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Objective:To summarize the atypical manifestations and treatment strategies of serous microcystic neoplasm of the pancreas.Methods:Review the case data of 11 cases of pancreatic serous microcystic adenoma with atypical preoperative clinical imaging findings admitted to Peking Union Medical College Hospital from July 2008 to October 2019, and summarize their clinical manifestations, CT/MRI features, and preoperative clinical diagnosis, surgical methods, postoperative conditions.Results:The median age of the 11 patients was 50 (46-66) years old, 7 females, and 4 males. There were 8 cases with back pain and 6 cases with weight loss. The preoperative imaging examination found that the lesion was located in the head and neck in 8 cases, with pancreaticobiliary duct dilatation in 7 cases, suspected vascular invasion in 3 cases, and pancreatic parenchymal atrophy in 2 cases, 3 cases showed rich blood supply and solid space, and 2 cases were connected to the pancreatic duct. Preoperative diagnosis of pancreatic malignant tumors accounted for 4 cases, neuroendocrine tumors in 3 cases, solid pseudopapillary tumors in 3 cases, and intraductal papillary mucinous tumors in 1 case. All patients underwent surgical treatment, 3 cases of distal pancreatectomy (2 cases of using Kimura method to protect the spleen), 3 cases of pancreaticoduodenectomy, 1 case of total pancreatectomy, 2 cases of pancreatic head resection with duodenum preservation, 2 cases of local resection. All patients had no early postoperative deaths. There were 2 cases of grade B pancreatic fistula, 2 cases of biochemical leakage, 1 case of postoperative abdominal hemorrhage, and 2 cases of delayed gastric emptying, all of which were cured after active treatment. The median postoperative hospital stay was 18 (7-63) days.Conclusions:Pancreatic serous microcystic neoplasm could be accompanied by atypical features such as pancreatic/bile duct dilation, parenchyma atrophy, or even present vessel invasion. Understanding the atypical clinic and image features would help improving differential diagnosis and treatment. For those with invasive features, surgical exploration should be recommended.
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Objective:To investigate the effects of three reconstruction methods after gastrectomy on long-term quality of life in patients with stage Ⅰ proximal gastric cancer.Methods:A retrospective study was performed on 157 cases including respectively total gastrectomy with Roux-en-Y anastomosis (TG+RY group, 75 cases), 39 cases of proximal gastrectomy with esophagogastrostomy (PG+EG group) and 43 cases of proximal gastrectomy with jejunal interposition anastomosis (PG+JI group). The primary outcomes were evaluated in terms of alimentary tract symptoms, nutritional status of postoperative patients and long-term complications. Secondary outcomes pertaining to safety and long-term survival status were included as well.Results:The improvement of Visick grading in PG+JI and TG+RY group were better than that in PG+EG group ( P adj<0.01); The nutritional status of PG+JI group was better than TG+RY group and PG+EG group ( P adj<0.01); PG+JI group and PG+EG group had extra complications related to remnant stomach, but there was no significant difference in anastomotic and biliary related complications among the three groups; The incidence of reflux esophagitis in PG+JI group was significantly lower than that in PG+EG group ( P adj<0.01). There was no significant difference between the three groups in operation time, intraoperative blood loss, early postoperative complications, pathological results, 5-year cumulative survival rate and 5-year disease-free survival rate ( P>0.05). Conclusions:PG+JI improves the long-term quality of life for patients with stage Ⅰ proximal gastric cancer compared to TG+RY and PG+EG .
