Objective:To assess the efficacy and prognosis of gastrointestinal stromal tumors(GIST)after preoperative targeted therapy us-ing the Choi criteria compared to pathological effects,and to observe the consistency between them.Methods:The clinicopathological data of 37 patients,who underwent preoperative treatment with targeted imatinib therapy for GIST,were retrospectively analyzed.Survival ana-lysis of the Choi criteria and pathological effects was conducted using the Kaplan-Meier method and Log-rank test.The consistency between the Choi criteria and the pathological effects was assessed using Spearman's correlation and Kappa tests.Results:The median preoperative treatment duration for the 37 patients was 10 months(range,2-36 months).According to the Choi criteria,there were no cases of complete response(CR),26 cases of partial response(PR),five cases of stable disease(SD),and six progressive disease(PD)cases.The difference in overall survival(OS)between the effective group(CR+PR)and the ineffective group(SD+PD)was statistically significant(P<0.01).Pathologic-al effects were evaluated as one complete effect,11 high effects,18 partial effects,and seven zero effect cases.The OS significantly differed between the effective(full effect+high effect+partial effect)and ineffective(zero effect)groups was statistically significant(P<0.01).The Choi showed moderate consistency with the pathological effects(r=0.592,P<0.01)with a(κappa=0.566).Conclusions:The Choi criteria were moderately correlated and consistent with the pathological effects.Both can be used to evaluate the efficacy and prognosis of preoperative targeted therapy for GIST.The combined use of these two criteria has better clinical application value than that of either alone.

Objective:To explore the clinical efficacy of 125I seeds implantation in treating cancer-induced pain and motor dysfunction caused by brachial plexus compression through neurophysiological monitoring. Methods:A retrospective study was conducted on 8 patients (4 males, 4 females; age 58-63 years) who underwent 125I seeds therapy for cancer-induced brachial plexus injury at Hebei Provincial People′s Hospital from January 2021 to August 2023. Pain severity was assessed by using the numerical rating scale (NRS) and motor function was evaluated by using the Fugl-Meyer (F-M) assessment. Electrophysiological monitoring was used to assess changes in sensory and motor branch conduction velocity (CV) of the musculocutaneous nerve, axillary nerve, median nerve, ulnar nerve, and radial nerve before and 3 months after treatment. Paired t-test was used for data analysis. Results:All 8 patients had moderate to severe pain (6 had motor dysfunction). The preoperative and postoperative NRS scores was 5.9±1.0 and 3.3±1.7, respectively ( t=4.93, P=0.002), while F-M scores was 44.8±7.6 and 54.8±5.7, respectively ( t=-3.52, P=0.017). Electrophysiological results showed that 7 patients had lesion involvement in the lower trunk of the brachial plexus, and 1 patient had involvement in the upper trunk. The preoperative and postoperative motor branch CV of the ulnar nerve was (47.2±2.6) and (59.7±8.2) m/s, respectively ( t=-3.17, P=0.034), while the sensory branch CV was (41.8±1.2) and (56.0±5.7) m/s, respectively ( t=-5.82, P=0.001). The nerve CV increased compared to the preoperative ones. Conclusions:125I seeds implantation has good clinical efficacy in treating cancer-related pain and motor dysfunction caused by brachial plexus compression. Changes in electrophysiology can quantitatively monitor the recovery of sensory and motor functions of the brachial plexus.

