The epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)is a kind of high-efficiency and low-toxicity tumor molecular targeted drugs.It becomes a research hotspot in non-small cell lung cancer (NSCLC)treatment because of its unique curative effect and well tolerance.EGFR-TKI is mainly applied to the second and third line treatment of patients with advanced NSCLC or first line treatment of EGFR mutation patients.With the development of research,the indications of EGFR-TKI expand unceasingly.The preoperative neoadjuvant therapy is likely to become a new kind of treatment mode.

Objective High performance liquid chromatography (HPLC) and liquid chromatography-mass spectrometry (LC/MS) methods were developed for the determination of ganciclovir and its related substances. Methods A Hypersil ODS2 column (4.6mm×250mm, 5μm) was used with a mobile phase of 0.02M potassium 1.0mL/min, and UV detector set at 254nm was used for monitoring the eluents. Results The method was simple, rapid, selective and capable of separating all related substances at trace level with a detection limit of 0.04μg/mL. It has been validated with respect to accuracy, precision, linearity, and limits of detection and quantification. The linearity range was 10.2-153.0μg/mL with r=0.9998. The percentage recoveries ranged from 96.7% to 101.6%, and RSD was 1.24%-1.96% (n=5). Conclusion The method was found to be suitable not only for monitoring the reactions during the process development but also for quality control of ganciclovir. For identification of related substances, LC/MS was used. The mainly related substances of ganciclovir active pharmaceutical ingredients (API) were determined as guanine, (1, 3-dioxolan-4-yl) methyl acetate, and diacetyl guanine.

Objective To evaluate the effect of meglumine cyclic adenosine (MAC) on heart rate variability (HRV) in aged-patients with coronary heart disease (CHD).MethodsSeventy six aged-patients with CHD were randomly divided into control group (n =36) and treatment group (n =40).The patients in control group were treated with nitrate,ozagrel,calcium antagonist,aspirin enteric-coated tablets,low molecular heparin,angiotensin-converting enzyme inhibitor ( ACEI ) or angiotensin receptor antagonist ( ARB ) and lipidlowering agents according to patients' conditions.Based on this,the patients in treatment group were treated with MAC 90 mg intravenous injection once a day for two weeks.The 24 h dynamic electrocardiogram was recorded.pre-ard post-treatment,and the changes of HRV indexes were observed.Results There was no statistical significance in HRV between the two groups before treatment ( P ＞ 0.05 ).However the HRV in two groups improved significantly after treatment ( P ＜0.01 ).The improvement of HRV was more significant in MAC group than that in control group (P ＜0.01 ).Conclusion MAC can significantly improve HRV in aged-patients with CHD.

Objective: To obtain polycystin-1 intracellular region. Methods: cDNA of polycystin-1 intracellular region was generated by PCR and then cloned into pProEX Hta, which was prokaryotic expression vector. After verified by sequencing, the recombinant was transformed into E.coli host to express and purify the fusion protein by affinity chromatography. Results: 660 bp cDNA of polycystin-1 intracellular region and 2.6×104 fusion protein were obtained. Conclusion: The fusion protein containing polycystin-1 intracellular region is obtained and is helpful for preparing anti-polycystin-1 monoclonal antibody.

The afferent and efferent connections of middle suprasylvian gyrus (MSS) were studied in 18 cats by means of anterograde and retrograde transport of horseradish peroxidase (HRP). 0.1～0.4?l of saline solution containing 50％ HRP and 2％ DMSO (dimethylsulfoxide) was injected into the cortical areas (areas 5, 7, LS, 21, 19) of MSS according to the map of Heath and Jones (1971). The frozen sections were processed with TMB method. Each cortical area of MSS has reciprocal connections with ipsilateral pulvinar (PUL), lateral posterior nucleus (LP) and posterior nucleus (PN) of the lateral nuclear group of thalamus and central medial nucleus (NCM), paracentral nucleus (PC) and central lateral nucleus (CL) of the intralaminar nuclear group. The cortical areas in rostral part of MSS have additional connections with posterior nuclear group (PO), central median nucleus (CM), parafascicular nucleus (PF), ventral anterior nucleus (VA) and ventral lateral nucleus (VL). Labeled terminals are more packed in lateral nuclear group than in intralaminar nuclear group. In nuclear reticularis (R), zona incerta (ZI) and ventral nucleus of lateral geniculate body (GLv) only labeled terminals could be found.In addition, labeled terminals were found in caudate nucleus, putamen, pretecrum, colliculus superior and nuclei pontis and labeled cells could be seen in locus caeruleus, amygdala and nuclei raphe. Both labeled cells and terminals were present in claustrum bilaterally, but notably ipsilaterally.

