Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) have shown great efficacy in the treatment of non-small cell lung cancer (NSCLC) patients with EGFR-mutation positive tumors.However,the response to EGFR-TKI is quite different even in EGFR-mutation positive patients.Besides that,different lesions in same patient can also show different response to EGFR-TKI.These phenomena might be associated with the heterogeneity of EGFR mutations,which involves intratumoral heterogeneity,intertumoral heterogeneity,and the heterogeneity before and after treatment.The article introduces the advance in heterogeneity of EGFR mutations from these three aspects.

In this paper, a novel electrochemiluminescent (ECL) detection approach was developed for highly sensitive detection of ECL inhibitors based on the ECL inhibition of Ru(bpy)32+/2-(Dibutylamino)ethanol (DBAE) system. A microfluidic ECL detection cell was fabricated to couple with the capillary electrophoresis system, the electrochemical system and the postcolumn injection system. Both Ru(bpy)32+ and DBAE solutions were injected directly to the working electrode surface by a micro-infusion system to obtain a high and stable ECL signal. The performance of this setup was demonstrated by the analysis of two typical ECL inhibitors, dopamine and epinephrine. Under the optimal conditions, the limit of detection (LOD) for dopamine and epinephrine was 50nM and 5nM respectively. The proposed method was also successfully used for the trace analysis of dopamine and epinephrine in human serum samples.

Objective: To explore the clinical effect between bridge locking anatomical plate with supported plate based four column in type III Riiedi-Allgower Pilon fracture. Methods: Retrospective study was performed on the clinical data of type III Riiedi-Allgower Pilon fracture undergoing surgery. Patients were divided into two groups according to internal fixation. Some parameters including operation time, blood loss, and drainage, healing time, full burden time, functional score and pain score were analyzed. Results: There was no significant difference between the operation time, blood loss and drainage between the two groups(t = 0. 37, P>0. 05;t = 0. 71, P>0. 05;t = 0. 24,/>>0.05). The healing time and full burden time of experimental group was lower than control group significantly ((=1.56, P<0. 05;i = 2.43, P<0.05). For American Orthopaedic Food and Ankle Society(AOFAS) score and visual analogue score(VAS) in postoperative 1 month, there was no significant difference between the two groups. For AOFAS score and VAS score in experimental group was lower than control group after 3 months (P<0. 05). There was no significant difference between two groups in reduction quality Burwell-Charnley score and complication between two groups. Conclusion Supported plate based four column could improve the life quality of patietns with Pilon fracture, which is worth to recommed in clinical application.

OBJECTIVETo assess the value of pulsed Doppler tissue imaging (PW-DTI) in evaluating the left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (DM).

METHODSSeventy-seven type 2 diabetic patients and 43 healthy volunteers underwent PW-DTI and mitral inflow pulsed wave Doppler (MPWD). Six positions of the mitral annulus were measured by PW-DTI for early diastolic velocity (Em), end diastolic velocity (Am), Em/Am ratio. Early mitral inflow velocity (E), end mitral inflow velocity (A), left ventricular isovolumetric relaxation (IVRT) and E/A ratio were measured by MPWD.

RESULTSIn the diabetic patients, Em, Em/Am and E/A ratios were significantly decreased and Am and A increased with prolonged IVRT. The two examination modalities showed a significant correlation between Em/Am and E/A. The detection rate of LVDD in the diabetic group was 94.81% by PW-DTI and 79.22% by MPWD.

CONCLUSIONPW-DTI and MPWD show a significant correlation in assessment of the left ventricular filling, but the former displays better performance in sensitive and accurate diastolic function evaluation and provides early evidence for of diabetic cardiomyopathy of due to its potent ability in differentiation of false-normal presentations.