Objective To investigate the anticancer effect of tanshinone Ⅱ A(TⅡ A)on gastric cancer cells and its mechanism.Methods Gastric cancer cells AGS and BGC-823 were used in this study,the semi inhibi-tory concentration(IC50)of T Ⅱ A in gastric cancer cells AGS and BGC-823 were calculated based on MTT colorimetric assay.The appropriate concentration of T Ⅱ A was selected.The effects of T Ⅱ A on cell apoptosis and death were analyzed by flow cytometry.Gastric cancer cells AGS and BGC-823 were divided into control group,T Ⅱ A group and T Ⅱ A+ferroptosis inhibitor Fer-1 group(TⅡ A+Fer-1 group).The levels of gluta-thione(GSH),cysteine(Cys),reactive oxygen species(ROS)and lipid peroxidation in each group were detec-ted and compared.The potential targets of T Ⅱ A were screened and verified by traditional Chinese medicine system pharmacology and String database.The levels of glutamate/cystine transporter(xCT)in each group were detected by Western blot,and the mRNA levels of TP53,solute carrier 7 family 11 members(SLC7A11),and prostaglandin peroxide endosynthase 2(PTGS2)were detected by real-time fluorescence quantitative PCR.Results TⅡA had a good anticancer effect on gastric cancer cells AGS and BGC-823 with IC50 of 2.880 μg/mL and 2.350 μg/mL,respectively.TⅡA could inhibit the growth and promote apoptosis and death of gastric cancer cells AGS and BGC-823.TⅡA treatment reduced GSH and Cys levels(P＜0.05),increased ROS and lipid peroxidation levels(P＜0.05),and finally induced ferroptosis in AGS and BGC-823 cells.Database analysis showed that TP53 was an important target of T Ⅱ A.T Ⅱ A promoted the expression of TP53 and inhibited the expression of xCT.Fer-1 attenuated the effects of T Ⅱ A on the expression of TP53 and xCT.After adding TP53 inhibitor,the effects of T Ⅱ A on SLC7A11,PTGS2,and TP53 were weakened(P＜0.05).Conclusion TⅡA has a good anticancer effect on gastric cancer cells AGS and BGC-823,and it could promote ferroptosis of gastric cancer cells through TP53/xCT pathway.

Objective:To explore the diagnostic efficacy difference and clinical diagnostic value of chronic lymphocytic leukemia flow (CLLflow) score and Moreau score (MS) in the diagnosis of chronic lymphocytic leukemia (CLL).Methods:According to the latest international and national diagnosis criteria for CLL, 133 patients with B-cell chronic lymphoproliferative diseases and uncertain immunophenotypes (B-CLPD), diagnosed by Zhengzhou Jinyu Comprehensive Haematological Pathology Diagnosis Centre from March 2020 to May 2021, were included in this study. Above patients were divided into the CLL group ( n=83) and non-CLL group ( n=50). The expression of clusters of differentiation (CD)5, CD10, CD20, CD19, κ light chain, λ light chain, FMC7, CD23, CD22, surface immunoglobulin M, CD200 and CD79 were detected by flow cytometry, and CLLflow score and MS score were calculated respectively according to the scoring rules. A fourfold table was used to compare the diagnostic efficacy of the two scoring systems, and the Kappa test and McNemar test were used to compare the consistency and superiority of the systems. Results:The rate of negative and positive CLLflow score were 4.8% (4/83) and 95.2% (79/83) in the CLL group and were 80.0% (40/50) and 20.0% (10/50) in the non-CLL group, and respectively (both P<0.001). The MS score (≤2, =3 and≥4) was 1.2% (1/83), 10.8% (9/83) and 88.0% (73/83) in the CLL group and was 86.0% (43/50), 14.0% (7/50) and 0 in the non-CLL group, there were significant statistical difference between the two groups ( P<0.001). The sensitivity, specificity, positive predictive value and negative predictive value of the CLLflow score were 95.2% (79/83), 80.0% (40/50), 88.8% (79/89) and 90.9% (40/44), respectively and those of MS score were 98.8% (82/83), 86.0% (43/50), 92.1% (82/89) and 97.7% (43/44) respectively. The overall coincidence rate, positive and negative coincidence rate between the CLLflow score and MS score were 91.0% (121/133), 93.3% (83/89) and 86.4% (38/44) respectively. Besides, the McNeamr dominance test presented no significant difference ( P>0.05) and high consistency (Kappa=0.796) between the two scoring systems. With MS≤2 and MS≥4, the sensitivity and the specificity of the MS score were 100% (73/73) and 97.7% (43/44) respectively, and for the CLLflow score, the sensitivity and the specificity were 97.3% (71/73) and 86.4% (38/44) in this MS range. With MS = 3, the sensitivity and specificity of the MS score were 100% (9/9) and 0 (0/7), and CLLflow was 88.9% (8/9) and 57.1% (4/7). Conclusions:The diagnostic efficacy is similar and presents high consistency between the CLLflow score and MS score in CLL diagnosis. For CLL patients with MS = 3, the specificity of MS is relatively low, combined assessment with CLLflow score could improve the diagnosis efficacy for CLL in these patients.

