The cytotoxic agents pemetrexed and docetaxel and the epidermal growth factor receptor (EGFR)tyrosine kinase inhibitors(TKIs)erlotinib and gefitinib are standard second-line therapies for non-small cell lung cancer. For patients without the EGFR mutation,more and more evidence has suggested the superiority of chemotherapy over targeted therapy. Adding targeted agents to standard second-line treatment is an trend of exploration,but without promising results nowadays. Crizotinib,targeting at anaplastic lymphoma kinase,has been shown excellent efficacy for second-line therapy in non-small cell lung cancer.

Targeted therapy of anti-angiogensis strategy is the standard treatment for metastatic renal cell cancer.In recent years,a number of new generation of anti-angiogensis agents have been tested in clinical trials,some of which have achieved promising outcomes.Other pathway inhibitors such as inhibitors of mamma-lian target of rapamycin and fibroblast growth factor receptor pathway have made progresses in some extent.

Objective To investigate the effects of swimming exercise training on left ventricular (LV)remodeling and its possible mechanism in spontaneous hypertensive rats (SHR).Methods Twenty eightweek-old male SHRs were divided into SHR control (SC) group and SHR exercise training (ST) group,with 10 rats in each group.Ten eight-week-old male Wistar rats were used as normal control (WC) group.The ST group was subject to 60-min moderate swimming exercise without loading once daily,6 times a week,for a total of 12 weeks; while the SC and WC group had no special intervention.The blood pressure was examined once weekly.After 12 weeks,the norepinephrine (NE)and serum angiotonin Ⅱ (ANG Ⅱ) levels were determined by ELISA.The LV hypertrophy was assessed by analysing the ratio of LV weights to body weights (LVW/BW) and cardiomyocyte diameter.The collagen deposited in LV was detected by sirius red staining.The expressions of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) in LV were determined by semi-quantitative real time-polymerase chain reaction (RT-PCR) and Western blotting.Results After 12 weeks,the blood pressure,serum NE and ANG Ⅱ levels,LVW/BW ratio,cardiomyocyte diameter and collagen volume fraction (CVF) increased significantly in SC group compared with WC group; while those in ST group decreased significantly.In addition,in ST group the mRNA and protein expressions of TNF-α,IL-6,IL-1 βand TGF-β1 also decreased significantly.Conclusions The swimming exercise could reduce the blood pressure of SHR and improve LV remodeling.This effect was mediated not only by improving the hemodynamics,but also by decreasing sympathetic nerve and renin-angiotensin system (RAS) activities,decreasing the gene expressions of cytokines.The swimming exercise may be an effective strategy for improving LV remodeling in hypertension.

Objective To investigate the efficacy of neoadjuvant chemotherapy combined with radical resection of cervical cancer in the treatment of stage IB2-ⅡB cervical cancer.Methods According to the treatment plan from October 2012 to October 2016 in the People′s Hospital of Luohu District of Shenzhen in 80 cases of stage IB2-II B cervical cancer patients were divided into observation group(n=43) and control group(n=37),the observation group was treated with neoadjuvant chemotherapy combined with radical surgery for cervical cancer,patients in the control group directly treated for radical resection of cervical cancer.Chemotherapy effect,operation time,intraoperative blood loss,postoperative pathological risk factor differences of two groups of patients were compared.Results (1)Evaluated the curative effect of neoadjuvant chemotherapy,squamous cell carcinoma group complete remission(CR) 4 cases,partial remission(PR) 22 cases,stable disease(SD),6 cases of disease progression(PD) in 0 cases,in adenocarcinoma group CR 1 cases,PR 3 cases,SD 5 cases,PD 2 cases of squamous cell carcinoma group adjuvant chemotherapy was significantly better than that of adenocarcinoma group,the difference was statistically significant(z=2.4968,P=0.0063).(2)The operation time((215±57) min) and intraoperative blood loss((682±145) ml) in the observation group were significantly lower than those in the control group(((259±62) min,(758±193) ml)),the difference was statistically significant(t=3.8780,2.2528,P=0.0002,0.0263).(3)The two groups of patients with ureteral fistula(P=0.5039),vesicovaginal fistula(P=0.3639),wound healing(P=0.5182),lower extremity deep venous thrombosis(P=0.4818) complications had no significant difference.(4)The positive rate of the observation group of lymph nodes(χ2=8.2005,P=0.0000),parametrial infiltration rate(χ2=8.1553,P=0.0000) was significantly lower than the control group,the difference was statistically significant.Two groups of patients with deep myometrial invasion rate(χ2=0.0991,P=0.7516),the incidence of cancer embolus(χ2=0.0130,P=0.9176) compared to no statistical significance.Conclusion The effect of neoadjuvant chemotherapy on cervical squamous cell carcinoma is better than that of adenocarcinoma.Compared with the direct for radical resection of cervical cancer,neoadjuvant chemotherapy combined with radical resection of cervical cancer patients for the treatment of stage IB2-ⅡB cervical cancer,operation time and blood loss are lower,node positive and parametrial invasion and postoperative pathologic risk factors in lymph node also can get better effect.

