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.

Objective To study the prevention and treatment of chylous leakage after Whipple operation.Methods Clinical data of 381 patients underwent Whipple operation from Jan 2010 to march 2013 were retrospectively analyzed.Results Among 381 patients,23 patients had chylous leakage,the incidence was 6.04％.While in 89 patients,in which intraoperative precautionary physical ligation or mattress suturing of the lymphatic vessels were undertaken,no chyle leakage occurred ; Most of chyle leakage occurred in malignant tumor after radical resection(21 patients),most chylous leakage was found 5-8 days after surgery,with daily volume of 260-450 ml.All patients of chylous leakage were cured by conservative treatment.Conclusions Chylous leakage are common in PD.Intraoperative preventive measures such as lymphatic duct ligation or safe suturing can effectively prevent chyle leakage.Conservative therapy heals most chylous leakage after Whipple operation.

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.

ObjectiveTo study the application effect of Orem self-care theory in nursing of postoperative chemotherapy patients after cervical cancer surgery. Methods60 patients receiving chemotherapy after cervical cancer surgery were randomly divided into the self-care group and the control group with 30 cases in each group,the control group received routine nursing,on this basis the self-care group was given nursing intervention according to different requirement of patients by using three nursing model of Orem self-care theory-supportive education,part compensation,complete compensation system.The nursing effect was compared between two groups. ResultsCompared with the control group,the rate of gastrointestinal adverse reaction was lower,the anxiety and depression symptom alleviated,satisfaction degree of patients and their relatives with nursing improved,self-care ability of patients was enhanced in the self-care group,all had significant differences. ConclusionsApplication of self-care theory in nursing care of patients during chemotherapy after cervical cancer can greatly mobilize the enthusiasm of patients and their families and reduce the incidence of gastrointestinal side effects.Meanwhile,it can make close nurse-patient relationship,improve the satisfaction degree of patients and their families,improve self-care capacity,improve the quality of care,reduce the psychological symptoms of patients,so it has significant social and economic benefits.

Objective To probe into the treatment effect and the influencing factors of early goal directed therapy(ECDT)in patients with septic shock.Method One hundred and twenty-six patients with septic shock were assigned into the treatment group(n=62)and the control group(n=64).The treatment group was administrated with EGDT,while the control group used conventional therapy for cycle and capacity support.Then sequential organ failure assessment(SOFA)score,APACHE Ⅱ score before treatment and 28-dav-mortality were respectively recorded before the above-mentioned treatment and at 24 hours after the therapy in the two groups.The treatment group was again subdivided into two groups after 6 hours recovery according to the resuscitation results:the sufficiently resuscitated group(n=40)and insufficiently resuscitated group(n=22).Age,genders,correlated haemodynamic parameter,SOFA score,APACHE Ⅱ score and serum lactic acid concentration before resuscitation and 28 d mortality were compared between the two groups.Results There was no significant difference in SOFA score and APACHE Ⅱ score before resuscitation between the treatment group and the control group[SOFA:(12.26±4.37)vs.(12.54±5.21);APACHE Ⅱ:(21.26±6.03)vs.(21.64±6.80)].The two scores at 24 hours after resuscitation[SOFA:(9.18±3.63)vs.(10.62±4.27);APACHEⅡ:(14.92±3.81)vs.(18.21±4.25);P＜0.05]and 28-day-mortality rate(48.39%vs.76.56%,P＜0.05)of the treatment group were significantly lower than those in the control group.There was significant difference in the age,mean arterial pressure (MAP),APACHEⅡ score between the sufficiently restoring group and the insufficiental resuscitated group.The 28-day-mortality of the sufficiently restoring group was significantly lower than that in the insufficiently restoring group.Conclusions EGDT can improve the prognosis in patients with septic shock.Ages,MAP and APPCHE Ⅱ score before resuscitation can be the important factors of EGDT.

Adult ; Aged ; Humans ; Male ; Middle Aged ; Radiographic Image Enhancement ; Silicosis ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Acute Disease ; Adenoviridae Infections ; epidemiology ; Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Humans ; Infant ; Infant, Newborn ; Respiratory Tract Infections ; epidemiology ; virology