At present,the treatment for non-small cell lung cancer (NSCLC) consists of surgery,radiation,chemotherapy,targeted therapy,etc.The epidermal growth factor receptor (EGFR) gene mutation opened a new era of individualized treatment.Multidisciplinary treatment come next after the combination of different treatment approaches,and the modality of targeted therapy like epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in combination with radiation was included.The present work reviews clinical progress for the EGFR-TKI combined with radiotherapy in advanced NSCLC.

Stereotactic body radiation therapy (SBRT) has been applied in extracranial metastases effectively,with the characteristics of concentrated dose distribution in target region,great dose gradient change in surrounding region and low dose in normal tissue beside target region.The radiation biology characteristics of SBRT,therapeutic mechanism,integration of SBRT into standard systemic therapy regimens have been studied further.

The clinical data of a child diagnosed with β-ketothiolase deficiency in Children′s Hospital of Chongqing Medical University in September 2018 were reviewed, and nutritional intervention and follow-up were carried out.The male child was 1 year and 4 months old, and he had clinical manifestations, including vomiting, diarrhea, mental depression and repeated metabolic acid poisoning.Gene detection: heterozygous variation of ACAT1 gene c. 401T>C (p.M134T) and c. 481T > C (p.Y161H). This study was mainly aimed at children with β-ketothiolase deficiency for nutritional treatment of individualized nutrition therapy, suggests that energy supply should be guaranteed and protein and fat intake should be limited in acute stage, and protein and fat intake should be increased gradually in remission stage, which can not only ensure growth and development, but also reduce the occurrence of metabolic crisis.

Objective We aimed to assess the sedative effects by intravenous injection of fentanyl on neonates with mechanical ventilation. Methods We divided 142 neonates with mechanical ventilation into the observation group (92 cases) and the control group (50 cases). The observation group received intravenous injection of fentanyl, while the control group was given no sedative medication. The pain and sedation was assessed before ventilation, 1 and 2 hours after ventilation and later every 4 hours by adoption of NPASS evaluation inventory. Results The scores of pain at different time points 2 hours after medication in the observation group were lower than those in the control group, especially 24 hours after medication. The mean airway pressure and oxygen concentration required by the observation group was lower than those of the control group. But no difference was seen in blood oxygen saturation between the two groups. Conclusions Intravenous injection of fentanyl was proper in the application of sedative treatment for neonates with mechanical ventilation. N-PASS inventory could effectively assess the pain and sedation condition and ensure the safe medication.

Objective To investigate the effect of electroacupuncture on serum insulin (INS) levels and gastric antral cholecystokinin (CCK) content in rats with diabetic gastroparesis (DGP).Methods Sixty SD rats were randomized into groups A, B, C, D and E, 12 rats each. Group A is a normal control. A DGP model was made by an intraperitoneal injection of 2% streptozocin (STZ) plus an irregular high sugar and fat diet in groups B, C, D and E. group B is a model one and did not receive treatment. Group C received electroacupuncture at points Zusanli, Sanyinjiao and Liangmen; group D, electroacupuncture at the control points of Zusanli, Sanyinjiao and Liangmen. Group C, an oral gavage of metoclopramide tablet solution. Blood sugar and urine sugar were determined using a OneTouch lood glucose meter and Tes-Tape, respectively. The gastric emptying rate and the intestinal migration rate were measured by an oral gavage of phenol red. Serum INS levels and gastric antral CCK content were measured by ELISA in every group of rats before and after treatment.Results There were statistically significant differences in blood and urine sugar values between group B, C, D or E rats and group A (P<0.01) and between group C rats and group B or E (P<0.05). There was a statistically significant difference in the gastric emptying rate between group B, C, D or E rats and group A (P<0.01) and between group C rats and group B or D (P<0.01,P<0.05). There was a statistically significant difference in the intestinal migration rate between group B or D rats and group A (P<0.01) and between group C rats and group B or D (P<0.01). There were statistically significant differences in serum INS levels and gastric antral CCK content between groups B and A rats (P<0.05,P<0.01). There was a statistically significant difference in gastric antral CCK content between groups D and A rats (P<0.01). There were statistically significant differences in serum INS levels and gastric antral CCK content between groups C or E rats and group B (P<0.05,P<0.01). There was a statistically significant difference in gastric antral CCK content between groups C and D rats (P<0.05).Conclusions Electroacupuncture can markedly improve gastrointestinal functions and promote gastric emptying in DGP rats. Its therapeutic effect may be related to electroacupuncture raising serum INS levels and reducing gastric antral CCK content.

Objective:To investigate the effects of electroacupuncture (EA) at Neiguan (PC 6) and Baihui (GV 20) by observing the changes of CCAAT/enhancer-binding protein(C/EBP) homologous protein (CHOP) and caspase-12 gene expressions in rats after cerebral ischemia-reperfusion injury (IRI), and explore whether the apoptosis pathway of endoplasmic reticulum stress (ERS) is involved in the protective mechanisms of EA.
Methods:Sixty rats were randomly assigned to five groups (12 in each group): a normal control group (group A), a sham-operation group (group B), an operation group (group C), an Edaravone group (group D) and an EA group (group E). The cerebral IRI rat model was induced by middle cerebral artery occlusion (MCAO) using intraluminal monofilament. 2,3,5-triphenyl tetrazolium chloride (TTC) staining was adopted in the measurement of cerebral infarction volume. Real-time polymerase chain reaction (RT-PCR) was used to determine the mRNA expressions of CHOP and caspase-12.
Results: Compared with group A and group B, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group C, group D and group E were increased, with statistical significances (P<0.05 orP<0.01); compared with group C, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group D and group E were decreased significantly (P<0.05 orP<0.01); there were no significant differences between group D and group E in comparing the above items (P>0.05).
Conclusion:EA at Neiguan (PC 6) and Baihui (GV 20) can effectively suppress the volume of cerebral infarction. Furthermore, the underlying mechanism of EA at Neiguan (PC 6) and Baihui (GV 20) is possibly related to the down-regulation of CHOP and caspase-12 mRNA expressions, so as to decrease cell apoptosis.

