Lung cancer is characterized by high malignancy and the majority of patients are diagnosed at the advanced or late stage.Chemoradiotherapy has insufficient effect on this malignant tumor.At present the immune therapy has become a new choice for lung cancer treatment.Ipilimumab,antibody to programmed death-1 ,immune cells,cytokines,melanoma-associated antigen A3 vaccine,liposomal BLP25,belagen-pumatucel-L and polypeptide vaccine have been proved effective for lung cancer through various clinical trials. Futhermore,most of them have been moved forward to phase Ⅲ clinical trials in order to get more strong evidence to support the immunotherapy incorporated into the multidisciplinary treatment of lung cancer.

Objective To investigate the effects of balance training on balance function and walking ability of hemiplegic patients.Methods 42 hemiplegic patients were randomly divided into the balance training group and control group with 21 cases in each group. All patients of two groups were given conventional rehabilitation therapy. Patients in the balance training group were mainly trained for balance function. The balance function and walking ability were assessed with Fugl-Meyer Balance Test and Holden Walking Classification before and after training.Results There was no significant difference between two groups before training ( P>0.05). After training, the balance scores were significantly improved in the balance training group compared with control group ( P<0.05). All patients could not walk independently before training. After training, 71% patients in the balance training group (control group was 51%) could walk independently, and there was significant difference between two groups ( P<0.05).Conclusion Balance training has important effect to improve balance function and walking ability of patients with hemiplegia.

Background and purpose:Lung cancer is the leading cause of morbidity and cancer-related mortality worldwide. A variety of driver genes were detected in lung cancer. Studies have shown that different gene mutations of lung cancer were found between different races. Most of Uyghurs live in Xinjiang, accompanied by a high morbidity of lung cancer. This study aimed to investigate the expression of driver genes in Uyghur patients with lung cancer in Xinjiang, China.Methods:This study collected the tissue specimens of 43 Uyghur patients with lung cancer, with a very different method to detectEGFR gene expression. real-time fluorescent quantitative polymerase chain reaction(RTFQ-PCR) was used to detectK-ras,ALK,ROS1, mutatedBRAF andPIK3CA gene expression. Analysis of the correlation between lung cancer gene mutations in Uyghur and clinical features of patients with lung cancer were performed.Results:Among 43 cases of specimens,EGFR mutation rate was 11.63%, while theEGFR gene mutation rates in adenocarcinoma and squamous cell carcinoma were 26.67% and 4.76%, respectively.EGFR gene mutation was not detected in large cell carcinoma, adenosquamous carcinoma and small cell lung cancer.EGFR gene mutation rate in patients with adenocarcinoma (26.67%) was signiifcantly higher than that in other types of lung cancer (3.57%). The difference was statistically signiifcant (P=0.024). There were 6 patients withK-ras12/13 heterozygous mutation, and the mutation detection rate was 16.28% (6/43). There were 2 patients withPIK3CA heterozygous mutation, and the mu-tation detection rate was 4.65% (2/43).EGFR andK-ras mutations occurred simultaneously in 1 case. No relationship was found betweenEGFR mutations and age, gender, smoking status, TNM staging, ECOG score among Uyghur lung cancer patients. This study did not ifnd mutation inALK,ROS1 fusion gene andBRAF gene among the 43 specimens. Conclusion:Compared with Asian populations, Xinjiang Uyghur patients with lung cancer have a lower rate ofEGFR mutations and a higher rate ofK-ras mutations, which is similar to the characteristics of European Caucasians.