OBJECTIVE：To establis h the evaluation model of hospital pharmacist post value of dispensing department ，and to provide scientific basis for optimizing the performance management of pharmacists in despensing department in hospital. METHODS：Based on factor counting method ，combined with questionnaire ，Delphi expert correspondence method and so on ，the hospital pharmacist post value evaluation model was established. Based on this ，the relative value scores of the pharmacists in the dispensing department was determined. RESULTS ：Hospital pharmacist post value evaluation model was established with 5 evaluation dimensions （knowledge，skills，responsibility，work autonomy ，work environment and intensity ，of which the first level weight coefficients were 0.194，0.166，0.365，0.216 and 0.058，respectively）and 31 evaluation elements. The above 5 evaluation dimensions contained 5，8，9，3，6 evaluation elements ，respectively，and the corresponding second-level weights were 0.052-0.431 （for example ，responsibility dimension with the highest weight ，including quality and safety control ，decision responsibility，responsibility for finance and assets ，the corresponding second-level weight coefficients were 0.279，0.140，0.132， respectively）. The relative value scores of 13 pharmacist post were 342.9-840.4 in the dispensing department of our hospital with this model ，among which the department responsible person had the highest score （840.4）and the prescription post score was the lowest（342.9）. CONCLUSIONS ：The hospital pharmacist post value evaluation model constructed by factor counting method can provide a scientific and reliable theoretical basis for realizing the rewards of different positions in the dispensing department.

Objective: To report the experience on the multi-disciplinary management of metastatic renal cell (mRCC) patients in a single center. Methods: Data of 168 mRCC patients treated by multi-disciplinary team (MDT) at Sun Yat-sen University Cancer Center from December 2007 to February 2019 was retrospectively analyzed.Three treatment groups were identified, including 76 patients with 55 males and 21 females, received anti-angiogenic agents alone (Group A), 66 patients with 55 males and 11 males, received anti-angiogenic agents plus local therapy (Group B)and 26 patients, with 19 males and 7 females, received anti-angiogenic agents plus immunotherapy and local therapy (Group C). The Sunitinib, Sorafenib, Axitinib were chosen for the TKI. The Pembrolizumab was used for immunotherapy. The stereotactic body radiation therapy and surgical excision were considered as the local therapy. The study aims to compare the age, gender, IMDC score, pathology, nbephrectomy, adverse events, progression-free survival and overall survival (OS). Results: Of all patients, the median follow-up duration was 23 months (ranging 6-117 cmonths). The PFS was 18.3 months and median OS was 33.5 months. The 2 years and 5 years survival rate was 66% and 35%, respectively. The median OS of Group A, B and C were 29.8 months, 44.6 months and not reached. 2y-OS was 58%, 67% and 89%, while 5y-OS 12%, 46% and 57%.There was no difference in age, gender, IMDC score, pathology, synchronous metastases or nephterectomy between the three groups. The prognostic result in TKI based combination therapy was superior to TKI therapy alone, which the 5y-OS was 51% and 11%, respectively. The prognostic result in group C's moderate-high risk mRCC patients was superior to group A and B. The median OS in TKI+ DC and CIK+ Pembrolizumab was 49.1 months and 53.1 months. On univariate analyses, IMDC score, nephrectomy and treatment group was associated with OS (P<0.05). On multivariate analyses, treatment group, nephrectomy was associated with OS (P<0.05). The risk of death of Group C decreased about 60% [HR 0.39 (0.17, 0.89), P=0.026]. 78 (46.4%) patients on TKI alone and 16 (61.5%) patients treated with TKI plus immunotherapy had Grade 3 or 4 adverse events. 16 (20.3%) patients had Clavien Ⅲ-Ⅳ toxicity after surgical procedures. 6 (5.7%) patients had Grade 3 toxiciy after SBRT. Conclusions Patients treated with combined therapy had better survival than those treated with anti-angiogenic agents alone. MDT approach could bring survival benefit to mRCC patients.

