Sunitinib malate (SU11248 ,Sutent) is an orally available small-molecule multitargeted tyrosine kinase inhibitor that has potent anti-angiogenic and antitumour activities.In 2006 sunitinib was approved by FDA for imatinib intolerant gastrointestinal stromal tumors (GIST) patients or imatinib resistant GIST patients.This article review the molecular-based mechanism,the mechanism of resistance,the biomarker,the clinical trials and the adverse effects of sunitinib in the treatment of imatinib-resistant GIST.

Objective To observe the different effect of Xuezhikang Capsule on the patients of coronary heart disease (CHD) with abnormal blood lipid in different syndromes.Methods Of the 116 patients of CHD with abnormal blood lipid diagnosed by coronary arteriography and blood test, 30 were blood stasis syndrome, 23 phlegm turbid syndrome, 26 phlegm retention syndrome, and 37 non-phlegm non-stasis syndrome. Based on the standard treatment with modern medicine, Xuezhikang Capsule was given 0.6g each time, twice a day, for 24 weeks in succession.Results After the treatment, total cholesterol (TC), triglyceride (TG) and low density lipoprotein-C (LDL-C) were decreased (P

Carcinoma, Hepatocellular ; therapy ; Catheter Ablation ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Humans ; Liver Neoplasms ; therapy ; Liver Transplantation

Objective To investigate the efficacy of transorally inserted anvil system(OrVilTM)in esophagogastrostomy and esophagojejunostomy after laparoscopic gastrectomy.Methods The clinical data of 34 patients with gastric neoplasms who were installed OrVilTM for esophagogastrostomy or esophagojejunostomy at the Changhai Hospital from July 2009 to February 2011 were retrospectively analyzed.After radical dissection of lymph nodes and full mobilization of esophagus,the esophagus was transected and the anvil was then transorally inserted into the esophagus by using the OrVilTB system.Double-stapling esophagogastrustomy or esophagojejunostomy with a circular stapler Was performed intracorporeally under direct laparuscopic view.Results The surgery was success fully completed in all the 34 patients with no conversion to open surgery.Two patients had difficulty in placing OrVilTM system.and the condition Was alleviated by reducing tension in the cuff and tilting the head back.The mean operation time,volume of blood loss,duration of postoperative hospital stay and time to gastrointestinal function recovery were 175 minutes(range,90-240 minutes),196 ml(range,50-800 ml),7.6 days(range,5-14 days)and 3 days(range,2-6 days).No postoperative anastomotic leakage Was detected.Thirty-three patients were followed up for 2-20 months with a mean time of(10±6)months,and no tumor recurrence or metastasis occurred.Conclusion OrVilTM system changes insert direction of the anvil,which significantly reduces the difficulty of laparoscopic operation,shortens the operation time and avoids the thoracotomy.

The complement system, the chief component of innate immunity, is not only required for host defense against pathogens and homeostasis, but also related to the pathogenesis and development of various kidney diseases. Recent study has shown that tissue-derived complement and immune cell-derived complement can each mediate local inlfammation. The comple-ment system acts as a bridge between innate and adaptive immunity. Furthermore it’s also a functional bridge between pathogenic humoral and cellular immune responses in an array of kidney diseases. Increasing evidence links inappropriate complement acti-vation and deifciencies of complement proteins to the pathogenesis of kidney autoimmune disease, ischemia-reperfusion injury, transplant rejection and complications in hemodialysis. The development of pharmacologic agents that target complement in pa-tients with this assortment of immune and/or inlfammatory kidney diseases has the potential to abrogate disease progression and improve patient health.

Objective To explore the facial nerve functional recovery law after resection of acoustic neuroma,and the influence of tumor size on postoperative facial nerve function. Methods According to the House-Brackman (HB) facial nerve function classification method, 89 patients with acoustic neuroma were performed microsurgical resection with the ret?rosigmoid approach and facial nerve preservation. The HB classification method was used to evaluate the facial nerve func?tion at operation, 15 d, 45 d, 3 m, 6 m, 12 m and more than 12 m after surgery. The recovery pattern of neurological function after operation was analyzed. al. According to the tumor size, patients were divided into three groups: diameter < 30 mm group (n=23), 30-40 mm group (n=31) and≥40 mm group (n=35). The facial nerve function was compared between different groups with early postoperative (within 15 days) and long-term (more than 12 months). Results The facial nerve function was the worst in 15 days after operation (excellence rate was 52.81%), but the function was returned to normal in postopera?tive 3 months (excellent rate reached 80.90%). After postoperative 12 months, almost all patients returned to normal func?tion (excellent rate was 91.01%), and the facial nerve recovery was more smoothly (excellent rate was 92.13%). Tumor size had remarkable effect on facial nerve function in the early postoperative period (χ2=23.34, P<0.05), and long-term period (χ2=14.46, P<0.05). And tumor size was positively correlated with classification of facial nerve function in the early stage (r=0.476, P<0.05) and long-term stage (r=0.379, P<0.05). The excellent rates of postoperative facial nerve function were decreased with the increased diameters of tumor size. Conclusion The facial nerve function may appear deterioration in early postoperative period (within 15 days) in patients with acoustic neuroma, which can return to the normal level in 12 months. The diameter of tumor is one of important factors influencing the early and long-term prognosis of postoperative fa?cial nerve function.

