Since the development of molecular biology,the treatment of advanced non-small cell cancer is shifting from traditional chemotherapy into molecular targeted therapy with genotyping as a guide′s help.The most widely used is epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs).With the appli-cation of EGFR-TKIs,the resistances to EGFR inhibitors are paid more and more attention,in recent years. The main mechanisms of acquired resistances are as follows:secondary mutation of the EGFR gene,amplifica-tion of c-MET,Her2 and other target genes,histological transformation,activation of the bypass mechanisms, loss of p53,the relief of negative feedback loops,overlap of mechanisms,etc.

Objective To compare the treatment effects of catheter directed thrombolysis and thrombetomy for acute ar?terial ischemia of the lower extremity. Methods Patients who visited Tianjin Medical University General Hospital from 2011 to 2013 and were attacked by acute ischemic disease of lower extremities within 3 days (n=66) were investigated. Thrombetomy and thrombolysis treatment had been performed to 32 cases and 34 cases respectively according to patients’ own willingness. Postoperative symptom remission rate, limb salvage rate, fatality rate, reperfusion injury rate (including re?nal inadequacy, heart failure, muscle fascia compartment syndrome), bleeding rate and limb dysfunction rate were compared between these two groups. Results There was no statistical difference on the rate of symptom remission (93.8% vs 94.1%), limb salvage(96.9%vs 100%), case fatality rate(3.1%vs 0), bleeding rate(0 vs 8.8%)and limb dysfunction rate (0 vs 5.9%)between these two groups. However, the incidence of reperfusion injury was higher in the group of thrombectomy (37.5%vs 2.9%, P<0.05)compared to that of the other group. Conclusion Similar effect of treatment and less reperfusion injury, especially renal injury, had been achieved by CDT compared with thrombetomy.

Objective:To summarize the characteristics of methylmalonic acidemia(MMA) with thrombotic microangiopathy as the prominent manifestation.Methods:Clinical data was collected from MMA patients with thrombotic microangiopathy as the prominent manifestation, who were treated at Shengjing Hospital of China Medical University from September 2014 to December 2019.The clinical manifestations, laboratory results, imaging results, histopathological examination, treatment and prognosis were analyzed.Results:Six children aged 1 month to 7 years old were included in our study, including 5 males and 1 female.Six cases were all MMA complicated hyperhomocysteinemia.All patients had a history of prodromal infection before admission.All cases had edema.Five patients were hypertenson and 4 patients accompanied neurologic presentation.One patient had a family history.All patients were treated with Vitamin B 12, levocarnitine, folic acid and betaine.Three patients′ psychiatric symptoms and renal function were improved and hemolysis were controlled.Two of them were similar with the same age children in intelligence and motor development, with normal renal function, good blood pressure control and normal urine protein.The third one was significantly improved in intelligence development, but still slightly worse than that of the children with the same age.He had no convulsions occurred in recent one year with antiepileptic drugs in oral.His blood pressure was maintained between 135/90-160/110 mmHg(1 mmHg=0.133 kPa), 24-hour urine volume was about 2 000 mL, creatinine was maintained at about 150 μmol/L, ionic level was normal, and urinary protein was 2 + .One case discharged from hospital.Two patients died of multiple organ failure. Conclusion:An early screening of metabolic diseases should be achieved for thrombotic microangiopathy of unknown etiology.Early screening of homocysteine is important for early detection and treatment.

Adolescent ; Depression ; complications ; diagnosis ; drug therapy ; Humans ; Male ; Tourette Syndrome ; complications ; diagnosis ; drug therapy ; Treatment Outcome

Diversity-oriented synthesis (DOS) aims to efficiently generate collections of small molecules with diverse appendages, functional groups, stereochemistry and skeletons, thus yielding diverse biological activities capable of modulating a wide variety of biological processes. In this review, we discussed the common strategies employed in DOS with specific examples from recent literature, including reagent-based approach, substrate-based approach, build-couple-pair strategy and privileged substructure-based DOS. The application of some DOS libraries in drug discovery is also presented.
Drug Design ; Drug Discovery ; Small Molecule Libraries

This paper presented the effects of experimental hyperinsulinemia on the main apolipoproteins (At, B) and on tbe process of reverse cholesterol transport in rabbit, which consisted of 1) uptake of cholesterol from peripheral tissue by HDL; 2) cholesterol esterification and 3) cholesterol ester transfer. The results showed that insulin could significantly decrease both serum and lymph Apo A1 levels and inhibit all the three steps of reverse cholesterol transport. The larger the dose of insulin, the greater the effects. Apo B did not seem to be influenced by insulin. It was further demonstrated by a series of statistical analyses that insulin had both direct and indirect inhibitory actions, to different extent, on each of the three main steps of reverse cholesterol transport.

Objective:To explore the clinical application value of multi-slice spiral CT in the diagnosis.Methods: Twenty nine patients with clinically suspected rib fractures and X-ray showed no 64 row helical CT scanning in patients with chest trauma fractures after reconstruction, multiplanar reconstruction and VR imaging.Results: Twenty nine patients with occult fracture of rib on the MPR, VR imaging were rib image good, 28 cases were single, multiple rib fractures in 1 cases, the total of 4 cases with rib fracture, incomplete fracture in 25 cases.Conclusion: The 64 row helical CT for occult rib fracture detection rates, diagnostic accordance rate was superior to X-ray plain film, various post-processing techniques applied to timely, accurate, intuitive display rib fracture location, shape, extent of chest trauma, occult rib fracture first choice inspection method.

Idiopathic membranous nephropathy(IMN) is one of the main pathology of nephrotic syndrome,and has a rising trend year by year.In recent years that IMN is organ specific autoimmune disease.Phospholipase A2 receptor(PLA2R) and thrombospondin type-1 domain containing 7A(THSD7A) are the two main antigens of IMN,which could be used to distinguish the IMN and secondary membranous nephropathy.The anti-PLA2R antibody and anti-THSD7A antibody are associated with diagnosis,severity and activity of the disease.The antibody titer and its change could be used to help deciding the beginning of therapy and the therapitive courses.

To evaluate the effects and safety of laparoscopic vertical banding gastroplasty (LVBG) in morbid obese subjects. The clinical data related to the metabolism of glucose, lipids and obesity in 26 obese Chinese patients with LVBG one year before and after the surgery were analyzed. The results showed that 1 year after LVBG, there was a reduction of 22.98?14.27kg in body weight, 9.31?5.13kg/m 2 in BMI, and a reduction of 47.19%?31.17% of body over-weight (EWL%) in these patients. BMI, waist, waist hip ratio, systolic blood pressure, fasting insulin, insulin resistance based on HOMA, triglyceride, cholesterol/HDL, ALT and blood creatine were decreased with reduction of body weight and BMI after LVBG. Changes in BMI and EWL% were significantly correlated with those of fasting insulin and insulin resistance. It is suggested that LVBG is effective and safe for reducing body weight and improving metabolism in the markedly obese patients.

0.05 ). Conclusions With low initial FGF addition of N2O does not affect the uptake of desflurane. The low-flow desflurane anesthesia is safe and economical.