Objective To investigate the clinical characteristic and surgical treatment of MGIST. Methods 40 cases MGIST surgical meterials were retrospectively analyzed. Results All cases were used surgery,the situation of the tumor is clear and most of them are not coated clearly. The diameter of the tumor is 5～16cm, in average (8.6±2.4)cm ;no lymph nodes metastasis during the surgery. No serious postoperative complications. Follow-up the pa-tients for 8～68 months, 14 of them died. Conclusion There is no specific characteristic on MGIST clinical perform-ance, pathological examination is the basis for the diagnosis. Surgical resection is the main treatment method.

Herpes simplex viruses (HSV) are human pathogens responsible for a variety of diseases,including localized mucocutaneous lesions,encephalitis,and disseminated diseases.HSV infection leads to rapid induction of innate immune responses.A critical part of this host response is the type I IFN system including the induction of type I IFNs,IFN-mediated signaling and amplification of IFN response.This provides the host with immediate countermeasure during acute infection to limit initial viral replication and to facilitate an appropriate adaptive immune response.However,HSV has devised multiple strategies to evade and interfere with innate immunity.This review will focus on the induction of type I IFN response by HSV during acute infection and current knowledge of mechanisms by which HSV interferes with this induction process.

Objective To study the clinical features of thyroid carcinoma and to explore the approach of early diagnosis for the disease.Methods The data of patients with thyroid carcinoma confirmed by pathology during January of 1999 to January of 2005 in the First Hospital affiliated to Shanghai Jiao Tong University were retrospectively reviewed,including clinical appearance,thyroid ultrasonography and radioisotope scanning.Results One hundred and twenty-seven consecutive patients,30 males and 97 females,mean age(48.9?13.6)years,were diagnosed with thyroid carcinoma by surgery and pathology.A total of 127 cases of thyroid carcinoma were included,which were 105 papillary thyroid carcinomas,14 follicular thyroid carcinomas,2 undifferentiated thyroid carcinomas and 6 medullary thyroid carcinomas.Thyroid ultrasonography findings showed the majority(85.1%)thyroid nodules were low echo nodules and the proportions of solid and mixed nodules were 81.8%and 17.4%,respectively.The proportion of cold nodules was 88.9% by radioisotope scanning.Mean values of serum triiodothyronine,thyroxine and thyrotropin were all within the normal range.Conclusion In the present study the thyroid carcinomas are predominant in females and the incidence of papillary thyroid carcinomas is very high.The diagnosis of thyroid carcinoma can not just depend on findings of ultrasonography,radioisotope scanning and serum thyroid hormone.

The efficiency of Siemens E.CAM is evaluated by analyzing and practicing the technology of Siemens U-fly.Basic testing procedure is run.Standard source 99mTc and 57Co is used respectively and the operation is performed according to the instruction.The detecting head's uniformity can be corrected in this way with satisfactory results.It is suggested uniformity should be tested every day before study because it is the most important factor for the quality of clinical images.

Objective To Research the efficacy and side effects of intra-abdominal chemotherapy immune to the abdominal cavity after colorectal cancer liver metastasis and local recurrence.Methods 172 eases of colorectal cancer patients after radical operation were randomly divided into conventional regulation 86 cases of abdominal chemotherapy group(control group) and the immune abdominal chemotherapy group of 86 cases(observation group).The control group received 5-FU1.0,MMC8mg intraperitoneal chemotherapy The observation group at the grass-rcots level to add IL-2 50 million U.Results Observation group effective rate .was 70.9% higher than 55.8% (P ＜0.05) ;the obsenation gionp the three-year survival rate 83.7%,dlsease-free survival rate was 44.2% higher than the 62.8%,22.1% (P＜0.05) ;observation group three-year recurrence rate of 25.6% and 34.9% lower than the rate of liver metastases in the control group of 37.8%,48.9% (P＜0.05) ;two groups of gastrointestinal reaction,ⅠⅡ or degree of bone marrow suppression,liver function mildly abnormal ( elevated alanine amiuotransferase) had no difference.Conclusion For advanced colorectal cancer patients with early immune abdominal chemotherapy,the effective prevention and treatment of abdominal cavity and liver metastasis planting to improve the survival rate,side effects of light,fewer complications,the extension of survival,worthy of clinical application.

Objective To improve the prognosis and radical resection of the extended pancreaticoduodenectomy for patients with pancreatic cancer in the ucinate process involving mesentery mot. Methods From Jan. 2004 to Dec. 2007, a total of 23 ( 14 male and 9 female, aged between 30 and 72 years old) patients with pancreatic cancer in the ucinate process involving mesentery root were treated in our department. Curative resection was performed for all patients by the extended pancreaticoduodenectomy with superior mesenteric artery (SMA) isolation and mesentery root resection. The surgical procedure, the safety and prognosis were analyzed retrospectively. Results 12 patients underwent the procedure, among them 11 also underwent combined SMV partial resection and reconstruction. The operation time was (4.2 ± 1.1 ) hours, and the blood loss was ( 1 635 ± 1 362) ml with the blood transfusion of ( 1 609 ± 1 462 ) ml. There was no operation related death in this case series, and mild to severe diarrhea occurred in 6 cases. The post-operative stay ranged 9 to 30 days. The pathological examination showed that the tumor size was (5.3 ± 1.4) cm. 13 patients (57%) had one or more lymph nodes metastasis. 20 patients (87%) had nerve involvement. Among 11 patients with SMV partial resection and reconstruction, 10 patients had endangium involvement. 22 patients had negative surgical margins for all specimens. Rapid intra-operative frozen pathological examination showed negative surgical margins in one patient, however, post-operative paraffin section pathological examination revealed nerve involvement between SMA and celiac trunk. After a follow-up of 5 to 42 months, liver metastasis occurred in 4 patients, and local recurrence occurred in 3 patients. The 1-year and 2-year accumulated survival rates were 77.2% and 42.5%, respectively. Conclusions Isolation SMA and the mesentery resection in extended pancreaticodudenectomy were safe and useful. Using this modified technique, Radical operation resection could be achieved in the treatment of pancreatic cancer in uncinate process.

