In recent years,minimally invasive surgery has become the mainstream trend of modern surgery with the rapid development of endoscopic and laparoscopic techniques.However,there are limitations when either technique is used alone.The laparoscopic and endoscopic cooperative surgery (LECS),which combines the advantages and makes up the deficiencies of these two techniques,has expanded the application field of minimally invasive surgery.Laparoscopic wedge resections are increasingly applied for gastric stromal tumor.Base on clinical experience of 43 patients who underwent laparoscopic wedge resections for surgical treatment of gastric stromal tumor,we conclude that this procedure is feasible and safe.

Gastrointestinal stromal tumors (GISTs) is a subset of mesenchymal tumors and represents the most common mesenchymal neoplasm of gastrointestinal tract.In the last decade,GISTs has become well known because of the effectiveness of imatinib mesylate.The molecular targets for tyrosine kinase receptor inhibitor are not only of importance for the treatment of patients but also useful for the development of a novel drug modalities and new strategies in basic cancer therapy.The improved understanding of the molecular mechanism of GISTs has made its diagnosis standardized.Many multicenter phase Ⅱor phase Ⅲ clinical trials have been completed to establish the role of adjuvant and neoadjuvant therapy.It is important to select the correct management strategy,which is multidisciplinary,integrated,and individualized.This paper provides an overview of the rational treatment of GISTs at present.

AIMTo investigate the role of serine/threonine protein phosphatases in regulation of cell signal transduction on voltage-dependent sodium channels in rat trigeminal ganglion (TRG) neurons. METHODSWhole-cell patch clamp techniques were used to record the total sodium current (INa-T) and the tetrodotoxin-resistant sodium current (INa-TTX-R) before and after okadaic acid, a potent inhibitor of the serine/threonine protein phosphatases 1 and 2A, perfusion on adult rat TRG neurons. RESULTS1μmol*L-1 okadaic acid inhibited INa-T by (20±13)% (n=9, P<0.05) and INa-TTX-R by (4±3)% (n=6, P<0.05), respectively. The inhibition on INa-T was significantly greater than that on INa-TTX-R (P<0.05). Furthermore, 1μmol*L-1 okadaic acid produced significant 3-4 mV hyperpolarizing shifts in the conductance-voltage curves of INa-T, while it had no effect on that of INa-TTX-R. CONCLUSIONThe serine/threonine protein phosphatases take part in the regulation of total and TTX-R sodium channels on rat TRG neurons. In addition, small-diameter TRG neurons express various voltage-gated sodium channel with different sensitivity to okadaic acid.

Objective To investigate the clinicopathologic features of epithelioid angiomyolipoma of renal(REAML). Methods Six cases of REAML were analyzed by histopathological and clinical characteristics.Of the 6 cases,4 cases were solitary tumors and 2 cases were multiple lesions.The diameter of tumors was about 9 cm in average.One case had a family history of nodular sclerosis.Three cases were found adipose tissue in CT scan and diagnosed for RAML,the other 3 cases were diagnosed for renal cancer.All cases were undergone surgical approach,3 cases were undergone resection of tumors only and the other 3 were performed nephrectomy. Results Pathological characters:tumor was mainly composed of epithelioid cells presented with invasive hyperplasia of atypical pleomorphism,hyperchromatic nuclei with frequent mitotic figures,giant neoplasic cells and extensive hemorrhagic necrosis immunohistochemcial staining showing a positive HMB45 and negative of EMA,CK in most neoplasic cells.All cases were followed up for 10 to 44 months,5 cases did not recurrence and metastases;the other had lung metastasis after operation 18 months later,without any treatment the patient died 10 months later. Conclusions Most of REAMLs are benign and often misdiagnosed for renal cancer by CT scan.HMB45 is positive in immunohistochemcial staining available for diagnose.The minority of REMAL is malignant potentially and should be followed up closely.Operation is major method.

China ; Congresses as Topic ; Fatty Liver ; Humans

Objective To investigate the current status of nurses'' needlestick injuries during venous blood sampling, evaluate effective prevention strategies.Methods A stratified cluster sampling method was used to investigate clinical nurses in China by questionnaire, contents of questionnaire included the general information of nurses, training and management on venous blood sampling among nursing staff, adherence to wearing gloves before blood sampling, the occurrence of needlestick injuries during the process of venous blood sampling in the past year and so on.Results A total of 2 861 questionnaires were distributed, and 2 575 valid questionnaires were recovered.93.17％ of the investigated nurses had participated in the training of venous blood sampling regularly;87.15％ received regular check of venous blood sampling;before venous blood sampling, only 72.74％ knew whether the patient had bloodborne infectious disease;only 61.01％ wore gloves during blood sampling.Incidence of needlestick injuries during venous blood sampling was 20.78％ in the past year.There was no significant differences in the incidence of needlestick injuries when using 3 different types of needles(Pearson x2=1.649, P=0.438).48.21％ of needlestick injuries occurred during disposing medical waste.Conclusion The training and management on nurses'' venous blood sampling is better in China, but incidence of needlestick injuries is still high.It is necessary to formulate safety operation regulations of venous blood sampling, standardize the operation procedures and specify the contents of training, so as to correct nurses'' unsafe behavior during venous blood sampling.

