Gastroenteropancreatic neuroencrine tumors (GEP-NETs) originate from the neuroendocrine cells of the digestive system.Over the past few years,the incidence has increased gradually.The clinical manifestations are diverse,and the related molecular mechanism is also more complex.Although there are more and more basic researches for GEP-NETs,the mechanism for carcinogenesis and metastasis has not been fully elucidated.This paper summarizes the latest progress on the development of GEP-NETs,and elaborates the new findings on tumor molecular mechanisms,mainly including the related receptors and its signaling pathways,gene mutations and epigenetic changes.

Objective To explore the change of cytoskeleton and the variance of Ca2+ in cultured cells during the invasion of Toxoplasma gondii. Methods Tachyzoites suspensions were gathered by routine method and used to infect phagocytic cells(J774A.1)and non-phagocytic cells (HUVEC). The ability of T. gondii invading into the cells and the influence of cytoskeleton inhibitor,colchicine and cytochalasin D,were observed by microscopy. The rearrangement of cytoskeleton of cells was observed by fluoromicroscopy. By using laser scanning confocal microscope,the variance of Ca2+ in J774A.1 and HUVEC was detected. Results Ca2+ increased greatly in J774A.1 during the invasion of T.gondii(P0.05). The microfilaments of J774A.1 were agglomerated during the invasion of T. gondii. Cytoskeleton inhibitor,cytochalasin D(P0.05)during the invasion and cytoskeleton was not changed. Cytochalasin D and colchicine showed little effect on the infection rate of HUVEC. Conclusion The concentration of Ca2+ increases greatly and cytoskeleton(mainly the microfilament)has been rearranged in phagocytic cell during the invasion of T. gondii,while both of them show no significant change in non-phagocytic cell.

Cancer pain can seriously disturb patients′quality of life.Intractable cancer pain not ame-nable to standard analgesics is a horrifying truth in parts of the patients.Interventional pain management tech-niques can be an effective alternative for those patients.Based on the evidence of evidence-based medicine, celiac plexus block or splanchnic nerve block are recommended for the management of upper abdominal cancer pain,pelvic cancer pain can be managed with superior hypogastric plexus block,and back pain due to vertebral compression fractures with tumor invasion can be managed with percutaneous vertebroplasty or kyphoplasty. Intercostal nerve block for chest wall cancer pain,ganglion impar block and saddle block for perineal pain due to pelvic tumors should be used only in the context of an experimental study or in cases of compassionate use with no other available forms of effective pain relief.

Objective To explore the first-aid treatments and nursing measures of children with Adams-Stokes syndrome.Methods Totally 6 data of patients with Adams-Stokes syndrome who was successfully rescued were analyzed and discussed.Results The main cause of Adams-Stokes syndrome were Severe ventricular tachycardia.The third degree atrioventricular block,Severe myocarditis,Dilated cardiomyopathy,the common inducing factors of Adams-Stokes syndrome were Hypokalemia,psychological factors,overeating,constipation.Conclusion The premise of the successful rescue on Adams-Stokes syndrome children are regulated observation、knowing the patient' s condition well,the medicine and goods for first-aid treatment all ready,and timely finding,correct estimate,giving emergency treatments timely,appropriate nursing are the keys of its successful rescue.

Objectives To investigate the epidemiological feature of respiratory syncytial virus (RSV) in hospitalized children with acute respiratory infection. Methods A total of 28 871 children with acute respiratory tract infection from Janu-ary 2007 to December 2011 were enrolled in the study. Nasopharyngeal aspirates were obtained from the respiratory tract by aseptic vacuum aspiration. Direct immuno-lfuorescence assay was used to detect RSV antigen. Correlation between RSV posi-tive rate and meteorological data including mean air temperature and total monthly rainfall, etc. was analyzed. Results The peak infection seasons of RSV during 2007-2010 were winter and spring in Suzhou, while in 2011 the infection rate of RSV was increased since July. The positive rates of RSV during winter and spring in 2007-2008, 2008-2009, 2009-2010 and 2010-2011 were 38.57%, 19.86%, 29.73%and 30.79%, respectively, with signiifcant difference (χ2=176.85, P<0.001). From July to September in 2011, the positive rate of RSV was 5.74%, 21.09%and 31.15%, respectively, higher than that of the same period from 2007 to 2010 (χ2=8.06~405.43, all P<0.05). The positive rate of RSV was negatively correlated with mean temperature, volume of rainfall, duration of sunshine and wind velocity (r=-0.799~-0.214, all P<0.05). Only mean temperature had a signiifcant impact on RSV activity by a stepwise multiple regression (P<0.001). Conclusions The date indicated that RSV was still an important etiological agent for acute lower respiratory infection in infants and young children in Suzhou area during winter and spring. The incidence of RSV was associated with the climate in Suzhou.