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Objective:To investigate the relationship between Tei index and right heart function in patients with pneumoconiosis complicated with pulmonary heart disease (PHD).Methods:108 cases of pneumoconiosis patients with PHD in our hospital from January 2018 to January 2020 were randomly selected and divided into three groups according to the X-ray diagnostic criteria of pneumoconiosis, including 50 cases in stage Ⅰ group, 25 cases in stage Ⅱ group and 33 cases in stage Ⅲ group. All patients were examined by ultrasonic cardiography (UCG); the right ventricular Tei index and brain natriuretic peptide (BNP) levels, right ventricular outflow tract (ROVT) diameter, main pulmonary artery (MPA) diameter, right ventricular anterior wall thickness (RVAW), right ventricular diameter (RV), right atrial diameter (RA), pulmonary artery pressure (PASP), Tei index were compared in groups; Pearson correlation analysis was used to analyze the correlation between UCG index and BNP level; multiple linear regression analysis was used to analyze the influencing factors of BNP.Results:The levels of RV, Tei index and BNP in Ⅰ stage group were significantly lower than those in Ⅱ stage group, and the levels of RV, Tei index and BNP in Ⅱ stage group were significantly lower than those in Ⅲ stage group ( P<0.05). There was no difference in ROVT, MPA, RVAW, RA, PASP in the three groups ( P>0.05). Pearson correlation analysis showed that ROVT, RV, Tei index in UCG indicators and BNP level were positively correlated ( P<0.05); multiple linear regression analysis showed that RVAW and Tei indexes were the main influencing factors of BNP levels ( P<0.05). Conclusions:The right heart Tei index of patients with pneumoconiosis and PHD has a good correlation with BNP level, and is the main influencing factor of BNP level, which can make up for BNP deficiency and effectively evaluate the right heart function of patients.
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Objective To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old.Methods In the present study,a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December,2012.Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy,as well as at 6 months and 12 months postpartum.Neurodevelopment at 2 years was assessed,using the Child Behavior Checklist.We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95％CIs,on children's behavioral problems at 2 years of age.Sensitivity analyses were performed among participants without postpartum depressive symptoms.Results After adjustment on factors as maternal age,gestation week,average monthly income per person,parental education and children's gender etc.,maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR =2.61,95％ CI:1.36-4.99) and internalizing problems (RR=1.94,95％ CI:1.22-3.08).However,maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46,95％CI:3.09-13.53),withdrawn (RR=2.42,95％CI:1.16-5.02),aggressive (RR=2.93,95 ％CI:1.45-5.94),internalizing (RR =1.79,95 ％CI:1.01-3.16) or externalizing problems (RR =2.56,95％ CI:1.49-4.42).In sensitivity analysis,antenatal maternal depression was found positively associated with children's emotional,internalizing and externalizing problems and the differences all statistically significant.Conclusions Maternal depression during pregnancy might increase the risks of children's behavioral problems.In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status,monitoring program regarding maternal mental health care should be strengthened.
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Objective To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old.Methods In the present study,a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December,2012.Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy,as well as at 6 months and 12 months postpartum.Neurodevelopment at 2 years was assessed,using the Child Behavior Checklist.We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95％CIs,on children's behavioral problems at 2 years of age.Sensitivity analyses were performed among participants without postpartum depressive symptoms.Results After adjustment on factors as maternal age,gestation week,average monthly income per person,parental education and children's gender etc.,maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR =2.61,95％ CI:1.36-4.99) and internalizing problems (RR=1.94,95％ CI:1.22-3.08).However,maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46,95％CI:3.09-13.53),withdrawn (RR=2.42,95％CI:1.16-5.02),aggressive (RR=2.93,95 ％CI:1.45-5.94),internalizing (RR =1.79,95 ％CI:1.01-3.16) or externalizing problems (RR =2.56,95％ CI:1.49-4.42).In sensitivity analysis,antenatal maternal depression was found positively associated with children's emotional,internalizing and externalizing problems and the differences all statistically significant.Conclusions Maternal depression during pregnancy might increase the risks of children's behavioral problems.In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status,monitoring program regarding maternal mental health care should be strengthened.
