Objective To investigate the clinical characteristic and surgical treatment of MGIST. Methods 40 cases MGIST surgical meterials were retrospectively analyzed. Results All cases were used surgery,the situation of the tumor is clear and most of them are not coated clearly. The diameter of the tumor is 5～16cm, in average (8.6±2.4)cm ;no lymph nodes metastasis during the surgery. No serious postoperative complications. Follow-up the pa-tients for 8～68 months, 14 of them died. Conclusion There is no specific characteristic on MGIST clinical perform-ance, pathological examination is the basis for the diagnosis. Surgical resection is the main treatment method.

ObjectiveTo understand knowledge level about chronic obstructive pulmonary disease (COPD)of medical doctors practising at district hospitals and community health service and impact of different models of continuing medical education on their knowledge level.MethodsKnowledge of COPD was investigated with a close-book examination in 372 medical doctors working at the grassroots of 10 urban copies of finished examination papers were returned in this investigation.with an average score of 50.1 and pass rate of 42.5%.About 67.7%and 67.5%of medical doctors passed the examination of knowledge on definition,risk factors and non.pharmacological treatment for COPD.respectively,and 19.9%of them passed the examination on pharmacological treatment for COPD.Different modes of continuing medical education made varied impacts on their acquisition of COPD knowledge.with an average score of 67 and pass rate of 73.3%in the intensified education group,respectively,significantly higher than those in general education group and non-education group.ConclusionsClinical knowledge and skills of COPD for medical doctors working at the grassroots in Beijing Was not so satisfactory and education should be strengthened urgently to raise their knowledge on COPD prevention and control.

Objective To determine the minimum alveolar concentration(MAC)of sevoflurane for blunting the responses to removal of the laryngeal mask airway(LMA)in 50%anesthetized children.Methods Twenty-five ASA Ⅰ or Ⅱ children aged 3-8 yr undergoing elective surgery under general anesthesia weTe enrolled in this stuay.Anesthesia was induced with inhalation of 8%Sevoflurane.LMA was inserted when the children lost eyelash reflex and the lower jaw was relaxed.Anesthesia was maintained with 3%sevoflurane.All the children kept spontaneous breathing during operation.Assisted ventilation waw performed when necessary to maintain PET CO2 at 35-45 mm Hg.After the surgery the target end-tidal sevoflurane concentration was maintained for 10 min before LMA was removed.Up-and-down sequential allocation was used to determine山e MAC.The initial end-tidal concentration was 1%and was increased/decreased by 20%in the next patient if the extubation response was positive or negative.Limb movement,breath-holding,laryngosposm and hypoxemia(SpO2<95%)were considered to be the signs of positive response.The midpoint from positive response to negative response was made the balance point.and the mean value ofthe concentrations of sevoflurane at all the balance points were calculated as MAC.Results The end-tidal sevoflurane concentration for blunting the responses to removal of LMA was 0.98%.Conclusion The MAC of sevoflilrane for blunting the responses to removal of LMA in 50%anesthetized children(aged 3-8 yr)is 0.98%.

Objective To observe the changes of NK cell subset (CD56+,CD16+CD56+,CD16+),T cell subset (CD4+,CD8+,CD4+/CD8+) counts and related cytokines (IL-2,IL-4,INF-γ) in children with viral pneumonia.Methods Thirty-two children with viral pneumonia in acute stage (within 2 days after pneumonia onset) and recovery phase (within the range of the third to the fifth day after pneumonia onset) were included in this study.Peripheral blood NK cell subsets and T cell substes were determined by the flow cytometry.Blood IL-2,IL-4 and INF-γ were detected by ELISA.NK cytoactivity was measured by LDH release method.Results (1) The levels of the CD16+CD56+ and CD16+NK cell counting in acute stage [(0.73±0.17)% and (0.39±0.20)%] were lower than those in the recovery phase [(1.47±0.22)% and (0.89±0.14)%],which showed significant difference (P<0.01),however the level of CD16+CD56+ and CD16+NK cell counting either in acute stage or recovery phase was significantly lower than those of healthy control group (P<0.01).The sub population counting and NK cell activity was directly correlated.CD56+NK cell counting showed no significant difference between viral pneumonia group and control group (P>0.05).(2) There was no significant difference in blood IL-2 and IL-4 level between viral pneumonia group (either in acute stage or recovery phase) and the control group (P>0.05).As compared with that of the control group,blood INF-γ level of viral pneumonia group showed no significant change in acute stage (P>0.05),but INF-γ level in recovery phase [(28.10±1.38)?μg/L] was higher than that in acute stage [(22.78±1.19)?μg/L] and there was significant difference (P<0.01).(3) As compared with that of the control group,CD4+ and CD4+/CD8+T cell counting of viral pneumonia group showed no obvious changes either in acute stage or recovery phase (P>0.05).CD8+T cell counting of both two stages were much lower than that of the control group (P<0.05),but there was no significant difference between the two stages (P>0.05).Conclusion The NK cell activity in children with viral pneumonia decline obviously,which might be related to the changes of T cell subsets;the activity of suppressor T cell was depressed in patients with viral pneumonia.There are maybe many factors involved in the NK cell activation.

