Targeted therapy of anti-angiogensis strategy is the standard treatment for metastatic renal cell cancer.In recent years,a number of new generation of anti-angiogensis agents have been tested in clinical trials,some of which have achieved promising outcomes.Other pathway inhibitors such as inhibitors of mamma-lian target of rapamycin and fibroblast growth factor receptor pathway have made progresses in some extent.

Objective: To systematically profile and characterize the circular RNA (circRNA) and microRNA (miRNA) expression pattern in the lesion epicenter of spinal tissues after traumatic spinal cord injury (TSCI) and predict the structure and potential functions of the regulatory network. Methods: Forty-eight adult male C57BL/6 mice (weighing, 18-22 g) were randomly divided into the TSCI ( n=24) and sham ( n=24) groups. Mice in the TSCI group underwent T 8-10 vertebral laminectomy and Allen's weight-drop spinal cord injury. Mice in the sham group underwent the same laminectomy without TSCI. The spinal tissues were harvested after 3 days. Some tissues were stained with HE staining to observe the structure. The others were used for sequencing. The RNA-Seq, gene ontology (GO) analysis, and circRNA-miRNA network analyses (TargetScan and miRanda) were used to profile the expression and regulation patterns of network of mice models after TSCI. Results: HE staining showed the severe damage to the spinal cord in TSCI group compared with sham group. A total of 17 440 circRNAs and 1 228 miRNAs were identified. The host gene of significant differentially expressed circRNA enriched in the cytoplasm, associated with positive regulation of transcription and protein phosphorylation. mmu-miR-21-5p was the most significant differentially expressed miRNA after TSCI, and circRNA6730 was predicted to be its targeted circRNA. Then a potential regulatory circRNA-miRNA network was constructed. Conclusion: The significant differentially expressed circRNAs and miRNAs may play important roles after TSCI. A targeted interaction network with mmu-miR-21-5p at the core of circRNA6730 could provide basis of pathophysiological mechanism, as well as help guide therapeutic strategies for TSCI.

Objective: To investigate the relationship between obstructive sleep apnea hyponea syndrome(OSAHS) and brain vascular diseases in old patients.Methods: Fifty-two old patients with OSAHS were observed by polysomography,dynamic blood pressure measurement and nuclear magnetic resonance.Results: Compared with the healthy controls,the incidence of apoplexy was obviously higher in the severe OSAHS group and the rate of hypertension is significantly higher in both the moderate and severe groups.Conclusion: There are high incidences of hypertension and apoplexy in old patients with OSAHS.

The transformation from the biomedical mode to socio-psycho-biological mode requires higher demands for medical education and comprehensive quality for the medical talents.The existing method of neurology education has disadvantages and cannot meet the needs of modern social life for doctors.By analyzing the neurology education situation that can not be adapted to progression of society,some measures to enhance neurology education are put forward.

Objective To evaluate the value of central venous pressure (CVP),central venous oxygen saturation (ScvO2) and venous-arterial carbon dioxide partial pressure gradient (Pv-aCO2) in the diagnosis of septic shock-induced left ventricular dysfunction.Methods Consecutive patients with septic shock were enrolled from September 2013 to September 2014 in ICU at Peking Union Medical College Hospital.The data of CVP,Pv-aCO2 and ScvO2 were recorded and analyzed.According to the left ventricular ejection fraction (LVEF) tested by bedside echocardiography,the patients were divided into two groups:new onset of left ventricular dysfunction (LVEF ＜ 50％) group and non-left ventricular dysfunction (LVEF ≥ 50％) group.A diagnostic model was created by logistic regression.The diagnostic performance and cut-off values of CVP,Pv-aCO2,ScvO2 were determined using receiver operating characteristic (ROC) curve analysis.Results Among 93 patients enrolled,39 were diagnosed with left ventricular dysfunction.In the new onset group,CVP [(12.5±3.9) mmHg(1 mmHg=0.133 kPa) vs (10.4±2.5)mmHg;P=0.005] and Pv-aCO2 [(7.5 ± 3.9) mmHg vs (4.5 ± 2.6) mmHg;P ＜ 0.001] were significantly higher than those in the non-left ventricular dysfunction group,while ScvO2 [(62.4 ± 10.5) ％ vs (72.6 ± 9.0) ％;P ＜ 0.001] was significantly lower.As far as the diagnostic value of these three parameters were concerned for left ventricular dysfunction,the sensitivity of CVP ≥ 12.5 mmHg was 46.2％,specificity 81.5％ with an area under ROC curve (AUCROC) 0.674;the sensitivity of Pv-aCO2 ≥ 5.0 mmHg 76.9％,specificity 37.0％,AUCROC 0.738;the sensitivity of ScvO2 ≤65.8％ 64.1％,specificity 78.6％,AUCROC 0.775.When the cut-off values were determined by ROC,the diagnostic performance of the model was ≥0.377 with the sensitivity,specificity and AUCROC 82.1％,79.6％ and 0.835,respectively.Conclusion In patients with septic shock,the logistic regression model established by CVP,Pv-aCO2 and ScvO2 contributes to the diagnosis of septic shock-induced left ventricular dysfunction.

