1.Key Information Research and Modern Clinical Application of Famous Classical Formula Yanghetang
Weilu NIU ; Mengjie YANG ; Chengqi LYU ; Shunxi WANG ; Ziwen WANG ; Huangchao JIA ; Liyun WANG ; Xuewei LIU ; Mingsan MIAO ; Xiaomeng WANG ; Yawei YAN ; Chunyong LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):238-246
Through data collection and collation combined with bibliometrics, this study conducted a series of textual research on Yanghetang, such as the name and origin, the evolution of prescription composition and modern clinical application. Yanghetang was first recorded in Bencao Yidu of WANG Ang in the Qing dynasty. In addition to Yanghetang, there were 3 bynames of Jiawei Yanghetang, Quanshengji Yanghetang and Zhenjun Yanghetang. Regarding the composition of the formula, a total of 4 versions of Yanghetang were collected. The first version is the 5 medicines version of Cervi Cornus Colla, Rehmanniae Radix Praeparata, Cinnamomi Cortex, Zingiberis Rhizoma and Ephedrae Herba in Bencao Yidu. The second version is the 7 medicines version of Waike Zhengzhi Quanshengji, changing Zingiberis Rhizoma to Zingiberis Rhizoma Praeparatum Carbonisata(ZRPC) and adding Sinapis Semen and Glycyrrhizae Radix et Rhizoma(GRR) on the basis of Bencao Yidu, and most of the Yanghetang is of this version. The third version is the 6 medicines version of Wushi Yifang Huibian, that is, on the basis of Bencao Yidu, Zingiberis Rhizoma is changed into ZRPC, and Sinapis Semen is added. The fourth version is the 6 medicines version in Yifang Jiedu, that is, on the basis of Bencao Yidu, Zingiberis Rhizoma is changed into Zingiberis Rhizoma Praeparatum, and GRR Praeparata cum Melle is added. Regarding the dose of Yanghetang, the doses of the medicines in Waike Zhengzhi Quanshengji was converted into the modern doses as follows:37.3 g of Rehmanniae Radix Praeparata, 1.87 g of Ephedrae Herba, 11.19 g of Cervi Cornus Colla, 7.46 g of Sinapis Semen, 3.73 g of Cinnamomi Cortex, 3.73 g of GRR, and 1.87 g of ZRPC. The origins of the above medicines are consistent with the 2020 edition of Chinese Pharmacopoeia. The processing specification of Rehmanniae Radix Praeparata is steaming method, ZRPC is ginger charcoal, Sinapis Semen is the fried products, and the rest of the medicines are raw products. The decoction method was verified by the decoction method in Chonglou Yuyao, which is similar in the time, and it is recommended that the above medicines should be added with 600 mL of water, decocted to 100 mL, and taken warmly 30 min after meal. For each dose, it is recommended to use 1-3 doses per day according to the doctor's advice in combination with clinical practice. The diseases involved in the ancient applications involved 42 diseases in 11 departments, including orthopedics, dermatology and gynecology, which were dominated by Yin-cold syndrome. However, the diseases involved in modern research also include 148 related diseases in 10 departments, such as orthopedics, obstetrics and gynecology, which is consistent with the ancient books. In recent years, the research hotspots of Yanghetang have focused on more than 10 fields, including osteoblasts, malignant tumors, wound healing, traditional Chinese medicine fumigation and so on, which are widely used. It is suitable for comprehensive research and development because of its rational formula composition, clear origin, processing and decoction method, and wide clinical application.
