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.

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.

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.

Objective To study the disease trend of Keshan in Hubei Province and provide a basis for scientifically making control and prevention strategy.Methods According to Chinese Surveillance Plan of Keshan Disease,physical examination and electrocardiogram were done for surveillance subjects and suspected patients were filmed chest X-ray in Keshan disease areas.Results Totally 4 822 people were monitored from 2007-2014.The numbers of females (2 589,53.69％) were more than those of the males (2 233,46.31％).The group of people under the age of 15 accounted for 52.47％ (2 530/4 822) which was higher than that of the group over the age of 55 (19.14％,923/4 822).The rate of electrocardiographic abnormality was the highest in 2011 (61.33％,268/ 437) and the lowest in 2014 (5.61％,23/410).In the eight years,only potential type of Keshan disease patients were detected,and the incidences from 2007 to 2014 were all lower than 3％ and had a decreasing trend yearly.No Keshan patient was detected in 2012-2014.Ninety-one suspected cases were taken chest X-ray.Most of the suspected cases (63.74％,58/91) had normal cardiothoracic ratio.The cardiothoracic ratio increased,excepting one,other 32 were all potential type Keshan disease patients.Conclusions The disease trend of Keshan disease in Hubei Province is weak.Nevertheless,surveillance and health education are indispensable,in case the disease relapses.

Objective To explore the value of conventional and contrast‐enhanced ultrasound(CEUS) in the diagnosis of tumors in front of the orbit equator . Methods Clinical data included conventional ultrasound and CEUS image of 133 cases (156 eyes) with orbital lesions were analyzed retrospectively . All lesions were confirmed by surgical pathology or clinical cure ,which included 26 cases of cystic lesions (epidermoid cysts ,dermoid cysts ,sebaceous cysts and mucous cysts) ,29 cases (30 eyes) of orbital hemangioma ,13 cases ( 16 eyes ) of inflammatory pseudotumor ,11 cases of lacrimal gland pleomorphic adenoma ,3 cases (5 eyes) of lymphoepithelial lesion ,36 cases (53 eyes) of malignant lymphoma ,5 cases of meibomian gland carcinoma ,4 cases of lacrimal gland adenoid cystic carcinoma ,3 cases of malignant melanoma and 3 cases of basal cell carcinoma . Results CEUS of benign cystic lesions showed the tumors were enhanced inhomogenously . Most CEUS of benign tumours displayed?slow in and slow out ,and high enhancement when reached the peak but the size of images had no change . While CEUS of malignant tumours showed?fast in and fast out ,homogeneous or inhomogeneous high enhancement and ill‐defined or irregular shape ,and volume increased compared to two‐dimensional ultrasound when reached the peak .Some other former district orbital lesions ,such as cystic lesion ,cavernous hemangioma ,pleomorphic adenoma and malignant lymphoma ,had their own ultrasound features . Conclusions CEUS combines with conventional ultrasound may contribute to the qualitative diagnosis of tumors in front of the orbit equator .

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.

Objective To explore the value of echocardiography in detecting left atrial systolic function in patients with hypertrophic cardiomyopathy(HCM) or hypertensive left ventricular hypertrophy (HLVH). Methods There were 3 groups in this study,the group of HCM, HLVH and control,each group had 30 cases. Left atrial diameter,interventricular septal thickness, posterior left ventricular thickness, peak E and A of mitralis were measured by conventional echocardiography. Left atrial fractional shortening (LAFS) was calculated. Tissue velocity imaging of all patients and controls were accepted in apical two, four and long axis chamber views. Strain rate(SR) imaging was performed on all cases, peak atrial systolic left atrial SR(LASRa) were measured at each segment (septal,lateral, posterior,anterior, and inferior walls of left atrium), mean LASRa was calculated by averaging data in all segments. Results Compared with controls, LAFS and mLASRs of HCM and HLVH were significantly higher ( P ＜0.05). Moreover, LAFS and mLASRs of HCM were significantly higher than HLVH (P ＜ 0.05). mLASRa correlated positively with LAFS of HCM and HLVH respectively ( r =0.81,0.88,all P ＜0.01). Conclusions The change of left atrial function of HCM and HLVH presented as pump function increased.

ObjectiveTo evaluate left atrial function in patients with dilated cardiomyopathy (DCM)by echocardiography.MethodsThere were 31 patients with DCM and 30 controls in this study.Left atrial diameter (LAD),left ventricular diameter (LVD) were measured by M-mode in parasternal long-axis view.Mitral flow parameters including peak velocities during early diastole (E) and late diastole (A) were measured by pulsed-wave Doppler echocardiography,and the E/A ratio was calculated.Left ventricular ejection fraction (LVEF) was measured with Simpson′s method on the 2-chamber (Ap2c) and 4-chamber (Ap4c) views.Strain rate (SR) imaging was performed on all cases.Peak SR was measured at each segment (septal,lateral,posterior,anterior,and inferior walls) and mean peak systolic left atrial SR (mLASRs),mean peak early diastolic left atrial SR (mLASRe) and mean peak atrial systolic left atrial SR (mLASRa) were calculated by averaging the data in all segments.ResultsCompared with controls,LAD and LVD were significantly increased ( P ＜0.01 ),the E/A ratio had no significant changes ( P ＞0.05).LVEF and left atrial fractional shortening (LAFS) turned lower,mLASRs,mLASRe,and mLASRa of DCM decreased significantly ( P ＜ 0.05).mLASRa of DCM correlated positively with LAFS ( r =0.79,P ＜ 0.01 ).ConclusionsThe left atrial function of DCM decreased,including the reservoir,conduit and pump function.Echocardiography could evaluate the left atrial function of DCM quantitatively.

Objective To probe into possibilities and sensitivity of CCD video camera system in the assessment of balance function.Methods The system is composed of a CCD video camera,a video image capture board and analysis software.Three indexes:Trunks,ayAngle (TSS Trunk Sway Speed(TSS) and fall index (FI).the normal group:FI≥I; mild group:0.7≤FI＜I; moderate group:0.4≤FI＜0.7; severe group:FI ＜0.4.Disorder of balance function group:42 patients with cerebrovascular accident,mean age of (67.4±8.0) years.Control group:42 healthy subjects,mean age of (65.3±6.5) years.All cases were measured by Berg balance scale and determinated three times by CCD video camera system with eye opening (eo) and eye closing(ec),and averaged.Results There were very significant differences in TSAeo,TSAec,TSSeo,TSSec,FIeo,FIec between disorder of balance function group and control group (P＜0.01).as well as Berg balance scale (P＜0.05).In disorder of balance function group,the differences among three groups were significant in TSAeo,TSAec,TSSeo,TSSec (P＜0.05).There were significant differences in TSAeo,TSAec,TSSeo,TSSec between severe group and mild group (P＜0.01) as well as in Berg balance scale (P＜0.05).Conclusions CCD video camera system has a higher sensitivity in assessment of body,balance than Berg balance sca land great value in clinical application.