Retinopathy of prematurity (ROP) is a kind of vasoproliferative disorders,which leads to vision loss even blindness in premature neonates.Major pathogenesis in ROP is vascular occlusion and retinal neovascularization precipitated by ischemia and hypoxia.Proliferative retinopathy is asscioated with several signaling pathways,such as Wnt signaling pathway,CCN1/cysteine-rich 61 (CCN1/Cry61) in pathological neovascularization,JAK/STAT (Janus kinase/signal transducer and activator of transcription) in intravitreous neovascularization,Apelin/ APJ (Apelin/angiotensin type Ⅰ receptor related protein) in pathological retinal angiogenesis.Deep understanding of the pathways is conducive to treat proliferative retinopathy by targeting pathologic neovessels.

Objective To investigate the pregnancy outcome of gestational intrahepatic cholestasis.Methods 70 pregnant women with intrahepatic cholestasis were selected as the study group.70 healthy pregnant women during the same period were selected as the control group.The pregnancy outcomes of two groups were compaind.Results (1) The maternal serum levels of bile acid,alanine aminotransferase,aspartate aminotransferase in study group were (65.61 ± 13.5) μmol/L,(134.31 ± 24.7) U/L,(97.35 ± 21.54) U/L,which were higher than those of the control group (3.34 ± 0.41) μ mol/L,(36.16 ± 4.15) U/L,(23.34 ± 4.45) U/L,and the differences were statistically significant(P ＜0.01).(2) In study group,the incidence rate of maternal gestational hypertension was 21.42％,premature rupture of membranes was 17.14％,incidence rate of postpartum hemorrhage was 15.71％,which were significantly higher than 7.14％,5.71％,4.29％ in the control group,the differences were statistically significant(P ＜ 0.05).(3) In study group,the incidence rate of neonatal asphyxia was 27.14％,therate of amniotic fluid contamination was 35.71％,fetal distress was 22.86％ and 30.00％ of the childrenwith low birth weight,whichwere higher than those of the control group,the differences were statistically significant(P ＜0.01).Conclusion Pre gnancy intrahepatic cholestasis can increase the incidence rate of perinatal complications,has serious impact on the prognosis of the fetus,and to strengthen the monitoring of pregnancy intrahepatic cholestasis has important clinical significance.

Objective To observe the characteristic variation of the patients' inner and outer retina who had chronic central serous chorioretinopathy (CSC) after being treated of photodynamic therapy (PDT).Methods Nineteen patients with chronic CSC were recruited,including 15 eye of men and 4 eye of women,logMAR BCVA was 0.1-1.0,0.39 ± 0.30.Meanwhile,24 healthy people were located in the control group.All the patients received PDT for the first time.All subjects including 24 healthy people underwent fourier domain optical coherence tomography (FD-OCT).Retinal thickness were investigated before PDT and 1,4,12,20 weeks after PDT respectively.Data were recorded including inner layer and outer layer.Retinal thickness were compared in fovea (1 mm),parafovea (3 mm)and perifovea(5 mm).Paired-samples t test was used to compare retinal thickness before and after PDT.The statistical differences of patients and control group were evaluated by independent-samples t test.The correlations between the best logMAR corrected visual acuity (BCVA) was analyzed by Pearson statistical analyses.Results The inner(F=13.814,10.095,4.689) and outer(F＝ 9.354,5.878,3.978) layer fovea thickness of CSC subjects in 1,4,12 week was thinner,the difference was statistically significant (P＜0.05).The outer layer fovea thickness at P12 (t =-3.725),parafovea of inner and outer retinal (t =-3.198,-2.722) was reduced when compared with control group,and differences have statistical sense,respectively (P＜0.05).There was correlation between logMAR BCVA and outer retinal thickness in fovea and parafovea (r =0.465,-0.728,-0.687; P＜0.05).Conclusion In our study,the inner and outer layer retinal thickness decreased generally after the first time PDT in CSC patients.

Objective: To observe the efficacy and safety of analgesic drugs in the standardized treatment of cancer pain patients at the pain clinic. Methods: The data of 787 cancer pain patients and their corresponding prescriptions for cancer pain were collected from April, 2012 to April, 2013 at the pain clinic. The obtained information comprise of diseases that lead to cancer pain, cause of pain, pain intensity, and efficacy and side effects of medications. Diseases that caused cancer pain include 658 cases with primary malignant lung cancer. Results: Pain was mainly caused by primary lung cancer in 787 cancer-related patients. An analgesic drug, namely, oxycodone hydrochloride, was administered in 54.6% via single drug therapy. The daily dosage range of this drug was 20 to 90 mg/d in 280 cases. About 35.6% of the studied patients with a daily dosage of 90 mg/d or lower had their pain effectively managed. After the treatment, the number of cases with moderate to severe pain was reduced from 437 (55.5%) to 248 (31.5%). The oral administration of opioid oxycodone hydrochloride tablets ranked first among the prescribed drugs for cancer pain, and single-drug therapy was the choice of medication. The majority of patients had satisfactory pain-relief with a daily dosage of less than 90 mg/d upon the administration of oxycodone hydrochloride sustained-release tablets and morphine sulfate controlled-release tablets. Side effects included mild constipation, nausea, vomiting, dizziness, loss of appetite, urinary retention, somnolence, and so on. Intervention treatment was needed in most of the patients. Conclusion: Pain clinic is critical in the administration of standardized treatment for cancer pain in hospitals. The establishment of pain clinic ensures the standardized treatment of cancer pain.