Objective:Entrepreneurial failure refers to the process of entrepreneurial performance continuous decline until the business is bankrupt. The aim of this research is to analyze implicit stigma effect against entrepre-neurial failure in college students. Methods:Sixty-four college students in a natural class participated in this survey, 4 D values of the total tool of entrepreneurial failure implicit stigma and its three dimensions (including cognitive appraisal,emotional reaction,and behavior tendency)were assessed with the traditional implicit association test (IAT). Through independent sample t test,the differences between zero and 4 D values were analyzed. The differ-ences of four D values at gender and entrepreneurial experienceon were explored,the difference between reaction time of the compatibility task and incompatibility task was analyzed,and the reliability of the tool of implicit stigma effect against entrepreneurial failure was evaluated. Results:The 4 D values were all greater than zero. In 3 inde-pendent dimensions and total IATs,the automatic association between entrepreneurial failure and negative words was closer relative to positive words (P<0. 001 ),it showed that their implicit negative attitude against entrepre-neurial failure was significant. Split-halfreliability and internal consistency coefficient of the total tool of entrepre-neurial failure implicit stigma were respectively 0. 87 and 0. 82. Conclusion:In this study,the entrepreneurial failure implicit stigma effect may be significant in college students. These college studeuts have implicit negative cognition and emotion,and discrimination behavior tendency against entrepreneurial failure.

Objective To investigate operative methods and indications for the surgical repair of hypospadias. Methods Clinical data of 91 cases of hypospadias repaired in this hospital between 1997 and 2003 were retrospectively analyzed. Results Postoperative urethral fistula took place in 15 cases, with an overall incidence of 16 5% (15/91), including 6 cases treated by Duckett procedure, 4 cases treated by Duckett combined with Duplay procedure, 1 case treated by Mathieu procedure, 2 cases treated by scrotal island flap procedure (Onlay procedure), 1 case treated by Denis-Browne procedure, and 1 case treated by Snod-grass procedure. Conclusions For patients with hypospadias associated with serious chordee, because the urethral plate can not be preserved, adaptable methods should include scrotal island flap procedure, Duckett procedure, or Duckett procedure combined with Duplay procedure. Urethral plate conserving operations are suitable for hypospadias without chordee or with mild chordee, involving the Mathieu procedure, Onlay procedure, Snod-grass procedure and Denis-Browne procedure.

Objective To investigate the clinical application of Fibroscan to noninvasive detection of liver fibrosis in asymp‐tomatic carriers(ASCs)with chronic hepatitis B virus(HBV).Methods Clinical data of 195 chronic HBV ASCs were retrospec‐tively analyzed ,including liver function ,HBV DNA quantitation ,liver stiffness(LS) ,color Doppler ultrasound results of the liver and spleen and histopathological findings of the liver.LS was evaluated by transient elastography(Fibroscan).Liver biopsy was performed in 80 carriers for histological examination.Results The LS value was(6.22 ± 2.50)kPa in 195 cases.There was no significant difference in the LS value between HBV DNA <500 copies/mL and HBV DNA≥500 copies/mL groups.The LS value in patients with HBV carrying duration>15 years was significantly higher than that in patients with HBV carrying dura‐tion≤5 years(P<0.01).It was (6.72 ± 2.33) kPa in patients(n=49)with liver tissue inflammation and necrosis

Objective To explore the effect of carotid atherosclerotic plaque ( CAP) on severity and recurrence of patients with cerebral infarction ( CI ) .Methods The prospective cohort study was utilized in this research. Existence and type of CAP were detected by Doppler ultrasound, and patients were divided into plaque group and without plaque group.The patients was evaluated by NIHSS on admission and 7 d, 14 d after admission, and patients were followed up for 1 year.The condition of CI recurrence was be observed.Results According to the Doppler ultrasound, patients were divided into plaque group ( 173 cases, 70.3%) and without plaque group ( 73 cases, 29.7%) .Compared with without plaque group, age, NIHSS score and incidences of hypertension, diabetes, hyperlipidemia, hyperfibrinogenemia were significantly increased (P<0.05 -0.01).In the patients who were conducted follow-up, cerebral infarction recurrence was in 39 cases (24.84%) in plaque group, recurrence time was 10.12 month.The recurrence time was 11.82 month in patient with non-vulnerable plaque, it was 10.62 month in patient with mixed plaque, and it was 9.13 month in patient with vulnerable plaque.Cerebral infarct recurrence was in 7 cases (10.45%) in without plaque group, recurrence time was 11.56 month.The recurrence rate in plaque group was significant increased than that in without plaque, however, the recurrence time for without plaque group was longer than that for plaque group ( all P<0.05 ) .The recurrence rate and recurrence time in patient with vulnerable plaque was significantly earlier than that in patient with non-vulnerable plaque (P=0.034).Conclusion The CAP in patients with acute CI can exacerbate the disease, and increase recurrence rate.It is especially in patients with vulnerable plaque.