Objective To investigate the dosimetric characteristics and their clinical applications of volumetric modulated Arc therapy (RapidArc) with fixed-fields intensity modulated radiotherapy for early stage nasal NK/T-cell lymphoma.Methods Ten patients with stage Ⅰ E and Ⅱ E nasal NK/T-cell lymphoma were enrolled in the study.Five field coplanar plan (5F),nine field coplanar plan (9F),five field non-coplanar plan (5F-N) and RapidArc plans were designed for each patient,in which 5F plan was set as the control group.Conformity index (CI) and homogeneity index (HI) as well as the maximum dose of organs at risks were compared.Results The target CI of 5F,9F,5F-N and RapidArc plan was 0.419±0.159,0.478 ±0.181,0.465 ±0.121 and 0.518 ±0.111,respectively.Compared with 5F (0.136±0.038),the target HI of 9F and RapidArc plan was 0.111 ±0.027 and 0.112 ±0.031 (t =3.11,3.04,P ＜ 0.05).9F plan significantly increased the Dmax of lens in the contralateral side(t =2.82,P ＜ 0.05) and in ipsilateral side (t =3.25,P ＜ 0.05),while 5F-N plan decreased the Dmax of optical nerves by up to 9％.RapidArc plan effectively reduced the radiation to organs at risk in lens (t =3.25,P ＜0.05),eyes (t =3.25,P ＜0.05),optical nerve (t =2.57,P ＜0.05) and optical chaism(t =7.62,P ＜0.05).The delivery efficiency of four plans ranked as RapidArc ＞ 5F ＞ 5F-N ＞ 9F.Conclusions RapidArc produced statistically significant improvement in the dose distributions of targets,and also reduced the Dmax of organs at risk,which would be the better choice of radiotherapy for nasal NK/T-cell lymphoma.

Objective To study the effect of itraconazole/IFN-gamma on IFN-? and IL-10 in nude mice and mice and clinical significance. Methods Systemic infection of animals that induced by abdominal injection of Candida albicans and Cryptococcus neoformans, Expression of IFN-? and IL-10 were detected by enzyme-linked immunosorbent assay (ELISA).Results After treated with Itraconazole and IFN-gamma, the levels of IFN-gamma were increased and ones of IL-10 were decreased significantly. Conclusions Itraconazole and IFN-gamma may play key roles in the immune function of those animals.

Objective To evaluate the curative effect and toxicities of platinum-based double regimens for patients aged ≥ 65 with advanced non-small-cell lung cancer (NSCLC) and identify the prognosis factors. Methods 70 patients aged ≥65 with staged ⅢA-Ⅳ NSCLC, who received platinum-based double regimens as first line treatment, were emrolled.Response rates and toxicities were evaluated.Progression free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox regression analysis was used to identify the potential prognosis factors.Results The median chemotherapy cycles was 3.The overall response rate was 41.5 % (22/53), and there was no difference between patients aged ＜70 and ≥70 (χ2 =1.945, P =0.378).The median PFS and OS were 6.0 months and 12.5 months.The chemotherapyrelated hematologic toxicities were common.Multivariate analysis revealed that performance status, numbers of metastasis, chemotherapy cycles were significant independent predictive factors for OS. Conclusion In elderly advanced NSCLC, platinum-based doublets show inspiring efficacy, but with more adverse events, and could not be all well tolerated. It should be personalized. Patients with poor performance status and multiple organs metastasis are hard to benefit from combined chemotherapy.Three to six cycles of chemotherapy is the optimal duration for patients who could be well tolerated.