Objective To study the effect of PPARγ ligand troglitazone (TGZ) on invasion and metastasis of gastric cancer cells, and investigate the relationship of PPARγ ligand with gastric cancer.Methods The expression of PPARγ in gastric cancer cell line MGC803 were detected by immunofluorescence cytochemistry method. The effect of different density TGZ on proliferation activity and adhesion of gastric cancer cell were detected by MTT chromatometry. The effect of different ligands on invasion and metastasis of gastric cancer cell MGC803 were detected by invasion system in vitro. Results The expression of PPARγ mainly located in cell nucleus. TGZ inhibited the proliferation of gastric cancer cell, decreased cell adhesion, locomotory capacity and invasion to matrigel, which had time and dose-dependent relationship.When treatment with 0. 1,1.0 and 10μ mol/ L TGZ, inhibition ratio of invasion and metastasis of cell was 8.79% ,31.31% ,51.42% and 28.29% ,4. 27% ,59. 27% respectively, which had statistical significance compared with control group( P <0. 05). When treatment was 10μ mol/L TGZ, cell adhesion was 0. 32 ±0. 03, it was statistically significant higher than that in control group (0. 52 ± 0. 04, P < 0. 05 ). Conclusion Human gastric cancer cell line MGC803 expressed functional PPARγ protein. TGZ inhibited adhesion and invasion of MGC803 cell on ECM at different degree, the effect of combination of two ligands was evident, which mechanism of action needed to be further investigated.

Background and purpose: Cyclin-dependent kinase 4 (CDK4) is a kind of protein kinases regulating the cell cycle progression, which has been reported to be overexpressed in endometrial carcinoma tissues. But the role of CDK4 in endometrial carcinogenesis and relative mechanisms has not been identiifed yet. In this study, we used a small interfering RNA targeting CDK4, and explored the effects of CDK4 on endometrial cancer cells HEC-1B biological function and relative mechanisms.Methods:The chemically synthesized small interfering RNA targeting CDK4 (si-CDK4) was transiently transfected into HEC-1B cells;the quantitative real time-PCR assays and Western blot assays were performed to explore the mRNA and protein expression levels of CDK4 and its downstream genes, Rb and p-Rb, in HEC-1B cells upon transfection;Moreover, the CCK-8, lfow cytometry (FCM) and invasion assays were performed to indentify the effects of si-CDK4 on the proliferation, cell cycle distribution, apoptosis and invasion abilities of HEC-1B cells, respectively. Results:The results showed that the mRNA and protein expressions of CDK4 were suppressed in HEC-1B cells upon transfection with si-CDK4 (P<0.01);Suppression of CDK4 inhibited cell proliferation and invasion of HEC-1B cells;the number of cells migrating through the transwell membrane in si-CDK4 group was 117±21, which was much fewer than the cells in si-control (269±39) and untreated groups (262±35) (P<0.01);the early apoptosis rate of cells treated with si-CDK4 [(21.7±3.5)%] was much higher than the untreated [(12.4±2.1)%] and si-control groups [(11.8±1.9)%] (P<0.01);moreover, suppression of CDK4 increased cells in G1 phase (P<0.01) and correspondingly decreased cells in S phase (P<0.01);further Western blot results showed that suppression of CDK4 down-regulated the expression of p-Rb in cells, but did not inlfuence the expression of total Rb. Conclusion:CDK4-siRNA speciifcally and efifciently blocks the constitutively activated CDK4 in human endometrial cancer cells HEC-1B, resulting in tumor suppression.

Objective: To investigate the relationship of ultrasonographic findings and cervical lymph node metastasis of papillary thyroid carcinoma (PTC). Methods Clinical and ultrasonographic data of 145 PTC patients were collected, including 60 cases with and 85 cases without cervical lymph node metastasis. The general data (age, sex) and ultrasonographic features (number of lesions, maximum diameter, margin, aspect ratio, invasion of capsule, internal echo, microcalcification, internal blood supply) were retrospectively analyzed. Logistic regression analysis was used to identify independent risk factors for cervical lymph node metastasis in PTC patients. Results: Univariate analysis showed that there were significant differences in age, maximum diameter of tumors, capsular invasion and internal blood supply between PTC patients with cervical lymph node metastasis and those without metastasis (all P<0.01). Logistic regression analysis showed that age ≤50 years old, abundant internal blood supply and invasion of thyroid capsule were independent risk factors for PTC cervical lymph node metastasis (all P<0.05). Conclusion: Patient's age, capsular invasion and internal blood supply of lesions are associated with cervical lymph node metastasis of PTC.

