Objective To explore the clinical behavior,pathological and immunohistochemical characteristics and diagnosis, treatment methods of gastrointestinal stromal sarcomas (GISS). Methods Retrospective analysis was perfomed over 36 GISS patients based on clinical data and pathological data. Results GISS occurred more in the stomach and small intestine, than colon and rectum. Immunohistochemical staining showed CD117, CD34 expression,the positive rates were 91.7% and 86. 1%. Conclusion GISS is a rare malignant tumor, GISS diagnosis depends on the histologic and immunohistochemical test. CD34 and CD117 in the positive diagnosis has its special significance. Surgery is the main treatment.

Usually individualized comprehensive treatments are applied to children with cerebral palsy. Among them, Kinesio taping is a simple treatment compared to orthosis, which allows greater rang of motion (ROM) and can more easily be accepted by patients, however, its effectiveness is controversial. This article introduced the mechanism that mainly includes relieving pain, improving joint mobility, increasing strength, relieving edema and increasing proprioception. The application of it in upper limbs, lower limbs and trunk of children with cerebral palsy was discussed. Finally, the advantages and limitations of Kinesio taping, suitable types of cerebral palsy and the therapeutic evaluation were analyzed.

Objective To research the effect of neoadjuvant chemotherapy with anthracycline and taxane in early or locally advanced breast cancer and its effects on ER, PR and Her-2.Methods 120 cases of early or locally advanced breast cancer patients were selected as the research objects, according to the order of admission, the patients were divided into the observation group and the control group.The control group were given conventional chemotherapy with EC regimen (epirubicin +cyclophosphamide), while the observation group were treated with anthracyclines and taxanes.The clinical efficacy and the expression of ER, PR and Her-2 receptor in the two groups after treatment were compared.Results The total effective rate of the observation group was 73.33%, which was higher than that of the control group (53.33%) (P<0.05).After treatment, the positive expression level (0~+++) of ER receptor in the observation group were 20.00%, 15.00%, 35.00%, 30.00%, respectively, the positive expression level(0~+++) of PR receptor were 26.67%, 20.00%, 23.33% and 30.00%, respectively, were significantly better than those of the control group ( ER:31.67%, 21.67%, 28.33%, 18.33%, PR:40.00%, 25.00%, 20.00%, 15.00%) (P<0.05).But there was no significant difference between the two groups in the expression of Her-2 receptor (25.00%, 11.67%, 30.00%, 33.33% and 31.67%, 21.67%, 16.67%, 30.00%, respectively).The incidence of adverse reactions in the observation group and the control group were 6.67% and 21.67%, respectively, and there was significant difference between the two groups ( P<0.05 ) .Conclusion In the treatment of early or late stage breast cancer , anthracycline combined with taxane neoadjuvant chemotherapy has a significant effect, which can effectively improve the expression of ER and PR receptors.In addition to improve the effect of clinical treatment, and reduce the incidence of adverse reactions in a certain extent,so it can be used as a new adjuvant chemotherapy in the clinical application of the best option.

Objective By the reform of vocational nursing Maternal and Child Care course teaching methods,to solve the problems existing in higher vocational curriculum in five-year nursing specialty such as too much repetition in teaching content,low learning interest and enthusiasm in students,and not being able to reach target level of personnel training effectively.Methods Higher vocational nursing class 2 (51students) were extracted as the experimental group,class 3 (50 students) were extracted as as the control group from grade 2009.The experimental group adopted the project teaching method,the control group used the traditional teaching method.At the end of the course,the results of knowledge and operating skills between the two groups were compared.Results The total scores of the experimental group were better than the control group in memorizing theoretical knowledge examination,interpretation,application.There were no differences in individual skill examination skills assessment between the two groups,comprehensive skills assessment and total scores of the experimental group was better than the control group.Conclusions Application of project teaching method in higher vocational nursing specialty maternal and child care course teaching in higher vocational cohesion.It can effectively avoid the repetition of teaching content which may lead to the low utilization rate in class,stimulate students' interest in learning,and develop students' comprehensive occupation ability,and make vocational course objectives to achieve high stage.