2.Growth and Development of Atractylodes chinensis and Microecological Response of Cultivated Soil Mediated by Two Microbial Fertilizers
Xuewei LIU ; Chunping XIAO ; Lili WENG ; Zhaoyang LI ; Xinxing HU ; Bo LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):157-165
ObjectiveThe effects of two microbial fertilizers (Bacillus subtilis fertilizer and Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer) on the growth and development, the accumulation of active ingredients, and the microbial community diversity of rhizosphere soil of Atractylodes chinensis were investigated. MethodsA field experiment was carried out with two-year-old Atractylodes chinensis as the test material. Plant samples were collected during the wilt stage (September 26, 2023) to determine the general agronomic traits of Atractylodes chinensis. High-performance liquid chromatography (HPLC) was utilized to evaluate the effects of microbial fertilizers on the synthesis and accumulation of four active ingredients (atractylodin, atractylon, β-eudesmol, and atractylenolide Ⅰ) in Atractylodes chinensi. PacBio Sequel sequencing technology was used to explore the differences in bacterial community structures and diversity in the rhizosphere soil of Atractylodes chinensis treated with different microbial fertilizers. ResultsThe two microbial fertilizers had significant growth-promoting effects on Atractylodes chinensis. Compared with those of the CK group, the stem diameter, stem and leaf dry and fresh weight, and rhizome dry and fresh weight of Atractylodes chinensis significantly increased by 0.47-1.07 times (P<0.05) after the application of the Bacillus subtilis fertilizer (16 kg/667 m2), and those significantly increased by 0.62-0.96 times (P<0.05) after the application of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer (1.5 kg/667 m2). The effect on plant height was not significant. The application of two microbial fertilizers was beneficial to the accumulation of atractylodin, atractylon, β-eudesmol, and atractylenolide Ⅰ (P<0.01), and the effect of the Bacillus subtilis fertilizer on the accumulation of active ingredients of Atractylodes chinensis was better than that of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. The results of high-throughput sequencing showed that compared with the CK group, the Bacillus subtilis fertilizer (8 kg/667 m2) could significantly increase the diversity of rhizosphere bacterial species by regulating the Simpson index and Shannon index (P<0.05), and the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer significantly reduced the bacterial diversity (P<0.05). The relative abundance of dominant bacteria was compared at the phylum and genus levels. The relative abundance of Proteobacteria (45.73%) and Burkholderia_Caballeronia_Paraburkholderia (9.98%) significantly increased after the application of the Bacillus subtilis fertilizer (P<0.01), and the relative abundance of Acidobacteriota (20.53%) and Sphingomonas (3.63%) increased significantly (P<0.01) after the application of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. The relative abundance of beneficial bacteria in the Bacillus subtilis fertilizer was slightly higher than that in the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. Pearson correlation analysis showed that Burkholderia_Caballeronia_Paraburkholderia and Sphingomonas were positively correlated with the content of atractylodin, atractylon, β-eudesmol, and atractylenolide Ⅰ (P<0.05). ConclusionThe application of the Bacillus subtilis fertilizer and Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer can increase the yield of medicinal materials and promote the synthesis and accumulation of active ingredients by regulating the rhizosphere microecological diversity of Atractylodes chinensis, and the application effect of the Bacillus subtilis fertilizer is better than that of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer.
3.Historical Evolution and Modern Clinical Application of Huoxiang Zhengqisan
Weilu NIU ; Mengjie YANG ; Chengqi LYU ; Cuicui SHEN ; Congcong LI ; Huangchao JIA ; Liyun WANG ; Xuewei LIU ; Mingsan MIAO ; Xiaomeng WANG ; Yawei YAN ; Chunyong LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):156-167