Objective To evaluate the validity of lipoprotien(a) [Lp(a)] concentration as diagnostic test for coronary heart disease (CHD) and stegnotic degree of coronary artherosclerosis. Methods 416 cases of patients who were assessed with coronary angiography were divided into four groups according to the stegnotic degree of coronary artherosclerosis. There were no stenosis and lipid plaque group, single branch group, double branch group, three branch and suffusive stenosis group. TC, HDL - C, LDL - C, ApoAl, ApoB, Lp(a) were examined in early morning fasting for 12 hours after the next admission day. Other risk factors were also recorded, such as hypertension. Results When Lp(a) concentration was used alone to diagnose CHD, the best cutoff value was 15 mg/dl. The crude agreement was 58.2% , the sensitivity was 57.5% , and the specificity was 59.3% . Along with the stegnotic degree of coronary artherosclerosis heavier, the levels of the crude agreement and the sensitivity had a indreasing trend,and levels of the false negative rate had a deoreasing trend. Conclusion The validity of Lp(a) concentration as diagnostic test for CHD is not satisfactory.

Objectives: The incidence of cervical carcinoma is increasing in young females.More and more clinical researches focus on the choice of therapeutic methods and improvement of the patients' survival.This study aimed to evaluate the efficacy of preoperative concurrent chemoradiation for stage Ⅰb-Ⅱb high-risk cervical carcinoma in young females.Methods: We retrospectively analyzed the clinical data of 118 female patients(≤35 years) with stage Ⅰb-Ⅱb high-risk cervical carcinoma,bulky,low-differentiation or non-squamous.According to preoperative treatments,the patients were divided into three groups,Group 1 preoperatively treated by concurrent chemoradiation,Group 2 by neoadjuvant chemotherapy and Group 3 by radiotherapy(intracavitary irradiation),all followed by radical hysterectomy.And those with pathologically reported pelvic lymph node metastasis,deep cervical stromal invasion,vascular tumor thrombosis,or surgical margin positivity received postoperative chemotherapy and/or radiotherapy.Results: The disappearance rate of cancer cells and the rate of superficial myometrial invasion were significantly higher in Group 1 than in the other two groups(P

Objective To study the anatomical variations adjacent to the umbilical portion of the left portal vein (U-point) radiologically and to determine their impact on treatment of hilar cholangiocarcinoma (HCCA).Methods From January 2014 to February 2016,47 consecutive patients who were diagnosed to suffer from Bismuth type Ⅰ,Ⅱ or Ⅲ a HCCA in our institution were retrospectively studied.All these patients underwent enhanced CT examination preoperatively and three-dimensional (3D) models were then reconstructed.Results Any variations of the left biliary system in relation to the U-point were analyzed.The findings showed that:B2 and B3 united above or lateral to the U-point in 31 patients (65.9％);B2 and B3 united medial to the U-point in 4 patients (8.5％);and B4 converged into B3 prior to B2 in 6 patients (12.8％).Rare variations were observed in 6 patients (12.8％).For the confluence patterns of B4:the central type was found in 10 patients (21.3％),the peripheral type in 35 patients (74.5％) and the combined type in 2 patients (4.2％).Analysis of the relationship between B1l and the confluence of B2 and B3 showed the distance to be (31.6 ± 6.2) mm in the above or the lateral patterns and (13.7 ± 4.7) mm in the medial pattern.The difference was significant (P ＜0.05).The distance from B1l to B4 was (7.1 ± 2.0) mm in the central and combined types but (16.4 ±4.0) mm in the peripheral type.The difference was significant (P ＜ 0.05).The left hepatic artery showed variations in the origin and course pattern in 4 (8.5％) and 6 patients (12.8％),respectively.The two-dimensional (2D) and 3D imagings showed excellent consistency in the evaluation of variations of the left biliary system in relation to the U-point and the left hepatic artery.Conclusions It is very important to know the variations of the left biliary and the vascular systems adjacent to the U-point in preoperative evaluating on resectability of HCCA.An accurate assessment could be accomplished using 2D imaging alone.However,3D reconstruction is a useful technique to use in complex case with locally advanced tumors.

Objective To explore the value of magnetic resonance perfusion imaging of 3D arterial spin labeling(3D-ASL)in the diagnosis of transient ischemic attack(TIA).Methods 78 of patients were diagnosed TIA on MR routine scan [T1 WI,T2 WI,T2-FLAIR,diffusion weighted imaging(DWI)],magnetic resonance angiography(MRA)and 3D arterial spin labeling(3D-ASL).The re-sult were analyzed by Chi-square test.Results In 78 patients,the abnormal routine scan was 0 case(0%);abnormal MRA 41 cases (52.6%);abnormal 3D-ASL 47 cases(60.2%);combination with each other were 60 cases(76.9%).29 cases with artery stenosis and abnormal ASL,12 case with artery stenosis and normal ASL,19 cases with normal vascular and abnormal ASL,18 cases with normal vascular and normal ASL.Conclusion 3D-ASL is better than routine magnetic resonance sequences in the diagnosis of TIA,which is convenient and should be a routine scanning sequence of TIA.3D-ASL,MRA and DWI have their own advantages and disadvantages, combination use can improve the diagnosis accuracy of TIA.

OBJECTIVE:To investigate the stability of cefoselis sulfate for injection in xylitol injection.METHODS:The mixture of cefoselis sulfate for injection and xylitol injection was observed within 6 h after mixing were observed at 25℃ and 37℃ with regard to its appearance,pH value,and UV spectra of cefoselis.The content of cefoselis sulfate in the mixture was determined by UV spectrophotometry.RESULTS:No marked change was noted for the mixture within 6 hours after mixing in terms of the appearance,pH value,ultraviolet absorption spectra and content.CONCLUSION:Cefoselis sulsate for injection is stable within 6 hours after mixing with xylitol injection.