ObjectiveTo examine the level of antisperm antibody (ASAb),antiendometrial antibody (EMAb) and anti-mulerian hormone(AMH) in serum of women with infertility and to provide a reliable basis for prediction,diagnosis and treatment of infertility.Methods Two hundred cases of women with infertility visiting our hospital between May.2010 and May.2011 were chosen as the infertility group and 100 cases of women with fertility experience visiting our hospital at the same period with the infertility group were chosen as the controlgroup.We examined the presence of ASAband EMAb and the levelsof AMHof the participants.ResultsIn the infertility group,the total positive rate of serum ASAb was 27.5％ (55/200) and the positive rates of ASAb-IgG,ASAb-IgM and ASAb-IgA were 11.5 ％ (23/200),22.5 ％ (45/200) and 9.5 ％(19/200) respectively.While in the control group,the rates were 6.0％ (6/100),1.0％ (1/100),0 and 2.0％(2/100) respectively ( x2 =5.33,5.37,5.41,4.05 ;P ＜ 0.05 ).The total positive rate of EMAb was 148.5％(97/200),and the positive rates of EMAb-IgG and EMAb-IgM were 13.5％ and 32.5％ respectively,and EMAb-IgG + EMAb-IgM positive rate was 5.5％ (11/20).These parameters were significantly higher than those in the control group [0,1.0％ (1/100),3.0％ (3/100),0,x2 =5.01,5.24,5.16,5.33 ;P ＜0.01 ].There was significantly difference on the level of AMH between the experimental group and the control group [ (5.39 ±1.42) μg/L vs.(2.55 ± 1.27 ) μg/L,t =5.39,P ＜ 0.01 ].Significant correlation was found between ASAb and EMAb( x2 =6.27,P =0.03) by correlation analysis.ConclusionThe level of AMH and the positive rates of ASAb and EMAb are higher in women with infertility than in normal people. Detection of ASAb,EMAb and AMH are important in in finding cause for infertility and taking appropriate measures to treat infertility

Objective To optimize the parameters for the diffusion tensor imaging (DTI)of the ulnar nerve in elbow.Methods 5 groups of DTI sequences with different b values and numbers of diffusion gradient directions (NDGDs)were used to collect ulnar nerve images from 13 volunteers,and then the diffusion tensor tractography (DTT)was established.The fractional anisotropy (FA),apparent diffusion coefficient (ADC),length of ulnar nerve fiber and DTI image quality were compared under different imaging parameters. Results DTI results for 18 normal ulnar nerves were included in the study.Under different imaging conditions,FAs showed no significant differences.With constant NDGDs,increasing b value decreased both image quality and ADCs of the ulnar nerve.NDGDs had no significant effects on ADCs or image quality.When b=1 000 s/mm2 and NDGDs=20,the length of the ulnar nerve fiber was the longest and DTT had the best subjective scoring in image quality.Conclusion b=1 000 s/mm2 and NDGDs=20 is recommended for DTI of elbow ulnar nerve,so as to obtain high image quality and stable observing targets.

Objective To evaluate the curative effect and toxicities of platinum-based double regimens for patients aged ≥ 65 with advanced non-small-cell lung cancer (NSCLC) and identify the prognosis factors. Methods 70 patients aged ≥65 with staged ⅢA-Ⅳ NSCLC, who received platinum-based double regimens as first line treatment, were emrolled.Response rates and toxicities were evaluated.Progression free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox regression analysis was used to identify the potential prognosis factors.Results The median chemotherapy cycles was 3.The overall response rate was 41.5 % (22/53), and there was no difference between patients aged ＜70 and ≥70 (χ2 =1.945, P =0.378).The median PFS and OS were 6.0 months and 12.5 months.The chemotherapyrelated hematologic toxicities were common.Multivariate analysis revealed that performance status, numbers of metastasis, chemotherapy cycles were significant independent predictive factors for OS. Conclusion In elderly advanced NSCLC, platinum-based doublets show inspiring efficacy, but with more adverse events, and could not be all well tolerated. It should be personalized. Patients with poor performance status and multiple organs metastasis are hard to benefit from combined chemotherapy.Three to six cycles of chemotherapy is the optimal duration for patients who could be well tolerated.

