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.

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) comprise an effective therapy for advanced non-small cell lung cancer patients with EGFR-activating mutations. Unfortunately, most patients eventually develop resistance to EG-FR-TKIs, probably due to a secondary point mutation of EGFR T790M. Thus, a sensitive method for accurate detection of T790M mu-tation is essential. Peripheral blood detection has gained our attention because it is convenient, making dynamic noninvasive quantita-tive detection of T790M mutation an optimal means of monitoring the efficacy of EGFR-TKIs. To date, the clinical significance of T790M mutation and EGFR-TKI resistance remains controversial. Several EGFR-TKIs targeting EGFR mutation, which have been in-troduced in recent years, showed better response in patients with T790M mutation, indicating that T790M may be a biomarker for con-quering resistance. This review introduces the methodology of T790M detection and its role in clinical practice.

Objective To investigate the correlations between ambulatory arterial stiffness index and intracranial/extracranial arterial stenosis.Methods One hundred and twenty-eight cases of ischemic cerebrovascular disease were collected in our hospital from January 2010 to March 2012.Joint diagnosis of cranial computer tomography(TCD) and magnetic resonance angiography (MRA) and,or CT angiography (CTA) were used to detect the degree and number of intracranial arteries,and in accordance with the lesions level,patients were divided into stenosis group,the mild stenosis group,the moderate stenosis group and severe stenosis group.24 h ambulatory blood pressure was monitored and ambulatory arterial stiffness index (AASI) was calculated and statistically analyzed.Results (1) Age,sex,hypertension proportion of diabetes,body mass index(BMI) of different Intracranial arterial stenosis in four groups did not have significant differences (P ＞0.05),but in AASI the without stenosis group is 0.48 ± 0.15 ; the mild stenosis group 0.62 ± 0.16,the moderate stenosis group 0.61 ± 0.17,severe stenosis group 0.64 ± 0.15,and there was significant difference (F =3.955,P =0.001).(2) Age,sex,hypertension proportion of diabetes,BMI of different extracranial arterial stenosis in four groups did not have significant differences (P ＞ 0.05),but in AASI the without stenosis group was 0.48 ± 0.01 ; the mild stenosis group 0.57 ± 0.11,the moderate stenosis 0.59 ± 0.12,and severe group 0.60 ±0.15,and there was significant difference (F =3.643,P =0.002).In comparison between any two group:light,moderate and severe stenosis AASI were significantly higher than those without stenosis,and there was significant difference (P ＜ 0.05).And there was significant different in AASI among different intracranial and extracranial arterial lesions (F =7.395,P ＜ 0.001).Compared to 0 branch pathological changes,1 branch,2 branch,3 branch and above,there was was significant difference(P ＜ 0.05).Conclusion Based on a 24-hour ambulatory blood pressure monitoring indicators,AASI was mainly reflecting the impact of atherosclerosis on blood pressure,associated with intracranial and extracranial artery stenosis.AASI would play a major role in clinical diagnosis and treatment of ischemic cerebrovascular and forecast.

OBJECTIVE To review and analyze the change in the MICs of vancomycin,teicoplanin and linezolid in meticillin-resistant Staphylococcus aureus(MRSA) strains isolated in our hospital from 2003 to 2007. METHODS The MICs of vancomycin,teicoplanin and linezolid were tested by Etest method on a sample of randomly selected MRSA strains. RESULTS The incidences of MRSA increased from 52.2% in 2003 to 74.5% in 2007.MIC of vancomycin increased from 1.85 ?g/ml in 2003 to 2.15 ?g/ml in 2007,and teicoplanin MIC geometric mean increased even more markedly from 1.28 ?g/ml in 2003 to 2.07 ?g/ml in 2007.The linezolid MIC remained almost unchanged. CONCLUSIONS The incidences of MRSA were increasing from 2003 to 2007.There is a upward trend in MIC of glycopeptide over the years,in which the increase for teicoplanin is higher than others two.

Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Glucose Transporter Type 1 ; metabolism ; Glucose Transporter Type 3 ; metabolism ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged

Aged ; Female ; Humans ; Male ; Middle Aged ; Silicosis

Objective: To analyze the prescription dosage for discharged patients in our hospital and investigate the potential risks.Methods: A retrospective research method was adopted to statistically analyze 55 872 discharge instructions from July to September in 2015,and more attention was paid to the prescriptions with dosage over 4 weeks,expecially the ones with 26-week dosage, and the related influencing factors were studied as well.

AIM:To set up a method for determining epimedin C and icariin in Xianling Guobao Capsules(Herba Epimedii,Radix et Rhizoma Salviae miltiorrhizae,Fructus Psoraleae,Radix Rehmanniae,etc.). METHODS:The chromatographic conditions included the column of Spherisorb C 18 (4.6 mm?250 mm,5 ?m),the mobile phase was acetonitrice and water as gradient eluent was at a flow rate of 1.0 mL/min,the detection wavelength was set at 270 nm and the column temperature was at 25 ℃. RESULTS:The linear range of epimedin C was 0.22-2.20 ?g and icariin was 0.04-0.40 ?g,respectively. The average recovery of epimedin C and icariin were 103.2% (RSD=3.1%) and 97.8% (RSD=3.2%),respectively. CONCLUSION:The method is reliable,stable and well reproducible,and can control the quality of Xianling Guobao Capsules.

Objective: To study quantitative changes of cochlear hair cells and spiral ganglion cells after blast exposure in guinea pigs. Methods: The number of hair cells was calculated using the surface specimen technique and computer image analysis technique after blast exposure. The number of spiral ganglion cells was calculated using pathologic technique and computer image analysis technique after blast exposure. Results: Quantitative observation was carried out 21 days after blast exposure. The number of total hair cells in uncus, the first and second gyre in normal control group and in blast group was 3 599?159.6 and 6 022?98.4 respectively, and the number of spiral ganglion cells in the 2 low parts of cochlear in normal control group and in blast group was 51? 4.72 and 27? 6.94 respectively, the difference in mean value between the groups being significant. Conclusion: Not only the hair cells reduce, but also the spiral ganglion cells are severely damaged after blast exposure. [

Objective To explore the changes of left atrial systolic function in patients with coronary heart disease after coronary artery bypass grafting (CABG). Methods Strain rate imaging (SRI) was performed on 23 patients with coronary heart disease before CABG, 1 week, 1 and 3 months after CABG to evaluate left atrial systolic function quantitatively. Results No significant change of left atrial systolic function was detected 1 week after CABG (P＞0.05 ). E/A and LVEF increased, LAFS, AEF and SRa decreased 1 month after CABG compared with those before CABG (P＜0.05). Three months after CABG, changes turned more significantly (P＜0.01). Left ventricular ejection fraction (LVEF) increased 1 and 3 months after CABG, and its changing rate negatively correlated with those of Sra (r=-0.751,-0.783; all P＜0.01). Conclusion Left atrial systolic function is affected by CABG, presenting as decrease of pump function. SRI can be used to evaluate the atrial systolic function quantitatively and monitor the changing of left atrial systolic function dynamically after CABG.