After many targeted drugs have entered into the treatment guideline or all stage clinical trial of non-small-cell lung cancer (NSCLC), many researchers undertake deep investigation on the role of molecular gene marker in targeted therapy of NSCLC. It is a good outset that mutation detection of epidermal growth factor receptor (EGFR) gene direct the selection of EFGR tyrosine kinase inhibitors (EGFR-TKI). To choose individualized therapy regimens according to molecular gene marker will be the important research direction, but also be the critical measure to improve the management level of NSCLC and prolong patient"s survival. Accompanied with deep investigation of targeted therapy, there will be more molecular gene markers to direct the formulation of individualized therapy regimens.

In this article, a method to determine the content of liquiritin, ammonium glycyrrhetate, costunolide and dehydrocostus lactone in Mongolia medicine Ga Ri Di-13 pill was established. The chromatographic condition for liquiritin and ammonium glycyrrhetate was listed as the below: with Dimma column (250 mm×4.6 mm, 5μm) as stationary phase; with acetonitrile (A)-0.4%phosphoric acid (B) as mobile phase; gradient elution: 0-10 min (16%-18% A), 10-30 min (18% A), 30-40 min (18%-27% A), 40-85 min (27%-45% A), and 85-86 min (45%-16%A); column temperature was set at 30℃; detection wavelength was 237 nm; and flow velocity was 1 mL·min-1. The chromatographic column condition for costunalide and dehydrocostus lactone was listed as the below: with Dimma column (250 mm×4.6 mm, 5μm) as stationary phase; with acetonitrile-water (65:35) as mobile phase; detection wavelength was 225 nm; column temperature was set at 30℃ and flow velocity was 1.0 mL·min-1. The linearity ranges of liquiritin, ammonium glycyrrhetate, costunolide, and dehydrocostus lactone were 0.1-1.2μg (r=0.999 9), 0.341-4.092μg (r=1.000 0), 0.12-1.2μg (r=1.000 0), and 0.106-1.06 (r=1.000 0), respectively; the average recovery rates were 97.07%, 100.13%, 98.44%, and 98.90%, respectively; the RSD were 1.00%, 1.84%, 2.21% and 3.38%,respectively. This method is specificity and reproducible, and can be used to determination of liquiritin, ammonium glycyrrhetate, costunolide and dehydrocostus lactone in Mongolia medicine Ga Ri Di -13 pill.

Lycopene is an important natural carotenoid,and is widely found in human tissues and blood,with the prevention of many types of cancer,anti-aging effect.It can inhibit the proliferation of cancer cells of oral malignancy,and increasing of gap-junction communication between cells to prevent oral cancer,and also can inhibit the development of colorectal cancer by reducing the activity of matrix metalloproteinase.It plays the role of anti-metastasis through enhancing the expression of anti-metastatic gene nm23-H1.

Recently,many studies find that microRNA plays a key role in the development,diagnosis,treatment and prevention of gastric cancer.It is confirmed that miR-451 can be used as a useful biomarker for the screening of gastric cancer.Studies also show that miR-203 and miR-21 may become diagnostic markers of gastric cancer.MicroRNA can play the role of oncogenes,and also can play the role of tumor suppressor gene,such as miR-141 plays the role of tumor suppressor gene through inhibition of the positive fibroblast growth factor receptor 2 gene expression.

Objective To study the effects of high cholesterol diet and activated macrophages (M) on glycoprotein secretion from the gallbladder tissue of guniea pig.Method Forty guniea pigs were randomized into group A fed with ordinary diet and group B fed with a diet containing 1.2% cholesterol for one week.Glycoprotein secretion from guinea pig gallbladder was observed in tissue culture using ~3H-glucesamine as a precursor,and in the meantime,with hydrocortisone and activated M to understand the effects on glycoprotein synthesis and secre- tion function of gallbladder epithelium.Results The activity of peritoneal M was significantly increased in guinea pigs fed with high cholesterol diet.High cholesterol diet induced significant release of ~3H-glucosamine-labeled gly- coprotein into the tissue culture medium as compared with the control level of guinea pig fed with normal diet.The gallbladder tissues were co-cultured for 16 hours with peritoneal M of guinea pig fed with high cholesterol diet. Mucin secretion had an evident increase compared with the controls (with the peritoneal M of guinea pig fed with normal diet at 10~4,10~6 cell/ml).Hydrocortisone (10~(-6),10~(-5),10~(-4)mol/l) caused a reversible dose-dependent inhibition on glycoprotein secretion from the gallbadder tissues of guinea pig fed with high cholesterol diet.Hydro- cortisone (10~(-4)mol/l) also inhibited the stimulatory effect of M activated by high cholesterol diet on glycoprotein hypersecretion in the gallbladder tissues of guinea pig fed with ordinary diet.Conclusion (1) High cholesterol diet can induce the increase of glycoprotein secretion from gallbladder tissues of guinea pig;(2) M can be actvi- ated by high cholesterol diet,which stimulates glycoprotein secretion from the gallbladder tissues of guinea pig. Considering the results of experiment using an animal gallbladder stone model,these findings suggest that the hy- persecretion of glycuprotein from guinea pig gallbladder tissue may be related to guinea pig M activated by high cholesterol diet and stimulated to release TNF,IL-I,etc.

