Recently,studies have demonstrated that several signaling pathways including Wnt,Notch,and Hedgehog which are involved in the regulation of the stem cells are abnormally activated in lung cancer.They are closely associated with some properties of the lung cancer stem cells,such as high tumorigenic,high metastasis,drug resistance and so on.In addition,several studies have shown that the population of the lung cancer stem cells,which are resistant to radiotherapy and chemotherapy significantly,highly express drug resistance proteins.Therefore,how to target lung cancer stem cells and ultimately cure the disease is becoming a hotspot in the cancer targeted therapy.

Chimeric antigen receptor T cells (CAR-T) therapy is progressing rapidly, and its safety has been widely concerned. At the 62nd American Society of Hematology Annual Meeting, a series of reports on the mechanism, predictive indicators and treatment strategies of major adverse reactions were carried out. These reports have certain guiding significance for comprehensively improving the safety of CAR-T therapy.

Objective: To evaluate the clinical effect of individualized enteral nutritional (EN) support in severe stroke patients.Methods: Totally 120 severe stroke patients with nutritional risk were divided into two groups according to single or double admission number.The 60 patients in the intervention group received an individualized EN with different formula and concentrations according to the clinical status,and supplemented trace elements as occasion required.In the routine group, the patients received EN with standard formula.The energy supply was 83-125 kJ· kg-1·d-1 in both groups.Blood albumin(Alb), pre-albumin(PA), hemoglobin(Hb) and vitamin C(VC) were examined before and after the 21-day nutritional support.The lung infection and gastrointestinal (GI) complications were observed, and the hospital stay and cost were recorded as well.Results: After 21 day''s nutrition support, the serum levels of Alb, PA and VC in the intervention group were not statisticly significant than before (P＞0.05), and the serum levels of Alb, PA and VC were significantly higher than those in the routine group(P＜0.05).The incidence of complications in the in the intervention group was lower than that in the routine group (P＜0.05), and the length of hospital stay and hospitalization was shorter than that in the routine group (P＜0.05).Conclusion: Individualized enteral nutritional support can significantly improve nutritional status, reduce inflammation reactions and GI complications in severe stroke patients, which is worthy of clinical use.

Epigenetics consists of DNA methylation,post-translational modification of histon,microRNA and long non-coding RNA,which regulate angiogenesis by acting on different targets.Epigenetics has become potential targets of anti-angiogenesis in tumor.

Chronic Disease ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Heart ; drug effects ; physiopathology ; Heart Failure ; drug therapy ; physiopathology ; Humans ; Kidney ; drug effects ; physiopathology

Objective To investigate the clinical efficacy of pre-hospital mild hypothermia in patients with severe craniocerebral injury,and to explore the possible mechanism by the changes of serum Malondialdehyde (MDA).Methods 120 cases of severe craniocerebral injury were divided into pre-hospital mild hypothermia group (group A,65 cases) and control group(group B,55 cases) by random number table.Patients in group A were gave pre-hospital mild hypothermia treatment,and patients in group B were gave mild hypothermia therapy only after hospitalization.Comparison of the change of serum MDA at admission,the 7th and 14th day between two groups,and the functional outcomes were evaluated by GOS score in 6 months after treatment.Results The MDA levels of two group at seventh days and 14 days were higher than that at admission [(10.4 ± 1.5)nmol/L and (8.2 ± 1.2)nmol/L in group A,(12.6 ± 1.9)nmol/L and (10.0 ± 1.4)nmol/L in group B,P ＜0.05],and it was the highest at 7th day,and its in group A was significantly lower than that in group B at 7th,14th day [(6.9 ± 1.1) nmol/L in group A,(6.6 ±1.0) nmol/L in group B,P ＜ 0.05].The good prognosis rate was 47.7％ (31 cases) in group A,higher than the 38.2％ (21 cases) in group B;The mortality rate was 12.1％ (8 cases) in group A,lower than the 21.4％ (12 cases)the group B,and the difference was statistically significant (Z =-2.132,P ＜ 0.05).Conclusion Pre-hospital mild hypothermia treatment can improve the prognosis of patients with severe craniocerebral injury and alleviate the damage of brain tissues.

[Objective]Exploring innovation in TCM diagnosis and treatment in Zhejiang before modern time,to provide reference for current TCM skil s' heritage and development in Zhejiang.[Method]Using literature research methods, the author sorts out the pre-modern Zhejiang Chinese medicine works. By analyzing and contrasting, the author finds innovative knowledge and information. [Result]Before modern times, the creative technology of TCM diag-nosis and treatment in Zhejiang was characterized with early start, long maintenance and wide range, moreover, in the clinical sections of internal medicine, gynecology, paediatrics, orthopaedics and rhinology, the new theory and new technology continual y came into being on treating rules, methods and diag-nosis. Therefore, it promoted the diagnosis and treatment levels in the whole. [Conclusion] Before the modern times, the creation of Zhejiang diagnosis and treatment technology originated from many doctors ’medical practices; the various diseases sourced from Zhejiang unique geographical and climatic environment offered good stage for generations of doctors to distinguish themselves; and the developed society and material civilization in Zhejiang area provided strong guarantee for Zhejiang doctors to find and invent new diagnosis and treatment technology.

