ObjectiveTo explore the clinical significance of lymph node metastasis in gastrointestinal stromal tumor (GIST).Methods A literature search to identify studies relating to GIST cases reported between January 1998 and December 2010 was conducted.The associations between lymph node metastasis and GIST clinicopathological features, gene expression, GIST stage, and GIST prognosis were evaluated.Results 6063 literatures were screened and only 16 GIST patients (median age of 49.25 years,10females) with lymph node metastasis were enrolled in this study.Among them,12 tumors were located in the stomach, 3 in the small intestine, and 1 in the esophagus.Morphologically, 13 specimens were mainly characterized by spindle cells.Gene analysis was examined in 7 cases.Conclusions Lymph node metastasis in GIST might more frequently found in the stomach, tumor stage of high grade, and cellular morphology of spindle-shaped.Gene mutation may have a relationship with lymph node metastasis.However, its clinical significance remains unclear.

ObjectivesTo compare clinical outcomes and safety of 5-Fu or capecitabine combined with oxaliplatin therapy for metastatic colorectal cancer. MethodsLiterature search were performed by key words,such as metastatic colorectal cancer,capecitabine,oxaliplatin,5-Fu on all randomized controlled trails reported on 5-Fu or capecitabine combined with oxaliplatin therapy for metastatic colorectal cancer before Jun.2011.Two authors drew the details of trail design,characteristics of patients,outcomes and so on from the studies included. Data analysis was performed by RevMan 4.2. ResultsAccording to the same screening criteria,6 clinical studies were included in this Meta-analysis. Sample volume in this Meta-analysis was 2189 colorectal cancer cases.The baseline characteristics of 5-Fu group were similar to those of capecitabine group.The short-term outcome such as response rate,RR was 0.92 [95 ％CI(0.82,1.02),P=0.12], and the long-term outcome such as median overall survival, median progression-free survival and the WMD was -0.19 [95 ％CI(-0.73,0.35),P=0.49],-1.91 [95 ％CI(-2.53,0.16),P=0.08],respectively,two groups weresimilar. In the comparison of Ⅲ-Ⅳ grade toxicity between the two groups, the incidences of neutropenic in 5-Fu group were higher than those in capecitabine group,and the RR was 0.24 [95 ％CI(0.11,0.55), P=0.0007]. However, the incidence of wand-foot symptoms in 5-Fu group was lower than those in capecitabine group, the RR was 2.83 [95％CI (1.66,4.82), P=0.0001]. ConclusionBoth 5-Fu and capecitabine were similarly effective in the therapy of metastatic colorectal cancer. And the Ⅲ-Ⅳ grade toxicity such as neutropenic was easier to happen in 5-Fu group,while the incidence of hand-foot symptoms was on the other hand.

Objective To evaluate the levels of LDH in cerebrospinal fluid in patients with different types of central nervous sys‐tem diseases .Methods Cerebrospinal fluid LDH were detected by rate assay in control group and disease group(including patients with acute leukemia ,lymphoma ,brain neoplasms and meningitis) .Results In ptients with acute leukemia ,the cerebrospinal fluid LDH level of central nervous system leukemia(CNSL) group was (28 .68 ± 9 .29)U/L ,which was higher than that of non CNSL group ,and the difference were significance(P<0 .05) .In lymphoma patients ,cerebrospinal fluid LDH level of brain metastasis pa‐tients was (125 .20 ± 115 .24)U/L ,which was higher than that of lymphoma patients without brain metastasis ,the difference was significant(P<0 .05) .In patients with brain neoplasms ,cerebrospinal fluid LDH level of meningeal carcinomatosis group was (77 . 37 ± 128 .15)U/L ,which was higher than that of primary brain neoplasms group ,the difference was significant(P<0 .05) .In pa‐tients with meningitis ,cerebrospinal fluid LDH level of tuberculous meningitis group and purulent meningitis group patients were (54 .48 ± 84 .60U/L) and (43 .54 ± 32 .05)U/L respectively ,which were higher than those of viral meningitis group patients ,and the differences were significant (P<0 .05) .Conclusion LDH in cerebrospinal fluid can be used in early diagnosis of CNSL ,brain metastsisly of mphoma ,meningeal carcinomatosis and differential diagnosis of meningitis .

OBJECTIVE:To study the pharmacokinetics and pharmacodynamics of single dose of intramuscularly injected methotrexate(MTX)in the treatment of ectopic pregnancy so as to provide theoretical bases for the choice dosage regimen.METHODS:Serum concentration of MTX in 8 cases with ectopic pregnancy were determined by fluorescence polarization immunoassay after injected i.m with single dose MTX(50mg/m2);The ?-HCG was monitored both before and after treatment and the lump sizes of the ectopic pregnancy were determined by B ultrasound.RESULTS:The pharmacokinetics of single dose of intramuscularly injected MTX conformed to two-compartment open model;Cmax occurred at 1.9h after drug taking with 2.31 ?mol/L;The time for the recovery of ?-HCG to normal was(24.8?10)days,the patency rate of oviducts of those who demanding procreation was 75%.CONCLUSION:Injection intramuscularly with single dose of MTX 50mg/m2 is effective in the treatment of ectopic pregnancy.

