Brain metastases (BM) are one of the main cause of death in patients with non small cell lung cancer ( NSCLC ).The prognosis is still poor, despite standard therapy based on surgery and radiotherapy.In recent years,with the deepening understanding of molecular mechanisms in lung cancer, epidermal growth factor receptor (EGFR) mutation might be considered as an effective therapeutic target for NSCLC with BM.Therefore,we review the current knowledge about the correlation between EGFR mutation with prevalence and prognosis in BM.

Since the first reported case of swine influenza A in Mexico,a total of 15 510 cases have been confirmed in 53 countries by May 29,2009.On April 29,2009,the World Health Organization(WHO)raised its pandemic alert from grade 4 to grade 5.The virus is described as a new subtype of A/H1N1 and is not detected in pigs or humans previously.The virus is sensitive to oseltamivir and zanamivir,but resistant to amantadine and rimantadine.The genetics of the virus are so novel that humans are unlikely to have much immunity to it.The virus can transmit from human to human;therefore it is necessary to enforce quarantine measure for close contactors because the virus transmits during latency.Precaution methods like covering noses and mouths with a tissue when coughing or sneezing can reduce the transmission opportunity.Hands should be washed frequently with soap,especially after coughing or sneezing.Public places with ventilation conditions,personal health behavior and health condition are critical for the prevention and control of this epidemic.

Objective To evaluate the clinical effects of Kangfuxin solution as the auxiliary treatment of chronic periodontitis.Methods 41 patients with chronic periodontal diseases were randomly divided into test group and control group.Following initial therapy,Kangfuxin solution was applied to the test group,but the control group received no drug.The bleeding on probing(BOP)was observed before treatment and 1 week after treatment.Results Before treatment.there was no significant difference in the index between the two groups.After initial therapy 1 week,both groups showed improvement in their examined index(all P＜0.01).The results of the test group were better than those of the control group,and the differences were statistically significant(P＜0.01).Conclusion Kangfuxin solution as the auxiliary treatment of periodontitis could effectively relieve the clinical symptoms and gain good clinical effect.It was worth to be used widely.

Several epidemic influenza viruses leading to worldwide periodical pandemics all result from the genetic reassortment of different influenza viruses.The novel 2009 A/H1N1 virus is a reassortment virus evolved from swine influenza virus A/H1N1,avian influenza virus H5N1,and human influenza virus A/H1N1.The 8 fragmente genes of the novel A/H1N1 virus had their own evolutionary characteristics.All the pandemic viruses in humans originate from avian influenza viruses and are transferred into humans after reassortment processes in pigs.Pigs as middle host and a mixing vessel of influenza A virus play an important role in the evolution of the 2009 novel A/H1N1 virus.More attention should be paid on the role of swine in the prevention and control of novel H1N1 virus epidemics in future.

Objective To compare the effects of laparoscopic hepatectomy (LH) versus conventional laparotomy hepatectomy (CLH) on cellular immunity. Methods Fifteen ASA Ⅱ-Ⅲ patients aged 34-61 yrs, weighing 48-75 kg undergoing laparoscopic hepatectomy (LH) were studied. Another 15 patients aged 33-64 yrs, weighing 46-73 kg undergoing conventional laparotomy hepatectomy (CLH) served as control. The preoperative liver function was rated as Child classification A in both groups. The patients were premedicated with phenobarbital 0.1 g and atropine 0.5 mg i.m. . Anesthesia was induced with fenlanyl 4 ?g?kg-1, propofol 1.5 mg?kg-1 and succinylcholine 2 mg?kg-1. After tracheal intubation the patients were mechanically ventilated and PETCO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with inhalation of isoflurane (MAC 1.0?0.31) and 60% N2O in O2 and intermittent i.v. boluses of vecuronium. The patients received after operation patient-controlled epidural analgesia (PCEA) with 0.125% ropivacaine and morphine 0.05 ?g?kg-1?min-1. Radial artery and right internal jugular vein were cannulated for BP and CVP monitoring. Peripheral venous blood samples were taken before operation and on the 1 st and 3rd postoperative day for determination of CD3+ , CD4+ , CD8+ T cells (by flow cytometry) and IL-6, TNF-?concentrations (ELBA) . Results CD3+ , CD4+ and CD8+ counts were significantly decreased while IL-6 and TNF-?levels were significantly increased on the 1st postoperative day compared with the baseline values before operation in both groups but there was no significant difference between the two groups. On the 3rd postoperative day CD3+ , CD4+ and CD8+ counts and IL-6, TNF-?levels returned to preoperative level in group LH while in group CLH CD3+ , CD4+ , CD8+ remained low and IL-6, TNF-?levels remained high.Conclusion The results suggest that LH exerts less effects on immune function than conventional laparotomy technique.

