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.

Acupuncture Therapy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy

Surgical treatment of colon cancer is the first choice in the therapy stages,supplemented with systemicor local radiotherapy and chemotherapy.With the developement of molecular biology,there has been a variety of treatment program,some of these methods have been accepted in clinical testing stage.But the safety of the treatment on colon cancer is still a hot topic.

The treatment of total avulsion of the hand is somewhat difficult and the result usually not satisfactory. Four cases of such patients were treated from 1983 to 1987. After routine debridement, digital nerves and its surrounding adipose tissue were preserved. An "S" shape skin flap was designed an raised in the contralateral upper abdominal quadrant to cover the injured hand like a bag, so that both sides of the hand were covered. The donor area (12cm2) was directly sutured. Nerve endings might grow into the flaps because of the preservation of digital nerves. Three patients were followed-up for 2 to 6 years, the injured hands regained good pain sensation as well as stereognostic and temperatuer sensations. The function of the hand is satisfactory, but the flap looked bulky and multiple plastic operations were necessary to seperate the fingers.

Objective To evaluate the diagnostic accuracy of transcranial doppler(TCD)as an additional screening tool for intracranial arterial steno-occlusive disease in patients with acute ischaemic stroke(AIS)by comparing with the computed tomography angiography(CTA). Methods Two hundred and twenty-four consecutive patients who were hospitalized within 7 days of the onset of symptoms and fulfilled the criteria for the clinical di-agnosis of AIS between May 2013 and May 2014 were enrolled for the study. Among the 224 patients,there were 118 males and 106 females with an average age of 61.2±12.6 years. High-resolution brain CTA was performed after completion of TCD. Results There was slight distinction of the diag-nostic accuracy of TCD for different arteries. TCD demonstrated the most accurate diagnosis for carotid artery vascular system,with a sensitivity of 96.19%and specificity of 98.60%. For the vertebrobasilar vascular system,TCD diagnosis showed a sensitivity of 71.11%and specificity of 94.31%. TCD findings were complementary to the CTA results(real-time embolization,collateral flow patterns and steal phenomenon). Conclusion TCD shows a high diagnostic accuracy comparing to CTA in evaluating intracranial and extracranial arterial stenosis in patients with AIS,especially for the carotid artery vascular system analysis within a short time interval. TCD can also provide additional real-time dynamic findings complementary to the information provided by CTA.

Objective To compare the clinical effects and safety of surgical clipping and intravascular interventional therapy in treatment of intracranial wide-necked aneurysm.Methods The clinical data of 158 patients with intracranial wide-necked aneurysm from February 2010 to February 2013 were retrospectively analyzed,all patients were divided into two groups:surgical clipping group with 92 cases and intravascular interventional therapy group with 66 cases,the postoperative curative effects,treatment time,hospital stay,hospital expenses and postoperative complications between two groups were compared.Followed up for 10-46 months,the recurrence rate were compared.Results The good prognosis and defective rates between surgical clipping group and intravasular interventional therapy group had no significant difference [90.2％(83/92) vs.90.9％(60/66),9.8％(9/92) vs.9.1％ (6/66)] (x2 =0.298,P ＞ 0.05).The preoperative Hunt-Hess classification and CT Fisher classification between two groups had no significant difference (P ＞ 0.05).Six months after discharge,mRS score was used to evaluate the curative effect,the defective rates in same level patients between two kinds of treatment methods had no significantdifference (P ＞ 0.05).The treatment time,hospital stay in surgical clipping group were significantly longer than those in intravascular interventional therapy group [(4.03 ± 1.01) h vs.(1.61 ± 0.98) h,(15.90 ± 2.03) dvs.(13.20 ± 1.95) d],hospital expenses was significantly lower than that in intravascular intervention therapy group [61 829.4 ±320.6) yuan vs.(99 876.2 ±371.5) yuan] (P ＜0.05).The postoperative complications rate between two groups had no significant difference (P ＞ 0.05).Followed up for 31.3 (10-46) months,the recurrence rate in surgical clipping group was significantly lower than that in intravascular intervention therapy group [1.1％ (1/94) vs.8.8％ (6/68)] (P ＜ 0.05).Conclusion Surgical clipping and intravascular interventional therapy in treatment of intracranial wide-necked aneurysm has their own different characteristics,so patients' treatment methods should be based on their preoperative status (especially preoperative Hunt-Hess and Fisher classification) and patients' economic conditions.

