Gastrointestinal stromal tumors (GISTs) are the most common malignant tumor of abdominal soft tissue. It originates from Cahal (Cajal) interstitial cells or common precursor cells, and is driven by the mutated KIT gene or platelet-derived growth factor receptor alpha (PDGFRa) gene, all expressing type Ⅲ tyrosine kinase receptors. Imatinib mesylate, a tyrosine kinase receptor inhibitor, has been used for the standard treatment of advanced GIST, which has achieved remarkable results. Thus, GIST has become the most successful example of target therapy for solid tumors. In the context of the era of precision medicine, with the deepening in research of GISTs molecular biology，the molecular targeted treatment of GISTs has obtained a clear venation from the first-line, second-line and third-line of the advanced stage to the postoperative auxiliary and preoperative treatment, providing significant survival benefits for GISTs patients. This article systematically and comprehensively combed the preoperative and postoperative molecular targeting therapy from advanced GIST to early GIST, and analyzed the problems, proposed solutions and prospects for the future, aiming to provide reference for clinical application of molecular targeting drug therapy for GIST.

AIM: To study the preparation and physiological compatibility of pulmonary administration with Saponius of Panax Notoginseng (PNS) liposomes. METHODS: PNS liposomes was prepared by thin film dispersion method. The prefered formulation was determined by factorial design. Ciliary movement in situtoad palate model and the changes of pulmonary edema index and pathology of lungs in rats were investigated to evaluate the physiological compatibility of PNS liposomes. RESULTS: PNS liposomes were proved to be large unilamellar vesicle (LUV) liposomes with spherical shape .The liposomes composed of PC and Ch has a high PNS capture efficiency of 78.5% ?2.15% . The mean vesicle size of liposomes were 1546.5nm ?321.4nm which were quite homogeneous in size distribution. The lasting time of ciliary movement after the rinsing of PNS liposomes was the 92.14% of the effect of PBS buffer. The pulmonary edema index and pathological changes of lung tissue in PNS liposomes group were significantly different from those in PNS solution group and close to those in PBS buffer group. CONCLUSION: PNS liposomes has good physiological compatibility with promising market development and application.

Combing report of medical and health talents cultivation in a new century with the current situation of nursing education in our country,We proposed as follows:first,advocating and implementing the third generation medical education actively; Second,setting up the competency-based nursing education mode; Third,developing interdisciplinary cooperation or cooperation within discipline gradually; At last,observing nursing education from global vision.The aim was to offer references for nursing educators and nursing managers.

Objective To explore the sub-health and TCM physical constitution of stroke patients’families.Method Four hundred and twelve family members of stroke patients hospitalized during September 2001 to May 2013 were involved in the survey by filling out TCM physical constitution scale(TCMPC)and the sub-health self-rating scale(SSS)for the purpose of investigating the sub-health and conditions of TCM physical constitution.Results Of all the patients,189 were in sub-health,accounting for 45.87%. There were 7 main clinical symptoms related to sub-health,including poor sleep,less activeness,proneness to upsets and irritation, memory loss,depression,tension in interpersonal relations and appetite loss,with the incidences ranging from 64.55%to 48.15%. In TCM,51.85%of the family members were balanced in physical constitution,10.58%of them had Yang-deficiency constitution, 14.29%of them had Yin-deficiency,23.28%of them other kind of constitution.Conclusions The family members of stroke patients have a high rate of sub-health.The members in sub-health hold a balanced constitution,Yang-deficiency or Yin deficiency.In order to eliminate their sub-health,improving the quality of care for patients with stroke,we should guide the families of stroke patients to develop good living habits,strengthen the TCM mental nursing,help them to establish a good social support system.

Objective To evaluate the clinical and aesthetic results of guide bone regeneration(GBR)with acellular dermal matrix and implant placement in the maxillary anterior region.Methods 29 cases in the maxillary anterior region were selected carefully, GBR with acellular dermal matrix were processed and the implants were placed immediately.Impressions were taken after soft tis-sue development with provisional implant restorations and the definitive restorations were finished.The follow-up time was 3 to 9 months.The evaluated indexes involved marginal bone level at mesial and distal aspects of the implants,the interproximal papilla in-dex score of Jemt′s classification and the level of the labial soft-tissue margin.Results 29 cases were good bone integration,implant without mobility.Hard and soft tissue around implants in good condition,aesthetic effect was satisfied.Conclusion Using acellular dermal matrix to come forward to tooth GBR and implanted implant during this period,can obtain satisfactory clinical effect in the short term.