In this study, bibliometric methods were used to systematically investigate the name and origin, the evolution of prescription composition, dose evolution, origin and processing method, decoction method, ancient application, modified application, modern application and other information of Huoxiang Zhengqisan. After research, Huoxiang Zhengqisan, also known as Huoxiang Zhengqitang, was first recorded in Taiping Huimin Hejijufang. The original formula is composed of 41.3 g of Arecae Pericarpium, 41.3 g of Angelicae Dahuricae Radix, 41.3 g of Perilla frutescens(actually Perillae Folium), 41.3 g of Poria, 82.6 g of Pinelliae Rhizoma, 82.6 g of Atractylodis Macrocephalae Rhizoma, 82.6 g of Citri Reticulatae Pericarpium(actually Citri Exocarpium Rubbum), 82.6 g of Magnoliae Officinalis Cortex, 82.6 g of Platycodonis Radix, 123.9 g of Pogostemonis Herba, and 103.25 g of Glycyrrhizae Radix et Rhizoma. In this formula, Magnoliae Officinalis Cortex is processed according to the specifications for ginger-processed products, Glycyrrhizae Radix et Rhizoma is processed according to the specifications for stir-fried products, and other herbs are used in their raw products. The botanical sources of the herbs are consistent with the 2020 edition of Pharmacopoeia of the People's Republic of China. The above herbs are ground into a fine powder with a particle size passing through a No. 5 sieve. For each dose, take 8.26 g of the powdered formula, add 300 mL of water, along with 3 g of Zingiberis Rhizoma Recens and 3 g of Jujubae Fructus, and decoct until reduced to 140 mL. The decoction should be administered hot, with three times daily. To induce sweating, the patient should be kept warm under a quilt, and an additional dose should be prepared and taken if needed. This formula is traditionally used to relieve the exterior and resolve dampness, regulate Qi and harmonize the middle, which is mainly used to treat a series of diseases of digestive and respiratory systems. However, potential adverse reactions, including allergies, purpura and disulfiram-like reactions, should be considered during clinical use. Huoxiang Zhengqisan features a rational composition, extensive clinical application, and strong potential for further research and development.
4.Historical Evolution and Modern Clinical Application of Huoxiang Zhengqisan
Weilu NIU ; Mengjie YANG ; Chengqi LYU ; Cuicui SHEN ; Congcong LI ; Huangchao JIA ; Liyun WANG ; Xuewei LIU ; Mingsan MIAO ; Xiaomeng WANG ; Yawei YAN ; Chunyong LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):156-167
In this study, bibliometric methods were used to systematically investigate the name and origin, the evolution of prescription composition, dose evolution, origin and processing method, decoction method, ancient application, modified application, modern application and other information of Huoxiang Zhengqisan. After research, Huoxiang Zhengqisan, also known as Huoxiang Zhengqitang, was first recorded in Taiping Huimin Hejijufang. The original formula is composed of 41.3 g of Arecae Pericarpium, 41.3 g of Angelicae Dahuricae Radix, 41.3 g of Perilla frutescens(actually Perillae Folium), 41.3 g of Poria, 82.6 g of Pinelliae Rhizoma, 82.6 g of Atractylodis Macrocephalae Rhizoma, 82.6 g of Citri Reticulatae Pericarpium(actually Citri Exocarpium Rubbum), 82.6 g of Magnoliae Officinalis Cortex, 82.6 g of Platycodonis Radix, 123.9 g of Pogostemonis Herba, and 103.25 g of Glycyrrhizae Radix et Rhizoma. In this formula, Magnoliae Officinalis Cortex is processed according to the specifications for ginger-processed products, Glycyrrhizae Radix et Rhizoma is processed according to the specifications for stir-fried products, and other herbs are used in their raw products. The botanical sources of the herbs are consistent with the 2020 edition of Pharmacopoeia of the People's Republic of China. The above herbs are ground into a fine powder with a particle size passing through a No. 5 sieve. For each dose, take 8.26 g of the powdered formula, add 300 mL of water, along with 3 g of Zingiberis Rhizoma Recens and 3 g of Jujubae Fructus, and decoct until reduced to 140 mL. The decoction should be administered hot, with three times daily. To induce sweating, the patient should be kept warm under a quilt, and an additional dose should be prepared and taken if needed. This formula is traditionally used to relieve the exterior and resolve dampness, regulate Qi and harmonize the middle, which is mainly used to treat a series of diseases of digestive and respiratory systems. However, potential adverse reactions, including allergies, purpura and disulfiram-like reactions, should be considered during clinical use. Huoxiang Zhengqisan features a rational composition, extensive clinical application, and strong potential for further research and development.
