact in community health institutions implemented among labor workers in Shenzhen City plays an im-portant role in patients ’ distribution and the interested parties can accept this mandatory system. Campared with Shenzhen City, the level of services is enough to meet patients’ primary health demands in some cities which the com-munity health service develops well, and it should be thought highly of the mandatory in the process of policy imple-mentation in order to ensure the implementation effect.