Objective To explore the necessity of EGFR?targeted therapy combined with synchronized whole brain radiotherapy ( WBRT ) for non?small?cell lung cancer ( NSCLC ) with mutated EGFR and brain metastasis by comparing the effects on prognosis between WBRT combined with tyrosine kinase inhibitor ( TKI) and TKI alone. Methods A retrospective analysis was performed in 43 patients with EGFR mutation?positive NSCLC and brain metastasis. In those patients, 24 patients received WBRT plus TKI and 19 patients TKI alone. Results The overall response rate ( RR) and 6?month intracranial disease control rate ( CR) were significantly higher in the WBRT+TKI group than in the TKI group ( 79% vs. 37%, P=0. 002;79% vs. 63%, P=0. 008). The median intracranial progression?free survival (IPFS) time was significantly longer in the WBRT+TKI group than in the TKI group ( 23. 7 vs. 8. 3 months, P=0. 025) . The multivariate analysis indicated that the control of lung cancer, WBRT+TKI, and single brain metastasis were favorable factors for substantially longer IPFS time ( P=0. 033,0. 019,0. 019) . In 23 patients with exon 19 deletion, 12 patients received WBRT+TKI and 11 patients TKI alone;compared with the TKI group, the WBRT+TKI group had significantly higher RR and 6?month CR as well as significantly longer IPFS ( 100%vs. 35%, P=0. 000;100% vs. 55%, P=0. 008;23. 7 vs. 8. 4 months, P=0. 003). In 20 patients without exon 19 deletion, however, there were no significant differences in RR or 6?month CR between the WBRT+TKI group (n=12) and the TKI group (n=8)(64% vs. 50%, P=1. 000;58% vs. 75%, P=0. 642).The median IPFS was 14. 4 and 8. 4 months ( P=0. 864) . Conclusions WBRT combined with TKI is superior to TKI alone in the treatment of NSCLC with brain metastasis. Patients with exon 19 deletion have substantially better treatment outcomes.

Objective To summarize the lung HRCT findings of lung Langerhans cell histiocytosis (LCH) in children. Methods A total of 54 children with lung LCH pathologically proved in our institute from September 2006 to December 2014 were retrospectively reviewed. Patients were subdivided into two subgroups, diffuse type (n=29) and localized type (n=25). In addition, 32 children with LCH but without pulmonary infiltration were selected as control group. HRCT findings of 54 LCH with lung involvement were reviewed and analyzed for distribution pattern. The age of onset, illness duration and pulmonary function were compared between the lung LCH group and the control group. The differences of HRCT findings in LCH patients between diffuse type and localized type were compared with χ2 test. The differences on the onset age, illness duration and pulmonary function between the LCH group with lung involvement and control group were compared with non-parametric test(Mann-Whitney U Test). The differences of pulmonary function between the LCH group with lung involvement and control group were compared with Fisher exact probability test. Results The signs of pulmonary LCH on HRCT included lobular hyperinflation (n=26), interlobular septa thickening (n=11), cystic lesions (n=11), ground?glass opacity (n=10), nodules (n=9), and centrilobular nodules (n=6). The signs presented in 21, 8, 7, 9, 4 and 6 cases in diffuse type group respectively and 5, 3, 4, 1, 5, 0 in localized type group. Among them, lobular hyperinflation, ground?glass opacity and centrilobular nodules were more prevalent in the diffuse group. The difference was statistically significant (χ2=14.77,2.01,0.55,4.84,0.06 and 3.91, P<0.05). The onset age of LCH group with lung involvement was younger than the other (Z=-2.40, P<0.05). However, there was no statistically significant difference in the illness duration (Z=-1.46, P>0.05) and pulmonary function between two groups (P>0.05). Conclusions Lobular hyperinflation, ground glass opacity and centrilobular nodules are the most common manifestations in LCH patients with lung involvement and the distribution is mostly diffuse. Nodules, cystic lesions and interlobular septa thickening may exist. Several signs may coexist simultaneously. Younger children with LCH are more vulnerable to lung involvement.

Objective To investigate the change of monocyte autophagy in patients after trauma.Methods ①According to Injury Severity Score(ISS) or Abbreviated Injury Scale(AIS),we divided our 51 subjected trauma patients into 3 groups,the minor injury group(n=21),the moderate trauma group(n=19) and the severe trauma group(n=11).Another 14 healthy volunteers served as control.We collected the peripheral blood in 24 h,3,5 and 10 d after trauma,then harvested the monocytes by density gradient centrifugation with adherence separation.Then we observed the autophagy phenomenon by using laser confocal microscopy and transmission electron microscopy;② After the isolated monocytes were dyed with MDC and lysed,they were detected and quantified for fluorescent intensity by fluorospectrophotometer(excitation wavelength 380 nm and emission wavelength 525 nm);③Blood sugar level of all patients were measured in 24 h,3 and 5 d respectively after trauma,and the correlation between autophagy and blood sugar was analyzed.Results Compared with control group,more autophagy in monocytes was observed and quantified in trauma patients than in health volunteers(P

Objective To understand the consulting relationship among students of some teaching class of epidemiology.Methods Data were collected through questionnaire and the network characteristics were analyzed with social network analysis software-NetDraw.Results The consulting network relation of this class was loosening,but there were a few people who have more degree and betweenness than others;some cliques were associated with major and sex.Conclusions Social network analysis can help teacher understand the consulting relationship among students,which may provide the base for making the management strategy on teaching class.