EML4-ALKfusiongeneisoneofthenoveltargetsinthetherapyoflungcancer,whichcan be detected in several kinds of tumors.A specific ALK inhibitor has been shown to exert anti-tumor effects in non-small cell lung cancer with the EML4-ALK fusion gene.Correlative study between EML4-ALK gene fusion and EGFR-Kras mutations might cast new insight on the tumor target therapy.

Since 2007, a number of published population-based studies have shown that stroke epidemiology has changed. There are some differences in morbidity, mortality, risk factors and clinical prognosis of stroke between the high-income countries and the less developed countries.

Objective: To investigate the therapeutic effects of Tuina (Chinese therapeutic massage) in a knee osteoarthritis (KOA) rat model and its influence on proteins associated with the Wnt/β-catenin signaling pathway. Methods: A total of 32 specific-pathogen-free grade Sprague-Dawley rats were used. Eight rats were randomly selected as the control group (CG). The remaining 24 rats underwent intra-articular injections with 0.2 mL of 4％ papain to prepare the KOA rat models. After the model was established, the 24 rats were randomly and equally assigned to 3 groups, including a model group (MG), a Tuina group (TG), and a positive medicine group (PMG), with 8 rats in each group. The Lequesne score was applied to evaluate the success of model development. After the model was successfully established, the CG did not receive any intervention, and the TG was treated with local, clockwise annular Rou-Kneading around the knee joint with the thumbs. The pressure in the longitudinal direction was 3 N, and the frequency was designed to be 120-140 times/min for 15 min, followed by flexing the joint 10 times. The PMG was intragastrically administered with celecoxib [24 mg/(kg·bw)] every day. These interventions were performed once a day, 6 d per week, for a total of 4 weeks. After treatment, the Lequesne score was applied again to assess the severity of the KOA in the rats; hematoxylin-eosin (HE) staining and a mixture of equal volumes of aqueous solutions of safranin O-fast green were used to stain and observe the cartilage morphology and structure; the modified Mankin score was applied to evaluate the pathology; enzyme-linked immunosorbent assay method was used to quantify the C-telopeptide fragments of type Ⅱ collagen (CTX-Ⅱ) and cartilage oligomeric matrix protein (COMP); Western blotting was then applied to quantify Wnt4, β-catenin, matrix metalloproteinase 13 (MMP-13), and bone morphogenetic protein 2 (BMP-2) protein expression; immunohistochemistry was conducted to determine the percentage of collagen type X (ColX)-positive cells. Results: The Lequesne score of the TG and PMG was both lower than that of the MG (P<0.01); the HE staining, safranin O-fast green stained morphology and structure, and modified Mankin scores of the TG and the PMG were also better than those in the MG (P<0.01). Compared with the CG, the amounts of CTX-Ⅱ and COMP in the serum were significantly increased (P<0.01); the expression of Wnt4, β-catenin, MMP-13, and BMP-2 proteins in the cartilage tissue was significantly increased (P<0.01), and the percentage of ColX-positive chondrocytes was significantly increased (P<0.01) in the MG. In comparison with those in the MG, the amounts of CTX-Ⅱ and COMP were significantly decreased (P<0.01), the expression of Wnt4, β-catenin, MMP-13, and BMP-2 proteins was significantly decreased (P<0.01), and the percentage of ColX-positive chondrocytes was significantly decreased (P<0.01) in the TG and PMG. Compared with the PMG, the contents of CTX-Ⅱ and COMP and the expression of Wnt4, β-catenin, MMP-13, and BMP-2 proteins were decreased (P<0.05 or P<0.01); the percentage of ColX-positive chondrocytes was significantly decreased (P<0.01) in the TG. Conclusion: Tuina can relieve the degeneration of KOA, and the mechanism may be related to the down-regulation of the Wnt/β-catenin signaling pathway, the decrease in MMP-13 and BMP-2 protein expression, the reduction in chondrocyte extracellular matrix degradation, and slowing down the terminal cell differentiation.

Objective: To review the efficacy of nutrition support and operation in management of chylothorax.Methods: 6 patients underwent conservative way(fat-free enteral nutrition+PN+ somatostatin) and 3 patients then received the operation.Results: 3 patients were cured with only conservative way,but 3 others were cured under operation.Conclusion:The conservative way(fat-free enteral nutrition+PN+ somatostatin) is a effective method in patients with chylothoral,and the operation is needed in some patients.

