Molecular targeted therapy is a treatment bed emerging recent years for the treatment of malignant tumors,imatinib mesylate in the treatment of gastrointestinal stromal tumor (GIST) is a successful example ofmolecular targeted therapy.Imatinib mesylate can inhibit tyrosine kinase andinhibition of cell proliferation by treatment of gastrointestinal stromal tumor.With the positive effect of imatinib in the treatment of GIST,the related adverse reactions and the prevention and treatment strategies are worth to be discussed.

Objective To investigate the X ray radiation protective measure during interventional procedure.Methods The X ray radiation dose at 1,2,3 meters from the X ray tube in front of and in the near of lead glass,plumbic suit were measured in 101 cases interventional procedure.The data were analyzed and evaluated.Results The shielding efficacy was 95% by the lead glass and plumbic suit double protection,the X ray radiation was reduced markedly.The X ray radiation attenuation was swift with the distance increasing.The X ray radiation attenuation was 53.8% from 1 meter to 2 meter,and 81% to 3 meter.The X ray radiation received by medical personnel increased significantly with the fluoroscopy and subtraction time adding.Conclusion The X ray radiation protection should be carried out from shielding protection,distance protection and radiation time reducing;That can reduce the damage of radiation to keep the operator healthy.

Objective To evaluate the clinical significance of low ligation and high ligation of inferior mesenteric artery (IMA) and lymph nodes dissection on radical resection for rectal cancer.Methods One hundred and fifty-six patients who were diagnosed rectal cancer in our hospital between May 2007 and May 2008 were divided into low ligation group (80 cases)and high ligation group (76 cases).The low ligation group was treated with low ligation of IMA and lymph nodes dissection,the high ligation group was cured by high ligation of IMA and lymph nodes dissection.cases.The IMA lymph nodes metastasis,number of lymph nodes,cancer recurernce rate,5-year survival rate,complication rate were compared and analyzed.Results The rate of lymph nodes metastasis around the origin of inferior mesenteric artery was 15.0％ in the low ligation group,the rate of lymph nodes metastasis around the origin of inferior mesenteric artery was 14.5％ in the high ligation group,and the difference was not statistically significant (P ＞ 0.05).Compared two groups of postoperative recurrence rate,5-year survival rate,anastomotic leakage rate,sexual dysfunction rate and urinary retention rate,there was no significant differences (P ＞ 0.05).The intestinal function recovery time and low anterior resection syndrome incidence of the low ligation group were lower than the high ligation group,there were significant differences (P ＜ 0.05).Conclusions Low ligation of inferior mesenteric artery and lymph nodes dissection can achieve radical resection for rectal cancer.Compared with traditional high ligation of inferior mesenteric artery,there were no differences for patients on recurrence rate,5-year survival rate and complication rate.

Objective To compare the clinical efficiency between laparoscopic and open complete mesocolic excision for right-sided colon cancer.Methods Between January 2011 and August 2012,a total of 134 patients with right-sided colon cancer who underwent CME at Fuzhou General Hospital of Nanjing Military Command were divided into laparoscopic (71) and open (63) groups.The intraoperative parameters,pathology,postoperative course and short-term outcomes were compared between groups.The chi-test and the student t test were used for statistics.Result There were no significant differences in the length of distal (P=0.427) and proximal margin (P=0.515),tumor diameter (P =0.440) and number of lymph nodes dissected (P =0.377).Postoperatively patients were followed for up to 12 months,no significant differences were found in local regional recurrence rates (4.2％ vs 1.6％) (P =0.622) and distal metastasis rates (5.6％ vs 3.2％) (P =0.684) between the two groups.The mean operative time (P =0.134) and postoperative complication rate (P =0.977) were similar.The mean intraoperative blood loss was less (P =0.000),bowel flatus passed earlier (P =0.000) and hospital stay shorter (P =0.000) in laparoscopic than that in open group.Conclusions Laparoscopic CME has the same oncologic clearance effects and short-term follow-up result compared with open CME for right-sided colon cancer,and laparoscopic CME is minimally invasive,less bleeding,less pain and quick recovery.

OBJECTIVETo explore the effect and safety of topical propranolol hydrochloride gel for treatment of infantile hemangioma. METHODS Thirty nude mice (BALA/c, nu/nu) were divided into three groups, experimental group, control group and normal group. Human hemangioma endothelial cells cultured in vitro were injected subcutaneously in experimental group and control group to establish infantile hemangioma model. Topical propranolol hydrochloride gel was applied on the surface of the hemangioman in experimental group and normal group. Tumor volumn change and the skin situations (edema, erythema, ulceration) were observed at different periods. 45 days after cell injection, the mice were killed and plasma concentration was detected in the experimental group and the control group by high performance liquid chromatography with evaporative light scattering detector, and tumors were subjected to histopathologic examination and immunohistochemistry for CD31 and CD34. The correlation between volumes and plasma concentration was statistically analyzed with SPSS 13.0 paired samples t test with α = 0.05 as statistical standard.

