Molecular Epidemiology ; trends

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract. GISTs have characteristic by a specific histological and immunohistochemical pattern. Malignant biological behaviors should be paid more attention in treatment. At present, operation is still the most important treatment method for GISTs. For patients with primary, localized GISTs, surgery represents the only chance of cure. The principle of surgery is complete resection of visible and microscopic lesions. Special care needs to be taken to avoid capsule rupture and intra-abdominal spillage, which increase the risk of recurrence. Positive resection margins may result in a higher risk of local and peritoneal relapse. Every effort should be taken to achieve negative margins. Although wide margins have not been shown to be beneficial, an en bloc resection is still recommended, when GISTs are densely adherent to adjacent organs. As GISTs rarely metastasize to lymph nodes, lymphadenectomy is not routinely indicated. While laparoscopic resection of GISTs is technically possible, it should only be undertaken when it will not increase the chance of tumor rupture. The success of imatinib in the treatment of recurrent and metastatic GISTs have prompted investigation into the adjuvant treatment for the significant risk of recurrence of GISTs and neo-adjuvant treatment for unresectable cases. Combined complete surgical resection and molecular therapy are the new therapy model which will improve therapeutic effect.
Gastrointestinal Stromal Tumors ; surgery ; Humans

Objective:To transfer full-length human mdrlcDNA into K562 cells and assess the feasibility and safety in vitro.Methods:PA317 cells were transducted via a virus vector,pHaMDR1/A,containing full-length human mdr1cDNA by calcium phosphate precipitation.The K562 cells were infected with the virus supernatant.The transfection rate was determined by using CFU selection,FACS and SP immunohistochemical methods respectively.The foreign Pgp function was tested by MTT assay and DNR exclusion with FACS analysis .The cellular cycle and the expression of bcl-2 and c-myc gene were detected by using CFU sclcction,FACS and SP immunohistochemical mcthods respcctively.The forcign Pgp function was tested by MTT assay and DNR exclusion with FACS analysis.The cellular cycle and the expression of bcl-2 and c-myc gene were detected by using PI via FCM and SP stain respectively.These data were analyzed with statistic graph and T-test for match pairs.Results:①The highest transfection rate of K562/MDR6-18 cells were 34%,even up to 84% after colchicine selection.②The exogenous Pgp expression of K562/MDR6-18 cells lasted for more than 4 months with a slow decrease after 10 generations.③The exogenous Pgp got an exclusive pump function.④K562/MDR6-18 cells appeared 1.46-2.22 times cross multidrug resistance phenotype.⑤K562/MDR6-18 cellular proliferation showed a mild,short,restored change.There was no abnormal apoptosis or proliferation.Conclusions:It implies a feasible,attractive and safe way that mdr1 gene transfers into target cells to get exogenous effective MDR.They also provide the basic protocol for using mdr1 gene modifying bone marrow transplantation against the myelosuppressive effects of anticancer drugs.

Objective:To explore the stratege of teratoma treatment in individual patient.Methods:53 cases(40 benign and 13 malignant) with teratoma were admitted from January 2001 to October 2003.Benign teratomas were treated with individual operation process in order to resect the whole tumor and to keep the function of the organ.In malignant teratoma chemotherapy was given before operation,then,tumor resection,and individual chemotherapy after operation.Results:40 benign cases treated with operation were all successful without complications except 3 newborn babies with low serum albumin and delayed wound healing.In 13 malignant cases,5 abdicated chemotherapy and 8 succeeded continuously with individual chemotherapy postoperation.Until now:initial lose to follow -up 5 examples,midway lose to follow -up 2 examples,PR3,CR3.Conclusion:It's important that the individual treatment of teratoma,especially individual chemotherapy against malignant teratoma can improve quality of life and increase cure rate in children with tumor.

