Objective To investigate the efficacy and toxicity of thalidomide plus irinotecan and cisplatin treatment for recurrent small cell lung cancer.Methods 62 Patients with recurrent small cell lung cancer in the same period were randomly divided into observation group and control group according to the principle of minimum distribution imbalance index.The observation group patients were treated with thalidomide plus irinotecan and cisplatin chemotherapy,and the control group patients were treated with irinotecan and cisplatin chemotherapy.The efficacy and toxicity of the two groups were compared.Results The overall response rate in the group observation was 86.7％ compared with 63.3％ in the control group,and the difference had statistical significance (x2 =8.52,P ＜ 0.05).The major toxicities were hematologic toxicity and gastrointestinal symptoms,and the side effects differences were not statistically significant (x2 =0.18,P ＞ 0.05).Conclusion The treatment of recurrent small cell lung cancer with irinotecan and cisplatin in combination with thalidomide has high efficiency,and the toxicity can be tolerated.

Objective To explore the ultrasonographic method in fetal coronary sinus (CS) dilation.Methods Totally 145 normal fetuses (normal group) and 72 fetuses of CS dilation (CS group) diagnosed prenatally were retrospectively reviewed.The long axis of coronary sinus was displayed in the non-standard four chamber view and the area of the sagittal view of CS was measured.Transverses scans combined with color Doppler were used to acquire four chamber view,left and right ventricular outflow tract views,three vessel view.In addition,sagittal scans with color Doppler were used to get short-axis view at the level of great arteries,vena cava long axis view,aortic arch view,and ductal arch view.The characteristics of CS were observed.Results CS area of sagittal view was positively correlated with gestational age (normal group:r=0.954,P＜0.05;CSgroup:r=0.904,P＜0.05).In the samegestational weeks,the CS area of the sagittal view in the normal group was less than that in the CS group (all P＜0.01).In CS group,52 fetuses were persistent left superior vena cava,15 fetuses were total anomalous pulmonary venous connection,5 fetuses were associated with right heart pressure overload.Conclusion Fetal CS sagittal section area is positively correlated with gestational age.When the fetal heart ultrasonography found CS dilation,other intracardiac malformations should also be considered.The etilogies of CS dilation should be analyzed clinically through multi-slice,multi-angle scanning.

Objective To analyze the abnormal fetal ductus arteriosus (DA) by echocardiography.Methods Seventy fetuses of abnormal DA diagnosed prenatally were retrospectively reviewed.Transverse scans combined with color Doppler were used to acquire four chamber view,left and right ventricular outflow tract views,three vessel view,and three-vesseltrachea view.In addition,sagittal scans with color Doppler were used to get vena cava long axis view,aortic arch view,and ductal arch view.The spatial relationship of the great arteries and trend of DA were observed.Results Abnormal fetal DA is mainly composed of DA absence,DA abnormal function and DA morphological abnormality.Among 70 cases of fetal DA,9 cases were diagnosed with DA absence,8 cases were DA atresia,11 cases were DA completed closure nearly,9 cases were shown with reverse DA blood perfusion,33 cases were shown with DA curvature and dilatation.Conclusion Prenatal diagnosis of DA absence and DA abnormal function is of great significance.Three-vessel-trachea view and ductal arch view combined with CDFI can make a definitive diagnosis.

Objective To analyze the current status of studies related to home enteral nutrition (HEN) in China,and provide scientific basis for the research and management of HEN in China.Methods We searched CNKI and WanFang Data since it built to January 1st,2018.The included studies were screened and categorized by publication information,study type,subjects of the study,topic,interventions and outcomes.Descriptive analysis was conducted after extraction of information.Results A total of 153 studies were included,of which 37 were observational studies,102 were experimental studies,12 were case report,and 2 were exploring articles.Since 2012,the number of studies has been increasing.Most of the subjects were elderly people who were diagnosed with diseases of digestive system,head and neck tumors and diseases of nervous system.These studies were featured as small sample size and short intervention time,follow-ups by telephone and home visit,less than 1/4 providing professional nutrition support team,and outcomes mainly as complication,nutritional biochemical indices,anthropometric indices and prognosis.Conclusion HEN in China is still in its infancy.The number of relative studies is still small and quality of literatures is very low,but it has been increasing.At present,there are some problems in the implementation of HEN in China,such as lack of standardized management model and professional team,short-term intervention,and single follow-up mode.The elderly and patients with digestive disease,head and neck tumors and nervous disease are the key subjects;more professional nutrition support team and scientific management model should be established in the future.