Objective: To investigate the application value of Information-Motivation-Behavioral Skill Model (IMB)-based continuing care on the recovery of nerve function and life quality in patients with stroke after thrombolytic therapy. Methods: Stroke patients who underwent thrombolytic therapy were randomly assigned to IMB group(35 cases) and control group(35 cases) according to the method of random number table. The control group recieved routine thrombolysis nursing, IMB group was given IMB-based continuing care. After six months of intervention, nerve function was evaluated by National Institute of Health Stroke Scale(NIHSS) and Modified Rankin Scale(MRS), the active ability was performed by Fugl-Meyer Assessment Scale(FMA) and Barthel Index(BI), the quality of life was assessed by the item short from health survey(SF-36), respectively. Results: Before intervention, the scores of NIHSS, MRS, FMA, BI, SF-36 between two groups was no significant difference (P>0.05). After three and six months of nursing, the NIHSS, MRS was (7.84±2.20), (5.00±1.60) points and (3.48±0.84), (3.07±0.69) points in IMB group, and (9.75±1.82), (8.21±1.37) points and (4.06±1.08), (3.91±0.71) points in control group, there was significant difference between two groups (t =2.417-8.647, P<0.01 or 0.05). After one, three and six months of intervention, FMA was (65.86±5.67), (76.41±8.47), (78.79±8.58) points, BI was (46.29±7.29), (58.09±10.20), (67.50±9.44) points, SF-36 was (33.13±4.64), (43.09±6.70), (49.83±8.56) points in IMB group, (58.53±8.92), (64.47±7.56), (71.81±8.90) points, (42.47±5.67), (48.74±5.39), (56.03±6.55) points and (29.63±4.06), (35.91±5.93), (41.02±9.05) points in control group, there was significant difference between two groups (t =2.333-5.972, P< 0.05). Moreover, in the repeated measures ANOVA showed the differences of NIHSS, MRS, FMA, BI, SF-36 were statistically significant for the group by time interaction(F=13.556-133.994, P<0.05). Conclusions IMB-based continuing care can promotes the recovery of nerve function and improves the quality of life in patients with stroke after thrombolytic therapy.

The number of H7N9 bird flu cases was high and the situation was grim in guizhou province in 2017. To understand the molecular characteristics of the hemagglutinin gene (HA) and the risk of human infection with avian influenza virus A(H7N9) in Guizhou Province, 2017. Homology, genetic evolution and pivotal sites related to receptor binding regions, pathogenicity and potential glycosylation of 14 avian influenza viruses A(H7N9) were analyzed by a series of bioinformation softwares. It was cleared that there was 95.9%-100% similarity among 14 strains in nucleotide of the HA gene, and there were 96.8%-97.8% and 96.8%-97.9% similarities with vaccine strains A/Shanghai/2/2013 and A/Anhui/1/2013 recommended by WHO, respectively. Phylogenetic analysis showed that 14 HA genes were directly evolved in the Yangtze River Delta evolution branch, but they could be derived from five diffenrent strains. Then 13 of 14 strains cleavage site sequences of HA protein revealed they were low pathogenic avian influenza viruses, while A/Guizhou-Weining/CSY01/2017 was high pathogenic avian influenza virus. Mutation G186V at the receptor binding sites in the HA was found in all 14 strains, and mutation Q226L in 13 strains besides A/Guizhou-Weining/CSY01/2017. All five potential glycosylation motifs in the HA were conservative.

Objective To explore the application effects of nursing team in patients with acute multiple trauma in multiple disciplinary team (MDT) model. Methods A convenient sampling method was used to select 82 patients with multiple injuries who were treated since the establishment of the trauma center in the First Affiliated Hospital of Zhengzhou University from July 2016 to June 2018. From July 2014 to June 2016, a total of 55 patients with multiple trauma before the establishment of the trauma center were seclected as the control group. The experimental group was used MDT model for rescue, and the control group was used traditional model for rescue. The doctors' arrival time, emergency examination time, emergency stay time, rescue success rate and postoperative complication rate of the specialists in the two groups were compared. Results The doctors' arrival time in the experimental group was (16.80±3.57) min, the time of emergency examination was (22.36±3.49) min, and the time of emergency stay was (38.19±8.18) min, which was shorter than those of the control group (23.27±5.76), (45.69±7.75), (55.49±13.67) min, the differences between the two groups were statistically significant (P＜0.01). The successful rescue rate of the treatment group was 96.3% (79/82), which was higher than 87.3% (48/55) of the control group. The difference between the two groups was statistically significant (P＜ 0.05). The postoperative complication rate was 3.7% (3/82) in the experimental group and 12.7% (7/55) in the control group, the difference between the two groups was statistically significant (P＜ 0.05). Conclusions Patients with multiple trauma received treatment with MDT model can effectively shorten the time of doctors' arrival, emergency examination time, emergency stay time, improve the success rate of treatment, and reduce the incidence of postoperative complications.