Objective To investigate the clinical effect of biological agents etanercept combined with methotrexate in the treat-ment of refractory rheumatoid arthritis .Methods 30 cases of refractory rheumatoid arthritis treated in January 2010 to January 2012 were selected and randomly divided into the two groups ,15 cases in each group .The control group was treated with oral meth-otrexate(MTX) 15 mg per week ,and the combined treatment group was treated with the biological agent etanercept 12 .5-25 .0 mg by subcutaneous injection ,twice per week ,combined with M TX15 mg per week .3 months were taken as a course of treatment .Re-sults The effective rates of ACR20 ,ACR50 and ACR70 in the combined treatment group were 73 .3% ,46 .7% and 26 .7% respec-tively ,which were significantly higher than those in the control group (P<0 .01) .4 cases in the combined treatment group appeared gastrointestinal discomfort .Conclusion Biological agent etanercept combined with M TX in the treatment of refractory rheumatoid arthritis has better clinical curative effect .

Acupuncture Therapy ; Anal Canal ; pathology ; Female ; Humans ; Intervertebral Disc Displacement ; complications ; Middle Aged ; Pain ; etiology ; Rectal Diseases ; etiology ; pathology ; therapy

It is significant for theory and application to study on marine microbial exopolysaccharides with differential structures and activities endowed by the specific marine environment.The recent progress of the research on the structures and bioactivities of marine microbial ex- opolysaccharides was reviewed,and the prospect of the research and development of the marine microbial exopolysaecharides was also expec- ted.

Objective To explore the effect of comprehensive experiments on clinical practice of internal medicine nursing in the patients with advanced simulation human Simman3G.Methods Two grades of nursing students were selected by random cluster sampling and divided into the experimental group and the control group.The control group used the traditional clinical probation method to carry out clinical probation teaching in Department of internal medicine,the experimental group used the advanced simulation human Simman3G to conduct a comprehensive simulation of teaching before clinical probation.After the completion of the internship the self compiled questionnaire was given to two groups of students to investigate their opinion on the clinical probation.Then we compared,the semester examination results between two groups.Results In the experimental group,the grade of internal medicine nursing was higher than the control group at the end of the semester,P ＜ 0.05.The results of questionnaire survey showed that there was no significant difference between the two groups in the promotion of theoretical knowledge and the two dimensions of the survey of nursing work environment.In the training of clinical thinking,improve nursing skill,communication skill,and the learning interest.At the great harvest of 5 dimensions of probation,the experimental group of students' recognition degree was significantly higher than the control group,P ＜ 0.01.Conclusion Before clinical probation of internal medicine nursing,the application of high-end analog teaching can significantly improve the effectiveness of clinical probation.

Objective To discuss the efficacy of sufentanil combined with propofol in iv anesthesia during laparoscopic cholecystectomy.Methods Totally 182 patients received laparoscopic cholecystectomy.They were divided into two groups according to odd or even number of hospitalization.The control group (81 cases) were given remifentani combined with propofol for iv anesthesia.The observation group (101 cases) were given sufentanil combined with propofol for iv anesthesia.The anesthetic effect of sufentanil combined with propofol for iv anesthesia during laparoscopic cholecystectomy was evaluated by breathing recovery time,opening time,extubation time,VAS scores after 1,6,12 h,and complications during anesthesia.Results Breathing recovery time,opening time,and extubation time of observation group were longer than those of control group (P ＜ 0.05).The VAS scores after 1,6,and 12 h of observation group were lower than those of the control group (P ＜ 0.05).During anesthesia,the proportion of restlessness in observation group was lower than that in control group (P ＜ 0.05).The complication rate of observation group was lower than that of control group (P ＜ 0.05).Conclusion Sufentani combined with propofol has a good anesthetic effect on patients receiving laparoscopic cholecystectomy with mild postoperative pain and less restlessness.It is worthy of clinical use.

Standardization management of the procurement,supply,maintenance,filing,rejection and measurement of medical equipment is very important for determination of the right obligations and responsibilities of medical equipment management facility. It also avails to establish a set of systemic regulations to improve the performance of medical equipment facility and the continuous education of medical engineering technicians.