There has always been no lack of discussion on Biaoben and Genjie theory in traditional Chinese medical acupuncture circles, but many questions still exist. This article expounds the original meaning of Biaoben and Genjie, traces the origin of the theory and sorts out the questions in Biaoben and Genjie theory, e.g. the difference in the position between Biaoben and Genjie, no record of the location of Genjie of six hand meridians, regularities in meridional qi circulation, understanding and valuing, and application and development to confirm the importance of Biaoben and Genjie theory and to give reference.

Primary hepatic carcinoma（PHC）is the second leading cancer that caused death in the world. The morbidity of PHC is increasing year by year,which threaten people's lives and health. Chronic hepatitis B is considered to be an independent risk factor for PHC,and the incidence of PHC is higher in patients who have progressed to liver cirrhosis. We reviewed the domestic and abroad literatures about the risk factors for hepatitis B cirrhosis progressing to PHC from the year of 1992 to 2018,and concluded that HBV-DNA,HBsAg,HBeAg expression,antiviral treatment time,different antiviral drugs,degree of cirrhosis,alanine transaminase and family history were related to the development of PHC from cirrhosis.

To investigate the cytotoxicity of the homemade peptide cationic liposome CDO14 and its efficacy of RNA interference (RNAi). MTT method was used to determine the cytotoxicity of the liposome to a human lung cancer cell line Luc-A549 that can express luciferase stably. Luciferase siRNA (Luc-siRNA) was transfected into Luc-A549 cells by CDO14. Contents of luciferase in the transfected cells were detected by luminous instrument and contents of total protein in these cells were detected by BCA method. Nude mice were inoculated with Luc-A549 cells in axilla to establish xenograft tumor model. Complexes of Luc-siRNA and the cationic liposomes were injected into the modeling mice via tail vein. Contents of luciferase in the transfected mice were detected by the whole body imaging system. The cytotoxicity of the homemade cationic liposome was similar to that of commercial liposome DOTAP, and lower than that of Lipo2000. The siRNA transfection efficacy mediated by CDO14 was higher than that mediated by DOTAP. The homemade peptide cationic liposome CDO14 is expected to serve as delivery vector in gene therapy because of its low cytotoxicity and high transfection efficiency.
Animals ; Cations ; Cell Line, Tumor ; Fatty Acids, Monounsaturated ; Genetic Therapy ; Genetic Vectors ; Humans ; Liposomes ; Luciferases ; Lung Neoplasms ; Mice ; Mice, Nude ; Peptides ; Quaternary Ammonium Compounds ; RNA Interference ; RNA, Small Interfering ; Transfection

Objective To explore the diagnostic value of sputum smear coupled with simplified clinical pulmonary infection score (CPIS) of ventilator associated pneumonia (VAP) in the early stage.Methods A cohort of 59 consecutive patients with VAP admitted in Intensive Care Unit from June,2014 to June,2016 were enrolled for a prospective and observational study.Concurrently,another 59 patients without pulmonary infection undergone mechanical ventilation over 48 hrs,were assigned into the control group.The criteria of exclusion were patients with pulmonary malignancies,autoimmune diseases and immunodeficiency.APACHE Ⅱ scores of all patients were recorded.All patients' inferior airway sputum which met the criteria was taken to make a validated sputum smear (i.e.polymorphonuclear leukocyte ＞ 25and squamous epithelial cell ＜ 10 per low-power field) for Gram stain and culture on the admission day.Meanwhile,simplified CPIS were calculated.Data were statistically processed by SPSS 15.0,enumeration data were statistically analyzed by Chi-Square test,and measurement data were represented as Mean ± SD.The significant differences in characteristics between two groups were analyzed by independent t test,and P ＜ 0.05 was considered statistically significant.As positive sputum smear and simplified CPIS ≥ 5 were set respectively as a positive screening criterion,sensitivity,specificity,positive predictive value and negative predictive value of each marker and combined markers were calculated.Results There were no significant differences in demographics and clinical features (including age,sex,APACHE Ⅱ scores) of patients in VAP and non-VAP patients (P ＞ 0.05).The rates of bacteria detected were Gram-negative [44.1％ (26/59)],Gram-positive [40.6％ (24/59)],none [10.2％ (6/59)] and both [5.1％ (3/59)] bacteria in VAP group,while [39.0％ (23/59)],[30.5％ (18/59)],[27.1％ (16/59)] and [3.4％ (2/59)]were found in non-VAP group correspondingly.There were no significant differences in the percentages of different bacteria in sputum smear between two groups (P ＞ 0.05).The values of diagnostic sensitivity of sputum smear and sputum smear coupled with simplified CPIS were 89.8％ and 84.7％;the specificity were 27.1％ and 79.7％;the positive predictive values were 55.2％ and 80.6％;and the negative predictive values were 72.7％ and 83.9％,respectively.Conclusions No matter the ventilated patients suffered VAP or not,bacteria might be detected from their lower respiratory tracts.Sputum smear could not be taken as an exclusively diagnostic evidence.While sputum smear coupled with simplified CPIS might improve the diagnostic efficacy of VAP,and provide the guildlines of appropriate choice of antibiotics employed in the early stage.

