Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

Objective: To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra-gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST). Methods: A retrospective case - control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra - gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann-Whitney U-test. Survival curves were drawn by the Kaplan-Meier method and compared with the Log-rank test. Results: Of the 20 EGIST patients, 8 were males and 12 were females with age of 61.0 (30.0 to 86.0) years and of the 32 DGIST patients, 12 were males and 20 were females with age of 55.5 (27.0 to 70.0) years. Compared with DGIST patients, EGIST patients were older (U=188.000, P=0.012], had larger tumor size [10.0 (3.0 to 29.0) cm vs. 4.0 (1.5 to 10.0) cm, U=98.500, P<0.001] and higher ratio of high risk classification [85.0% (17/20) vs. 12.5% (4/32), χ²=26.870, P<0.001]. Among the 20 EGIST patients, 5 were diagnosed with distal metastasis and received imatinib (400 mg/d), and the other 15 patients underwent radical resection who were included in survival analysis. All the 32 DGIST patients underwent radical resection. The median follow-up of whole group was 43 (14 to 76) months. The 3-year recurrence/metastasis-free survival rate of 15 cases undergoing radical resection in the EGIST group was 85.6%, which was lower than that of the DGIST group (88.6%), and the difference was not statistically significant (P=0.745). There was no significant difference in the 3-year overall survival rate between the EGIST group (92.9%) and the DGIST group (100%) (P=0.271). Conclusions As compared to DGIST, EGIST mostly occurs in those with older age, larger tumor size and higher risk grade. The prognosis of EGIST patients after radical resection is similar to that of DGIST patients.

Objective To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra?gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST). Methods A retrospective case?control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra?gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann?Whitney U?test. Survival curves were drawn by the Kaplan?Meier method and compared with the Log?rank test. Results Of the 20 EGIST patients, 8 were males and 12 were females with age of 61.0 (30.0 to 86.0) years and of the 32 DGIST patients, 12 were males and 20 were females with age of 55.5 (27.0 to 70.0) years. Compared with DGIST patients, EGIST patients were older (U=188.000, P=0.012], had larger tumor size [10.0 (3.0 to 29.0) cm vs. 4.0 (1.5 to 10.0) cm, U=98.500, P<0.001] and higher ratio of high risk classification [85.0% (17/20) vs. 12.5% (4/32), χ2=26.870, P<0.001]. Among the 20 EGIST patients, 5 were diagnosed with distal metastasis and received imatinib (400 mg/d), and the other 15 patients underwent radical resection who were included in survival analysis. All the 32 DGIST patients underwent radical resection. The median follow?up of whole group was 43 (14 to 76) months. The 3?year recurrence/metastasis?free survival rate of 15 cases undergoing radical resection in the EGIST group was 85.6%, which was lower than that of the DGIST group (88.6%), and the difference was not statistically significant (P=0.745). There was no significant difference in the 3?year overall survival rate between the EGIST group (92.9%) and the DGIST group (100%) (P=0.271). Conclusions As compared to DGIST, EGIST mostly occurs in those with older age, larger tumor size and higher risk grade. The prognosis of EGIST patients after radical resection is similar to that of DGIST patients.

Objective To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra?gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST). Methods A retrospective case?control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra?gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann?Whitney U?test. Survival curves were drawn by the Kaplan?Meier method and compared with the Log?rank test. Results Of the 20 EGIST patients, 8 were males and 12 were females with age of 61.0 (30.0 to 86.0) years and of the 32 DGIST patients, 12 were males and 20 were females with age of 55.5 (27.0 to 70.0) years. Compared with DGIST patients, EGIST patients were older (U=188.000, P=0.012], had larger tumor size [10.0 (3.0 to 29.0) cm vs. 4.0 (1.5 to 10.0) cm, U=98.500, P<0.001] and higher ratio of high risk classification [85.0% (17/20) vs. 12.5% (4/32), χ2=26.870, P<0.001]. Among the 20 EGIST patients, 5 were diagnosed with distal metastasis and received imatinib (400 mg/d), and the other 15 patients underwent radical resection who were included in survival analysis. All the 32 DGIST patients underwent radical resection. The median follow?up of whole group was 43 (14 to 76) months. The 3?year recurrence/metastasis?free survival rate of 15 cases undergoing radical resection in the EGIST group was 85.6%, which was lower than that of the DGIST group (88.6%), and the difference was not statistically significant (P=0.745). There was no significant difference in the 3?year overall survival rate between the EGIST group (92.9%) and the DGIST group (100%) (P=0.271). Conclusions As compared to DGIST, EGIST mostly occurs in those with older age, larger tumor size and higher risk grade. The prognosis of EGIST patients after radical resection is similar to that of DGIST patients.

Objective To compare the lung volume before and after the operation for the treatment of chronic empyema with CT 3-dimensional imaging,and to evaluate its role in the assessment of pulmonary function. Methods A total of 78 patients with chronic empyema from 2000 to 2016 in our hospital were enrolled in this study.The patients were divided into two groups according to the operational styles,with 47 cases in the decortication group and 31 cases in the catheter drainage group respectively.Reformation of the chest CT data was used to determine the lung volumes and the routine pulmonary function tests(PFT)were performed before and after the operation. The lung volumes and the PFT results before and after the operation were compared between the two groups with t test. Then multiple linear regression analysis was applied to test the relationship between the lung volumes and the values of PFT after the operation. Results The mean lung volume of catheter drainage group was(1 548±467)cm3,while it was(1 418±802) cm3for the decortication group preoperatively(t=1.665,P=0.07).After the operation,the mean lung volume of decortication group was(2 677±815)cm3,while it was(2 169±185)cm3for the catheter drainage group. There was statistically significant difference for the increase of lung volume between the two groups after operation(t=2.371,P<0.05).There was no significant difference between the two groups before the operation for the values of the PFT(t=1.467 to 1.874,P>0.05). After the operation, the values of the PFT in the decortication group were higher than those in the catheter drainage group(t=1.990 to 2.799, P<0.05). The changes of postoperative lung volume were positively correlated with the values of the PFT(β=0.312 to 0.701,P<0.05). Conclusions Decortication has a better effect on the lung volume and the pulmonary function for patients suffered from chronic empyema. CT modeling (3-dimensional-imaging) is an effective method for evaluating the pulmonary function of postoperative lung according to the lung volume measurement.