Objective To examine the clinical features of sporadic patients with H7N9 avian influenzain Taizhou city of Zhejiang province and to characterize its viral genes.Methods Fifteen patients with H7N9 influenza infection confirmed by Zhejiang Provincial Centre for Disease Control and Prevention during January 201 4 and January 201 5 were included in the study.The basic diseases,poultry exposure history,clinical manifestation,laboratory examination,imaging features,treatment and outcome and viral gene sequencing were analyzed retrospectively.Results The first clinical symptoms were fever and cough in all patients,acuterespiratory distress syndrome(ARDS)occurred in 1 3 patients,the average time from onset to antiviral therapy was (7 ±2)d.Among 1 5 patients,9 survived and 6 died,including 2 died of multiple organ failure (MOF).The phylogenetic tree showed that there was highly homologous in hemagglutinin (HA)and neuraminidase(NA)genes between human H7N9 virus strains and poultry reference strains.The result of genetic sequencing indicated that human H7N9 virus strains had mutations at 226 (Q226L)sites in HA protein.Conclusions ARDS is likely to occur in patients with H7N9 viral infection,and early antiviral treatment usually leads to a good prognosis.With the occurrence of adaptive mutation in avian influenza virus H7N9,spread from poultry to the human beings may take place.

Objective To observe the effects and safety of oxycodone hydrochloride combined with parecoxib sodium in preventing postoperative hyperalgesia induced by remifentanil. Methods Eighty-eight ASA Ⅰ or Ⅱ patients undergoing elective laparoscopic myomectomy surgery were randomly divided into four groups (C,O,P,PO) with 22 cases in each group. Patients in group C,O,P,PO were given with 10 mL saline, 0.1 mg?kg-1 oxycodone hydrochloride, 40 mg parecoxib sodium, 0.1 mg?kg-1 oxycodone hydrochloride and 40 mg parecoxib sodium 30 min before the end of the surgery, respectively. The VAS scores were recorded at the end of surgery 30 min, 1 h, 2 h, 4 h, 8 h, and the cases of agitation, rigor, vomiting and increasing of analgesics were recorded. Results Compared with group C, the VAS scores in group O, P,PO were significantly lower(P<0.05). The VAS scores in group PO were lower than those in group O,P(P<0.05). The cases of agitation and rigor in group PO (0.0%, 5.0%) were less than those in group C (45.0%,23.0%) (P<0.05). The increased doses of analgesics in group PO(0) were less than those in groups C (12), group P (5), and group O (5)(P<0.05). Conclusion Oxycodone hydrochloride combined with parecoxib sodium can effectively prevent postoperative hyperalgesia induced by remifentanil, and reduce the incidence of postoperative agitation.

Objective To evaluate the diagnostic ability of fusion images of SWI and DWI in ischemic penumbra(IP)of patients with acute ischemic stroke(AIS).Methods 47 AIS patients were retrospective analyzed.Two neuroradiologists analyzed the fusion images of SWI and DWI respectively.SDM was defined as that the hypo-intensity signals of intramedullary or sulcal veins were dilated or increased on fusion images compared with contralateral areas.The results compared with the PDM,which was considered as the“gold standard”.Areas under the receiver operating characteristic curve(AUC)were used to assess the efficacy of SDM which determined by fusion images and compared to PDM.Chi-square test was used to analyze the consistency between the two neuroradiologists and also the consistency between SDM and PDM in IP assessment Results The fusion images of SWI and DWI had a high diagnostic efficacy compared to PDM, AUC of the two radiologists were 0.885,0.877,the diagnostic sensitivity were 84.2%,78.9% and specificity were 92.9%,96.4%respectively.There was also a high consistency in SDM assessment through fusion images between the two neuroradiologists (Kappa=0.908,P >0.05). Conclusion Fusion images of SWI and DWI have a high diagnostic efficacy in IP assessment,which may be considered as a simple approach for IP assessment in patients with AIS.