Objective To analyze clinical manifestations and histopathological features of 6 subtypes of psoriasis presenting mainly as skin manifestations.Methods Clinical and histopathological data were collected from 313 patients with psoriasis in the Department of Dermatology of Xijing Hospital between 2013 and 2017,and analyzed retrospectively.Results Among the 313 patients,there were 31 patients with guttate-type psoriasis mainly induced by upper respiratory tract infections,60 with plaque psoriasis with the main precipitating factors being upper respiratory tract infections,overexertion,cold weather and so on,42 with erythrodermic psoriasis induced mainly by the withdrawal of systemic glucocorticoids,60 with generalized pustular psoriasis with the main precipitating factors being upper respiratory tract infections,pregnancy,drugs and so on,60 with palmoplantar pustulosis without definite precipitating factors,and 60 with acrodermatitis continua without definite precipitating factors.The 6 subtypes of psoriasis had similar typical pathological manifestations,including parakeratosis,Munro's microabscess and/or spongiform pustules of Kogoj,thinning or absence of the granular layer,psoriasis-like epidermal hyperplasia,capillary ectasia in the dermal papillae,lymphocytic infiltration and so on.Atypical pathological manifestations were observed in 98 (31％) of the 313 patients,which included 4 with guttate type psoriasis (13％),3 with plaque psoriasis (5％),12 with erythrodermic psoriasis (29％),41 with generalized pustular psoriasis (68％),12 with palmoplantar pustulosis (20％) and 26 with acrodermatitis continua (43％).These atypical pathological manifestations included serous fluid exudation,irregular epidermal hyperplasia,non-neutrophilic spongiosis,keratinocyte necrosis,dermal neutrophilic infiltration and dermal eosinophilic infiltration.Conclusions Different subtypes of psoriasis have different clinical manifestations and similar typical histopathological features.Atypical pathological features can interfere with the diagnosis of psoriasis,and attention should be paid to the differential diagnosis.

BACKGROUNDWith the development of antibody technology, more and more immunoconjugates are used in clinical treatment for different cancers. The aim of this study is to investigate the inhibitive effects of 5F11-DOX immunoconjugate on human lung adenocarcinoma cell line LTEP-A2 in vitro and in vivo and to explore the potential mechanism.

METHODSThe 5F11-DOX immunoconjugate was produced by diluted glutaraldehyde crosslinking. The killing efficiency of 5F11-DOX was detected by clonogenic assay. The distribution of DOX was observed under fluorescence microscope and the 5F11 location was determined by immunohistochemistry. The therapeutic efficacy of 5F11-DOX and free DOX was detected on subcutaneous or intraperitoneal exnogenic transplanted tumors of human lung adenocarcinoma A2 cells in nude mice.

RESULTS5F11-DOX of 0.04mg/L could kill all the A2 cells in vitro and the killing efficiency was 10 times as that of the free DOX. Fluorescence microscopy showed that fluorescence of DOX in 3mg/L 5F11-DOX group was much stronger than that in 3mg/L free DOX group after treating A2 cells with 3mg/L 5F11-DOX or DOX for 3h, then incubating the cells with fresh medium for another 24 hours. Immunohistochemistry showed that 5F11 located in cell membrane and cytoplasm and fluorescence microscopy proved that DOX located inside the cells. The average sizes of subcutaneous or intraperitoneal exnogenic transplanted tumors in 5F11-DOX group were obviously smaller than those of the control group and free DOX group at the same dosage (P < 0.05), and the anti-tumorogenicity efficacy of 5F11-DOX was 4-8 times as that of free DOX. The HE staining showed that extensive necrosis occurred in the center of tumors and around cancer nests in 5F11-DOX group.

CONCLUSIONSThe killing efficacy of 5F11-DOX on human lung adenocarcinoma cell line A2 is obviously higher than that of the free DOX.

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare type of malignant neuroendocrine tumor with poor prognosis, with the median overall survival being around one year in advanced diseases. The prognosis of patients with non-small cell lung cancer has been greatly improved with the application of molecular detecting techniques, targeted therapy and immunotherapy. However, little progress has been made in the diagnosis and treatment of LCNEC with no unified standard of diagnosis and treatment protocol. The clinical molecular diagnosis and treatment of LCNEC is of great significance. Exploring the research progress related to the diagnosis and treatment of LCNEC can provide reference for improving the existing clinical diagnosis and treatment difficulties of LCNEC.