OBJECTIVETo summarize the clinical features of those Duchenne and Becker muscular dystrophy (DMD and BMD) patients who are complicated with epilepsy, and try to analyze the genotype- phenotype correlation.

METHODBy a retrospective analysis of 307 patients with DMD and BMD who attended Peking University First Hospital from February 2006 to September 2014,7 patients complicated with epilepsy were identified and their clinical data were collected. The possible mechanism of epilepsy in DMD and BMD patients was proposed after analyzing the genotype-phenotype correlation.

RESULT(1) Among 307 DMD and BMD patients, 7 cases had epilepsy, the prevalence was 2. 28%. (2) The age of onset of epilepsy ranged from 8 months to 11 years. Focal seizure was the most common seizure type (6 cases) , while other seizure types were also involved, such as generalized tonic-clonic seizure. As to epilepsy syndromes, 1 boy was diagnosed as benign childhood epilepsy with centrotemporal spikes (BECT). Six patients were treated with 1 or 2 types of antiepileptic drugs and seizures were controlled well. On follow-up, 6 of the 7 children had normal mental development, while the remaining 1 patient was diagnosed as mild mental retardation. (3) DMD gene mutations of all 7 patients were analyzed. Exons deletions were found in 6 cases while point mutation was found in 1 case.

CONCLUSIONThe prevalence of epilepsy in DMD and BMD patients was higher than the prevalence in normal population. The age of onset of epilepsy varies, and focal seizure may be the most common seizure type. Some patients may also present as some kind of epilepsy syndrome, such as BECT. In most patients, seizures can be controlled well by 1 or 2 types of antiepiletic drugs. No clear correlation was found between genotype and phenotype in DMD and BMD patients who were complicated with epilepsy, probably due to limited number of cases.

Anticonvulsants ; therapeutic use ; Child ; Epilepsy ; complications ; drug therapy ; epidemiology ; Exons ; Genotype ; Humans ; Intellectual Disability ; etiology ; Male ; Muscular Dystrophy, Duchenne ; complications ; genetics ; Mutation ; Phenotype ; Prevalence ; Retrospective Studies ; Seizures ; Sequence Deletion

OBJECTIVE:To observe analgesia,sedation effects and safety of flurbiprofen axetil combined with hydromorphone for postoperative patient-controlled intravenous analgesia (PCIA) after orthopedics surgery. METHODS:Totally 90 patients with combined spinal epidural anesthesia underwent lower limb surgery were selected from anesthesology department in the Affiliated Hospital of Chengde Medical College during May 2016-Jan. 2018. They were divided into SF group,H group and KH group according random number table,with 30 cases in each group. The postoperative PCIA pump drug liquid formula of SF group included Sufentanil citrate injection 2-3 μ g/kg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL;that of H group included Hydromorphone hydrochloride injection 0.12 mg/kg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL;that of KH group included Hydromorphone hydrochloride injection 0.12 mg/kg+Flurbiprofen axetil injection 50 mg+Tropisetron hydrochloride for injection 10 mg+0.9% Sodium chloride injection diluted to 100 mL. The operation time, intraoperative medication (epidural application frequency of additional ropivacaine,frequency of ephedrine and atropine),effective pressing times of analgesic pump and the analgesic effect of PCIA were observed in 3 groups. VAS score and Ramsay sedation score were observed 2,6,12,24,48 h after surgery. The hospital anxiety and depression scale (HAD) score,profile of mood states (POMS) score and the occurrence of ADR were observed before and after surgery. RESULTS:There was no statistical significance in operation time,epidural application frequency of additional ropivacaine or frequency of ephedrine and atropine among 3 groups (P＞0.05). The effective pressing times of analgesic pump in KH group were significantly lower than SF group and H group. The proportion of patients with excellent and good anesthesia effect in KH group was significantly higher than SF group and H group (P＜0.05);there was no statistical significance between SF group and H group(P＞0.05). VAS score of 3 groups 48 h after surgery were significantly lower than 6, 12,24 h after surgery;that of KH group was significantly lower than SF group and H group(P＜0.05);there was no statistical significance between SF group and H group(P＞0.05). There was no statistical significance in Ramsay score among 3 groups at different time points(P＞0.05). Before surgery,there was no statistical significance in HAD score or POMS score among 3 groups (P＞0.05). After surgery,HAD score and POMS score of KH group and H group were significantly lower than before surgery and SF group(P＜0.05);there was no statistical significance in KH group and H group,before and after surgery in SF group(P＞0.05). No vomiting,respiratory depression,pruritus and digestive tract bleeding were observed in 3 groups. The incidence of dizziness and nausea in H group and KH group were significantly lower than SF group (P＜0.05);there was no statistical significance between KH group and H group(P＞0.05). CONCLUSIONS:The flurbiprofen axetil combined with hydromorphone show good analgesic and sedative effect for PCIA after orthopedics operation,and can significantly improve emotion and mood of patients with good safety.