Objective: To investigate the effect of alendronate on serum total alkaline phosphatase (AKP) and bone specific alkaline phosphatase (BAP) in the elderly female patients with postmenopausal osteoporosis and explore their correlations.Methods: A retrospective study was performed.Totally 286 elderly female patients with postmenopausal osteoporosis were divided into two groups(according to AKP levels before the treatment of alendronate): the normal AKP group (n=245) and the elevated AKP group (n=41).Raised AKP of all the patients in the elevated AKP group was not associated with hepatobiliary problems.The changes of AKP and BAP levels were analyzed after the treatment of alendronate.The correlations between BAP and AKP levels before and after the treatment of alendronate were analyzed, as well as between the changes in AKP (ΔAKP) and BAP (ΔBAP) levels.Results: AKP and BAP tended to be higher in elderly patients.BAP levels in the normal AKP group were higher than those in the elevated AKP group (P＜0.05).BAP was signicantly correlated with AKP both before and after the treatment (P＜0.05), as well as the correlation between ΔAKP and ΔBAP (P＜0.05).Conclusion: AKP and BAP both tend to increase with age.In elderly female patients with postmenopausal osteoporosis and elevated AKP associated with non-hepatobiliary problems, alendronate treatment can lower AKP levels, and the decrease is strongly correlated with the decrease in BAP.

Objective To study the influence of volume change of tumor bed on radiotherapy dose volume distribution after breast conserving surgery for early breast cancer.Methods 13 early breast cancer patients received breast-conserving surgery were selected.For all 3 CT scanning in patients with tumors,row delineation of tumor and normal tissue target positioning,the tumor bed after volume as well as the planned radiation dose volume were compared in three times of scans.Results 13 cases of three CT scans of patients with tumor bed volume point to (32.85±9.30)cm3,(24.50±4.71)cm3,(16.48±4.46)cm3,there were statistically significant differences before and after(t=2.888,5.723,4.458,all P<0.05);3 planned radiation dose in patients with volume was stepped down,and the differences were statistically significant (F=20.28,96.32,14.21,16.75,26.29,all P<0.001).Conclusion Earlier the tumor bed following breast surgery volume decreased rapidly,tumor volume change will affect the target area of the bed covers and the exposure of normal tissue dose-volume.

Objective:To explore the protective effect of Wuzhi capsules on vancomycin-induced kidney injury in rats and investi-gate the action mechanism. Methods:Totally 24 male SD rats were randomly divided into the blank control group,the model control group and the model test group with 8 ones in each. The rats in the model control group and the model test group were intravenously in-jected vancomycin via tail veil,200 mg·kg-1per day for 10 consecutive days,while those in the blank control group were injected sa-line at the same volume. Meanwhile,the rats were orally administered Wuzhi solution(0.25 g·kg-1) in the model test group and sa-line at the same volume in the blank control group and the model control group. The levels of 24-h microalbuminuria(MALB),neutro-phil gelatinase associated lipocalin(NGAL) and kidney injury molecule 1 (KIM-1) in urine were determined,and those of cystatin C (Cys C),serum creatinine (Scr) and blood urea nitrogen(BUN) in serum and those of superoxide dismutase(SOD),malondialde-hyde(MDA) and glutathione peroxidase(GSH-Px) in renal tissues were also determined. Results:The levels of the renal index,Cys C,Scr,BUN,MALB,NGAL,KIM-1 and MDA in the model control group and the model test group were significantly higher than those in the blank control group,and those in the model control group were significantly higher than those in the model test group(P<0.05 or P<0.01). The levels of SOD and GSH-Px in the model control group and the model test group were significantly lower than those in the blank control group,and those in the model control group were significantly lower than those in the model test group(P<0.05). Conclusion:Wuzhi capsules can effectively relieve vancomycin-induced renal injury in rats probably by inhibiting the oxida-tive reaction.

Aliphatic amines in infant food packaging materials were extracted and concentrated by 0 . 5 mL of acidified methanol using gas purge microsyringe extraction ( GP-MSE ) . Pre-column fluorescence labeling of amines was achieved in mild conditions with 10-ethyl-acridine-2-sulfonyl chloride ( EASC ) as labeling reagent. The derivatization was carried out at 60℃ and pH 10. The derivatives were successfully separated on a Hypersil GOLD column with excitation and emission wavelengths of 262 and 430 nm, respectively. The detection limits were in the range of 0. 4-0. 6 μg/kg, and the quantitation limits were in the range of 1. 2-2. 1 μg/kg. All analytes were in good linearity in the concentration range of 2. 0-2000 μg/L with correlation coefficients of higher than 0. 998. The developed method was characterized by celerity, accuracy and high sensitivity. It was successfully applied to the determination of aliphatic amines in infant food packaging materials.