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To observe and analyze the effect of CT-guided drug injection around the nerve root in the treatment of lumbar disc herniation the 140 patients diagnosed with lumbar disc herniation in our hospital, were selected as the study subjects for CT-guided drug injection around the nerve root and treatment efficacy was observed. According to the modified Mac Nab criteria, there were 80 cases, 50 cases, 6 cases of excellent and good rate at 92.86%; the patients whose onset time was less than three months and more than three months were compared in terms of VAS scores before and after surgery. The result showed that the postoperative pain score was significantly lower in patients whose onset time was less than three months compared to those whose onset time was more than three months, P<0.05; observation of patients' quality of life before and after treatment shows great improvement in quality of life after treatment, P<0.05. the treatment of lumbar disc herniation with CT-guided drug injection around the nerve root can achieve relatively good results with significantly improved therapeutic effect and grear application value
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Objective To investigate the related prognostic factors of stage Ⅳ gastric cancer.Methods The clinical data of 248 patients with stage Ⅳ gastric cancer and intact follow up data in the Tumor Prevention and Treatment Center of Sun Yat-Sen University from 2000 to 2010 were retrospectively summarized.The twelve clinicopathological parameters served as the observation indicators,including age,sex,body mass reduction,H b,CEA,CA19-9,Borrmann type,tumor location,tumor size,pathological pattern,operative mode,metastatic sites and therapeutic model.The survival curve was drawn by using the Kaplan-Meier method.The median survival time was calculated.The univariate analysis was conducted with Log-rank test.The prognosis multivariate analysis was conducted by the Cox's proportional hazards regression analysis.Results MST in the patients of whole group was 254 d.The univariate analysis showed that sex,Borrmann type and therapeutic mode were the related factors afecting gastric cancer prognosis,while the Cox regression model revealed that above 3 indicators were also independent factors affecting the prognosis of the patients with stage Ⅳ gastric cancer in this group(P＜0.05).Conclusion The treatment mode is an important independent factor affecting the survival of stage Ⅳ gastric cancer,the translational medicine model of palliative chemotherapy combined with palliative operation conduces to improve the prognosis in the patients with stage Ⅳ gastric cancer.
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BACKGROUND:Most bone marrow mesenchymal stem cel s are infused intravenously and have very low efficiency of homing to the bone marrow. However, cel infusion via the femoral approach is little reported. OBJECTIVE:To explore the distribution of luciferase gene modified red fluorescent protein transgenic bone marrow mesenchymal stem cel s in vivo through different infusion routes. METHODS:Luciferase gene modified bone marrow mesenchymal stem cel s at different gradients (5×106, 1×106, 1×105, 1×104) were seeded or injected into the in vitro pore plate or free femurs to observe the fluorescence imaging and select the best concentration of cel s. Luciferase gene modified bone marrow mesenchymal stem cel s at the best cel concentration were injected into the mice via the femur and the tail vein, respectively. The distribution of fluorescence and cel number in the mice were explored by using bioluminescence, pathological examination, flow cytometry and quantitative PCR. RESULTS AND CONCLUSION:Ex vivo fluorescence intensity of luciferase gene modified bone marrow mesenchymal stem cel s was positively correlated with the cel concentration;fluorescent cel s in vivo appeared in the femur first and then quickly spread to the lungs in the femur group, while fluorescent cel s in the tail vein group spread to the lungs quickly after cel infusion. Fluorescent cel s could be seen in the spleen, liver and other organs 24 hours later in the two groups. The distribution and migration of cel s in mice could be observed successful y by bioluminescence;5 minutes after cel infusion, the lungs of mice in the two groups began to emit fluorescence that could spread to the liver, spleen and other tissues 24 hours later, and the fluorescence intensity reached its peak after 15 minutes. The distribution of bone marrow mesenchymal stem cel s in mice had no significant difference between the femur group and the tail vein group. To conclude, cel injection through the bone marrow cavity and tail vein fails to promote the homing of bone marrow mesenchymal stem cel s to the bone marrow.