Objective To explore the CT, MRI?PET features of Heroin Spongiform Leukoencephalopathy (HSLE).Methods CT and MRI of 29 patients, and PET of 4 patients were analysed.Results 1.CT and MRI showed extensive and symmetric lesions in white matters of bilateral cerebellum,posterior crus of internal capsule and parieto occipital region;2.Cerebral CT showed hypodense areas, MRI showed corresponding areas with decreased signal intensity on T1 weighted images and increased signal intensity on T2 weighted images, no edema, FLAIR and enhancing scan showed no destruction of brain blood barrier, PET imaging showed hypometabolism or non metabolism changes in corresponding areas; 3. PET imaging showed non metabolism areas in untreated patients' posterior limb of internal capsule, parietooccipital lobes and cerebellum, and the metabolism in corresponding areas of improved patients was low obviously; 4.PET imaging showed hypometabolism in grey matter of untreated and improved patients, and the metabolism in the grey matter remarkable improved patient was normal.Conclusion CT and MRI changes of HSLE sufferers almost limited in brain white matters, PET imaging showed hypometabolism or non metabolism changes in corresponding areas, the metabolism improvement in grey and white matters was very important to the improvement of HSLE sufferers, PET was more appropriate than MRI to the prognoses of HSLE sufferers.

Objective To evaluate the influence of the placement of instant hand disinfectant in compliance and qualified rate of hand hygiene of clinicians.Methods Hand hygiene compliance of clinicians in departments of gyne-cology,obstetrics,and general surgery were observed after the placement of instant hand disinfectant at the door-way of wards,hand specimens were taken to check hand hygiene effectiveness.Results Before and after placement of instant hand disinfectant at the doorway of wards of above departments,hand hygiene behaviors of 300 person-times were observed.Hand hygiene compliance rate among clinicians in department of gynecology,obstetrics,and general surgery increased from 32.33% to 74.33%,33.67% to 85.67%,and 26.33% to 64.00%,respectively(all P <0.001).Each department selected 98 hand hygiene specimens,the qualified rate was 98.98%,100.00% and 94.90% respectively.Conclusion The placement of instant hand disinfectant at the doorway of each ward can effec-tively improve clinicians’hand hygiene compliance and hand hygiene effectiveness.

OBJECTIVE To investigate(meticillin-resistant Staphylococcus aureus MRSA) the antibiotics resistance and curative effect of herbal Tanreqing-injection combined with vancomycin in the treatment of MRSA pneumonia.METHODS All data of microbiology about sputum culture between 2001-2007 were statistically analyzed with a retrospective method in a hospital,in order to understand the MRSA prevalence trends and their resistance.From 100 cases of MRSA pneumonia,50 cases were treated by vancomycin alone,another 50 cases were treated by Tanreqing injection plus vancomycin.RESULTS There were 3082 MRSA strains and 162(meticillin-sensitive S.aureus MSSA) strains in 3244 S.aureus strains;nosocomial infection cases accounted for 78.07% in MRSA-positive sputum samples;MRSA wasn't resistant to vancomycin,but resistant to other antibiotics.Resistance rates had a significant difference between MRSA and MSSA(P

BACKGROUND:Children usually wear school bags when walking, and overweight school bags do harm to the lower extremity and foot, thus affecting the child development. OBJECTIVE:To investigate the effect of obesity on gait characteristics of children wearing school bags during walking. METHODS:Forty pupils were enrolled in accordance with body mass index and China school-age children and adolescents overweight, obesity screening body mass index classification standard, including 20 obese children (body mass index: (28.13±3.4) kg/m2) and 20 non-obese ones (body mass index: (17.44±1.57) kg/m2). The gait parameters of children wearing school bags during walking were measured using a 2-m Footscan Plantar Pressure Plate System from RSscan International. RESULTS AND CONCLUSION: Compared with the non-obese children, the peak pressures under the metatarsal heads II-V, midfoot and heel lateral were significantly higher in obese children wearing school bags during walking (P < 0.05). The time to peak pressures under the toes II-V, the metatarsal heads IV, V and midfoot was also significantly higher (P < 0.05). In addition, the arch index for the foot, and right foot axis angle were significantly larger in the obese children as compared with the non-obese children (P < 0.05). To conclude, obese children wearing school bags during walking have weaker walking stability with flatter foot pattern, the larger foot axis angle and dynamic plantar pressure distribution changes compared with non-obese children, which can result in foot damage.

Migrant workers incur the challenges of linkage and compatibility of medical insurance systems for their migration across regions and change of identities. To identify a medical insurance system adaptable to their needs, the paper recommends the following: Take their medical insurance into the national account of medical insurance; build a linkage mechanism between cities and villages, and that between cities as well; make the medical insurance system more compatible and portable, in order to safeguard their right of health.

ObjectiveTo study the dose and time effects of X-ray radiation on the expression of Pokemon gene and protein in human lung adenocarcinoma cell line A549.MethodsA549 cells was exposed to different doses of X-ray (2,4,6 and 8 Gy),and the expression of Pokemon mRNA and protein of the cells was detected by using Quantitative real-time PCR and western-blotting at 2,4,8,12,24,and 48 h after irradiation. 3-( 4,5-Dimethylthiazol-2-yl )-2,5-diphenyltetrazoliumbromidewasused to detectthe proliferation of A549 cells at 1,2,3,4,and 5 d after 2 Gy X-ray irradiation.The mock treated A549 cells were used as the control.ResultsThe expression of Pokemon mRNA trended to decrease after irradiated with 4,6 and 8 Gy in the earlier period and increased in the later period with statistical difference at the most time points (t =3.40 -154.76,P =0.000 -0.041 ).The expression of Pokemon protein trended to increase and reached the peak at 8 h after irradiated of 2,4,6 and 8 Gy with statistical difference at the most time points ( t =4.18 - 89.64,P =0.000 - 0.039).Compared with the control,the proliferation of A549 cells was significantly inhibited during 3 to 5 d after irradiation of 2 Gy ( t =2.34 - 18.19,P =0.000 -0.040).ConclusionsX-ray irradiation may increase the expression of Pokemon mRNA and protein in A549 cells,which might be correlated with radiation-resistance of A549 cells.