5.Development and application of a drug price adjustment system in medical institutions
Liping YANG ; Zhigang ZHAO ; Li YANG ; Xuewei HAN ; Jing LIU
China Pharmacy 2025;36(19):2433-2436
OBJECTIVE To resolve account discrepancies caused by drug price adjustment in medical institution pharmacy management and reduce the time required for price adjustment. METHODS The problems existing in the drug price adjustment models of domestic medical institutions were investigated, and a drug price adjustment system was developed based on price- invoice synchronization mechanism. The system optimized the drug price adjustment process through batch number matching and real-time monitoring functionalities. The account consistency rate and price adjustment time were evaluated before and after system implementation. RESULTS A drug price adjustment system was successfully developed, featuring an innovative “synchronized entry and exit” mode, batch number matching, real-time monitoring, intelligent automation, and electronic traceability. After implementation, the account consistency rate for Western medicines increased from 86.89% (86.66%, 89.63%) to 100% (100%, 100%) (P=0.005), while Chinese patent medicines and herbal medicines maintained a 100% (100%, 100%) account consistency rate. Concurrently, the drug price adjustment time significantly decreased from 6.00 (5.00, 7.00)d to 2.50 (1.50, 3.00) d (P< 0.001). CONCLUSIONS The developed system significantly improves account consistency, shortens price adjustment time, and demonstrates notable innovation and practical utility.
6.Textual Research on Lianggesan from Ancient Literature and Its Modern Clinical Application
Weilu NIU ; Chengqi LYU ; Mengjie YANG ; Shunxi WANG ; Jingkang QIAO ; Huangchao JIA ; Liyun WANG ; Xuewei LIU ; Mingsan MIAO ; Jianwei LI ; Gang WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):223-234
Lianggesan was first recorded in Taiping Huimin Heji Jufang, which was composed of Rhei Radix et Rhizoma, Natrii Sulfas, Gardeniae Fructus, Forsythiae Fructus, Scutellariae Radix, Glycyrrhizae Radix et Rhizoma(GRR), Menthae Haplocalycis Herba, Lophatheri Herba and Mel. It was clinically applied to treat fire-heat syndrome in the upper and middle Jiao, and the curative effect was positive. In this study, the bibliometric method was used to conduct a detailed textual research on the formula name, medicinal composition, dosage evolution, origin and processing, functional indications and other aspects of Lianggesan. Research revealed that Lianggesan has six other names, such as Lianqiao Yinzi, Lianqiao Jiedusan, Jufang Lianggesan, Jiegu Lianggesan, Hejian Lianggesan and Qingji Lianggesan. Based on the edition of Taiping Huimin Heji Jufang, an analysis of the evolution of its formula composition revealed that the missing Chinese medicines were predominantly bamboo leaves and honey, while the added Chinese medicines were primarily supplements introduced to address changes in disease manifestations. After textual research, the dosage for one dose of Lianggesan from Taiping Huimin Heji Jufang was as follows:826 g of Rhei Radix et Rhizoma, 826 g of Natrii Sulfas, 826 g of GRR, 413 g of Gardeniae Fructus, 413 g of Menthae Haplocalycis Herba, 413 g of Scutellariae Radix, and 1652 g of Forsythiae Fructus. Decocting method was as following:Grinding the Chinese medicines into coarse powder(2-4 mm), taking 8.16 g per dose, adding 300 mL of water, along with 2 g of Lophatheri Herba and 5 g of Mel, and decocting to 140 mL. The residue was removed and taken warmly 30 min after meals. It was recommended to take it three times daily until improvement was achieved. The origins of the 9 Chinese medicines were consistent with the 2020 edition of Pharmacopoeia of the People's Republic of China. Except for GRR, which required single frying(stir-frying), the remaining medicines were all raw products. The description of the function of this formula in ancient books was summarized as purging fire and promoting bowel movements, clearing heat from the upper body and purging the lower body, and the main syndromes included facial redness, tongue swelling, red eyes, etc. In modern applications, the formula is primarily used for respiratory and digestive system diseases, including acute lung injury, chronic obstructive pulmonary disease, herpetic angina and aphthous stomatitis, covering 142 types of diseases. In summary, this paper can provide a basis for further research and development of Lianggesan through the literature review and key information combing.