Objective To investigate the clinical effect ofFuzheng-Shugan decoction on the treatment of patients with the treatment nodule.Methods A total of 80 patients with thyroid nodule from Jan.2014 to Dec.2015, divided into two groups. The efficacy, thyroid stimulating hormone, high risk factors, the maximum diameter and volume of thyroid nodules were observed.Results The effective rate of observation group was significantly higher than of the control group (90.00%vs.27.50%,χ2=32.237,P=0.000). The shortness of breath (1.62 ± 0.86vs. 4.35 ± 1.13,t=12.159), foreign body sensation (2.53 ± 0.62vs. 4.23 ± 0.56,t=12.289), irritability (1.56 ± 0.53vs. 3.52 ± 1.25,t=9.130), sweating (1.85 ± 0.62vs.4.23 ± 0.56,t=18.017), tongue (1.58 ± 0.93vs. 3.71 ± 1.25,t=8.646) and neck pain (0.82 ± 0.35vs. 3.92 ± 0.65,t=26.558) in the obversation group were significantly lower than those in the control group (P<0.05). The thyroid stimulating hormone levels in the observation group (1.05 ± 0.21 mIU/Lvs. 2.16 ± 0.71 mIU/L,t=9.482), were significantly lower (P<0.05). The maximum diameter (8.52 ± 4.72 mmvs. 12.27 ± 5.69 mm,t=3.208) nodule volume (0.26 ± 0.71 cm3vs. 0.96 ± 1.02 cm3,t=3.562) and high risk factors (2.73 ± 1.45vs. 4.05 ± 1.36,t=4.199) in the observation group were significantly lower than those in the control group (P<0.05).Conclusion TheFuzheng-Shugan decoction can improve TCM syndrome, reduce the risk factors, and effectively reduce the nodule maximum diameter and volume.

Objective To investigate the detection of anti-cyclic citrullinated peptide(anti-CCP)antibody,alkaline phosphatase (ALP),glucose-6-phosphate isomerase(G6PI)and rheumatoid factor(RF)in the diagnosis of rheumatoid arthritis(RA).Methods Serum RF,anti-CCP body,ALP and G6PI were detected in 206 cases of RA,68 cases of other autoimmune diseases and 48 persons with the healthy physical examination,at the same time the erythrocyte sedimentation rate(ESR)was measured;the sensitivity and specificity of each indicator and the relationship between each index and RA′s diagnosis.Results The serum level of each index in the RA group was significantly higher than that in the other two groups(P <0.05).The sensitivity of RF,anti-CCP antibody and G6PI for diagnosing RA is similar;the specificity of anti-CCP body was highest(94.8%),RF was similar to G6PI;ALP with rela-tively lower sensitivity and specificity also reflected the potential of RA to some extent.Conclusion The simultaneous detection of serum RF,anti-CCP body,G6PI and ALP can improve the accuracy of early diagnosis of RA,reduce the missed diagnosis and guide the clinical treatment.

This paper introduces the perioperative care of twelve chronic heart failure patients treated with cardiac resynchro-nization therapy,such as psychological care and correction of heart function during perioperative period, careful preparation of rescue instruments and observation of patients' conditions during the operation, intensive electrocardio monitoring,prevention of incision infection,nursing care of body position,and observation and treatment of postoperative complications during the postop-erative period. All the patients passed through the perioperative period safely and were discharged upon recovery. After a 1-6 months' follow-up,the patients' symptoms of heart failure was significantly improved and the exercise capacity was increased.

Object To prepare Panax notoginseng saponin (PNS) liposomes and investigate their characterization of pharmaceutics and pulmonary pharmacokinetics in rats. Methods The film-disperion method was used to prepare PNS liposomes by investigating its form, vesicle size, entrapping efficiency and stability. The study of pulmonary pharmacokinetics in rats was carried out by pulmonary instillation. Results The entrapment of PNS liposomes was 78.50%. The mean vesicle size was 1.5 ?m with uniform externality. The drug leakage from PNS liposomes was slow. Low temperature was required for its storage. The pulmonary pharmacokinetics parameters were as follows: T 1/2 ?=7.00 h, T 1/2 ?=27.72 h, AUC= 2 218.9 ?g?h/mL, the absolute bioavailability was 70.14%. Conclusion PNS liposomes with high entrapment and stability can prolong its circulation in blood and improve the PNS bioavailability via lung approach.

With the development of detection technology,point of care testing POCT) presents a tendency of diversity.However,the blood glucose meter and blood gas analyzer are still the major types of POCT in most hospitals.How to manage them effectively has become everyone's concern.The decrease in detection quality is caused by personnel,equipment,reagents,quality control and result reports.According to the baseline survey of POCT carried out in Guangzhou Women and Children's Medical Center,6 key points to improve the quality management were found.Meanwhile,the application of plan-do-check-action (PDCA) may allow access to an effective POCT management program.