BACKGROUNDIt was reported that tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) was a powerful pulmonary carcinogen, predominantly inducing adenocarcinoma of the lung in mouse. The aim of this study is to assay metabolites of NNK, which are 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its O-glucuronide (NNAL-Gluc), and their ratio (NNAL-Gluc/NNAL) in smokers and non-smokers' urine, and to explore the carcinogenicity of NNK among different people.

METHODSUsing high pressure liquid chromatograph (HPLC) and gas chromatograph-mass tadom (GC-MS/MS), NNAL-Gluc and NNAL in 24h urine were detected in 8 healthy smokers, 10 lung cancer smokers and 4 healthy non-smokers.

RESULTSBoth of the two metabolites were not found in non-smokers' urine. The ratios of urine NNAL-Gluc/NNAL were greatly different among different smokers. The mean ratio of NNAL-Gluc/NNAL in healthy smokers was 4.95, and 0.5 in lung cancer smokers.

CONCLUSIONSThe results provide the first evidence for metabolite detection of tobacco-specific nitrosamine in Chinese smokers' urine . The result suggests that detoxification ability of healthy smokers is higher than that of lung cancer smokers. It may provide a detective way to screen high risk people for lung cancer in smokers.

Background and objective Pulmonary sarcomatoid carcinoma(PSC)is a rare subtype of non-small cell lung cancer(NSCLC),which is featured by low incidence,high malignancy rate,robust aggressive behavior and inferior prognosis.To date,there is no standardized treatment.The aim of this study is to better understand and accumulate more clini-cal experience of the disease by summarizing the clinicopathological features,diagnosis methods,therapeutic regimen and prognostic factors of PSC.Methods A total of 39 patients with PSC who diagnosed and received treatment in Beijing Chest Hospital from December 2013 to December 2023 were retrospectively recruited,and information including demographic char-acteristics,clinicopathological features,tumor-node-metastasis(TNM)stage,diagnosis method and therapeutic regimen were carefully collected.Meanwhile,follow-up was conducted.Kaplan-Meier method was used to analyze the prognostic factors of the disease.Results The PSC patients in this study ranged in age from 45 to 76 years old,including 35 males and 4 females.There were no specific clinical manifestations of PSC at initial diagnosis.Among the 39 patients,20 underwent surgical resec-tion and 19 received palliative chemoradiation or symptomatic supportive treatment.The 1-year and 5-year survival rates were 61.90％and 35.20％respectively.Univariate analysis indicated that family history of carcinoma,primary tumor site,TNM stage,lymph node metastasis,distant metastasis,whether or not received surgical resection,surgical method,treatment regimens,tumor tissue programmed cell death ligand 1(PD-L1)expression＞1％and mesenchymal-epithelial transition factor(MET)pathway abnormalities were correlated with the overall survival(OS)of patients(P＜0.05).In the subsequent multivariate analysis,lymph node metastasis emerged as the only independent prognosticator in predicting inferior OS(P=0.037).Conclu-sion PSC is rarely seen in clinical practice and commonly occurs in elder men with smoking history.Tumor tissue PD-L1 ex-pression＞1％and MET abnormalities may predict inferior prognosis of PSC and lymph node metastasis was determined as the independent prognosticator of PSC.Surgical resection along with adjuvant medical treatment is the cornerstone for early and locally advanced patients,and the clinical utility of molecular targeting therapy and immunotherapy in PSC needs to be further investigated.

Objective To retrospectively analyze the clinical data of 47 young NSCLC patients mutation style of EGFR and PD-L1 expression in tumor cells, to understand their clinicopathological and molecular characteristics. Methods We enrolled 47 young (≤40 years old) patients confirmed as NSCLC who underwent surgical resection, and 94 old patients (≥60 years old) were matched as 1:2 by R language. EGFR mutation status was detected by ARMS-PCR, and the expression of PD-L1 was detected by immunohistochemistry. Results The median age of 47 young patients with NSCLC was 37 years old. The disease was more common in women and the majority type was adenocarcinoma. In youth group, the 19del and 20ins were more frequent, but the exon 21 L858R point mutation proportion was higher in elder group. The expression of PD-L1 was significantly increased in the solid predominant histological subtype. The PD-L1 expression in 19del patients was higher than that in the patients with L858R mutation in youth group. Conclusion The majority of young NSCLC patients are female, nonsmokers and suffered from adenocarcinoma cancer. The proportion of EGFR alteration in 19del and 20ins in youth group is higher than that in elder group. The positive rate of PD-L1 expression in solid predominant histological subtype is higher than that with other subtypes. The expression of PD-L1 in young patients with EGFR 19del is higher than that with L858R.