7.Aloe-emodin inhibits scar tissue fibrosis through thrombospondin-1-PI3k-Akt pathway.
Hongbao GENG ; Xingyi ZHANG ; Siwei ZHOU ; Na LI ; Jia LIU ; Xuewei YUAN ; Chunliu NING ; Xudong ZHANG ; Wei HUANG
West China Journal of Stomatology 2025;43(5):636-647
OBJECTIVES:
To propose a hypothesis that aloe-emodin may inhibit scar tissue fibrosis through thrombospondin-1(THBS1)-PI3K-Akt pathway.
METHODS:
By cultivating fibroblasts derived from scar tissue after cleft palate surgery in humans, aloe emodin of different concentrations (10, 20, 30, 40 and 50 μmol/L) was added to the cells which activity was detected. At the same time, transcriptome sequencing was performed on scar tissue and cells, and bioinformatics methods were used to explore potential targets and signaling pathways of scar tissue fibrosis.
RESULTS:
Aloe-emodin had a concentration dependent inhibitory effect on fibroblast proliferation,with the 40 μmol/L concentration group showing the most significant effect. The results of tissue and cell sequencing indicated that differentially expressed genes were significantly enriched in extracellular matrix-receptor interaction pathway, and shared a common differential gene which was THBS1. The ORA analysis results indicated that differentially expressed genes, including THBS1, were significantly enriched in the PI3K-Akt signaling pathway.
CONCLUSIONS
Aloe emodin may inhibit the PI3K-Akt pathway by downregulating THBS1, thereby reducing the proliferation activity of fibroblasts derived from postoperative palatal scar tissue.
Thrombospondin 1/genetics*
;
Humans
;
Signal Transduction/drug effects*
;
Fibroblasts/cytology*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Fibrosis
;
Phosphatidylinositol 3-Kinases/metabolism*
;
Cicatrix/metabolism*
;
Cell Proliferation/drug effects*
;
Anthraquinones/pharmacology*
;
Cells, Cultured
8.Analysis of molecular typing,virulence and drug resistance features of bacterial strains in simultaneous outbreaks of paraty-phoid fever A and B
Xuewei TONG ; Zhaohui DENG ; Xueyan YE ; Chunyan LIU ; Yibeibaihan MAIMAITI ; Xin ZHANG
Chinese Journal of Clinical Laboratory Science 2024;42(5):377-383
Objective To investigate the molecular typing,virulence,and drug resistance features of bacterial strains in a simultane-ous outbreak of paratyphoid fever A and B,and then provide evidence for the prevention and treatment of the simultaneous transmission of different types of paratyphoid fever.Methods The clinical data of 31 patients confirmed as paratyphoid fever in the Hospital of Xin-jiang Production and Construction Corps from September 2018 to November 2018 were retrospectively analyzed.The isolated strains were performed serotyping and drug sensitivity tests.The molecular typing and the detection of virulence and drug resistance genes were carried out by multiplex PCR,pulsed-field gel electrophoresis(PFGE),and multilocus sequence typing(MLST).Results A total of 32 strains of Salmonella paratyphi were isolated from 31 patients,with 19 strains classified as type A and 13 as type B.The intermedi-ate rates of all strains against ciprofloxacin were 100%.The molecular typing and serotyping results of 11 representative strains were consistent.The PFGE fingerprints of Salmonella paratyphi A and B were also consistent.The MLST of Salmonella paratyphi A was ST85,and that of Salmonella paratyphi B was ST86.All strains carried virulence island SPI1-SPI5 representative genes such as invA,sitC,sseL,sifA,mgtC,siiE,and sopB,and regulatory gene phoP.Salmonella paratyphi A also carried cytolethal distending toxin(CDT)genes with trimeric structure such as cdtB,pltA,and pltB.The virulence plasmid genes such as pefA,prot6E,and spvB were all negative.Conclusion The simultaneous transmission of Salmonella paratyphi A and B has the characteristics of high pathogenicity and poor sensitivity to ciprofloxacin,which should be highly concerned by clinical and laboratory personnel.