RESULTSAt 45 days, the volume of the tumor in control group was (366.57 ± 17.08) mm³, which has a significant difference as compared to the experimental group (13.36 ± 2.09) mm³ (P < 0.05); and the plasma concentration was (16.83 ± 1.53) ng/ml in experimental group, and (18.42 ± 2.21) ng/ ml in normal group (P > 0.05 ). Topical propranolol hydrochloride gel (3%) has no irritation to nude mice's skin.

CONCLUSIONSTopical application of 3% propranolol hydrochloride gel is effective and safe for the treatment of infantile hemangioma.

Animals ; Gels ; administration & dosage ; Hemangioma ; drug therapy ; pathology ; Humans ; Immunohistochemistry ; Mice ; Mice, Nude ; Propranolol ; administration & dosage ; Skin Neoplasms ; drug therapy ; pathology ; Tumor Burden ; drug effects

OBJECTIVETo investigate the effect of topical propranolol gel on the levels of plasma vascular endothelial growth factor (VEGF), basic fibroblastic growth factor (bFGF) and matrix metalloproteinases-9 (MMP-9) in proliferating infantile hemangiomas (IHs) of superficial type.

METHODS33 consecutive children with superficial IHs were observed pre-treatment, 1 and 3 months after application of topical propranolol gel for the levels of plasma VEGF, MMP-9 and bFGF by enzyme-linked immunosorbent assay (ELISA) in Department of General Surgery of Dongfang Hospital from February 2013 to February 2014. The plasma results of IHs were compared with those of 30 healthy infants. The clinical efficacy in IHs was evaluated by Achauer system. Differences of plasma results between the healthy group and the IHs group pre-treatment were analyzed using Mann-Whitney U-test. Paired sample comparisons of any two time points of pre-treatment, 1 month and 3 months after treatment in IHs were evaluated by Wilcoxon signed-rank test.

RESULTSThe clinical efficiency of topical propranolol gel at 1, 3 months after application were 45.45%, 81.82% respectively. The levels of plasma VEGF and MMP-9 in patients pre- treatment were higher than those in healthy infants [(362.16 ± 27.29) pg/ml vs (85.63 ± 8.14) pg/ml, (1376.41 ± 42.15) pg/ml vs (687.27 ± 44.1) pg/ml, P < 0.05], but the level of bFGF did not show significant difference [(176.03 ± 13.60 ) pg/ml vs (235.94 ± 35.43 ) pg/ml, P > 0. 05 ]. The concentrations of VEGF and bFGF at 1, 3 months after treatment decreased obviously [(271.51 ± 18.59) pg/ml vs (362.16 ± 27.29 ) pg/ml, (135.85 ± 12.66) pg/ml vs (176.03 ± 13.60) pg/ml], 1 month after treatment vs pre-treatment, P < 0.05; (240.80 ± 19.89) pg/ml vs (362.16 ± 27.29) pg/ml, (107.31 ± 5.82) pg/ml vs (176.03 ± 13.60) pg/ml, 3 month after treatment vs pre-treatment, P < 0.05, whereas the levels of plasma MMP-9 declined slightly [(1321.18 ± 48.74) pg/ml vs (1376.41 ± 42.15 ) pg/ml, (1468.68 ± 32.78) pg/ml vs (1376.41 ± 42 2.15 ) pg/ml, P > 0.05 ].

CONCLUSIONSPropranolol gel may suppress the proliferation of superficial infantile bemangiomas by reducing VEGF and bFGF.

Administration, Topical ; Case-Control Studies ; Child ; Enzyme-Linked Immunosorbent Assay ; Fibroblast Growth Factor 2 ; blood ; Gels ; Hemangioma ; blood ; drug therapy ; Humans ; Infant ; Matrix Metalloproteinase 9 ; blood ; Propranolol ; pharmacology ; Time Factors ; Vascular Endothelial Growth Factor A ; blood

Objective To investigate the change of ATM phosphorylation in HepG2 cells following a condnuous low dose-rate irradiation.Methods Cells were pemistendy exposed to low dose-rate(8.28 cGy/h) irradiation.Indirect immunofluorescence and Western blot were used to detect the expression of ATM phosphorylated proteins.Colony forming assay Was used to observe the effect of a low dose-rate irradiation on HepG2 cell survival.Results After 30 min of low dose-rate irradiation.the phosphorylation of ATM occurred.After 6 h persistent irradiation,the expression of ATM phosphorylated protein reached the peak value,then gradually decreased.After ATM phosphorylation was inhibited with Wortmannin,the surviving fraction of HepG2 cells was lower than that of the irradiation alone group at each time point(P<0.05).Conclusions Continuous low dose-rate irradiation attenuated ATM phosphorylation.suggesting that continuous low dose-rate irradiation has a potential effect for increasing the radiosensitivity of HepG2 cells.

