Objective To investigate the relationship between molecular biological markers and recombinant human endostatin targeted therapy in non-small-cell lung cancer(NSCLC).Methods 68 cases patients with non-small-cell lung cancer to meet the requirements were randomly divided into group A (n=34)and group B (n=34).Group A received docetaxel and cisplatin(DP)and gefitinib;group B received recombinant human endostatin on the base of group A.The biological markers species,such as,EGFR,KRAS,VEGF,BRCA1,EML4-ALK,ERCC1,β-tubulin and CD3 were detected by immunohistochemical.The types of population for different programs were summarized according to the expression of biological markers and progression free survival (PFS)of the two groups. Results Group B median PFS was significantly longer than that in group A;no matter low or high expression of VEGF and BRCA1,group B median PFS was significantly longer than that in group A(P<0.05);high expression of ERCC1,KRAS,EML4-ALK andβ-tubulin,group B median PFS was significantly longer than that in group A(P<0.05);low expression of EGFR and CD3,group B median PFS was significantly longer than that in group A (P<0.05 ).Conclusion No matter low or high expression of VEGF and BRCA1 ,low expression of KRAS, ERCC1,EML4-ALK and β-tubulin and high expression of EGFR and CD3 in patients with non-small cell lung cancer may be more sensitive to the treatment of DP and gefitinib combined with recombinant human endostatin.

OBJECTIVE To strengthen the hospital infection control and the link management, and to improve the medical care and nursing quality. METHODS The main methods were to strengthen the organization leadership, set up and enhance the management system of infection; strengthen the continuing education about the hospital infection knowledge, control the hospital infection, and standardize medical personnel′s hand hygiene; choose the correct washing and maintenance method for the apparatus and instruments; and strengthen the management of the medical wastes. RESULTS After that to set up the management of each link, eliminate the dangers in medical action, improve the antiseptic quality, and decrease the rate of hospital infection. CONCLUSIONS The hospital infection controls and the link management are two of the important indexes of appraising the management level of the hospital, and it is the important guarantee of improving medical care and nursing quality and supporting the medical treatment′s security.

Objective To evaluate the clinical outcome of anterior subcutaneous internal fixator (ASIF) system with triple pedicle screws in stabilizing Tile type B pelvic fractures.Methods From August 2013 to April 2015,38 cases of pelvic fractures were stabilized with the ASIF system using triple pedicle screws.There were 24 male and 14 female cases,with the age range of 16-74 years [(41.5 ±5.5) years].Causes of injury were traffic accidents (n =28),crushing injury (n =6) and fall from height (n =4).All cases had Tile type B fractures,including 5 cases of type B1,29 type B2 and 4 type B3.Intraoperative blood loss,operation time,length of hospitalization and complications were detected.Postoperative function evaluation was done using the Majeed score.Results All cases were available for follow-up of 6.5-13.5 months (mean,10.5 months).Intraoperative blood loss was (30.8 ± 7.1)ml,operation time was (51.5 ± 9.2) minutes,and length of hospitalization was (5.0 ± 3.1) days.Among them,34 cases showed bilateral hip flexion over 95 degrees after operation,and 24 cases were able to squat fully 1.5 months after operation.No cases experienced nonunion,delayed union,superficial or deep surgical wound infection,urethral injury and dysuresia.Two cases developed temporary lateral femoral cutaneous nerve numbness.According to the Majeed score,excellent results were found in 32 cases (84％) and good results in 6 cases (16％).Conclusion ASIF system with triple pedicle screws results in high healing rate and few complications in the treatment of Tile type B pelvic fractures,and hence deserves popularization in clinic.

