Objective:To investigate the biological behavior spectrum of platelet-derived growth factor alpha receptor (PDGFRA)-mutant gastrointestinal stromal tumor (GIST), and to compare the clinical values of the Zhongshan method of benign and malignant evaluation with the modified National Institutes of Health (NIH) risk stratification.Methods:A total of 119 cases of GIST with PDGFRA mutation who underwent surgical resection at Zhongshan Hospital, Fudan University from 2009 to 2020 were collected. The clinicopathological data, follow-up records, and subsequent treatment were reviewed and analyzed statistically.Results:There were 79 males and 40 females. The patients ranged in age from 25 to 80 years, with a median age of 60 years. Among them, 115 patients were followed up for 1-154 months, and 13 patients progressed to disease. The 5-year disease-free survival (DFS) and overall survival (OS) were 90.1% and 94.1%, respectively. According to the modified NIH risk stratification, 8 cases, 32 cases, 38 cases, and 35 cases were very-low risk, low risk, intermediate risk, and high risk, and 5-year DFS were 100.0%, 95.6%, 94.3%, and 80.5%, respectively. There was no significant difference in prognosis among the non-high risk groups, only the difference between high risk and non-high risk groups was significant ( P=0.029). However, the 5-year OS was 100.0%, 100.0%, 95.0% and 89.0%, and there was no difference ( P=0.221). According to the benign and malignant evaluation Zhongshan method, 43 cases were non-malignant (37.4%), 56 cases were low-grade malignant (48.7%), 9 cases were moderately malignant (7.8%), and 7 cases were highly malignant (6.1%). The 5-year DFS were 100.0%, 91.7%, 77.8%, 38.1%, and the difference was significant ( P<0.001). The 5-year OS were 100.0%, 97.5%, 77.8%, 66.7%, the difference was significant ( P<0.001). Conclusions:GIST with PDGFRA gene mutation shows a broad range of biological behavior, ranging from benign to highly malignant. According to the Zhongshan method, non-malignant and low-grade malignant tumors are common, the prognosis after surgery is good, while the fewer medium-high malignant tumors showed poor prognosis after surgical resection. The overall biological behavior of this type of GIST is relatively inert, which is due to the low proportion of medium-high malignant GIST. The modified NIH risk stratification may not be effective in risk stratification for PDGFRA mutant GIST.

Objective:To discuss the characteristics of common diseases of fighter pilots and provide evidence and support for improving the health level and combat capabilities of Chinese fighter pilots by the Meta-analysis of disease spectrum.Methods:The information of disease spectrum of Chinese fighter pilots was extracted from the literatures collected by SinoMed, China Academic Journal Network Publishing Database, China Scientific Journal Database, Wanfang Data and PubMed before December of 2020. STATA 16 and SPSS 26 software were used to make system evaluation for the constituent ratio of single disease, and the diseases were analyzed in subgroups by years.Results:Seventeen literatures, that published from 2002 to 2020, were collected for Meta-analysis and 9 431 persons were involved (aged from 20 to 60 years) based on the statistical analysis from 1965 to 2019. The results indicated metabolic diseases, spinal diseases, aviation occupational diseases, hepatobiliary diseases, etc.. The Meta-analysis showed that the proportion of spinal diseases was 29.5% (95 %CI was 20.8%~38.2%, I2=99.0%), metabolic diseases was 22.2% (95 %CI was 12.5%~31.8%, I2=99.5%), valvulopathy and arrhythmia was 15.1% (95 %CI was 7.3%~22.8%, I2=97.0%), aviation occupational diseases was 14.3% (95 %CI was 8.2%~20.4%, I2=94.4%), hepatobiliary diseases was 10.5% (95 %CI was 5.4%~15.5%, I2=98.9%) and gastrointestinal diseases was 8.4% (95 %CI was 5.5%~11.3%, I2=94.0%) in Chinese fighter pilots. Conclusions:The metabolic diseases, spinal diseases and hepatobiliary diseases are accounted for a relatively higher proportion among Chinese fighter pilots, and corresponding protective measures should be taken to improve the health level of pilots through the work of medical support departments at all levels.

Objective:To discuss the characteristics of common diseases of fighter pilots and provide evidence and support for improving the health level and combat capabilities of Chinese fighter pilots by the Meta-analysis of disease spectrum.Methods:The information of disease spectrum of Chinese fighter pilots was extracted from the literatures collected by SinoMed, China Academic Journal Network Publishing Database, China Scientific Journal Database, Wanfang Data and PubMed before December of 2020. STATA 16 and SPSS 26 software were used to make system evaluation for the constituent ratio of single disease, and the diseases were analyzed in subgroups by years.Results:Seventeen literatures, that published from 2002 to 2020, were collected for Meta-analysis and 9 431 persons were involved (aged from 20 to 60 years) based on the statistical analysis from 1965 to 2019. The results indicated metabolic diseases, spinal diseases, aviation occupational diseases, hepatobiliary diseases, etc.. The Meta-analysis showed that the proportion of spinal diseases was 29.5% (95 %CI was 20.8%~38.2%, I2=99.0%), metabolic diseases was 22.2% (95 %CI was 12.5%~31.8%, I2=99.5%), valvulopathy and arrhythmia was 15.1% (95 %CI was 7.3%~22.8%, I2=97.0%), aviation occupational diseases was 14.3% (95 %CI was 8.2%~20.4%, I2=94.4%), hepatobiliary diseases was 10.5% (95 %CI was 5.4%~15.5%, I2=98.9%) and gastrointestinal diseases was 8.4% (95 %CI was 5.5%~11.3%, I2=94.0%) in Chinese fighter pilots. Conclusions:The metabolic diseases, spinal diseases and hepatobiliary diseases are accounted for a relatively higher proportion among Chinese fighter pilots, and corresponding protective measures should be taken to improve the health level of pilots through the work of medical support departments at all levels.

Objective To research the pathogeny and the electromyographic characteristics of myokymia.Methods The clinical features and electromyography of 42 elderly patients with myokymia were examined. Results Symptomatic myokymia (SM) in 27 cases was caused by low salt syndrome, thyrotoxemia, urinaemia, chronic wasting diseases (such as carcinoma of the stomach or liver), brachial plexus neuropathy, lead poisoning, chronic inflammatory demyelinating polyradiculoneuritis, succinylcholine narcosis, restless leg syndrome or Isaac's syndrome.Symptomatic facial myokymia was caused by neoplasm of the brain stem or in posterior cranial fossa, multiple sclerosis or other causes. Primary myokymia ( PM ) in 15 cases involved idiopathic generalized and benign myokymia.Compared with PM, SM was more constant and powerful. Myokymia potential appeared in the electromyograms of 42 of the patients. The majority of patients with SM had accompanying myotonic discharge. Conclusion The pathogeny and electromyographic characteristics of symptomatic myokymia are different from the primary stage.