Adult ; Aged ; Diabetes Mellitus, Type 2 ; complications ; diagnostic imaging ; physiopathology ; Diastole ; Echocardiography, Doppler, Pulsed ; methods ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; Ventricular Dysfunction, Left ; diagnostic imaging ; etiology

OBJECTIVE: To investigate the efficacy and safety of total spine endoscopy in the treatment of lumbar disc herniation combined with posterior apophyseal ring separation. METHODS: From January 2015 to January 2018, a total of 21 patients with lumbar disc herniation complicated with posterior apophyseal ring separation were treated with total spine endoscopy via interlamina approach. There were 17 males and 4 females. The age ranged from 18 to 48 years old and the median age was 27 years old. All were single segment unilateral disc herniation, interlaminar approach was adopted, and the herniated disc was removed unilaterally at the symptomatic side under the microscope, and all or part of the broken bonewas removed. RESULTS: There were no complications such as incision infection, intervertebral space infection, intestinal injury, dural injury and cerebrospinal fluid leakage. The operation time ranged from 32 to 92 minutes and the median time was 57 minutes. Postoperative imaging examination showed that 2 patients had complete resection of osteotomy of posterior edge of vertebral body, 16 patients had partially resection and 3 patients had no resection. All intervertebral discs were completely removed. All 21 patients were followed up, and the duration ranged from 12 to 36 months, with a median of 15 months. The VAS of lumbago was 7.10±1.20 before surgery, 3.46±0.23 on the 3rd day after surgery, 2.36±0.19 on the 6th month after surgery; and the VAS of leg pain was 8.80±0.55 before surgery, 3.54±0.28 on the 3rd day after surgery, and 2.59±0.26 on the 6th month after surgery. The Oswestry Disability Index score was (69.71±9.37)% before surgery, (32.19±6.95)% on the 6th month after surgery, and (20.95± 6.16)% at the latest follow up. Onthe 1st year after operation, 16 patients got an excellent result, 4 good and 1 fair according to Macnab evaluation system. CONCLUSION Total spine endoscopy via interlaminal approach can be used as an option in the treatment of lumbar disc herniation combined with vertebral posterior margin dissociation, which can reduce trauma and injury to the lumbar dorsal muscle and achieve similar decompression effect as open surgery. The long term efficacy needs to be further proved by prospective randomized controlled studies with larger sample size.
Adolescent ; Adult ; Diskectomy, Percutaneous ; Female ; Humans ; Intervertebral Disc Displacement ; Lumbar Vertebrae ; Male ; Middle Aged ; Neuroendoscopy ; Prospective Studies ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective::To observe the effect of Jianpi Qingchang decoction on hormone withdrawal in patients with hormone-dependent spleen deficiency damp-heat ulcerative colitis. Method::The 60 patients with hormone-dependent ulcerative colitis with spleen deficiency and damp-heat were selected and collected from the outpatient department and the inpatient department of Longhua Hospital, Shanghai University of Traditional Chinese Medicine(TCM) between April 1, 2012 and January 31, 2014.All of patients in two groups were treated with standard hormone reduction method. The control group was given orally Bupi Yichang pills, 6 g/time, 3 times/day, and the experimental group was given orally Jianpi Qingchang recipe, 300 mL water decoction, 1 dose/d, 2 times/d. All of the patients received continuous treatment for 3 months. After treatment, disease activity index, mucosal healing evaluation, curative effect changes of TCM syndromes and changes of inflammatory factors in the two groups were observed. Result::Compared with before treatment, the two groups of Mayo scores after treatment were significantly reduced (P<0.01), and the experimental group was reduced more significantly than the control group (P<0.01). After treatment, 66.67%of patients in experimental group were in remission, and 13.33%of patients in control group were in remission, with statistically significant differences between two groups (P<0.01). After treatment, the healing rate of the control group was 46.67%, while that of the experimental group was 70.0%, with statistically significant differences (P<0.01). After treatment, the effective rate of TCM syndromes in control group was 80.0%, while that in experimental group was 96.67%, with statistically significant differences (P<0.01). Compared with control group before treatment, the levels of IL-1 in both groups were decreased (P<0.05), while the levels of IL-6 and IL-10 were increased (P<0.05). Compared with control group after treatment, the changes in experimental group were significantly better than those in control group (P<0.05). Conclusion::Jianpi Qingchang decoction can reduce the index of disease activity in patients with hormone-dependent ulcerative colitis due to spleen deficiency and dampness-heat, promote mucosal healing and improve the curative effect of TCM symptoms, and thus is worthy of clinical promotion.