Objective:To investigate the correlation between the methylation and expression of Runt associated transcription factor 2 (RUNX2) gene in peripheral blood and sensitivity to neoadjuvant chemotherapy in breast cancer.Methods:90 female breast cancer patients who received full-course neoadjuvant chemotherapy and surgical resection for the first time in our hospital from Jan. 2021 to Jun. 2022 were included as the study objects, and 90 healthy women who underwent physical examination in our hospital during the same period were included as the control group. The methylation level of RUNX2 gene in peripheral blood of all subjects was detected by sulfite conversion method, and the mRNA expression level of RUNX2 gene in peripheral blood was detected by fluorescence quantitative PCR. The effects of neoadjuvant chemotherapy in breast cancer patients were divided into sensitive and insensitive groups.Results:The positive rate of RUNX2 gene methylation in peripheral blood of breast cancer patients was 41.11% (37/90) , significantly lower than that of the control group (64.44% (58/90) , the difference was statistically significant ( χ2=9.830, P=0.002) . The mRNA expression level of RUNX2 gene in peripheral blood of breast cancer patients was 1.73±0.24, which was significantly higher than that of the control group (1.19±0.18) , and the difference was statistically significant ( t=5.221, P<0.001) . The mRNA expression level of RUNX2 methylation-positive patients in peripheral blood of breast cancer patients was 1.26±0.20, significantly lower than that of RUNX2 methylation-negative patients (1.84±0.26) , and the difference was statistically significant ( t=4.981, P<0.001) . The positive rate of RUNX2 gene methylation was 49.28% (34/69) in patients with sensitivity to neoadjuvant chemotherapy, significantly higher than 14.29% (3/21) in patients with insensitive chemotherapy, and the difference was statistically significant ( χ2=8.142, P=0.004) . The mRNA expression level of RUNX2 gene in peripheral blood of neoadjuvant chemotherapy sensitive patients was 1.62±0.17, which was significantly lower than that of insensitive patients (2.09±0.22) , and the difference was statistically significant ( t=5.283, P<0.001) . The ROC curve showed that the sensitivity and specificity of RUNX2 mRNA expression in peripheral blood to predict the effect of neoadjuvant chemotherapy were 85.7% and 85.5%, respectively. Conclusion:The methylation and expression level of RUNX2 gene in peripheral blood are related to the sensitivity of neoadjuvant chemotherapy in breast cancer, and can be used as a marker to predict the efficacy of neoadjuvant chemotherapy in breast cancer.

Myelodysplastic syndrome (MDS) is a malignant hematologic tumor, which is currently difficult to cure. The theory of Xuanfu was proposed by Liu Wansu, which is unique in the clinical evidence of Chinese medicine and is less frequently applied to hematological diseases. The application of Xuanfu theory in myelodysplastic syndrome provides new ideas for the treatment of the disease. The abnormal flow of Qi, blood and fluids caused by the occlusion of the Xuanfu is the cause of toxic stasis obstruction, which is the pathogenesis of toxic stasis obstruction. Thus, the method of dispersion of Bone from Xuanfu, the external treatment of Xuanfu, and regulation of liver qi and Xuanfu help to return to normal of opening and closing function of Xuanfu, and release toxic stasis. In this paper, we analyzed the evidence of toxin-stasis obstruction in myelodysplastic syndrome from the theory of Xuanfu, aiming to provide a feasible theoretical basis for clinical treatment of the disease.