Objective To evaluate the efficacy,safety and the possible mechanism of shenfu injection (SFI)in the treatment of severe acute pancreatitis(SAP).Methods A total of fifty-eiSht patients with SAP admitted to Research Institute of General Surgery of Nanjing Military Command from June 2006 to September 2008 were randomized into the conventional group(n=28)and SFI group(n=30).Patients in SFI group were treated by plus SFI(50 ml per day for 7 days)on routine treatment.The time to pain ease,bowel sound recovery times,body temperature recovery time were observed;APACHE Ⅱ score,Binder point was calculated;serum amylase,TNF-α and IL-1β were measured.The complication rate,operation rate,mortality were analyzed.Results The duration of abdominal pain,recovery of bowel sound,body temperature,and mean hospital stay days in SFI group were 95.3±2.8)d,(5.1±1.7)d,(7.1±2.4)d and(32.4±6.4)d;7 days later the APACHE Ⅱ score,Binder point was 8.63±1.33 and 6.50±1.66.respectively;the serum levels of amylase,TNF-α,and IL-1β were(1152±576)U/L,(48.7±16.4)ns/na and(199.3±53.3)ng/ml,respectively.12 episodes of severe complication occurred,operation rate was 3.33%(4/30)and the mortality rate was 0%.All the parameters were statistically significantly lower than those in the conventional group(P＜0.05 or P＜0.01).There was no adverse event related to SFI.Conclusions SFI was safe and effective for SAP,and the mechanism may be related to inhibit over-release of inflammatory medium and cytokines,and improve microcirculation.

Objective To evaluate the efficacy and safety of different concentrations of propranolol gel in treatment of infantile hemangiomas(IH).Methods Sixty-three consecutive infants with hemangiomas from Mar.2011to Sep.2012 in Department of General Surgery,Fuzhou General Hospital of Nanjing Military Command,were divided randomly into A,B,C groups and respectively treated with propranolol hydrochloride 1％ (20 g ∶ 200 mg,A group),2％ (20 g:400 mg,B group),3％ (20 g:600 mg,C group),evenly applied to the surface of the hemangiomas,3 times a day.Follow-up treatment was performed for 6 months.Details of adverse reactions,gender,age,tumor location,complications,and hemangioma size,texture,color and recurrence after stopping were recorded,and hospital review and efficacy evaluation were performed every month.Results After 6 months of treatment,A group had effective treatment in 11 patients(52.38％),ineffective treatment in 10 patients (47.62％),B group had effective treatment in 12 patients (57.14％),ineffective treatment in 9 patients (42.86％),and C group had effective treatment in 19 patients (90.48％),ineffective treatment in 2 patients(9.52％).After taking color Doppler ultrasound examination revealed IH thickness revealed significantly thinner.Conclusions External use of propranolol hydrochloride gel is an effective option for superficial hemangiomas,And 3％ concentration of propranolol gel is superior to the efficacy of the other 2 drugs.

Objective To observe the effect of duodenal endoluminal sleeve (ELS)on.glucose metabolism of non-obese type 2 diabetes mellitus (T2DM)rats.Methods 24 male spontaneously diabetic Goto-Kakizaki (GK) rats were randomly divided into surgery group(ELS,n =12)and sham-operated group (SO,n =12).Fasting plasma glucose(FPG) levels of the 2 groups were observed before surgery(0 weeks),or on 1 st,3rd 6th,12th,and 24th week after surgery.Oral glucose tolerance test(OGTT) was performed before surgery (0 weeks),or on 6th and 24th week after surgery.Blood glucose versus time curve was depicted and glucose tolerance area under the curve(AUC)was calculated.Glucagon-like peptide-1 (GLP-1)concentration levels were measured 2 hours after glucose load.Results There was no significant difference between the 2 groups in various indicators before surgery.For ELS group,FPG level significantly decreased on 1 st,3rd 6th,12th,and 24th week after surgery (Fintra-group =5.982,P ＜ 0.01)compared with that before surgery.AUC and blood glucose peak were both loweron 6th and 24th week after surgery than those before surgery (Fintya-group =11.602,P =0.003).OGTT glucose peak reduced to 30 minutes from the original 60 minutes.GLP-1 level significantly increased after glucose load (Fintra-group =43.24,P ＜ 0.05) ; All the index of SO group had no significant change.Conclusion Duodenal ELS has effect on blood glucose control and glucose tolerance improvement in non-obese T2DM rats.