All the cortical areas in MSS except for area 7 have reciprocal connections with primary sensory areas of the cerebral cortex (SⅠ, SⅡ) and with some thalamic nuclei which are related with specific sensations (e. g. layer B of lateral geniculate nucleus, medial interlaminar nucleus, medial part of posterior nuclear group).Area 7 lying in the central part of MSS, has close connections with its surrounding areas and is thus indirectly connected with the specific sensory system.Both homotopic and heterotopic callosal connections exist for some cortical areas of cat's MSS. The heterotopic callosal connections of a given cortical area are always corresponding to the areas which have ipsilateral connections with the given area.Most of the labeled cells are found in layer Ⅲ of cerebral cortex and are pyramidal in shape, the rest are in layer Ⅱ, Ⅳ,Ⅴ and Ⅵ. The labeled terminals (and/or preterminals) are distributed to all layers of cortex, predominantly in superficial layers (Ⅰ～Ⅲ).

Objective To prepare poriferous ?-tricalcium phosphate(?-TCP) particles and investigate the possibility of these particles to serve as bone graft and bone tissue engineering scaffold.Methods Poriferous anorganic bone particles were prepared with healthy bovine cancellous bone by removal of cells,defat and double calcination,finally with ?-TCP remained as the main ingredient.A bone defect was made in rabbit's femur,and it was repaired with poriferous ?-TCP bone graft.The results were observed by X-ray,molybdenum target films,fluorescence label and histology at the 4th,8th and 12th week after operation.Results The nature of cancellous bone structure was still maintained in the poriferous ?-TCP bone graft,even retaining its contour after it was transplanted in the bone defect.At the 4th week after operation,the graft was integrated with neighboring tissues,and the new bone gradually grew in the ?-TCP bone graft pores,with delineation of bone defect remaining clear.There was no obvious absorption of the graft,neither growth of soft tissues or bone tissue into the central part.At the 8th week after operation,the soft tissue further grew into the inside of the ?-TCP bone graft,and little bone tissue grew in the central part.At the 12th week after operation,the graft was firmly surrounded with new bone tissue,the demarcation between the graft and new bone becoming obscure,and the graft was partially absorbed,with thickening of bone trabeculae,which extended into the center of ?-TCP bone.However,the speed and quantity of the new bone formation were deteriorated.Histologic examination also found that the ?-TCP bone graft degenerated slowly with passage of time.Conclusion The poriferous ?-TCP bone graft possesses excellent osteogenesis for repairing a bone defect,and may be used as bone tissue engineering scaffold,though its degradation speed should be ameliorated.

Taking the Second Affiliated Hospital of Zhejiang University School of Medicine as an example,the paper discussed its practices in optimizing outpatient service process.These practices include innovating convenient outpatient service process,establishing a coordination center of hospital's beds to strengthen pre-hospital one-stop management,implementing day surgery to improve inpatient service,implementing professional and humanized hospital clinical care,introducing the concept of fast tract surgery to promote accelerated rehabilitation after surgery,and establishing a follow-up center for inpatients discharged.Such efforts have improved the medical services' efficiency and quality,and improved the patients' satisfaction.

