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.

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.

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.

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

Adult ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Heart Neoplasms ; pathology ; Humans ; Myxoma ; pathology ; Ovarian Neoplasms ; secondary ; surgery ; Pulmonary Veins ; Sarcoma ; diagnostic imaging ; metabolism ; pathology ; secondary ; surgery ; Tomography, X-Ray Computed ; Vascular Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To investigate the symptom characteristis as well as the clinical assessment methods of dysphagia and oral motor function in children with cerebral palsy(CP).Methods A total of 116 children with CP,aged 18 months to 96 months(66 boys and 50 girls),treated in Qingdao Rehabilitation Center for Disabled Children from June 2009 to September 2010,were included in the study.Diagnosis and subtype of CP were determined by neuropaediatrician,the dysphagia disorders survey(DDS)as well as oral motor assessment were conducted by the speech therapists.Results Of the 116 cases,22.4％ of the cases were with mild dysphagia and 34.5％ with moderate to severe dysphagia,resulting in a prevalence of dysphagia of 56.9％.The main problems of these cases occurred during oral phase and pharyngeal phase,including inadequate feeding skills(involving sucking,biting,chewing or/and swallowing),coughing,vomiting and choking during feeding,cry/overextension of neck and head during feeding,drooling,hypertonic tongue and inadequate tongue lateralization.The severe dysphagia was encountered frequently in children with spastic quadriplegic,dyskinetic or mixed type CP children.Of the 116 cases,90 cases(77.59％)were with oral motor dysfunction(including all spastic quadriplegic,dyskinetic or mixed type children).The oral motor scores of CP children were significantly lower than those of the controls(P ＜ 0.01).Conclusions Oral phase dysphagia and oral motor disorder might be considered as the common clinical problems among the patients with CP,and could be assessed by using DDS combined with oral motor assessment,but for dysphagia during pharyngeal or esophagus phase,the videofluoroscopic modified barium swallow should be used for further evaluation.

[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 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.

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.