9.Methylthioadenosine phosphorylase and p16 as surrogate diagnostic markers for CDKN2A homozygous deletion in brain tumors
Shengnan WANG ; Wei WANG ; Xuewei ZHANG ; Yanqiu ZHANG ; Yanlei XIONG ; Li LIU ; Lianghong TENG
Chinese Journal of Pathology 2024;53(5):439-445
Objective:To examine whether immunohistochemistry of methylthioadenosine phosphorylase (MTAP) and p16 could be used to predict the CDKN2A status in various brain tumors.Methods:A total of 118 cases of IDH-mutant astrocytomas, 16 IDH-wildtype glioblastoma, 17 polymorphic xanthoastrocytoma (PXA) and 20 meningiomas diagnosed at Xuanwu Hospital, Capital Medical University, Beijing, China from November 2017 to October 2023 were collected and analyzed. The CDKN2A status was detected by using fluorescence in situ hybridization or next-generation sequencing. Expression of MTAP and p16 proteins was detected with immunohistochemistry. The association of loss of MTAP/p16 expression with CDKN2A homozygous/heterozygous deletion was examined.Results:Among the 118 cases of IDH-mutant astrocytoma, 13 cases showed homozygous deletion of CDKN2A. All of them had no expression of MTAP while 9 cases had no expression of p16. Among the 16 cases of IDH wild-type glioblastoma, 6 cases showed homozygous deletion of CDKN2A. All 6 cases had no expression of MTAP, while 3 of these cases had no expression of p16 expression. Among the 17 PXA cases, 4 cases showed homozygous deletion of CDKN2A, and the expression of MTAP and p16 was also absent in these 4 cases. Among the 20 cases of meningiomas, 4 cases showed homozygous deletion of CDKN2A. Their expression of MTAP and p16 was also absent. Among the four types of brain tumors, MTAP was significantly correlated with CDKN2A homozygous deletion ( P<0.05), with a sensitivity of 100%. However, it was only significantly correlated with the loss of heterozygosity (LOH) of CDKN2A in astrocytomas ( P<0.001). P16 was associated with CDKN2A homozygous deletion in IDH-mutant astrocytoma and PXA ( P<0.001), but not with the LOH of CDKN2A. Its sensitivity and specificity were lower than that of MTAP. Conclusions:MTAP could serve as a predictive surrogate for CDKN2A homozygous deletion in adult IDH-mutant astrocytoma, PXA, adult IDH-wildtype glioblastoma and meningioma. However, p16 could only be used in the first two tumor types, and its specificity and sensitivity are lower than that of MTAP.
10.A real-world study of clinicopathological characteristics and prognostic factors of gastrointes-tinal stromal tumor with initial surgical resection
Xiaona WANG ; Jingxin CAO ; Baogui WANG ; Hongjie ZHAN ; Yong LIU ; Xuewei DING ; Ning LIU ; Rupeng ZHANG ; Han LIANG
Chinese Journal of Digestive Surgery 2024;23(8):1080-1086
Objective:To investigate the clinicopathological characteristics and prognostic factors of gastrointestinal stromal tumor (GIST) with initial surgical resection.Methods:The retro-spective cohort study was conducted. The clinicopathological data of 847 GIST patients who under-went initial surgical resection in Tianjin Medical University Cancer Institute & Hospital from January 2011 to December 2020 were collected. There were 405 males and 442 females, aged (60±10)years. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the nonparameter rank sum test. The Kaplan-Meier method was used to calculate survival rates. Univariate analysis was conducted using the Log-rank test. Multivariate analysis was conducted using the COX regression model. Results:(1) Clinicopatholo-gical characteristics. Of 847 patients, the tumor primary location was stomach in 585 cases, jejunum and ileum in 142 cases, duodenum in 76 cases, colorectum in 10 cases, esophagus in 3 cases, and extra-gastrointestinal in 31 cases. There were 13 cases with liver metastasis and 22 cases with abdominal metastasis. The tumor maximum diameter was (7±5)cm, and the number of nuclear divisions was 4(range, 0-60) cells/50 high-power field or 5 mm 2. According to risk classification of National Institutes of Health (NIH), 31 cases were of extremely low risk, 238 cases were of low risk, 213 cases were of moderate risk, 365 cases were of high risk. There were 839 of 847 patients positive for CD117, 788 cases positive for Dog-1, 710 cases positive for CD34, respectively. There were 272 cases with Ki-67 <5%, 214 cases with Ki-67 of 5%- 9%, 198 cases with Ki-67 ≥10%, 163 cases with missing data. R 0 resection was in 814 cases and non-R 0 resection was in 33 cases. (2) Gene testing and postoperative adjuvant therapy of GIST patients. ① Gene testing. Of 847 patients, 424 underwent genetic testing. The proportion of genetic testing was 1.89%(1/53) in 2011, 9.76%(8/82) in 2012, 8.45%(6/71) in 2013, 15.66%(13/83) in 2014, 50.00%(40/80) in 2015, 55.26%(42/76) in 2016, 73.86%(65/88) in 2017, 68.27%(71/104) in 2018, 80.65%(75/93) in 2019, 88.03%(103/117) in 2020, respectively. Of 424 with genetic testing, 338 cases had KIT mutation, 31 cases had PDGFRA mutation, 55 cases were wild type. ② Adjuvant therapy. Of 847 patients, 253 patients underwent postoperative adjuvant therapy. The proportions of postoperative adjuvant therapy were 8.82%(21/238), 41.78%(89/213), 39.18%(143/365) in patients of low risk, moderate risk, high risk. Of 578 patients with moderate to high risk, the proportion of postoperative adjuvant therapy was 15.15%(5/33) in 2011, 14.71%(10/68)in 2012, 22.45%(11/49) in 2013, 29.09%(16/55) in 2014, 41.38%(24/58) in 2015, 46.15%(24/52) in 2016, 32.81%(21/64)in 2017, 60.00%(45/75) in 2018, 60.42%(29/48) in 2019, 61.84%(47/76) in 2020, respectively. Of 253 patients underwent postoperative adjuvant therapy, 247 cases received imatinib had 6 cases received sunitinib. (3) Comparison of clinicopathological characteristics of GIST with non-gastric origin and gastric origin. Of 847 patients, 262 cases had non-gastric origin and 585 cases had gastric origin. There were significant differences in gender, the number of tumor, tumor maximum diameter, Ki-67 index, risk classification of NIH, and R 0 resection between the two groups ( χ2=8.62, 8.40, 12.97, 6.57, Z=-6.15, χ2=17.19, P<0.05). (4) Analysis of influencing factors for recurrence-free survival rate in GIST patients. Results of multivariate analysis showed that the year of initial diagnosis, primary site, tumor maximum diameter, mitotic image, risk classification of NIH, R 0 resection, genetic testing and postoperative adjuvant therapy were independent factors influencing recurrence-free survival rate in GIST patients with initial surgical resection ( hazard ratio=0.58, 0.61, 2.00, 1.71, 5.81, 2.56, 0.65, 0.38, 95% confidence interval as 0.39-0.85, 0.45-0.83, 1.46-2.74, 1.24-2.35, 3.16-10.69, 1.63-4.02, 0.46-0.94, 0.25-0.56, P<0.05). Conclusions:GIST with initial surgical resection is common located in stomach, with high positive rate in CD117 and Dog-1. The number of people undergoing genetic testing and targeted therapy for GIST is increasing year by year. There are significant differ-ences in clinicopathological characteristics between GIST with non-gastric origin and gastric origin. The year of initial diagnosis, primary site, tumor maximum diameter, mitotic image, risk classifica-tion of NIH, R 0 resection, genetic testing and postoperative adjuvant therapy are independent factors influencing recurrence-free survival rate in GIST patients with initial surgical resection.

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