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Objective To observe the clinical efficacy of reinforcing and reducing by acupuncturing at lower He-sea points along and against channel's direction in treating gastroesophageal reflux disease (GERD).Method Sixty-one GERD patients were randomized into a treatment group of 34 cases and a control group of 27 cases. The treatment group was intervened by reinforcing and reducing by acupuncturing at lower He-sea points along and against channel’s direction, while the control group was treated with oral administration of Omeprazole tablets. The two groups were intervened once a day, 4 weeks in total. The clinical efficacies in the two groups were compared based on the symptoms scores before and after the treatment.Result The total effective rate was 97.1% in the treatment group versus 85.2% in the control group, and the difference was statistically significant (P<0.05). The relapse rate 6 months after the treatment was 16.7% in the treatment group versus 50.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Reinforcing and reducing by acupuncturing at lower He-sea points along and against channel’s direction is an effective approach in treating GERD.
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Objective To realize scientific allocation of medical monitors in clinical departments by evaluating quantitatively their social and economic benefits.Methods Analyses were executed on social and economic benefit indexes,including number or times of patients involved,utility time,volatility of utilization rate (VOUR),payback period and investment yield.Results Totally 457 monitors were involved in the study from January to June 2015,and the monitors had the number or times of patients being 20,utility time being 383 h,VOUR lower than 10％ (except that of February),mean payback period being 0.64 a and yearly mean investment yield being 137％.Conclusion The monitor has to be allocated by the equipment division in case of low social benefit.In case of high social benefit while low economic benefit,the monitor manufactured in China gains advantages due to short payback period,high investment yield and long free warranty time.The foreign monitor with specific function has to be selected in case of high social and economic benefits as well as requirements on special function.
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Surgery remains the primary treatment for patients with localized gastrointestinal stromal tumor (GIST), however, even after complete resection of the tumor, there is still a part of patients with tumor recurrence and metastasis. Imatinib, as adjuvant therapy in GIST patients with intermediate and high risk of recurrence, can significantly improve the disease-free survival, but whether it can prolong the overall survival is still unknown. It has reached a consensus that the intermediate and high risk patients should receive adjuvant therapy, but the duration for adjuvant therapy is still under investigation, especially for high-risk patients. Adjuvant therapy is recommended for at least 3 years, while in the end of adjuvant therapy, some patients still develop recurrence and metastasis. In 2017, results from PERSIST-5 study reported by the ASCO conference indicated that 5-year adjuvant therapy may further prolong disease-free survival of intermediate and high risk patients. In addition, adjuvant therapy is still not individualized based on the combination with different genotypes, and present adjuvant therapy is recommended for GIST patients with positive CD117 and intermediate-high risk of recurrence. It remains controversial whether different genotypes are associated with alternative adjuvant treatment options. Results of more researches are expected to provide better guidance for clinical treatment in the future.
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<p><b>OBJECTIVE</b>To explore the effects of electroacupuncture (EA) on behavioral function and synaptic plasticity in hippocampal CA3 area in rats with chronic stress depression.</p><p><b>METHODS</b>According to the random number table method, 144 SD male rats were assigned into a blank group, a model group, an EA group and a fluoxetine group, then each group was divided into a 7 d subgroup, a 14 d subgroup and a 21 d subgroup, 12 rats in each subgroup. The chronic mild unpredictable stress stimulus combined with lonely breeding were applied to establish the depression model of rats, which was performed simultaneously with intervention treatment. The rats in the EA group were treated with EA (dilatational wave) at "Shenting" (GV 24) and "Baihui" (GV 20), while the rats in fluoxetine group were treated with intragastric administration of fluoxetine, once daily. With open-field test, sugar consumption experiment and transmission electron microscope, the changes of behavior and neuronal synapse inhippocampal CA3 area were observed.