Objective:To explore the optimal duration of preoperative imatinib therapy in patients with locally advanced gastrointestinal stromal tumors (GIST) in order to optimize surgical timing and long-term survival benefits.Methods:A total of 171 patients with locally advanced GIST who received preoperative imatinib therapy and subsequent surgical resection between November 2012 and October 2024 at Fujian Cancer Hospital and Union Hospital of Fujian Medical University were retrospectively analyzed. Patients were divided into three groups according to the duration of preoperative imatinib treatment: short-term (≤6 months, n=50), intermediate-term (7-12 months, n=87), and long-term (>12 months, n=34). Imaging response, pathological efficacy, recurrence-free survival (RFS), and overall survival (OS) were compared among the groups. Univariate and multivariate Cox regression analyses were used to identify the optimal treatment duration. Results:The median duration of preoperative imatinib therapy was 9 (6, 12) months. After treatment, the average maximum tumor diameter decreased from (10.37±5.74) cm to (6.99±4.34) cm, with an average shrinkage of 31.5%. The objective response rates in the short-, intermediate-, and long-term groups were 50.0% (25/50), 58.6% (51/87), and 52.9% (18/34), respectively; high-grade pathological response rates were 28.0% (14/50), 37.9% (33/87), and 29.4% (10/34), with no statistically significant differences among groups (all P>0.05). With a median follow-up of 46 months, 39 patients experienced recurrence and 20 died. The intermediate-term group had 3- and 5-year RFS rates of 87.1% and 79.6%, respectively, significantly better than those of the short-term group (75.5% and 55.5%, P=0.004). The long-term group had 3- and 5-year RFS rates of 85.3% and 75.5%, which were between the other two groups, but not significantly different (all P>0.05). For OS, the intermediate-term group had 3- and 5-year rates of 97.3% and 92.7%, superior to the short-term group (84.4% and 72.4%, P=0.007), while the long-term group (88.2% and 79.4%) showed no significant advantage (all P>0.05). Stratified analysis revealed that among non-gastric primary tumor patients with c-Kit exon 11 mutations, partial response on imaging, or postoperative imatinib ≤24 months, the intermediate-term group had significantly better RFS and OS than the short-term group (all P<0.05), but had no differences compared to the long-term group ( P>0.05). Multivariate Cox regression analysis indicated that preoperative imatinib duration was not an independent factor for RFS ( P>0.05), but treatment for 7-12 months was an independent protective factor for OS ( HR=0.275, 95% CI: 0.089-0.851, P=0.025), while prolonging therapy beyond 12 months conferred no additional OS benefit ( P>0.05). Conclusions:In patients with locally advanced GIST, preoperative imatinib therapy for 7-12 months yielded the most favorable prognosis, with significantly improved RFS and OS compared to ≤6 months of treatment. Extending preoperative therapy beyond 12 months did not provide additional survival benefit.