ObjectiveTo observe the effect of donor liver pretreated by breviscapine on liver transplantation ischemia/reperfusion injury in rats. Methods SD rats served as liver donors and recipients (n =48 each).The recipients were divided into four groups by random number table.The donors in groups A and C were not pretreated with breviscapine,but those in groups B and D were pretreated with 20 mg/L Breviscapine.The cold ischemia time in donor livers of groups A and B was 30-40 min,and that in groups C and D was 12 h. Clotting function, liver function, serum thrombomodulin,caspase3,and relative activity of NF-kB after liver transplantation were assessed,and the pathological changes and TUNEL apoptosis staining were observed.ResultsThe mortality in groups C and D was 40.0％ (8/20) and 29.4％ (5/17),respectively (P＞0.05).There were no significant changes in coagulation function in all groups after operation. The liver function was improved,pathological lesions were alleviated,and apoptosis rate,serum TM,caspase3 expression and activity of NF-kB in the liver tissues of group D were significantly decreased as compared with group C at 3rd day after operation (P＜0.01),but all these parameters in group B had no significant change compared to group A.ConclusionPretreatment of donor livers with breviscapine can reduce the ischemia/reperfusion injury and apoptosis after liver transplantation in rats probably by inhibiting the apoptosis-related pathway and alleviating the damage to the endothelial cells of the liver microcirculation.

Objective To explore and compare the clinical efficacy of levetiracetam tablets and compound sodium valproate sustained release tablets in the treatment of children and adolescents with epilepsy.Methods From April 2017 to April 2018,80 children and adolescents with epilepsy treated in Chaonan Minsheng Hospital of Shantou were selected as study objects,and they were randomly divided into two groups by drawing lots,with 40 cases in each group.The observation group was given levetiracetam tablets,and the control group was treated with valproate.The improvement of EEG after therapy,the total effective rate,and the incidence of adverse reactions were observed and evaluated.Results The EEG improvement rates after treatment for 6 months in the observation group and control group were 41.17％,45.71％,respectively,the difference was not statistically significant(x2 =0.508,P ＞0.05).The EEG improvement rates after treatment for 9 months in the observation group and control group were 70.58％,74.28％,respectively,the difference was not statistically significant (x2 =0.225,P ＞ 0.05).The total effective rate in the observation group was 92.50％,which was 95.00％ in the control group,the difference was not statistically significant between the two groups (x2 =0.354,P ＞ 0.05).However,the incidence rate of adverse reactions of the observation group(22.50％) was significantly lower than that of the control group(45.00％)(x2 =6.864,P ＜ 0.05).Conclusion Both levetiracetam tablets and compound sodium valproate sustained release tablets have appreciable efficacy and safety in the treatment of epilepsy in children and adolescents,but levetiracetam therapy has less adverse reactions,which deserves further promotion in monotherapy of epilepsy in children and adolescents.

Objective To evaluate the application of matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) technology in the identification of filamentous fungi,and analyze the susceptibility of filamentous fungi to commonly used antibiotics.Methods A total of 100 strains of filamentous fungi were collected and identified rapidly by MALDI-TOF MS.The obtained results were compared with those from microscopic examination.The susceptibility of filamentous fungi was detected by the Etest method.Results Among 100 strains of filamentous fungi identified by MALDI-TOF MS,61 reached to the species level(score≥2.000),36 to the genus level(score between 1.700 and 1.999),and 3 failed to be identified (score ＜ 1.700).There was inconsistent results for one strain of filamentous fungi between MALDI-TOF MS and microscopic examination.The MIC90 of amphotericin B against Epidermophytonfloccosum was 0.19 μg/mL,while that against Aspergillus flavus was above 32 μg/mL.The MIC90 of itraconazole against Trichophyton tonsurans,Microsporum canis and Epidermophytonfloccosum were all below 0.38 μg/mL,while that against Aspergillus niger was above 32 μg/mL.The MIC90 of fluconazol were above 256 μg/mL for most of strains.The MIC90 of voriconazole and caspofungin against Aspergillus fumigatus,Aspergillus flavus,Aspergillus niger,Trichophyton rubrum,Trichophyton tonsurans and Microsporum canis were ≤0.38 μg/mL and ≤ 1 μg/mL,respectively.Conclusion The MALDI-TOF MS technology may be used to identify the filamentous fungi isolated from clinical specimens quickly,accurately and high-throughput.Voriconazole and caspofungin have effective anti-filamentous fungi activity.

Objective To explore the application of a three-dimensional simulation system in extended liver resections.Methods A three-dimensional surgical simulation system was used for preoperative assessment and for computer simulation to estimate the resected liver volume,the residual liver volume,and the surgical resection margins.The software virtual liver resection was used to choose the most optimal surgical option.The actual resection,the postoperative liver volume and the actual surgical resection margins were compared.Results 1 patient was diagnosed by ultrasound to develop ascites on post-operative day 2.Another patient was diagnosed by transthoracic ultrasound to have moderate pleural effusion on postoperative day 1.Postoperative liver failure developed in 1 patient.There was no patient who developed bile leakage.The average length of stay was 6 ～ 85 days (average 22 d).There was no recurrence within 1 month after surgery and there was no postoperative deaths.Condusions The three-dimensional surgery simulation system was effective.It gave an accurate evaluation and simulation of the liver surgery.In extended liver resection,it gave good guidance and help.