Lung cancer, with growing morbidity and mortality worldwide, is one of the most malignant tumors, representing a significant threat to human health and life.The application of next-generation genomic technologies has offered a more comprehensive look at the mutational landscape across the different subtypes of nonsmall cell lung cancer (NSCLC).A number of recurrent mutations such as TP53, KRAS, and epidermal growth factor receptor (EGFR) have been identified in NSCLC.While targeted therapeutic successes have been demonstrated in the therapeutic targeting of EGFR and ALK, the majority of NSCLC tumors do not harbor these genomic events.This review looks at the current treatment paradigms for lung adenocarcinomas (LAC) and squamous cell carcinomas, examining genomic aberrations that dictate therapy selection, as well as novel therapeutic strategies for tumors harboring mutations in KRAS and TP53 which, to date, have been considered undruggable.A more thorough understanding of the molecular alterations that govern NSCLC tumorigenesis, aided by next-generation sequencing, will lead to targeted therapeutic options expected to dramatically reduce the high mortality observed in lung cancer.

Objective To investigate the preventive and therapeutic effects of nonsteroidal anti-inflammatory drugs ( NSAIDs) via rectum for hyperamylasemia and pancreatitis after ERCP (endoscopic retrograde cholangiopancreatography).Methods Sixty patients who underwent ERCP for various reasons were randomly divided into preventive and control groups.In addition to routine diazepam (10 mg) and anisodamine (10 mg) given intramuscularly in both groups before ERCP, 100 mg of indometacin suppositories was administered by rectum in preventive group.Serum amylase level was measured before and 6 hours and 24 hours after the procedure.Results Serum amylase levels at 6 hours after ERCP in preventive and control groups were (367.5 ± 268.7 ) U/L and (1034.2 ± 713.5 ) U/L, respectively ( P < 0.05 ), which were (324.9±142.3)U/L and (826.8 ±395.7)U/L, respectively, at 24 hours after ERCP (P<0.05).Conclusion Rectal use of NSAIDs can prevent hyperamylasemia and acute pancreatitis induced by ERCP.

To evaluate the effects of LASIK ( laser in situ keratomileusis) rectification for pediatric refractive errors. Methods MEDLINE, Embase, the Cochrane library, Chinese Journal Full-text Database and Chinese Biomedical Literature Database were searched for related literatures in Chinese and English languages. A meta-analysis was performed based on the results. Results This study included 256 eyes (255 patients) from 12 independent researches. Meta-analysis showed postoperation corrected vision improved significantly ( WMD=-0.22, CI: -0.26 ～ -0.19, P＜0.00001 ) and LASIK was safe in children. But, considering heterogeneity among articles, Random effect model was applied and revealed the heterogeneity was a little large and the results had a certain bias ( I2 =46.3% ,close to 50% ). Conclusion Current studies have shown that LASIK plays a positive role in children while the safety and predictability have not yet been clear.Moreover, there lacks enough evidence to assess the middle-and long-term efficacy. Thus, more large scale,long-term, randomized control trials should be launched to evaluate the positive and negtive aspects of LASIK in pediatric refractive errors.

Objective To experiment the use of allodecellular skin extracellular matrix for the replacement of urethral. Methods Skin extracellular matrix was obtained from 2 dogs by decellularization process.18 experimental dogs were used and a 4 cm segment of urethral was resected in each.In the experimental group of 15 dogs,the resected urethral was replaced by the allo skin ECM.In the control group of 3 dogs,the resected urethral was replaced by allograft transplantation of untreated skin.The neourethral segment was studied with ecectronmicroscopy and immunohistochemical procedures. Results In the experiment animals,urothelial and monocytes could be seen in the ECM area and fully filled up the area after 6 weeks.The histological structure was not much different with a normal urethra.In the control group with allograft transplantation,rejection and necrosis occurred 8～10 days after the transplantation.On the basis of the experiment,skin ECM has been successfully used in clinical practice for 2 patients. Conclusions Alloskin ECM may be an ideal tissue engineering material for the replacement of urethral.