Objective Compare the analgesia effects of using different intervention method among neonatal infants, and then find out the most effective method. Methods Divided 120 neonatal infants into the control group, the NNS group and the position group, there were 40 cases in every group. Using the N-PASS scale evaluated the pain degree at the points of 1 and 5 minutes respectively after stimulation among the 3 groups. Results There was significant difference between the 3 groups on the pain degree,P

Objective To investigate the effects ofLiuwei-Dihuang Pills combined with Ginkgo Biloba Leaves Extract Tablets on diabetic complications in patients with type 2 diabetes mellitus (T2DM). Methods Seventy-eight patients with T2DM were randomized into a TCM treatment group and a conventional treatment group by random number table method, 39 in each group. The patients in the conventional treatment group were regularly using antihyperglycemic drugs or insulin. On the basis of conventional treatment group, the patients in the TCM treatment group were additionally treated withLiuwei-Dihuang Pills and Ginkgo Biloba Leaves Extract Tablets. Intima-media thickness (IMT) of internal carotid artery, vibration perception threshold (VPT) and diabetic retinopathy in both groups were detected before the treatment, 12 and 36 months after the treatment.Results The VPT in the left foot 12 months after the treatment in the TCM treatment group were significantly lower than that in the conventional treatment group (13.98 ±4.38 Vvs. 18.70 ±2.43 V;t=2.764, P=0.008). IMT of internal carotid artery (left: 0.81 ± 0.16 mmvs.0.70 ± 0.10 mm,t=3.120,P=0.003; right: 0.81 ± 0.17 mmvs. 0.73 ± 0.12 mm,t=2.286,P=0.026), VPT (left foot: 14.82 ± 6.45 Vvs. 20.63 ± 9.75 V,t=2.714, P=0.009; right foot: 16.73 ± 7.10 Vvs. 20.73 ± 10.35 V,t=2.001,P=0.048) and incidence of diabetic retinopathy (35.9%vs. 53.8%;χ2=5.804,P=0.016) 36 months after the treatment in the TCM treatment group were significantly lower than those in the conventional treatment group.ConclusionsLiuwei-Dihuang Pills combined with Ginkgo Biloba Leaves Extract Tablets can effectively reduce the progression of diabetic complications in patients with T2DM.

ObjectiveTo detect the expressions of Toll-like receptor(TLR) 7 and 9 mRNA in peripheral blood mononuclear cells(PBMCs) from patients with vitiligo and their significance.Methods Real-time fluorescence-based quantitative reverse transcription-PCR was performed to detect the expressions of TLR7 and TLR9 mRNA in PBMCs from 50 patients with vitiligo and 25 normal human controls.Two-sample t test was conducted by using SPSS 11.5 software to compare the expression difference of TLR7 and TLR9 mRNA between the patients and controls.ResultsThe mRNA expression level (the ratio of the absolute copy number of a target gene to a control gene) of TLR7 and TLR9 in PBMCs were significantly higher in patients with vitiligo than in the normal human controls(0.85 ± 1.90 vs.0.44 ± 1.18,P ＜ 0.05; 0.94 ± 2.25 vs.0.11 ±0.31,P ＜ 0.01 ).No significant difference was observed in the expression level of TLR7 or TLR9 mRNA in PBMCs between patients with stable and active vitiligo,or between patients with localized and generalized vitiligo(both P ＞ 0.05).ConclusionsThe expression level of TLR7 and TLR9 mRNA is elevated in PBMCs from patients with vitiligo,which may be involved in the pathogenesis of vitiligo.

Objective To explore the clinical features and gene mutations of blepharophimosis-ptosis-intellectual-disability syndrome (BPID). Methods The clinical data, diagnosis and treatment of a child with BPID in neonatal intensive care unit (NICU) were reviewed. Based on the literature retrieved from PubMed database, the common classification, clinical features, diagnosis and genetic counseling of BPID and its affiliated blepharophimosis-mental retardation syndromes (BMR) were reviewed. Results This male infant was 39 weeks of gestational age with birth weight of 1920 g, and was admitted to NICU 15 min after birth due to dyspnea. The main clinical manifestations were facial deformity such as biepharophimosis, ptosis and micromandible, inspiratory dyspnea with laryngeal cartilage softening, malformations of the thorax and feeding difficulties. A heterozygous mutation in UBE3B gene was identified by complete exon sequencing and he was diagnosed of BPID, a rare genetic disorder. Reviewing the literature, there was no relevant report in domestic. While one foreign literature was found to report 5 patients from 4 families having a subtype of BMR, a kind of autosomal recessive diseases caused by mutations in the UBE3B gene. Conclusion BPID is a rare clinical entity of BMR. Complete exon sequencing can be used to diagnose the disease.