Objective:To investigate the characteristics of renal disease spectrum in children aged 0-3 years old, and to evaluate the clinical value of renal biopsy in children aged 0-3 years old with renal diseases.Methods:It was a retrospective analysis study. The children aged 0-3 years old with kidney diseases receiving renal biopsy and having complete clinical data in Shanghai Children's Hospital from January 1, 2009 to December 31, 2020 were enrolled. The clinical and pathological data of the children were collected. The spectrum of renal diseases, clinical phenotype, renal pathology, and the relationship between renal pathology/genotype and clinical phenotype were analyzed.Results:A total of 117 children aged 0-3 years old with kidney diseases were enrolled in the study, accounting for 6.5% (117/1 790) of all children (0-18 years old) with renal biopsies during the same period. There were 77 males and 40 females. The age was (2.20±0.51) years old (5-35 months). All cases of renal biopsies in children aged 0-3 years old were successful without serious complications. Nephrotic syndrome was the common clinical phenotype of kidney diseases in children aged 0-3 years old (59.0%, 69/117), followed by hematuria and proteinuria (29.1%, 34/117). Primary glomerular disease (69.2%, 81/117) was the major clinical type of renal diseases, followed by hereditary kidney diseases (29.1%, 34/117), in which Alport syndrome was the main hereditary kidney disease (79.4%, 27/34). Renal pathological types of children aged 0-3 years old were mainly distributed in minimal change disease (30.8%, 36/117), followed by glomerular minor lesion (26.5%, 31/117), mesangial proliferative glomerulonephritis (15.4%, 18/117), and focal segmental glomerulosclerosis (10.3%, 12/117). Among 40 children aged 0-3 years old with hematuria with/without proteinuria, 25 cases were diagnosed as Alport syndrome by abnormal immunofluorescence of type IV collagen in renal tissues. Among the 28 children with kidney diseases who underwent genetic testing, 23 cases had gene mutations, mainly in COL4A5 gene (60.9%, 14/23), among which 4 children had gene mutations in 8 children with refractory nephrotic syndrome. Among the children aged 0-3 years old with clinical manifestations of hematuria, the proportion of gross hematuria in children diagnosed with Alport syndrome (59.3%, 16/27) was significantly higher than that in children without Alport syndrome (20.0%, 3/15, χ2=5.999, P=0.014). Conclusions:Primary glomerular disease is the principal type of kidney diseases in children aged 0-3 years old, followed by hereditary kidney disease. Attention should be paid to children aged 0-3 years old with gross hematuria. Renal biopsy in children aged 0-3 years old is safe and reliable, and it is an essential means for the diagnosis of renal diseases. Renal biopsy combined with gene testing can better understand the etiology of kidney diseases and guide treatment in children aged 0-3 years old.

ObjectiveTo investigate the effect of ivabradine， an inhibitor of peripheral HCN channel， on remifentanil-induced hyperalgesia in mice. MethodsThe model of remifentanil-induced hyperalgesia was established by intravenously infusing remifentanil 2 μg/（kg·min） for 1 h through tail vein of adult male C57/BL6 mice. To observe the effect of ivabradine on remifentanil induced hyperalgesia， ivabradine （5 mg/kg） was injected subcutaneously 30 minutes before remifentanil infusion. Forty mice were equally and randomly divided into 4 groups： saline group， remifentanil group， remifentanil + vehicle group and remifentanil + ivabradine group. In each group， six mice were used to test mechanical and thermal pain thresholds at 24 h before （baseline） and on 1 d， 3 d， 5 d after remifentanil or saline infusion. Four mice of each group were used to detected c-Fos positive cell in spinal dorsal horn by immunofluorescence on 1 d after remifentanil or saline infusion. ResultsCompared with the saline group， a significant decrease in mechanical or thermal threshold was observed on 1 d and 3 d after remifentanil infusion （P<0.001）， and the number of c-Fos positive neurons in the lumbar dorsal horn increased significantly （P<0.001）. Compared with vehicle group， subcutaneous injection of ivabradine effectively inhibited remifentanil induced hyperalgesia （P<0.001） and blocked the increase of c-Fos positive neurons in the lumbar dorsal horn on 1 d following remifentanil treatment （P<0.001）. ConclusionsIvabradine could effectively prevent remifentanil-induced hyperalgesia in mice. The possible mechanism underlying this effect is that ivabradine suppresses the enhanced peripheral nociceptive input onto spinal cord neurons.