Calcineurin (CaN) serves as a key enzyme in human immune regulation. The most important target of this enzyme is the transcription factors of nuclear factors of activated T cells (NFATc). The discovery of the immunosuppressive function of CaN inhibitors (CNIs),ciclosporin A (CsA) and tacrolimus (FK506),has helped overcome the immune rejection of organ transplantion and changed organ transplantion fundamentally. Both of these drugs are still widely used in clinical and basic research,but their therapeutic effects are limited by their serious side effects,including renal tox?icity and neurotoxicity. Therefore,the development of new CNIs with higher specificity and fewer side effects in the clinic is a focus of research. In this paper,the newly discovered and synthesized CNIs in recent decades,including the CsA and FK506 derivatives,direct inhibitors of CaN,as well as the inhibitors that specifically interfere with CaN-NFATc interaction,were summarized.

Hepatic cavernous hemangioma is the most common benign tumor of liver.Hepatic artery embolism chemotherapy is one of the commonly used treatment methods,but more and more related complications and sequelae have been reported recently,including obstructive jaundice caused by damaged biliary tract.Because the symptoms are not typical,obstructive jaundice might be misdiagnosed as malignant biliary tumor,which brought troubles to subsequent treatment.In this article,the clinical data of 2 patients with obstructive jaundice following transcatheter hepatic arterial chemoembolization for hepatic cavernous hemangioma were retrospectively analyzed,and the experience in the diagnosis and treatment of this disease was summarized.

Objective To elucidate the effects of thalidomide on proliferation of human renal cell line 786-0 and the expression of basic fibroblast growth factor (bFGF) in this cell line. Methods Cell was treated with different doses of thalidomide(6.25 μg/ml, 25 μg/ml, 100 μg/ml) respectively or normal saline as control; cell survival rate was analyzed by MTT assay. The mRNA level of bFGF was detected by reverse transcriptase-polymerase chain reaction (RT-PCR). bFGF protein expression in 786-0 cells was detected by flow cytometry (FCM). Results Thalidomide, ranging from 6.25 μg/ml to 100 μg/ml, suppressed the proliferation of 786-0 cell line in vitro significantly. After application of thalidomide for 48 and 72 hours, the IC50 was 46.42 μg/ml and 19.56 μg/ml respectively. Apoptosis rate increased from 12.43 % to 30.30 %, accompanying with reducing expression of bFGF. Application of thalidomide (25 μg/ml) induced the most significant inhibition to the bFGF in the cell line. Conclusion Thalidomide down-regulates bFGF expression, inhibit the proliferation, and induce apoptosis in 786-0 cell line.

Objective To perform the main application of MRI arterial spin labeling (ASL) in cerebral blood flow (CBF) on hippocampus of patients with temporal lobe epilepsy for quantitative measurement,to assess the relationship between temporal lobe epilepsy occurrence and hippocampal perfusion and to explore the critical value of hippocampal CBF predict the temporal lobe epilepsy early.Methods Forty-two subjects by video EEG (VEEG) and conventional MR sequences screend were divided into 3 groups eventually,namely group of healthy control,the group with one temporal lobe abnormal discharge,that conventional MRI in hippocampus is not abnormal and the last group with one side hippocampus sclerosis confirmed by conventional MRI in temporal lobe epilepsy patients,then for the hippocampal 3D ASL examination.We provided six same size regions of interest (ROI) in the hippocampal head,body,tail respectively with the best level display to measure and record bilateral hippocampal cerebral blood flow values (CBF values) of every subject,and to explore the relationship between the cerebral blood flow value in the hippocampus and temporal lobe epilepsy.Results Mean cerebral blood flow (CBF) value of each subject's unilateral hippocampus was calculated.The average CBF value of the hippocampus in the healthy control group was 53.82 ± 0.98ml/(100g · min).The average CBF of the hippocampus in epileptic unilateral abnormal discharge group with the ipsilateral and contralateral were 49.12 ± 5.31ml/(100g · min) and 55.99 ± 1.65ml/(100g · min).The average CBF of the hippocampus in epileptic unilateral hippocampal sclerosis group with the ipsilateral and contralateral were 39.57 ± 2.08ml/(100g · min) and 48.06 ± 1.74ml/(100g · min).Then pairwise comparison of the unilateral hippocampal average CBF value among the 3 groups of experimenters in different groups was performed.The results showed that in the eight times,the first six times had statistically significant differences.Comparing between the healthy control group and epilepsy unilateral temporal lobe abnormal discharge group,to calculates the best critical point by the ROC curve,the cut-off value was 46.76.Conclusion Magnetic resonance arterial spin labeling (ASL) technique can evaluate the cerebral blood flow in the hippocampus of patients with temporal lobe epilepsy by quantitative measurement of hippocampal CBF value.The changes of hippocampal perfusion in patients with temporal lobe epilepsy should be preceded by the changes of imaging.ASL quantitative measurement of hippocampal CBF value is helpful for early diagnosis and treatment of temporal lobe epilepsy.