Objective To detect the expression of Id1 and p53 in human breast cancer and study their relationship. Methods To choose 80 cases of breast cancer from the surgical department of Tangshan people's hospital. All patients didn't get radiotherapy and chemotherapy before surgery. The expression of Idl and p53 of breast cancer were studied by using SABC immunohistochemistry. Results The expressions of Id1 were found in cytoplasm, while the expression of p53 was found in cell nucleus. The positive rates of Id1 and p53 were 87.5 %(70/80)and 90.0%(72/80) respectively in breast cancer tissues. The expression of Id1 and p53 were significantly higher in breast cancer tissue than those in adjacent non-tumor breast tissues,benign tumor tissues and normal breast tissues(P ＜0.05). The positive rates and expression intensity of Id1 in breast cancer had significant correlation with lymph node metastasis and pTNM stage of the tumor, but had no significant correlation with age, histological differentiation and tumor size. The positive rates and expression intensity of p53 in breast cancer had significant correlation with lymph node metastasis of the tumor, but had no significant correlation with age, histological differentiation,tumor size and pTNM stage. Conclusion Expression of Id1 in human breast cancer is up-regulated. Its expression is associated with lymph node metastasis and TNM stage and represents an independent marker for prognosis of breast cancer. To reduce the expression of Id1 will become the strategy of curing breast cancer. Expression of Id1 and p53 in human breast cancer have the same clinic significance. Each of them can represent an independent marker for prognosis of breast cancer.

Objective To evaluate the saf ety and efficiency of phacoemulsificatio n combined with intraocular lens implant and trabeculectomy in patients with glau coma and cataract after filtrating surge ry failure. Methods Thirty-two cases （32 eyes） patients underwent phacoemulsific ation combined with intraocular lens imp lant and trabeculectomy after filtrating surgery failure. Outcome measures inclu ded intraocular pressure （IOP） and visua l acuity. The followed-up periods rang ed from 6 months to 2 years. Results In 21 of the 32 eyes（66％），postoperative vi sual acuity were above 0.5. In 6 of the 32 eyes（18％），postoperative visual acuity were between 0.1 to 0.4. In 27 of 32 e yes（84.3％）， postoperative IOP were between 12.23 to 20.55 mmHg. Conclusion phac oemulsification combined with intraocula r lens implant and trabeculectomy in patients with glaucoma and cataract after f iltrating surgery failure is a safe and effective treatment for these patients.

ObjectiveTo evaluate the effects of selective cyclooxygenase-2 inhibitor nimesulide lone and combined with cisplatin on tumor growth,and Ki67 and Caspase-3 expression in lung cancer xenografts in nude mice. Methods The mice were randomly divided into 4 groups:the control group,the nimesulide group,the cisplatin group and the nimesulide combined with cisplatin group. A549 cells were injected into BALB/c nude mice subcutaneously.On the 21st day after treatment tumor tissues were collected,and the xenografts growth were observed. The expression of Ki67 and Caspase-3 were detected by immunohistochemical method.ResultsNimesulide combined with cisplatin could significantly inhibited the xenografts growth compared with nimesulide or cisplatin.The tumor inhibition rate was 44.33％ in the nimesulide group,53.61％ in the cisplatin group and 80.41％ in the nimesulide combined with cisplatin group (P ＜ 0.05).Immunohistochemical analysis showed that the expression rates of Caspase-3 was significantly increased in the nimesulide combined with cisplatin group (67.43 ± 23.57 ) ％,the cisplatin group (48.40 ± 20.37 ) ％,and the nimesulide group (38.65 ± 15.37)％,compared with the control group (27.63 ± 13.03)％ (P ＜ 0.05).The expression rate of Caspase-3 was significantly increased in the nimesulide combined with cisplatin group compared with the nimesulide group or the cisplatin group (P ＜ 0.05 ).The expression rate of Ki67 was significantly decreased in the nimesulide group combined with cisplatin group (24.34 ± 15.90)％,the cisplatin group (40.85 ± 22.47)％ and the nimesulide group (53.33 ± 19.67)％ compared with the control group ( 80.43 ± 16.88 ) ％ ( P ＜ 0.05 ).The expression of Ki67 was significantly decreased in the nimesulide combined with cisplatin group compared with the nimesulide group or the cisplatin group ( P ＜ 0.05 ).Conclusion Nimesulide can inhibit human lung cancer A549 cells xenografts in nude mice growth,Nimesulide enhanced the inhibitory effects of cisplatin.The mechanism may be related to inhibition of tumor cell Ki-67 expression,increased expression of Caspase-3,inhibition of tumor cell proliferation,and inducing tumor cell apoptosis.

p21 activated kinase 4 (PAK4) is a member of a family of serine/threonine kinase.PAK4plays an important role in a variety of cellular functions including cell cycle,cell proliferation,apoptosis,and cytoskeletal reorganization.Recently,PAK4 has been shown to overexpress in a variety of malignancies,and contribute to cancer cell migration and invasion through multiple signalling pathways.

To study on one case of severe cerebral parlsy. Special education and rehibilitative training for children with severe cerebral parlsy arc investigated in the current study.

AIM:To explore the effects of the combined use of human telomerase reverse transcriptase (hTERT) gene antisense oligodeoxynucleotide (ASODN) and cisplatin on apoptosis of HL-60 cells. METHODS:PCR-ELISA was used to determine telomerase activity in HL-60 cells untreated or treated with ASODN, the expression levels of hTERT protein were assayed by immunofluorescence using fluoresce isothiocyanate (FITC) label. Apoptosis was detected by DNA electrophoresis and flow cytomertric cell cycle analysis. RESULTS:The expression levels of hTERT protein and telomerase activity in HL-60 cells treated with ASODN were shown to decrease with time, the DNA fragments were obviously found and the percentage of apoptosis cells was significantly enhanced in HL-60 cells with the combined use of hTERT ASODN and cisplatin compared with the combined use of hTERT sense oligodeoxynucleotide and cisplatin or cisplatin alone, respectively. CONCLUSION:Inhibition of telomerase activity by hTERT ASODN increases the cisplatin-induced apoptosis of HL-60 cells.