Antitumor drugs that target the signaling of vascular endothelial growth factor and its receptors have attracted increasing attention with the development of antiangiogenic targeted therapy. Apatinib is a second-generation vascular endothelial growth factor receptor-2 inhibitor and a potent antiangiogenic agent. Apatinib is one of the recent oral molecular targeted anti tumor drugs. Clinical studies have indicated that apatinib exhibits high bioavailability and a tolerable safety profile. A series of large-scale randomized and controlled clinical trials before and after the release of the drug in the market have demonstrated encouraging objective response rate and survival benefit across a broad range of malignancies, including non-small cell lung cancer, breast cancer, and gastric cancer. Apa-tinib was approved and launched in China in 2014 as a subsequent-line treatment for patients with advanced gastric cancer. Apatinib is currently undergoing phase II/III clinical trials for the treatment of numerous cancer types, such as gastric carcinoma, lung cancer, he-patocellular carcinoma, esophageal cancer, and colorectal cancer. These clinical trials are conducted to determine the antitumor activi-ty of apatinib when administrated alone or in combination with other therapies. This review summarizes the latest research progress of apatinib, including antitumor mechanisms, clinical effects on different tumor types, safety profile and adverse effects, drug interac-tions, as well as drug resistance and biomarkers. This article presents a deeper understanding of the clinical application of apatinib in anti tumor treatment, and provides reference for future clinical practice in therapeutic options for cancer patients.

Objective To explore the effects and safety of citalopram combined with low-dose risperidone on refractory depression. Methods All of 54 patients with the refractory depression were ran-domly divided into two groups: augmented treatment group (taken citalopram 20 mg/d, risperidone 0.5-2.0mg/d) and mono-thempy group (taken citalopram alone 20 mg/d). The treatment lasted for 6 weeks. They were estimated with Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and treatment emergent symptom scale (TESS) at baseline and every two weeks subsequently. Results In the augment-ed treatment group, total effective rate was 60.7% and recovery and excellence rate was 50.0%, while that was 26.9% and 15.4% in mono-therapy group (P< 0.05). The adverse effect of two groups was minor. Conclu-sion Rispefidone may be a useful and safe adjunct to citalopram in treatment of refractory depression.

BACKGROUND: Benzo[a]pyrene injures central and peripheral nerves at a certain degree. The study is at an initial phase concerning to the neurotoxicity of benzo[a]pyrene allied with other toxic objects.OBJECTIVE: Molecular biological technique integrated with neuron culture were applied in the study of benzo[a]pyrene and lead applied separately or in combination on neurotoxicity and nuclear DNA damage in vitro.DESIGN: Repeated measure.SETTING: Teaching-Research Room of Labor and Hygiene of Chongqing Medical University and Laboratory of Thermobiology and Molecular Toxicology of Occupation Medical Institute of Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was performed in Laboratory of Thermobiology and Molecular Toxicology of Occupation Medical Institute of Tongji Medical College ofHuazhong University of Science and Technology from June to September 2003. Ten SD rats of 8-day old were employed and their brain tissues were prepared as primary cell culture object, which were divided into 10 culture groups, 5 culture dishes in each group. The managements were as follows in each group: [1] blank control; [2] solvent control[parallel management with equivalent dimethyl sulfoxide (DMSO) +liver microsome enzyme]; [3] lead group of low concentration (acetic lead 5 μmol/L) (No. 1 group); [4] lead group of high concentration (acetic lead 50 μmol/L) (No. 2 group); [5] benzo[a]pyrene group of low concentration (benzo[a]pyrene 5 μmol/L + liver microsome enzym) (No. 3 group); [6]benzo[a]pyrene group of high concentration (benzo[a]pyrene 50 μmol/L +liver microsome enzym) (No. 4 group); [7] lead of low concentration +benzo[a]pyrene of low concentration group (No. 5 group); [8] lead of low concentration + benzo[a]pyrene of high concentration group (No. 6 group);[9] lead of high concentration + benzo[a]pyrene of low concentration group (No.7 group); [10] lead of high concentration + benzo[a]pyrene of high concentration group (No. 8 group).METHODS: After stained poisoning for 90 minutes, trypsin digestion method was used for sample collection and trypan blue staining method was applied to assay cell survival rate in each group. Single-cell gel electrophoresis (SCGE) was used to determine the damage of nuclear DNA in each group.MAIN OUTCOME MEASURES: Neuronal survival rate and damage rate of nuclear DNA in poisoning with benzo[a]pyrene and lead either in separation or in combination.RESULTS: [1] Cell survival rates in various groups poisoned with benzo [a]pyrene and lead of two concentrations either in separation or combination were lower than the controls [poisoning group (44.14±4.80)% to(82.40±2.70)%, the controls (88.44±2.53)% to ( 90.12±2.23)%, P ＜ 0.05to 0.01]. [2] Degrees of nuclear DNA damage in single poisoning group with benzo[a]pyrene of high concentration, lead of low concentration + benzo[a]pyrene of high concentration, lead of high concentration + benzo[a]-pyrene of low concentration and lead of high concentration + benzo[a]pyrene of high concentration were higher than the controls [63% (19/30), 87%(26/30), 80% (24/30), 97% (29/30), 13% (4/30), 20% (6/30), P ＜ 0.01].CONCLUSION: Both benzo[a]pyrene and lead present neurotoxicity in vitro and coordinate with each other. The damage of benzo[a]pyrene is worse than lead in neuronal nuclear DNA cultured in vitro.