Objective:To investigate the clinical efficacy and safety of compound carraghenates suppositories in the treatment of wounds after anal fissure operation. Methods:Eighty-eight cases of patients with anal fistula post-operation wounds were diagnosed from June 2011 to June 2014 and randomly divided into the observation group (n=44) and the control group (n=44). The control group was treated with the conventional treatment and the observation group was treated with external compound carraghenates suppositories additionally. The efficacy, average healing time, growing time of granulation tissue and removal time of necrotic tissue, pain disappear-ance time and wound edema disappearance time after the operation and the area of wound surface in the two groups were observed and compared. Results:After the 14-day treatment, the time of wound healing, granulation growth and cure in the observation group was shorter than that in the control group (P<0. 05). In the observation group, the total effective rate (93. 18%) was higher than that in the control group (77. 27%, P<0. 05). After the 7-day and 14-day treatment, the pain score and wound edema score in the observa-tion group were significantly lower than those in the control group (P<0. 05), and the wound area was significantly smaller than that in the control group (P<0. 05). Conclusion:The clinical efficacy of external compound carraghenates suppositories in the treatment of wounds after anal fissure operation is significant, safe and reliable.

Objective To investigate the effects of intensive insulin therapy on the functions of vascullar endothelial cells in septic patients. Methods One hundred and twenty septic patients were randomly assigned to intensive insulin therapy 1 ,intensive insulin therapy 2 and conventional insulin therapy, serum von Willebrand factor (vWF),thrombomodulin protein(TM),endothelin-1 (ET-1) and nitric oxide(NO) of the three groups of patients were determined by enzyme-linked immunoadsorbent assay double antibody sandwich principle (ELISA) before treatment and the next 3 d,7 d after treatment. At the same time we observed the three groups of patients with 28-d mortality, the days of hospitalized in ICU, number of days for using mechanical ventilation, △ APACHE Ⅱ score and △MODS score. Results After treatment of 3 days,vWF was (142.57 ± 10.07)%, (137.32 ±9.66)% and (138. 32 ± 8. 80) % in the CIT, IIT1 and IIT2 group, respectively. After treatment of 7 days, vWF was (126.27 ±10.49) %, (116. 55 ± 9. 36) % and (120.72 ± 9. 53) % in the CIT, IIT1 and IIT2 group, respectively. After treatment of 3 days, TM was (6. 87 ± 1.62) μg/L, (5.95 ± 1.60) μg/L and (6. 17 ± 1.33) μg/L in the CIT, IIT1and IIT2 group, respectively. After treatment of 7 days, TM was (4. 55 ± 1.48) μg/L, (3.35 ± 0.94) μg/L and(3. 87 ± 1.20) μg/L in the CIT, IIT1 and IIT2 group, respectively. After treatment of 3 days, ET-1 was (61.27 ±9. 20) ng/L, (55.97 ± 9.03) ng/L and (57. 37 ± 7. 70) ng/L in the CIT, IIT1 and IIT2 group, respectively. After treatment of 7 days, TM was (43. 12 ± 6. 17) ng/L, (33.77 ± 6. 20) ng/L and (35.95 ± 5.73) ng/L in the CIT, IIT1and IIT2 group, respectively. Compared with conventional insulin therapy, vWF, TM and ET-1 were significantly decreased (P ＜ 0.05), NO were significantly higher (P ＜ 0.05) in IIT1 and IIT2, but the two sub-groups had no significant difference (P ＞ 0.05). In the CIT, IIT1 and IIT2 groups respectively, the mortality at 28 days were 20.0%, 12. 5 % and 45.0%, the days of hospitalized in ICU were (9.50 ± 3. 70) d, (7. 72 ± 3.29) d and (8.02 ±2. 90) d, number of day for using mechanical ventilation were (8. 92 ± 3.79) d, (7.23 ± 3. 32) d and (7. 37 ±3. 29) d, △ APACHE Ⅱ score were 8. 87 ± 3.46,7. 20 ± 2. 81 and 7.42 ± 3. 18, △ MODS score were 4. 15 ± 2. 15,3.20 ± 1.48 and 3.32 ± 1.74, with significant differences (P ＜ 0.05). These indices were significantly decreased (P ＜ 0.05) in IIT1 and IIT2, but the two sub-groups also had no significant differences (P ＞ 0.05). Conclusions Intensive insulin therapy on patients with sepsis has a protective effect of vascular endothelial cells, and the blood glucose controlled in the 6. 6 - 8. 3 mmol/L can significantly decrease the incidence of hypoglycemia, and intensive insulin therapy can also significantly improve the prognosis of patients with sepsis.