</p><p><b>RESULTS</b>On 7 d, 14 d and 21 d, compared with the blank group, the open-field test score, sugar consumption and body mass were significantly lower in the model group (all<0.01); compared with the model group, the open-field test score, sugar consumption and body mass were significantly higher in the EA group and the fluoxetine group on 14 d and 21 d (<0.01,<0.05). On 14 d and 21 d, compared with the blank group, the synapse in hippocampal CA3 area was significantly lower in the model group (both<0.01); compared with the model group, the synapse in hippocampal CA3 area was significantly higher in the EA group and the fluoxetine group (<0.01,<0.05). The neurons cells in hippocampal CA3 area in the model group showed pyknosis and deformation from 7 d with fusion structure and unclear boundary of synapse, which were significantly improved on 21 d; the neurons cells in hippocampal CA3 area in the EA group and the fluoxetine group were significantly improved from 14 d and restored to normal level on 21 d, in addition, the structure of synapse restored to normal level.</p><p><b>CONCLUSIONS</b>EA is involved in the regulation of synaptic plasticity in hippocampal CA3 area, and promotes the recovery of depression symptoms.</p>
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Toutianliang manipulation is the most representative compound needling technique of traditional reinforcing and reducing and has the remarkable efficacy on heat syndrome with muscle and bone involved for example. Professor ZHANG Jin is one of the famous acupuncture master in China and has contributed his lifelong to the research of acupuncture manipulation techniques. He has summarized 24 single-type manipulations and has given the comprehensive explanation of the manipulations for meridian conduction, reinforcing or reducing techniques for the excess or deficiency. In the paper, Toutianliang manipulation was introduced briefly and the key operation steps had been discussed.
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Humans , Acupuncture Therapy , History , Methods , China , History, 20th Century , History, 21st CenturyABSTRACT
<p><b>OBJECTIVE</b>To explore the material basis of conduction along meridian.</p><p><b>METHODS</b>Sixty SD rats(30 males,30 females) were randomly assigned into a normal group,an acupuncture group,a verapamil blocking group and a 0.9%NaCl blocking group(control group),15 rats in each one. Fluo 3-AM(calcium fluorescence probe) was injected at the observation part in femoral stomach meridian of foot-(meridian part) and the approaching femoral meridian part(non-meridian part) in the normal group and the acupuncture group,and then incubation was applied. In the verapamil blocking group,verapamil was injected at local meridian part and non-meridian part,and in the control group 0.9%NaCl was injected. Then Fluo 3-AM was injected at the meridian part and non-meridian part in the two groups,and incubation was implemented. Caimaging changes in cells were recorded for more than 20 min after injection of every part in each group respectively. After the above operations in the last three groups,acupuncture was used at "Zusanli"(ST 36) immediately,with electroacupuncture for one min,then Caimaging changes in cells at the meridian and non-meridian parts were recorded for more than 20 min.</p><p><b>RESULTS</b>In the normal group, Cafluorescence intensity at the meridian part was higher than that at the non-meridian part. In the acupuncture group,after acupuncture Cafluorescence intensity at the meridian part was obviously higher than before,but the change before and after acupuncture was not apparent at the non-meridian part. After verapamil blocking local calcium channel and acupuncture,the Cafluorescence of the meridian part did not strengthen,and the change of that before and after acupuncture at the non-meridian part was not obvious. In the control group,after injecting 0.9%NaCl at local part,Cafluorescence intensities of the meridian and non-meridian parts showed no obvious change,so was that before and after acupuncture.</p><p><b>CONCLUSIONS</b>The voltage-gated calcium channel at the meridian part is highly correlated with its tissue cells exciting conduction.</p>