Objective　To investigate the significances of telomerase activity and P53 expression in Non-small cell lung cancer (NSCLC). Methods　The activity of telomerase in cancerous tissues was detected by PCR-ELISA, and the expression of P53 protein was detected by S-P method. Results　The telomerase activity and P53 expression were significantly higher in NSCLC tissues than in normal lung tissues. The telomerase activity and P53 expression had close association with the differentiation of cancer cells and lymph node metastasis. Conclusion　It is very valuable to measure telomerase activity and P53 expression in studying the initiation and progression of NSCLC.

Objective To investigate the clinical efficacy of re-modified Sugiura procedure for the treatment of portal hypertension.Methods The retrospective cohort study was adopted.The clinical data of 119 patients with portal hypertension who were admitted to Second People's Hospital of Yichang from June 2006 to October 2014 were collected.Seventy-two patients who underwent pericardial devascularization were allocated into the Hassab group,and the other 47 patients who underwent the re-modified Sugiura procedure were allocated into the R-M Sugiura group.All the patients firstly underwent splenectomy.The patients of the Hassab group received the classical surgery of pericardial devascularization,and the operation in the R-M Sugiura group was improved on the modified Sugiura procedure in several aspects:(1) the cardia was transected obliquely.(2) Paraesophageal vessels were preserved by selective pericardial devascularization.(3) The pedicled omentum covered the anterior anastomosis and was sutured to the posterior abdominal wall.Observed indices included (1) intraoperative and postoperative situations:operation time,volume of intraoperative blood loss,postoperative anal exhaust time and duration of postoperative hospital stay.(2) Postoperative complications:postoperative pleural effusion,perioperative digestive tract re-bleeding,difficult swallowing,portal vein thrombosis and gastric dynamic dysfunction.(3) Situation of follow-up.The follow-up was performed by telephone interview and outpatient examination to observe the grading of the esophageal varices at postoperative month 6 and 18 using gastroscope till February 2016.Measurement data with normal distribution were presented as x ± s,and comparison between groups was done by the t test.Count data were analyzed by the chi-square test.Ranked data were analyzed by Wilcoxon rank test.Results (1) Intraoperative and postoperative situations:operation time of the Hassab group and the R-M Sugiura group was (201 ± 27) minutes and (255 ± 32) minutes,respectively,with a statistically significant difference between the 2 groups (t =9.67,P ＜ 0.05).The volume of intraoperative blood loss,postoperative anal exhaust time and duration of postoperative hospital stay were (380 ± 86) mL,(2.7 ± 0.7) days,(14.2 ± 2.4) days in the Hassab group and (401 ± 72) mL,(3.0 ± 1.7) days,(15.1 ± 2.7) days in the R-M Sugiura group,respectively,showing no statistically significant difference (t =1.35,1.26,1.86,P ＞ 0.05).(2) Postoperative complications:dysphagia was detected in 3 patients of the Hassab group and in 10 patients of the R-M Sugiura group at the postoperative day 10,with a statistically significant difference between the 2 groups (x2 =0.86,P ＜ 0.05).However,dysphagia was detected in 1 patient of the Hassab group and in 4 patients of the R-M Sugiura group at the postoperative day 20,showing no statistically significant difference between the 2 groups (x2 =2.03,P ＞ 0.05).The number of postoperative pleural effusion,perioperative digestive tract rebleeding,portal vein thrombosis and gastric dynamic dysfunction of the Hassab group and the R-M Sugiura group were 23,6,10,8 cases and 20,1,6,6 cases,respectively,showing no statistically significant difference (x2=1.39,1.02,0.03,0.08,P ＞ 0.05).(3) Situation of follow-up:all the patients were reexamined using gastroscope to observe the grading of esophageal varices.There were 0,7,56,9 patients of G0,G Ⅰ,G Ⅱ,G Ⅲ grading of varices in the Hassab group and 35,12,0,0 patients in the R-M Sugiura group at postoperative month 6,showing a statistically significant difference between the 2 groups (Z =-9.64,P ＜ 0.05).There were 0,0,48,24 patients of G0,G Ⅰ,G Ⅱ,G Ⅲ grading of varices in the Hassab group and 24,20,3,0 patients in the R-M Sugiura group at postoperative month 18,showing a statistically significant difference between the 2 groups (Z =-9.28,P ＜ 0.05).Conclusion The re-modified Sugiura procedure is more effective than the Hassab operation in curing portal hypertension,and it could also reduce the rate of rehemorrhage and improve the short-term and long-term prognosis.

Purpose:To observe the therapeutic effect of gemcitabine combined with 5-FU for the treatment of advanced cholangiocarcinoma. Methods:21 patients were given gemcitabine and 5-FU intravenously. Results:There was no complete response .The partial response rate was 23.8% and SD,38.1%.12 patients(57.14%) had amelioration of pain and improvement in quality of life.The toxicity was low and tolerable. Conclusions:Gemcitabine combined with 5-FU was an effective and safe regimen for treating advanced cholangiocarcinoma and worthy of further evaluation.