Objective: To establish a curve of dosage gradient-liver signal intensity of superparamagnetic iron oxide (SPIO) in normal rats and to find an appropriate dose for enhancement. Methods: Seventy-two SD rats, 4 rats a group at random, underwent MR enhancement with 0, 2, 5, 8, 10, 12, 15, 20, 30, 40, 50, 60, 70, 80, 100, 140, 210, 280 μmol/kg SPIO respectively after plane examination. The signal-to-noise ratio of liver was measured and a curve of dosage gradient-liver signal intensity was made. Results: (1)With the increase of SPIO dose, the signal intensity of both T1 and T2 weighted images of liver declined. (2)T2 weighted images was more sensitive than T1 weighted images in small dose, the ED50 of T1 weighted was 8 μmol/kg, and the ED50 of T2 weighted was 5 μmol/kg. (3)When the dose was greater than 15 μmol/kg, the signal intensity of T1 weighted images declined more rapidly than T2 weighted, the effect of enhanced T1 weighted images resembled T2 weighted ones, and its images was with more fine resolution. (4)At the dose of 40 μmol/kg, the signal intensity of T1 weighted images approached the background noise, and at the dose of 15 μmol/kg, the signal intensity of T2 weighted images approached the background noise. Conclusion: Good effect of T1 and T2 enhanced MR imaging can be acquired at the dose of 20-10 μmol/kg SPIO respectively, the best contrast-to-noise ratio is found on T2 weighted enhanced MR image.

Objective To investigate the effect of the bedside lung ultrasound in emergency (BLUE)-plus lung ultrasound protocol on lung consolidation and atelectasis of critical patients.Methods All patients who need to receive mechanical ventilation for more than 48 hours in ICU from June 2010 to December 2011 in Peking Union Medical College Hospital were included in the study.BLUE-plus and BLUE lung ultrasound,bedside X-ray,lung CT examination were performed on all patients at the same time.The condition of lung consolidation and atelectasis discovered by BLUE-plus lung ultrasound protocol was recorded and compared with bedside X-ray or lung CT.The difference in assessment of lung consolidation and atelectasis between BLUE-plus lung ultrasound protocol and BLUE protocol was compared.Results A total of 78 patients were finally enrolled in the study.The lung CT found 70 cases (89.74％) had different degrees of lung consolidation and atelectasis.The sensitivity,specificity and diagnostic accuracy of lung consolidation and atelectasis by the bedside chest X-ray were 31.29％,75.00％ and 38.46％,respectively.BLUE-plus lung ultrasound protocol found 68 cases with lung consolidation and atelectasis,and its sensitivity,specificity,and diagnostic accuracy were 95.71％,87.50％ and 94.87％,respectively,which were significantly higher than those of lung CT.BLUE protocol found 48 cases of lung consolidation and atelectasis,and its sensitivity,specificity,and diagnostic accuracy were 65.71％,75.00％ and 66.67％,respectively.The position of lung consolidation and atelectasis which hadn't been found by BLUE protocol was mainly proved to be located in the basement of lung by lung CT.Conclusions The incidence of lung consolidation and atelectasis in critical patients who received mechanical ventilation is high.The BLUE-plus lung ultrasound protocol has a relatively higher sensitivity,specificity and diagnostic accuracy for consolidation and atelectasis,which can find majority of consolidation and atelectasis.As BLUE-plus lung ultrasound is a bedside noninvasive method allowing immediate assessment of most lung consolidation and atelectasis,it will be likely the alternative of the CT and play a key role in assessment of lung consolidation and atelectasis.