Objective To explore the clinical efficacy of secondary unreamed intramedullary nailing following primary external fixation for open tibial shaft fractures.Methods From March 2011 to June 2014,we treated 28 open tibial shaft fractures.They were 17 men and 11 women,aged from 21 to 62 years (average,38.2 years).After thorough debridement,the tibia was stabilized temporarily with external fixation.The wounds were handled with primary closure or secondary repair with skin grafts or tissue flaps.After the wounds healed,the external fixation was replaced by unreamed intramedullary nailing.Fracture union and complications were documented.The clinical efficacy was evaluated at the final follow-ups according to the Johner-Wruhs scoring system.Results All the 28 patients were followed up for 12 to 18 months (average,13.5 months).Bony union was achieved in all after 4 to 15 months (average,4.9 months).Delayed union was observed in 4 cases which were healed after dynamic fixation.There was no deep infection,nail breakage,malunion or limb shortening in any one.Mild knee pain was reported by 5 cases after surgery.According to the Johner-Wruhs criteria,18 cases were excellent,7 good,and 3 moderate,giving an excellent to good rate of 89.3％.Conclusion Primary external fixation and secondary unreamed intramedullary nailing can result in good fracture union with satisfactory biomechanical stability and favorable early rehabilitation in the treatmeut of open tibial shaft fractures.

Objective To study the dynamic CT features of severe acute respiratory syndrome (SARS) in recovery phase, and to analyze the correlative remaining factors on CT images. Methods Total 50 patients with SARS were followed-up with chest spiral CT and HRCT in 3, 6, 9, 14, 24 months after onset. Results (1)The pulmonary lesions were completely absorbed in 24 cases in 3 months, 30 cases in 6 months and 37 cases in 24 months. Abnormal CT findings were showed in 13 patients later, which appeared ground-glass opacity 8,irregular lines 6, thickening of interlobular septa 4, subpleural lines 2 and bronchiectasis 2. (2)Reviewing the lesions on CT between the remained group in the third month and the absorption group, there was a difference in the extent and the progress of the lesions .(3) There was a difference of the appearance rate of remaining lesion in lungs in two groups (≥40 ages and

Objective To investigate the effect of median nerve electrical stimulation on the activity, speech and quality of life in patients after severe traumatic brain injury. Methods 60 patients with severe traumatic brain injury were divided into 2 groups: the control group (A) and the treated group (B). The patients in Group A were treated with the routine medicine and rehabilitation. Based on the routine therapy, the patients in Group B were treated with the right median nerve electrical stimulation. Their outcome, activity, speech and quality of life were assessed. Results The scores of Glasgow Outcome Scale (GOS), speech assessment, and the quality of life in Group B improved compared with that in Group A (P<0.05), the activity seemed to improve, but not significantly. Conclusion The right median nerve electrical stimulation is effective to promote the recovery of neurological function and improve the quality of life in patients with severe traumatic brain injury.

Objective: To investigate the delay in identification of pulmonary tuberculosis and influencing factors among children and adolescents in Jiaxing City, Zhejiang Province from 2013 to 2022, so as to provide the reference for targeted prevention and control measures. Methods: The information of pulmonary tuberculosis patients in Jiaxing City from 2013 to 2022 were captured from the Tuberculosis Information Management System of Chinese Disease Control and Prevention Information System, including demographics, diagnosis, treatment and etiological results. The delay in identification of pulmonary tuberculosis was analyzed among children and adolescents, and the factors affecting the delay in identification of pulmonary tuberculosis were identified using a multivariable logistic regression model. Results: A total of 2 407 pulmonary tuberculosis cases were reported among children and adolescents in Jiaxing City from 2013 to 2022, including 1 522 males (63.23%). The median age was 21.00 (interquartile range, 4.00) years. There were 410 students (17.03%), and 1 856 cases with non-local household registration (77.11%). There were 596 cases with delay in identification of tuberculosis (24.76%), 895 cases with delay in healthcare-seeking (37.18%) and 128 cases with delay in definitive diagnosis (5.32%). Multivariable logistic regression analysis that children and adolescents who occurred symptoms in the first quarter (OR=1.684, 95%CI: 1.261-2.249), were diagnosed first in county-level medical institutions (OR=3.800, 95%CI: 2.898-4.983) and had positive results of etiological testing (OR=1.534, 95%CI: 1.255-1.874) were more likely to delay in identification of pulmonary tuberculosis. Conclusions The delay in identification of pulmonary tuberculosis is associated with the time of symptom onset, the level of medical institution making first diagnosis, and the results of etiological testing. It is suggested to reinforce the publicity of pulmonary tuberculosis prevention and control, expand the coverage of screening programs and improve the diagnosis capability of medical institutions.

OBJECTIVETo investigate the effects of nano-lead exposure on learning and memory and iron homeostasis in the brain of the offspring rats on postnatal day 21 (PND21) and postnatal day 42 (PND42).