Objective:To investigate the treatment effect of cytosine deaminase gene combined 5-FC thermochemotherapy for colon cancer liver metastasis in Nude Mice. Methods:The models of liver metastasis of colon cancer had been established by injecting human colon cancer cells Lovo into portal vein in 30 BALB/c nude mice,which were divided into transgenic group and non-transgenic group randomly. Transgenic group:virus supernatant was injected into abdominal cavity(0.2 mL/d,for 5 days); non-transgenic group:sodium chloride was injected into abdominal cavity(0.2 mL/d,for 5 days). In both groups 42 ℃ 5-FC was injected into the abdominal cavity (500 mg?kg-1?d-1,for 21 days). After treatment,all mice were sacrificed,and then PCR and RT-PCR were performed to detect the expression of targeted gene in carcinoma. The pathology changes of tumor were observed. Results:The targeted gene were detected in the tumor tissues. The rates of liver metastasis tumors were 26.7%(4/15),100.0%(15/15) in transgenic group and non-transgenic group respectively(P

Objective To investigate the target effect of cytosine deaminase genetherapy combined thermochemotherapy on liver metastasis of colon cancer in nude mice.Methods Plasmid G1CEACDNa were transferred into the human colon cancer LoVo cells by liposomes method.The models of liver metastasis of colon cancer were established by injected LoVo-CEACD into peritonum in 45 BALB/C nude mice,then which were randomly divided into three groups:The control(C)group;the prodrug therapy(PDT)group and the prodrug thermochemotherapy(PDTCT group)and 42 ℃ sodium chloride,38 ℃ 5-FC and 42 ℃ 5-FC were injected into the abdominal cavity [500 mg/(kg?d),for 21 d],respectively.After natural death of all mice,their life span,rate of liver metastasis and number of liver metastasis nodules were surveyed and compared among the three groups.The levels of the expression of target gene were detected by RT-PCR in carcinoma tissue,normal liver,stomach,lung,pancreas,small intestine and large intestine tissues.Pathological features were observed.Apoptotic index(AI)of tumor cells were analyzed in every group respectively.Results The CD gene was detected in the tumor tissues,but not in tissues of normal liver,stomach,lung,pancreas,small intestine and large intestine.In C,PDT and PDTCT group,the life span was(25.80?3.65),(34.27?4.08)and(41.87?3.91)d respectively;the rate of liver metastasis was 100.0%(15/15),40.0%(6/15)and 13.3%(2/15),respectively;the number of liver metastasis nodules was(2.93?1.16),(0.80?1.01)and(0.20?0.56),respectively;and AI of tumor cells was 4.59%,9.87%,17.4%,respectively.The life span of PDT and PDTCT guoup was significantly longer than that of group(P

Objective To summerize our experience in the diagnosis and treatment of pancreatic cystic neoplasms.Methods A retrospective analysis was conducted on the clinical data of 126 patients with pancreatic cystic neoplasms seen between January 2003 and December 2012 in the Fuzhou General Hospital.Results There was no special clinical manifestation in this series of 126 patients with pancreatic cystic neoplasms.The diagnostic accuracies of ultrasound,CT and MRI were 90.8％ (109/120),93.4％ (114/122) and 96.3％ (103/107) respectively.Eighteen and ten patients were observed to have elevated serum CA19 9 and CEA respectively.One hundred and five patients received conventional open surgery,while 21 patients underwent laparoscopic operations.The operations in cluded enucleation of tumor (n=11),pancreatic segment resection (n=5),spleen preserving distal pancreatectomy (n=30),distal pancreatectomy (n=26),duodenum-preserving pancreatic head resection (n=4),pylorus-preserving Whipple resection (n=5),Whipple procedure (n=38),total pancre atectomy (n=2) and exploratory laparotomy and biopsy (n=5).The perioperative mortality rate was 0.8％ (1/126).Pancreatic fistula (B and C) occurred in 16 patients (12.7％,16/126),and postoperative hemorrhage (B and C) occurred in 9 patients (7.1％,9/126).One hundred and fourteen patients were followed up from 6 to 72 months (median 52.4 months).The five-year survival rates for all the pancreatic cystic neoplasms,non-invasive and invasive neoplasms were 80.5％,96.4％ and 40.7％ respectively.Conclusions Pancreatic cystic neoplasms are a rare subset of pancreatic tumor,being increasingly detected due to the widespread use of abdominal imaging and improved imaging techniques.Most of them are benign,but some are malignant or they have malignant transformation and metastatic potential.Patients with asymptomatic benign pancreatic cystic neoplasms,especially small size,are candidates for observation.Patients with clinical symptoms or having a high suspicion of malignancy should be offered surgical resection.Non-invasive neoplasms should receive pancreatic preserving operations.Pancreatectomy plus regional lymph nodes dissection with or without combined resection of adjacent multi organs should be adopted for invasive neoplasms.

Because of hardness to heal and easiness to recurrence,chronic ulcer of lower limp has become one of the hardest diseases in clinic,which brings physical and mental pain to the patients.Although medical technology develops rapidly,to find a simple,effective and economic method is still the focus.Here,progress and current situation of treatment were summarized for chronic ulcer of lower limp.