Objective:To explore the optimal duration of preoperative imatinib therapy in patients with locally advanced gastrointestinal stromal tumors (GIST) in order to optimize surgical timing and long-term survival benefits.Methods:A total of 171 patients with locally advanced GIST who received preoperative imatinib therapy and subsequent surgical resection between November 2012 and October 2024 at Fujian Cancer Hospital and Union Hospital of Fujian Medical University were retrospectively analyzed. Patients were divided into three groups according to the duration of preoperative imatinib treatment: short-term (≤6 months, n=50), intermediate-term (7-12 months, n=87), and long-term (>12 months, n=34). Imaging response, pathological efficacy, recurrence-free survival (RFS), and overall survival (OS) were compared among the groups. Univariate and multivariate Cox regression analyses were used to identify the optimal treatment duration. Results:The median duration of preoperative imatinib therapy was 9 (6, 12) months. After treatment, the average maximum tumor diameter decreased from (10.37±5.74) cm to (6.99±4.34) cm, with an average shrinkage of 31.5%. The objective response rates in the short-, intermediate-, and long-term groups were 50.0% (25/50), 58.6% (51/87), and 52.9% (18/34), respectively; high-grade pathological response rates were 28.0% (14/50), 37.9% (33/87), and 29.4% (10/34), with no statistically significant differences among groups (all P>0.05). With a median follow-up of 46 months, 39 patients experienced recurrence and 20 died. The intermediate-term group had 3- and 5-year RFS rates of 87.1% and 79.6%, respectively, significantly better than those of the short-term group (75.5% and 55.5%, P=0.004). The long-term group had 3- and 5-year RFS rates of 85.3% and 75.5%, which were between the other two groups, but not significantly different (all P>0.05). For OS, the intermediate-term group had 3- and 5-year rates of 97.3% and 92.7%, superior to the short-term group (84.4% and 72.4%, P=0.007), while the long-term group (88.2% and 79.4%) showed no significant advantage (all P>0.05). Stratified analysis revealed that among non-gastric primary tumor patients with c-Kit exon 11 mutations, partial response on imaging, or postoperative imatinib ≤24 months, the intermediate-term group had significantly better RFS and OS than the short-term group (all P<0.05), but had no differences compared to the long-term group ( P>0.05). Multivariate Cox regression analysis indicated that preoperative imatinib duration was not an independent factor for RFS ( P>0.05), but treatment for 7-12 months was an independent protective factor for OS ( HR=0.275, 95% CI: 0.089-0.851, P=0.025), while prolonging therapy beyond 12 months conferred no additional OS benefit ( P>0.05). Conclusions:In patients with locally advanced GIST, preoperative imatinib therapy for 7-12 months yielded the most favorable prognosis, with significantly improved RFS and OS compared to ≤6 months of treatment. Extending preoperative therapy beyond 12 months did not provide additional survival benefit.

Objective To investigate the influence of intensive heart rate control on inflammatory factor and cardiac function in patients with chronic heart failure. Methods From January 2015 to December 2015 ,a total of 120 CHF patients in New York Heart Association(NYHA)functional classes Ⅱ to Ⅳ were enrolled and randomized into treatment group(n=60)and control group(n=60). All the patients were in stable situation af-ter conventional drug treatment. The patients in treatment group underwent intensive heart rate control for target HR (55~60 beats/min)through adjusting the dose of metoprolol sustained-release tablets. The concentration of C-reac-tion protein(CRP),interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factorα(TNF-α)were de-tected before and after 6-month treatment. The resting heart rate and the concentration of brain natriuretic peptide (BNP),left ventricular ejection fracetion(LVEF),left ventricular end diastolic diameter(LVEDD)and left ven-tricular end systolic dimension(LVEDD)were measured at the start and 6-months after treatment. Results After 6-month treatment,the resting heart rate of the patients in the treatment group decreased significantly compared with that of the control group(P<0.001). Inflammatory factors(CRP,IL-1β,IL-6 and TNF-α)levels decreased significantly compared with that of control group (P < 0.05). The echocardiography parameters (LVEDD and LVESD)and the concentration of BNP of the patients in the treatment group decreased significantly(P < 0.05), LVEF of treatment group increased significantly(P < 0.05). Conclusion Intensive heart rate control in patients with chronic heart failure can significantly reduce Inflammatory factor levels and improve the cardiac function.

In clinical work of emergency visit and department of cardiology ,some cases are usually encountered , their cardiac troponin levels rise ,but there is no corresponding cardiac ischemic manifestations on ECG ,even no chest tightness and chest pain etc .The present article collected some related data for those patients without acute myocardial infarction but their troponin levels rose abnormally .They were reviewed as follow .

Objective　To explore the microorganism contaminat ion situation and disease incidence in family and requirements of disinfection. Methods　The sanitation conditions in 212 families in Shanghai were investigated, and 200 of them were taken samples for microbiolo gical test. Re sults　I n recent a year, members in 82.1% of families caught diseases caused by microorg anism infection. Only 18.4% of families usually used disinfectant, the disinfect ed object mostly was dishware. 22.8% of samples was contaminated seriously. Fungus was detected in 63.9% of samples. The average positive rate of HBsAg was 4.2%. Conclusions　Domestic environment was potentially cont aminated by microorganism.

This article introduces a American Nati onal Standard-Safe use and han dling of glutaraldehyde-based products in health care institution. It pro vides g uidelines for the safe use and handling of glutaraldehyde as a disinfectant and sterilant in heath care institution by design consideration, proper work practi ces, information on properties and vapor monitoring of glutaraldehyde, and perso nnel qualifications, training, protective attire and health consideration.