Objective To investigate the relationship between expression of active form of caspase-3 and cell cycle in Fas-mediated apoptosis of B lymphocytoma cell line MML-1. Methods MML-1 cells were incubated with agonistic anti-Fas antibody for different time,and cell apoptosis was induced.Cell apoptotic rates were analysed by flow cytometry,and sensitivity of MML-1 cells to apoptosis was determined.The expression of active form of caspase-3 was analysed by double staining with PI-Triton X and FITC-active caspase-3.Cyclin A,B_1 and E were selected as cell cycle markers for S,G_2/M and G_1 phase of MML-1 cells,and the expression of active form of caspase-3 was detected by flow cytometry. Results The cell apoptotic rate reached 56% after induction by Fas for 6 h.After induction by Fas for 4 h,the active form of caspase-3 was mainly expressed in cells of G_1 phase,while rarely in cells of S and G_2/M phase.Cells with negative cyclin A and B_1 and positive cyclin E expressed active form of caspase-3. Conclusion The expression of active form of caspase-3 in MML-1 cells mediated by Fas might be cell cycle dependent.Cells entering into late G_1 and early S phase first express active form of caspase-3,and their sensitivity to Fas-mediated apoptosis is the highest.

Objective To investigate the efficacy and safety of crizotinib in patients with advanced anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC),and focuse on analysis of its prognostic factors.Methods Fifty patients with advanced (stage m B-Ⅳ) ALK-positive NSCLC confirmed by cytology or histology in Peking Union Medical Collage Hospital from January 2013 to September 2016 were collected.The relevant clinical imformation and treatment protocols were recorded.The efficacy and safety of crizotinib were followed up,and its prognostic factors were analyzed.Results At the end of follow-up,the median progression free survival (PFS) of progressed patients (n =24) was 9.6 months (95％ CI:8.3-10.9 months),of which five patients died.The median follow-up time of non-progressed patients (n =26) was 10.7 months.The most common adverse event was abnormal liver function (48.0％,24/50).In the single factor analysis of Kaplan-Meier,younger or equal to 40 years old patients had a longer PFS (P =0.017),and the COX regression analysis (Enter method) also had statistical significance differences (HR =6.1,95％ CI:1.4-27.5,P =0.018).However,gender (HR =0.8,95％ CI:0.2-2.6,P =0.697),smoking history (HR =1.5,95％ CI:0.4-5.6,P =0.524),pathology (HR =1.1,95％ CI:0.3-4.2,P =0.922),tumor stage (HR =1.7,95％ CI:0.4-8.4,P =0.502),epidermal growth factor receptor (EGFR) mutant type (HR =0.4,95％ CI:0.4-4.3,P =0.461),EGFR unknown (HR =1.3,95％ CI:0.3-6.1,P =0.727),Eastern Cooperative Oncology Group Performance Status (ECOG) PS score (HR =2.0,95％ CI:0.6-6.8,P =0.290),the status of previous treatment (HR =0.6,95％ CI:0.2-1.8,P =0.385) and brain metastasis (HR=0.7,95％CI:0.1-3.2,P=0.628) were not associated with disease progression Conclusion Crizotinib has good efficacy and is safe and well-tolerated to advanced ALK-positive NSCLC patients,and age is the independent prognostic factor.

Objective To explore the indications for percutaneous renal biopsy of asymptomatic hematuria in children. Methods The renal pathological types of 485 children with asymptomatic hematuria were analyzed retrospectively. According to the degree of hematuria and whether or not combined with proteinuria, the children were divided into microscopic hematuria group, gross hematuria group and hematuria with proteinuria group. The microscopic hematuria group was further divided into urine red blood cell<15/HPF group, (15～30)/HPF group, and >30/HPF group according to hematuria degree. Results In 227 males and 258 females with the average age of 7.23±2.93 years, there were 318 cases in microscopic hematuria group, in which the most common pathological types were minor lesions (64.8%), followed by focal glomerular lesions (16.7%) and focal segmental glomerulosclerosis (8.2%). There were 119 cases in gross hematuria group, in which the most common pathological types were also minor lesions (26.1%), followed by IgA nephropathy (24.4%) and mesangial proliferative glomerulopathy (20.2%). There were 48 cases in hematuria with proteinuria group, in which the most common pathological types were IgA nephropathy (29.2%) and minor lesions (29.2%). The distribution of the pathological types among microscopic hematuria group, gross hematuria group and hematuria with proteinuria group were statistically different (χ2=152.03, P<0.001). In three groups, microscopic hematuria group had the highest proportion of minor lesions, while gross hematuria group and hematuria with proteinuria group had higher proportion of IgA nephropathy and mesangial proliferative glomerulonephritis . In microscopic hematuria group, there were 149 children with urine red blood cell<15/HPF, 96 with urine red blood cell (15～30)/HPF, and 73 with urine red blood cell >30/HPF. There was no difference in pathological types among three sub-groups (χ2=15.18, P=0.51), and mild lesions were the most common pathological types in each group. Conclusion Renal biopsy should be performed at earliest possible time to make pathological diagnosis in asymptomatic hematuria children with gross hematuria or proteinuria.