To explore the clinical application and value of small incisions in the treatment of benign thyroid diseases with endoscopic assistance.A total of 57 cases with thyroid nodules were operated under the assistance of ultrasonic scalpel and endoscope with the lifting-up of special instrument and small neck incisions.However one malignant case was converted iuto open surgery according to frozen sections.The other 56 cases were successfully operated.The mean operative duration was 42 min and postoperative stay 2 -3 days.All incisions achieved primary healing and the length range was 1.5 - 3.5 cm.Except for transient hoarseness in 1 case,there was no such complications as choking,lip paralysis or hemorrhage,etc.All were discharged uneventfully.This surgical approach shall be recommended for its merits of miniinvasiveness,less hemorrhage,fewer complications and wider applications.

Medical consumables management plays an important role in hospital management from the view of both enhancing the hospital management and facilitating the computation of consuming material cost.Based on the practical experience of the consumables management system,this paper presents a plan for medical consumable management system based on C/S mode,and its main functions and features.

Objective To investigate the clinical application of Cystatin C as a biological marker for monitoring hepatic pathological change in patients with virus hepatitis.Methods Two hundred and seven patients infected with hepatitis B or C virus(HBV, HCV)were divided into cirrhosis group(group A),chronic HBV group(group B),chronic HCV group(group C),and liver cancer group(group D). 32 healthy controls(group H) were recruited . The serum TIMP-1,TIMP-2,and Cystatin C as well as some traditional markers for monitoring liver function and renal function including creatinine, creatinine clearance rate, alanine transaminase, and aspartate transaminase were determined.Results In these groups, serum Cystatin C(F=28.334, P

A case of 76-years-old male patient with nasal bleeding as the first symptom in our hospital, who was finally diagnosed as tsutsugamushi disease. This old man was bited by insect in farmland 2 days before the symptom occurred. PE: Left thigh and right buttock have eschar, with splenomegaly. Routine blood test: WBC (decrease) 3.9 x 10(9)/L, RBC (decrease) 3.86 x 10(9)/L, PLT (decrease) 41 x 10(9)/L, HGB (decrease) 117 g/L; Chest CT: lung interstitial pneumonia, a small amount of bilateral pleural effusion. Oxk-ag 1:320. The patient was discharged after treatment with chloramphenicol for 8 days.
Aged ; Epistaxis ; diagnosis ; etiology ; Humans ; Male ; Scrub Typhus ; complications ; diagnosis

Objective:To prepare monoclonal antibodies(McAb)against cystatin C(Cys C)and to establish the particle enhanced turbidimetric immunoassay(PETIA)for determining human serum Cys C.Methods:The prokaryotic expression vector pET32a(+)/Cys C was constructed and Cys C expression was induced.McAbs against Cys C were prepared with the hybridoma technique after mice were immunized with the purified recombinant protein.Then the McAbs were covalently attached to uniform microparticles,PETIA method for determination of human serum Cys C was established,and primary evaluation tests of methodology were performed.Results:Three hybridoma cell lines were obtained successfully,the secreted antibodies were isotype of IgG1,and Western blot confirmed that the antibodies reacted specifically to the Cys C protein.After one of the hybridoma cell lines was injected into mice abdominal cavity,the ascites abundant for McAb was obtained.The titer of the McAb against the purified protein was 1∶4?106.With the self-made McAb,PETIA for human serum Cys C was established.The primary evaluation tests of methodology revealed that self-established PETIA method had a satisfactory performance,which was equal to the import kit.Conclusion:The prepared McAb against Cys C is prepared,which could be used to establish PETIA for determining human serum Cys C.

Objective To analyze the expression of secreted aspartyl proteinases (Sap) in human vaginal infection in vivo. Methods Vaginal swabs were collected from 9 healthy volunteers and 20 patients with vaginal candidiasis, and the expression of Sap1-6 was evaluated by reverse-transcriptase polymerase chain reaction using specific primer sets. Results The Sap2 and Sap5 were the most common genes expressed in the patients with vaginal candidiasis. The expression Sap3 and Sap4 was detected in all subjects. All six Sap genes were simultaneously expressed in some patients with vaginal candidiasis. Conclusion The data shows that the Sap genes may be involved in the pathogenesis of vaginal candidiasis.

In order to analyze the in vivo expression of Candida albicans secreted aspartyl proteinases (SAP) in human vaginal infection, the vaginal secretion from 29 human subjects was collected by vaginal swab, and the expression of SAP1-SAP6 was detected by reverse-transcriptase polymerase chain reaction using specific primer sets. It was found that Sap2 and Sap5 were the most common genes expressed during infection; Sap3 and Sap4 were detected in all subjects and all 6 SAP genes were simultaneously expressed in some patients with vaginal candidiasis. It was suggested that the SAP family is expressed by Candida albicans during infection in human and that Candida albicans infection is associated with the differential expression of individual SAP genes which may be involved in the pathogenesis of vaginal candidiasis.