Objective: To explore the association between Vitamin A, E and mycoplasma pneumoniae pneumonia in children. Methods: 153 children with mycoplasma pneumoniae pneumonia and 653 health children were selected as cases and controls, respectively. Propensity score matching (PSM) analysis were conducted to reducing confounding bias between groups. Blood samples were collected to test serum levels of vitamin A and E using high performance liquid chromatography (HPLC). Logistic regression was implemented to determine odds ratios (OR) and 95% confidence intervals (CI) for evaluating the association of mycoplasma pneumoniae pneumonia with the serum levels of Vitamin A and E. Results: After propensity score matching, the study cohort included 153 cases with mycoplasma pneumoniae pneumonia and 306 health children as controls. Before matching, with age and gender adjusted, logistic regression analysis indicated that higher serum levels of Vitamin A and E led to a lower risk of mycoplasma pneumoniae pneumonia (OR=0.075, 95% CI: 0.007-0.815; OR=0.854, 95% CI: 0.792-0.986). After matching, higher serum level of Vitamin E had a significantly lower risk of mycoplasma pneumoniae pneumonia (OR=0.877, 95% CI: 0.810-0.950). Conclusions The serum levels of Vitamin A didn't have a statistically significant association with mycoplasma pneumoniae pneumonia. However, we observed an obvious association between Vitamin E and mycoplasma pneumoniae pneumonia. Hence Vitamin E clinical monitoring and supplementation are vital for preventing and treating mycoplasma pneumoniae pneumonia.

Objective To study the effect of self-management diary on blood glucose control and pregnancy outcomes in pregnant women with gestational diabetes mellitus.Methods The clinical data of 72 pregnant women with gestational diabetes mellitus admitted in our hospital were retrospectively analyzed.According to the different nursing intervention patterns, the patients were divided into control group and observation group.Pregnant women of two groups were given supportive treatment of conventional symptomatic drugs.Pregnant women in the control group were given routine general nursing interventions to guide their healthy dietary in their families, and the pregnant women in observation group were given self-management diary nursing intervention, therapeutic efficacy in blood glucose control compliance rate and pregnancy outcomes were compared.Results The levels fasting blood glucose, Postprandial 2 h blood glucose and glycosylated hemoglobin after intervention in two groups were statistically significant (P<0.05).The control level of blood glucose in observation group was better than the control group(P<0.05).The level of serum C-peptide (fasting serum C-peptide and postprandial 2 h peptide) in the observation group was significantly better than that in the control group (P <0.05).The cesarean section rate and mother-infant health indices of the observation group were significantly better than that in the control group, the differences were statistically significant(P<0.05).Conclusion Nursing intervention model is of great significance to improve the nursing quality of the whole hospital.Implementation of self-intervention model of pregnant women can not only effectively control gestational diabetes mellitus of pregnant women and significantlyreduce rate of cesarean section;so it is worthy of clinical application.