Objective The aim of this study was to identify the clinical features and prognostic factors of leptomeningeal metastasis ( LM ) in non?small cell lung cancer ( NSCLC ) patients undergoing treatment with epidermal growth factor receptor ( EGFR ) tyrosine kinase inhibitors ( TKIs ) . Methods Twenty?five cases of NSCLC with LM, treated in our hospital during January 1, 2003 to October 31, 2013, were enrolled in this study. Medical records were reviewed for clinical features and treatments, and the survival and prognostic factors were analyzed. Results NSCLC?LM were more common in female patients (64.0%), and most were adenocarcinomas (72.0%). Twenty (80.0%) patients underwent anti?cancer treatment, among them 17 patients underwent EGFR?TKIs treatment. The median overall survival ( mOS ) after the diagnosis of LM was 4.9 months for the whole group (25 cases). Patients receiving EGFR?TKIs treatment had a longer median survival than patients not receiving EGFR?TKIs (5.3 months vs. 1.2 months, P=0.022) . Eleven patients who developed LM before the targeted therapy had a prolonged median survival of 8.1 months after EGFR?TKIs treatment. The univariate analysis showed that female gender and EGFR?TKIs treatment were favorable prognostic factors influencing the survival ( P<0.05) , while age, LM at the time of initial diagnosis, LM developed during the EGFR?TKIs treatment, whole?brain radiotherapy ( WBRT), intrathecal chemotherapy, or systemic cytotoxic chemotherapy were not associated with mOS (P>0.05 for all). The multivariate analysis showed that female gender ( P=0. 012 ) and EGFR?TKIs treatment ( P=0.008 ) were significant predictors of a good prognosis. Conclusions EGFR?TKIs treatment may confer benefit for NSCLC?LM patients. Female patients and EGFR?TKIs treatment are favorable prognostic factors for survival.

Objective The aim of this study was to identify the clinical features and prognostic factors of leptomeningeal metastasis ( LM ) in non?small cell lung cancer ( NSCLC ) patients undergoing treatment with epidermal growth factor receptor ( EGFR ) tyrosine kinase inhibitors ( TKIs ) . Methods Twenty?five cases of NSCLC with LM, treated in our hospital during January 1, 2003 to October 31, 2013, were enrolled in this study. Medical records were reviewed for clinical features and treatments, and the survival and prognostic factors were analyzed. Results NSCLC?LM were more common in female patients (64.0%), and most were adenocarcinomas (72.0%). Twenty (80.0%) patients underwent anti?cancer treatment, among them 17 patients underwent EGFR?TKIs treatment. The median overall survival ( mOS ) after the diagnosis of LM was 4.9 months for the whole group (25 cases). Patients receiving EGFR?TKIs treatment had a longer median survival than patients not receiving EGFR?TKIs (5.3 months vs. 1.2 months, P=0.022) . Eleven patients who developed LM before the targeted therapy had a prolonged median survival of 8.1 months after EGFR?TKIs treatment. The univariate analysis showed that female gender and EGFR?TKIs treatment were favorable prognostic factors influencing the survival ( P<0.05) , while age, LM at the time of initial diagnosis, LM developed during the EGFR?TKIs treatment, whole?brain radiotherapy ( WBRT), intrathecal chemotherapy, or systemic cytotoxic chemotherapy were not associated with mOS (P>0.05 for all). The multivariate analysis showed that female gender ( P=0. 012 ) and EGFR?TKIs treatment ( P=0.008 ) were significant predictors of a good prognosis. Conclusions EGFR?TKIs treatment may confer benefit for NSCLC?LM patients. Female patients and EGFR?TKIs treatment are favorable prognostic factors for survival.

Background and objective Intradural extramedullary spinal cord metastases in lung cancer is rare, and it leads to severe neurological damage. hTe aim of this study is to identify the clinical features of intradural extramedullary spinal cord metastases in primary lung cancer patients.Methods hTe 8 cases of lung cancer with intradural extramedullary metastases, who were hospitalized in Peking Union Medical College Hospital (PUMCH) during May 2013 to May 2016, were enrolled in the retrospective study. Medical charts of the 8 patients were reviewed systematically.Results Intradural extramed-ullary spinal cord metastases was diagnosed in 7 cases with non-small cell lung cancer (NSCLC) and 1 case with small cell lung cancer (SCLC). Cauda equina syndrome was the most common clinical manifestation. Malignant cells in cerebrospinal lfuid were positive in all the 5 cases (100%) who underwent lumbar puncture. Contrast-enhanced magnetic resonance imaging (MRI) of spine manifested as diffuse abnormal enhancement of pial lining of spinal cordin 3 cases, intradural extramedullary nodules in 4 cases, and both of them in 1 case. Neurological symptoms were improved or stable in 4 cases who underwent targeted therapy and/or radiotherapy. hTe median overall survival was 5.8 months.Conclusion Intradural extramedullary spinal cord metastases can be diagnosed with caution according to its neurological symptoms and contrast-enhanced MRI presentation. Targeted therapy and/or radiotherapy may be effective for symptoms control.