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<p><b>OBJECTIVE</b>To retrospectively analyze the clinicopathology of patients with gastric gastrointestinal stromal tumor(gGIST) who underwent radical excision within 18 years in 10 domestic medical centers in order to understand the status of domestic surgical treatment of gGIST.</p><p><b>METHODS</b>Clinicopathological data of gGIST patients undergoing radical excision in 10 medical centers from January 1998 to January 2016 were collected, and their operational conditions, postoperative adjuvant therapy, gene detection and survival were analyzed retrospectively.</p><p><b>RESULTS</b>A total of 1 846 cases were recruited in this study, including 246 cases from Guangdong General Hospital, 331 cases from Sun Yat-sen University Cancer Center, 374 cases from Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, 342 cases from Nanfang Hospital of Southern Medical University, 265 cases from Fujian Medical University Union Hospital, 148 cases from Fudan University Shanghai Cancer Center, 49 cases from West China Hospital of Sichuan University, 43 cases from Peking University Cancer Hospital and Institute, 28 cases from the 81st Hospital of Pepole's Liberation Army(PLA), 20 cases from Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute. There were 918 male (49.7%) and 928 female patients (50.3%) with median onset age of 59(18 to 95) years old. Fundus(735 cases, 39.8%) and body (781 cases, 42.3%) of stomach were the common sites of lesions. The average size of tumor was (5.3±4.6) cm. There were 1 421 cases with mitotic count ≤5(77.0%). According to the operation procedure, 924 cases (50.1%) underwent laparoscopic surgery, 759 cases (41.1%) laparotomy, 120 cases (6.5%) endoscopic surgery, and 20 cases (1.1%) laparoscopic combined with endoscopic surgery, 6 cases (0.3%) laparoscopic excision surgery through gastric wall and cavity, and 17 cases (0.9%) laparoscopy and then were transferred to laparotomy. Wedge excision were performed in 1 308 cases (70.9%), proximal gastric excision in 226 cases(12.2%), distal gastric excision in 92 cases (5.0%), total gastrectomy in 94 cases (5.1%), and local gastrectomy in 126 cases(6.8%). Multi-visceral excision was performed in 138 cases, and the splenectomy was performed in 83 cases(60.1%)with the highest ratio. According to modified NIH classification, 399 cases(21.6%) were extreme low risk, 580 cases(31.4%) were low risk, 424 cases(23.0%) were moderate risk, 443 cases (24.0%) were high risk. A total of 461 cases received postoperative imatinib adjuvant therapy, accounting for 53.2%(461/867) of patients with moderate and high risk. Among 1 846 cases, 1 402 cases (75.9%) had complete follow-up data and the median follow-up time was 33.6 (0.1 to 158) months. The 5-year survival rates of extreme low risk, low risk, moderate risk and high risk were 100%, 98.5%, 92.5%, and 79.2% with significant difference(P=0.000).</p><p><b>CONCLUSIONS</b>Gastric GIST occurs mostly in fundus and body of stomach in China. Wedge excision is the main operational procedure and laparoscopic operation is over 50%. General prognosis of gastric GIST is quite good.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Agents , Therapeutic Uses , China , Combined Modality Therapy , Gastrectomy , Gastrointestinal Neoplasms , Gastrointestinal Stromal Tumors , Pathology , General Surgery , Imatinib Mesylate , Therapeutic Uses , Laparoscopy , Laparotomy , Postoperative Period , Prognosis , Retrospective Studies , Splenectomy , Stomach Neoplasms , Pathology , General Surgery , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To elucidate the historic and current diagnosis and treatment status of gastrointestinal stromal tumor (GIST) in the Chinese population based on four high volume databases.</p><p><b>METHODS</b>Clinicopathological data of GIST patients with follow-up information between January 1998 and December 2015 from Sun Yat-sen University Cancer Center, Union Hospital of Huazhong University of Science and Technology, Southern Medical University Nanfang Hospital and Guangdong General Hospital were retrospectively analyzed. Kaplan-Meire method was used to draw survival curve. The accumulative survival rate was calculated by life table method. Comparison of survival rate among groups was examined by Log-rank test.