METHODSTwenty adult pregnant female Sprague-Dawley rats were randomly divided into control group and nano-lead group. Rats in the nano-lead group were orally administrated 10 mg/kg nano-lead, while rats in the control group were administrated an equal volume of normal saline until PND21. On PND21, the offspring rats were weaned and given the same treatment as the pregnant rats until 42 days after birth. The learning and memory ability of offspring rats on PND21 and PND42 was evaluated by Morris water maze test. The hippocampus and cortex s amples of offspring rats on PND21 and PND42 were collected to determine iron and lead levels in the hippocampus and cortex by inductively coupled plasma-mass spectrometry. The distributions of iron in the hippocampus and cortex were observed by Perl's iron staining. The expression levels of ferritin, ferroportin 1 (FPN1), hephaestin (HP), and ceruloplasmin (CP) were measured by enzyme-linked immunosorbent assay.

RESULTSAfter nano-lead exposure, the iron content in the cortex of offspring rats on PND21 and PND42 in the nano-lead group was significantly higher than those in the control group (32.63 ± 6.03 µg/g vs 27.04 ± 5.82 µg/g, P<0.05; 46.20 ±10.60 µg/g vs 36.61 ± 10.2µg/g, P<0.05). The iron content in the hippocampus of offspring rats on PND42 in the nano-lead group was significantly higher than that in the control group (56.9 ± 4.37µg/g vs 37.71 ± 6.92µg/g, P<0.05). The Perl's staining showed massive iron deposition in the cortex and hippocampus in the nano-lead group. FPNl level in the cotfex of offspring rats on PND21 in the nano-lead group was significantly lower than that in the control group (3.64 ± 0.23 ng/g vs 4.99 ± 0.95 ng/g, P<0.05). FPN1 level in the hippocampus of offspring rats on PND42 in the nano-lead group was significantly lower than that in the control group (2.28 ± 0.51 ng/g vs 3.69 ± 0.69 ng/g, P<0.05). The escape latencies of offspring rats on PND21 and PND42 in the nano-lead group were longer than those in the control group (15.54 ± 2.89 s vs 9.01 ± 4.66 s; 6.16 ± 1.42 s vs 4.26 ± 1.51 s). The numbers of platform crossings of offspring rats on PND21 and PND42 in the nano- lead group were significantly lower than those in the control group (7.77 ± 2.16 times vs 11.2 ± 1.61 times, P<0.05; 8.12 ± 1.51 times vs 13.0 ± 2.21 times, P<0.05).

ONCLUSIONn Nano-lead exposure can result in iron homeostasis disorders in the hippocampus and cortex of offspring rats and affect their learning and memory ability.

Animals ; Cerebral Cortex ; drug effects ; metabolism ; Female ; Hippocampus ; drug effects ; metabolism ; Homeostasis ; Iron ; metabolism ; Lead ; toxicity ; Learning ; drug effects ; Maternal Exposure ; adverse effects ; Memory ; drug effects ; Pregnancy ; Rats ; Rats, Sprague-Dawley

The American Transplant Congress (ATC) is an influential academic congress in the field of organ transplantation. In this article, the hotspots of liver transplantation in 2020 ATC were summarized, including the latest research progress in donor liver procurement and quality assessment, donor liver preservation and ischemia-reperfusion injury (IRI), liver transplantation for hepatocellular carcinoma and other hepatic malignancies, complications after liver transplantation, transplantation immunology, perioperative management and donor-derived infection, pediatric liver transplantation and cell therapy, etc.

At present, there are various treatment methods for hepatocellular carcinoma (HCC), including surgical treatment, interventional treatment, and immunotherapy, and even so, the five-year survival rate of HCC patients is only 12.5%. Influencing factors for the prognosis of HCC have always been the focus of research. With the in-depth research on programmed cell death protein 1 (PD-1) inhibitors in the treatment of HCC in recent years, the role of programmed cell death ligand 1 (PD-L1) and soluble programmed cell death ligand 1 (sPD-L1), as the ligands of PD-1, in immune escape and their value in predicting prognosis have attracted more and more attention. This article elaborates on the current controversies, consensus, and advances in PD-L1 and sPD-L1 as immune markers in evaluating the prognosis of HCC.