Purpose/Significance To expound the development of the application of new generation intelligent technologies in the medi-cal field in China,and to provide ideas for the future development of intelligent medical technologies in China.Method/Process Literature related to the application of medical intelligence technology from 2000 to 2023 is searched and screened on CNKI,and the knowledge graph is drawn by descriptive statistical analysis and CiteSpace software for visualization analysis.Result/Conclusion The number of papers pub-lished in the application research field of domestic medical intelligence technology shows a trend of steady growth and then leveling off.The hot keywords mainly include smart medical care,health care,health management,etc.,forming 8 main cluster sets.Future research should strengthen cooperation and exchanges between researchers and organizations,and pay more attention to the challenges posed by the applica-tion of technology in terms of security and privacy,technology supervision,talent team construction and technological energy consumption.

Background and objective Eye is a rare site of lung cancer metastasis, and ocular metastasis is one of the largest challenges to cancer patients' quality of life (QOL). Here we present our experience on ocular metastasis of lung cancer and review relevant literature in an attempt to investigate the clinical features, treatment, and prognosis of these tumors. Methods The records of 9 patients with ocular metastasis of lung cancer treated at our hospital were analyzed. A literature re-view identified 42 cases reported in the last 10 years and their medical records were retrospectively estimated. Results The me-dian age of our patients was 51 years (range 41-61). Diagnosis of lung cancer included non-small cell lung carcinoma (NSCLC) in 7 patients, in which adenocarcinoma (ADC) were recorded in 6 patients, small cell lung carcinoma (SCLC) in 1 patient, and unknown in 1 patient. The site of ocular metastasis included choroid (n=8) and iris (n=1). In the literature review, SCLC con-stituted 21.4% (n=9) and ADC constituted 47.6% (n=20). Choroid presented to be the most common site for eye metastasis (66.7%, n=28). As for disease control rate, systemic chemotherapy for lung cancer patients with ocular metastasis presented to be only 28%. Meanwhile, combination of systemic treatment with ocular treatment could improve patients' eye symptoms effectively. Conclusion The most common lung cancer that metastasizes to the eye is ADC. The choroid is the most common site for ocular metastasis. Ocular treatment can improve patients' eye symptoms, while the effect of systemic chemotherapy treatment is limited.

Background and objective Epidermal growth factor receptor (EGFR) and KRAS gene are important driver genes of non-small cell lung cancer (NSCLC).The studies are mainly focused on detection ofEGFR gene for advanced NSCLC,and the mutation feature of EGFR and KRAS gene in early NSCLC tissue is unknown.This study aims to investigate the mutations of EGFR and KRAS gene in NSCLC,and the relationship between the genotype and clinicopathologic features.Methods The hotspot mutations in EGFR and KRAS gene in 754 tissue samples of stage Ⅰ-Ⅲa NSCLC from Department of Pathology,Peking Union Medical College Hospital were detected by modified amplification refractory mutation system (ARMS) real-time PCR kit,and analyzed their correlation with clinical variables.Results The hotspot mutation rates in EGFR and KRAS were 34.5％ and 13.1％ respectively,and there were EGFR-KRAS double mutations in 3 samples.The mutation rate of EGFR was higher in females than that in males (39.5％ vs 29.4％,P=0.076),significantly increased in adenocarcinomas (38.7％) compared to that in the other forms of NSCLC (P＜0.01),but still lower than that reported in some Asian studies of advanced adenocarcinoma (-50％).Meanwhile,the mutation rate of KRAS was remarkably higher in males than that in females (16.6％ vs 9％,P=0.048),increased in adenocarcinomas compared to that in the other forms of NSCLC,but the difference was not significant (P=0.268).Samples harbored EGFR mutation were younger than those harbored KRAS mutation (P=0.031,5),and had significant difference in gender between the two groups (P＜0.01).Conclusion The mutation rate of EGFR in stag Ⅰ-Ⅲa NSCLC patients was lower than that in advanced NSCLC patients.And the percentage of the NSCLC patients with EGFRKRAS double mutations is 0.9％.

Purpose/Significance Based on the concepts of healthy cities and smart cities,the paper introduces a new concept-smart healthy cities.It explores the definition,scope,function,challenges,and strategic responses associated with the concept.Meth-od/Process Through literature review and case study analysis,the theoretical foundations,characteristics,objectives,and implementa-tion strategies of healthy cities and smart cities are compared,revealing differences and points of convergence,proposing the origins,def-initions,and delineations of smart healthy cities,and exploring the relationships among healthy cities,smart cities,and smart healthy cit-ies.Result/Conclusion Smart healthy cities enhance urban health governance and the well-being of residents through technological in-novation.Effective integration of advanced technologies with urban governance policies is essential,alongside the implementation of di-verse strategies to drive progress.Future urban development should focus more on the theoretical and practical collaborative development within the smart healthy cities framework.