Objective To evaluate the feasibility and safety of stent implantation in treating patients with symptomatic vertebral artery kinking. Methods Forty-two patients with vertebral artery kinking confirmed by digital subtraction angiography and accorded with the stent implantation indications were chosen in our study; these patients were performed stent implantation. The stenosis and haemodynamics changes, and recent and postoperative complications were observed; Malek scale was adopted to evaluate the clinical efficacy during the 1-year follow-up. Results The success rate of stent implantation for patients with symptomatic vertebral artery kinking was 100%(42/42). The percentage of stenosis was significantly reduced from (75.6 ± 13.5)%to (8.3 ± 3.1)%after stenting, and the mean flow velocity of kinking lesion was obviously decreased from (49.5 ± 12.4) cm/s to (31.7 ± 15.0) cm/s, and there were statistical differences (P<0.01). The cerebellum hematoma was noted in 1 patient , subcutaneous hematoma of puncture point appeared in 2 and femoral artery pseudoaneurysm after the stenting in 1;all these complications did not cause serious consequences. Malek scale indicated that 36 cases got 1 point,4 cases got 2 points, 1 case got 3 points, 1 case got 4 points and no one got 5 points;36 patients (85.7%, 36/42) were asymptomatic during the 1-year follow-up;no significant in-stent restenosis was found. Conclusions Symptomatic vertebral artery kinking can be treated safely and effectively with stent implantation.

Objective To evaluate the therapeutic efficacy and safety of micro-invasive craniopuncture scavenging technique (MPST) for treatment of intracranial hematoma in patients with hypertensive cerebral hemorrhage (HICH).Methods All the clinical randomized controlled trial (RCT) studies published on MPST and internal medicine conservative treatment of HICH were searched via computer screening of databases including Cochrane clinical trials database, the Chinese biomedical literature database (CBM), Chinese periodical network full-text special topic database, Chinese science and technology periodical database and electronic periodicals database of Wanfang from January 2006 to January 2017. The study group was given the MPST plus basic treatment, and the control group was given conservative treatment. The studies collected meeting the eligible criteria were sorted and analyzed by the software RevMan 5.0, the differences in therapeutic effect and mortality were compared between the two groups, and a funnel chart was plotted to analyze the potential publication bias.Results A total of 13 RCTs published studies consistent with the eligible criteria were found, including1556 patients. The Meta-analysis showed that the effective rate in the study group was significantly higher than that in the control group [odds ratio (OR) = 4.29, 95% confidence interval (95%CI) 3.33 - 5.53,P < 0.01]; the fatality rate was markedly lower than that of the control group (OR = 0.25, 95%CI 0.19 - 0.35,P < 0.01). The funnel graph showed that each study had asymmetrical scatter plot of the variable quantity of research results, indicating a publication bias being present, which might be related to the subjectivity of the researchers in publishing their results.Conclusions Using MPST to treat HICH can significantly improve the therapeutic efficiency and reduce deterioration rate. However, due to the low quality of clinical research, it is necessary to carry out rigorous andmulti-center randomized controlled studies to further confirm the results.