</p><p><b>RESULTS</b>A total of 2 610 cases were enrolled into the study, including 667(25.6%) cases from Sun Yat-sen University Cancer Center, 754(28.9%) cases from Union Hospital of Huazhong University of Science and Technology, 692(26.5%) cases from Southern Medical University Nanfang Hospital and 497 (19.0%) cases from Guangdong General Hospital. There were 1 394 male and 1 216 female cases with the ratio of 1.15 to 1.00. The age of patients was from 18 to 95 (median 58.0) years old. Three-year was used as a time stage, then 18 years were divided into 6 stages. New GIST patients increased gradually year by year. There were 13(0.5%) cases during 1998 to 2000, 68(2.6%) cases during 2001 to 2003, 256(9.8%) cases during 2004 to 2006, 517 (19.8%) cases during 2007 to 2009, 814(31.2%) cases during 2010 to 2012, and 942 (36.1%) cases during 2013 to 2015. Primary GIST sites were esophagus in 50(1.9%) cases, stomach in 1 686(64.6%) cases, duodenum in 206 (7.9%) cases, jejunum and ileum in 446 (17.1%) cases, colon and rectum in 133 (5.1%) cases, and non-gastrointestinal tract in 89 (3.4%) cases. GIST lesions of 2 404(92.1%) cases located in the primary sites and relapse/metastasis occurred in 206 cases when consulting. Among 206 relapse/metastasis cases, liver metastasis was found in 126 (61.2%) cases, abdominal cavity/pelvic cavity metastasis in 64 (31.1%) cases, liver plus abdominal cavity/pelvic cavity metastasis in 12 (5.8%) cases, and other site metastasis in 4 (1.9%) cases. Among all the patients, 352 received gene detection, including 1 (0.4%) during 2004 to 2006, 7 (1.4%) during 2007 to 2009, 150 (18.4%) during 2010 to 2012, and 194 (20.6%) during 2013 to 2015. Most of the primary oncogenic mutational site occurred in c-Kit, including 30 (8.5%) cases in exon 9, 242 (68.8%) cases in exon 11, 4 (1.1%) cases in exon 13, 2 (0.6%) cases in exon 17, while 3 (0.9%) cases in PDGFRA exon 12 and 20 (5.7%) cases in PDGFRA 18, besides, no mutations of KIT and PDGFRA were detected in 51 (14.5%) cases. A total of 2 202 cases underwent operation, including 2 038 (92.6%) of radical resection and 164 (7.4%) of palliative resection. Among 2 038 patients undergoing radical resection, 450 (22.1%) cases were very low risk, 593 (29.1%) cases were low risk, 283 (13.9%) cases were moderate risk and 712 (34.9%) cases were high risk according to NIH risk classification. Of 995 patients with moderate and high risk, 550(55.3%) cases received postoperative imatinib adjuvant therapy, whose ratio in above 6 time stages was as follows: 0, 42.8%(12/28), 19.8%(20/101), 9.8% (21/215), 65.7% (176/268) and 85.6% (321/375). Of 206 relapse/metastasis patients, 200 (97.1%) cases received imatinib as the first-line therapy, and 22 (10.7%) received sunitinib as the second-line therapy. A total of 1 743 patients had complete follow-up data and median follow-up time was 35.9 (0.1 to 173.8) months. The 5-year overall survival rates in very low, low, moderate and high risk patients were 100%, 97%, 95% and 78% respectively.</p><p><b>CONCLUSION</b>This retrospective study provides the largest data of GIST and indicates the historic changes of clinicopathological characteristics, diagnosis and treatment of GIST for further domestic GIST research.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Agents , Therapeutic Uses , China , Combined Modality Therapy , Exons , Gastrointestinal Stromal Tumors , Diagnosis , Pathology , Therapeutics , Imatinib Mesylate , Therapeutic Uses , Indoles , Therapeutic Uses , Liver Neoplasms , Mutation , Neoplasm Recurrence, Local , Proto-Oncogene Proteins c-kit , Pyrroles , Therapeutic Uses , Retrospective Studies , Survival RateABSTRACT
Objective To observe the clinical efficacy of skin needling plus flash cupping for hemifacial spasm. Method Forty patients were randomized into a treatment group and a control group, 20 in each group. For both groups, the following acupoints were selected: Baihui (GV20), Sishencong (EX-HN1), Yifeng (TE17), Xiaguan (ST7), Cuanzhu (BL2), Yangbai (GB14), Taiyang (EX-HN5), Quanliao (SI18), Jiache (ST6), Dicang (ST4), Hegu (LI4), and Waiguan (TE5). Skin needling plus flash cupping was used for the treatment group, while even reducing-reinforcing needling method was used for the control group. Seven-day treatments were considered as a treatment course, and the therapeutic efficacy was analyzed after 3 courses. Result The cure rate was 65.0%in the treatment group versus 45.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Skin needling plus flash cupping can produce a significant efficacy in treating hemifacial spasm, better than ordinary needling method.