Objective:To explore the effective ability and strategy of improving in-hospital emergency in large general hospitals through investigating and analyzing the epidemiological characteristics and outcomes of patients treated by rapid response team (RRT) in the Fourth People's Hospital of Shenyang.Methods:The clinical data of 145 patients treated by RRT in the Fourth People's Hospital of Shenyang from April 1st to June 30th in 2019 were retrospectively analyzed. The clinical data including gender, age, RRT response time, disease type, direct cause of RRT initiation, the incidence of cardiac arrest, intensive care unit (ICU) admission rate and outcome were statistically analyzed. The correlation between indicators was analyzed by Pearson correlation. Pareto diagram was used to analyze the direct cause of RRT initiation.Results:A total of 145 patients were treated by RRT within 3 months. The ratio of male ( n = 85) to female ( n = 60) was 1.42∶1. The age of patients treated by RRT was (72.83±14.84) years old, and the response time was (3.27±1.42) minutes. The incidence of cardiac arrest was 23.4% (34/145), and the ICU admission rate was 29.7% (43/145). The hospital mortality was 40.0% (58/145), and the rescue success rate was 60.0% (87/145). Correlation analysis showed that there was a significant positive correlation between the incidence of cardiac arrest and hospital mortality ( r = 0.545, P < 0.01). According to the disease type of patients treated by RRT analysis, respiratory system diseases ( n = 44, 30.3%) accounted for the most, followed by circulatory system diseases ( n = 43, 29.7%), nervous system diseases ( n = 25, 17.2%), digestive system diseases ( n = 19, 13.1%), trauma ( n = 5, 3.4%), endocrine system diseases ( n = 3, 2.1%), urinary system diseases ( n = 2, 1.4%) and others ( n = 4, 2.8%). Further analysis showed that patients aged between 85 years old and 94 years old were prone to the respiratory system diseases, accounting for 48.5% (16/33) of the population in this age group, while the cardiovascular system diseases were the most common in patients older than 55 years old, accounting for 31.0% (40/129) of the population in this age group. Pareto diagram showed that the percentages of direct causes of RRT initiation ranked from high to low, the cumulative percentage of pneumonia ( n = 30, 20.7%), acute myocardial infarction ( n = 26, 17.9%), stroke ( n = 20, 13.8%), septic shock ( n = 14, 9.7%), heart failure ( n = 10, 6.9%), respiratory and cardiac arrest ( n = 9, 6.2%), and gastrointestinal bleeding ( n = 7, 4.8%), which were the main direct causes of RRT initiation with a total of 80%. Conclusions:Respiratory system and circulatory system diseases are the main causes for RRT treatment in first-aid patients in the Fourth People's Hospital of Shenyang. The hospital mortality significantly increases once patients suffered cardiac arrest. The RRT can provide effective intervention earlier and faster, and establish a complete RRT emergency strategy, which is helpful to improve the in-hospital emergency ability in large general hospitals.

Post-stroke dementia (PSD) includes all types of dementia after stroke, which may be the result of cumulative effects of cerebrovascular disease, Alzheimer's disease, and white matter changes. The incidence and prevalence of PSD are high. Its risk factors are mainly vascular risk factors, such as hypertension, atrial fibrillation, and diabetes. Other risk factors also include various imaging phenotypes of cerebrovascular disease, such as white matter hyperintensities, cerebral microbleeds, and brain atrophy. The clinical evaluation of PSD should be conducted at least 3-6 months after the onset of stroke. The prevention of PSD should focus on controlling vascular risk factors and preventing stroke.