To investigate the effect of interleukin-1beta (IL-1beta) on I(A) and I(K) currents in cultured murine trigeminal ganglion (TG) neurons, whole-cell patch clamp technique was used to record the I(A) and I(K) currents before and after 20 ng/mL I(L)-1beta perfusion. Our results showed that 20 ng/mL IL-1beta inhibited I(A) currents (18.3 +/- 10.7)% (n=6, P<0.05). I(L)-1beta at 20 ng/mL had no effect on G-V curve of I(A) but moved the H-infinity curve V0.5 from -36.6+/-6.1 mV to -42.4+/-5.2 mV (n=5, P<0.01). However, 20 ng/mL IL-1beta had effect on neither the amplitude nor the G-V curve of I(K). IL-1beta was found to selectively inhibit I(A) current in TG neurons and the effect may contribute to hyperalgesia under various inflammatory conditions.

0.05).ConclusionThe neoadjuvant radiochemotherapy can improve the sphincter-saving rate,probably can improve the resection rate and reduce the recurrence rate for the middle-lower rectal carcinoma.

Objective - （ ） To explore the influence on the diagnosis of occupational noise induced deafness ONID using three ， Methods versions of diagnostic criteria in 2002 2007 and 2014. A total of 1 766 workers who asked for ONID diagnosis were selected as the research subjects using judgment sampling method. The results of pure tone audiometry were collected. GBZ 49-2002Diagnostic Criteria of Occupational Noise-inducedHearing Loss（ The ONID was diagnosed using hereinafter referred to as GBZ 49-2002），GBZ 49-2007Diagnostic Criteria of Occupational Noise-induced Deafness（ GBZ 49-2007） hereinafter referred to as GBZ 49-2014 Diagnostic of Occupational Noise-induced Deafness（ GBZ 49-2014）， and hereinafter referred to as and the Results - - ， - diagnostic results were compared. Compared with GBZ 49 2002 and GBZ 49 2007 diagnosis with GBZ 49 2014 had （ vs ， vs ， P ）， （ vs ， a higher rate of ONID 57.9% 66.0% 44.8% 66.0% both <0.01 and had a higher rate of mild ONID 47.3% 54.6% vs ， P ） - - 36.0% 54.6% both <0.01 . The diagnostic rate for ONID using GBZ 492014 was higher than those using GBZ 49 2002 and - （ P ）Conclusion - GBZ 49 2007 in each age groups all <0.01 . GBZ 49 2014 improved the diagnostic rate of ONID compared - - with GBZ 49 2002 and GBZ 49 2007. The reason is related to the inclusion of 4 000 Hz hearing threshold with a weight of 0.1 - as the diagnostic hearing threshold and the use of a new age and gender correction method in GBZ 49 2014.

Abstract: Objective　To investigate the distribution and drug resistance of pathogenic bacteria separated from ascites of patients in Children’s Hospital Affiliated to Zhengzhou University from 2015 to 2021, and to provide a basis for rational clinical antimicrobial agents. Methods　Bacterial culture, bacterial identification and drug sensitivity analysis were performed on 1 058 non-duplicate ascites culture specimens from January 2015 to December 2021. The clinica1 and microbiologica1 data were ana1yzed by WHONET 5.6 and SAS 9.4 Results　Of the 1 058 specimens, 586 (55.39%) were positive for pathogenic bacteria, with a total of 781 strains isolated. There was no significant trend of increase or decrease in the positivity rate over different years. Male children (63.99%) were more prevalent than female children. Appendicitis (59.22%) was the most common disease and Escherichia coli was the most common causative bacteria. Among neonates (≤28 d), the bacteria with the highest detection rate were Klebsiella pneumoniae (23.50%) and Enterococcus faecium (23.50%), while among children (>28 d), the highest detection rate was Escherichia coli (35.98%). Gram-negative bacteria accounted for 64.79% of the 781 strains, mainly Escherichia coli (38.28%), Klebsiella pneumoniae (8.58%), and Pseudomonas aeruginosa (5.89%); Gram-positive bacteria accounted for 29.45%, mainly Enterococcus faecium (8.58%), Streptococcus constellatus (2.69%), and Enterococcus avium (2.43%); fungi accounted for 1.66% and anaerobic bacteria accounted for 4.10%. The resistance rates of Escherichia coli to cefoperazone/sulbactam, piperacillin/tazobactam, imipenem and meropenem were 6.02%, 4.35%, 4.35%, and 3.68%, respectively. The resistance rates of Klebsiella pneumoniae to these drugs were 59.70%, 59.70%, 50.75% and 53.73% respectively. Linezolid-resistant strains of Enterococcus faecium were found. Conclusion　Appendicitis is the most common abdominal infection in children, and the distribution of ascites pathogens varies with ages and diseases. The pathogenic bacteria are mainly Gram-negative bacteria, and the drug resistance of Klebsiella pneumoniae was more serious. It is particularly important to use antibiotics correctly and rationally to reduce the emergence of drug resistant bacteria.