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Objective To observe the clinical efficacy of Tiao Shen Ding Zhi (mind-regulating) needling method in treating anxious neurosis. Method Fifty-eight patients with anxious neurosis were randomized into a treatment group and a control group, 29 in each group. The treatment group was intervened by Tiao Shen Ding Zhi needling method, while the control group was by conventional needling. The total effective rates of the two groups were observed. Result The total effective rate was 96.5% (28/29) in the treatment group versus 82.8% (24/29) in the control group, and the difference was statistically significant (P<0.05). Conclusion Tiao Shen Ding Zhi needling method can produce a higher total effective rate than conventional acupuncture in treating anxious neurosis.
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ObjectiveTo investigate the effect of acupuncture on motor function and serum expressions of TNF-aand IL-6 contents in cerebral hemorrhage rats.MethodSeventy-two male Wistar rats were randomized into sham operation, model and acupuncture groups. A rat model of cerebral hemorrhage was made by intracerebral injection of autoblood. Baihui-to-Qubin acupuncture was performed after successful model making. The TNF-aand IL-6 contents of rat serum were measured by enzyme linked immunosorbent assay at three time points: one, three and seven days.ResultBaihui-to-Qubin acupuncture markedly increased the neurological function score and reduced neurologic deficits in cerebral hemorrhage rats. At the same time point, serum TNF-aand IL-6 contents were significantly lower in the acupuncture group of rats thanin the model and acupuncture group; there were statistically significant differences (P<0.01).ConclusionBaihui-to-Qubin acupuncture can reduce neurologic deficits in cerebral hemorrhage rats. It may be related to decreases in serum TNF-aand IL-6 contents after acupuncture.
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Background Bietti crystalline dystrophy (BCD) is a congenital and autosomal recessive hereditary eye disease characterized by multiple glistening intraretinal crystals scattered over the fundus.Studies determined abnormality of fatty acid metabolism probably is associated with BCD.However,the study on the alteration of blood lipid level in BCD patients is rare.Objective This trail was to study the change of serum lipids in BCD patients.Methods A total of 50 patients with bilateral BCD and 50 matched healthy volunteers were included from November 2011 to March 2013 in Beijing Tongren Eye Center with the approval of Ethic Committee of Beijing Tongren Hospital.Written informed consent was obtained from each subject before any medial examination.Peripheral blood of 3 ml was collected from the subjects.The serum concentrations of triglyceride (TG),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured and analyzed.The examination outcome was identified based on the criteria of China Adult Dyslipidemia Prevention Guideline (Version 2007).Results Abnormality of serum lipid content was detected in 58.00％ patients (29/50),and hypertriglyceridemia and hypercholesteremia were in 34.48％ (10/29),respectively,and mixed hyperlipidaemia was in 27.59 ％ (8/29).The serum levels of TG,TC and LDL-C were (1.63± 1.19) mmol/L,(5.10±1.05) mmol/L and (3.27±0.97) mmol/L in the BCD group,which were significantly higher than (0.93± 0.33) mmol/L,(4.33 ±0.56) mmol/L,(2.63 ±0.51) mmol/L of the normal group (t =4.036,4.496,4.095,all at P=0.000).Conclusions The serum lipid levels elevate in BCD patients,which might be related to the occurrence of BCD.