Objective To investigate the clinical effects of synthetic medical calcium phosphate and calcium sulfate as the bone replacements for bone defects.MethodsA total of 85 bone trauma patients combined with bone defects treated between February 2000 and October 2011 were randomized to calcium phosphate group ( n =43 ) and calcium sulfate group ( n =42 ) according to bone substitutes.The patients had orthopedic conventional treatment and then received external fixation ( external fixators,plasters) or internal fixation (plates,needles).Forty-three patients in the calcium phosphate group were all treated with medical calcium phosphate and 42 patients in the calcium sulfate group were all treated with medical calcium sulfate.Postoperative complications,fracture healing time and bone substitute absorption time of the two groups were observed and compared.ResultsAfter artificial bone filling for bone defects,all fractures were healed,with average healing time of 12.5 weeks ( range,9-17 weeks) in the calcium phosphate group and 11.3 weeks (range,7-15 weeks) in the calcium sulfate group.No complications or abnormal reactions occurred in the calcium sulfate group,whereas four patients with incision exudation was founded in the calcium phosphate group,and was cured after dressing change.The average follow-up period was 54.5 weeks (range,14-70 weeks).Average absorption time of bone substitute for the calcium phosphate group was 7.3 weeks,longer than that for the calcium sulfate group (P ＜ 0.05 ).Conclusions Medical calcium phosphate and calcium sulfate artificial bones can both be used as bone substitutes and are characterized by convenience,safety and good healing under the auxiliary of internal and external fixators.The calcium sulfate is sturdier and has relatively stronger supporting ability than the calcium phosphate.As the bone substitute,the calcium sulfate has more precise clinical effects,fewer complications and shorter healing time than the calcium phosphate.

Objective To explore the feasibility of Ilizarov technique in managing large tibia defects combined with soft tissue defects.Methods A total of 24 patients with large tibial defects combined with soft tissue defects caused by compound open tibial fractures were fixed with Ilizarov technique from September 2003 to September 2010.All patients belonged to open tibial fractures,including 20 patients with Gustilo type Ⅲ B and four with Gustilo type Ⅲ C.After debridement,the soft tissue defect areas was 10 cm ×6 cm and the bone defect was(8 ±4)cm.Fifteen patients with tibial defects ＜5 cm were treated with one stage debridement,fibula resection and tibial defect end compression.The other nine patients with tibial defect ＞ 5 cm were managed by one stage debridement,bone transport and bone lengthening.Then,15 patients were treated with one stage debridement,wound closure or wound reduction,bone grafting treatment and second stage cleansing of the incarcerated skin and fracture end.Results All patients were followed up for average 14 months(10-24 months),which showed reconstruction of the bone defects,restoration of the limb length,fracture healing and less than 2 cm difference between health limb and contralateral limb.One patient experienced common peroneal nerve palsy after operation,but recovered three months later.Of all,19 patients recovered without extra surgery,three restored with skin graft and two received skin flap.Conclusion Ilizarov technique is an effective option for treating the tibial defects combined with soft tissue defects at one stage.

Objective To investigate the effect of methylprednisolone pretreatment on cardiopulmonary bypass(CPB)-induced intestinal barrier injury in patients undergoing cardiac surgery.Methods Ninety NYHA Ⅰor Ⅱ patients,aged 30-50 yr,weighing 50-75 kg,scheduled for elective cardiac surgery with CPB,were randomly divided into 3 gnoups(n =30 each):control group without CPB(group Ⅰ),control group with CPB(group Ⅱ)and administration of methylprednisolone before CPB group(group Ⅲ).Anesthesia was induced with midszolam,fentanyl,etomidate and rocuronium and maintained with intravenous infusion of propofol and intermittent iv boluses of fentanyl and rocuronium.The patients were mechanically ventilated after tracheal intubation.In group Ⅲ,methylprednisolone 10 mg/kg was injected intravenously before operation and CPB.While in groups Ⅰ and Ⅱ,the equal volume of normal saline was injected instead.The blood samples were taken from the central vein before induetion of anesthesia(T1),before CPB(T2),at 30 min after the beginning of CPB(T3),at 30 rin afier the end of CPB(T4)and at 120 min after operation(T5)for determination of the plasma endotoxin concentration.Infection was recorded within 7 days after operation.Results The plasma endotoxin concentrations at T1 were within the normal range in all groups,without significant difference among the three gnoups(P ＞0.05).The plasma endotoxin concentration at T3-5 and incidence of postoperative infection in group Ⅲ were significantly lower than those in group Ⅱ,while higher than those in group Ⅰ(P ＜ 0.05).Conclusion Methylprednisolone pretreatment can reduce CPB-induced impairment of the intestinal harrier function in patients undergoing cardiac surgery.

Objective To investigate the surgical management of huge pelvic tumor.Methods The clinical data of 56 patients with huge pelvic tumor who were admitted to the Cancer Hospital of Henan Province from February 2005 to January 2012 were retrospectively analyzed.Tumor resectability was assessed via enhanced computed tomography or three-dimensional reconstruction,and the tumors were freed and resected by combination of muliiple surgical approaches.All the patients were followed up via telephone or re-examination at the out-patient department to learn the recurrence and metastasis of tumor.The survival rate was calculated using the life table.Results Fifty patients received preoperative computed tomography examination,and the imaging data of 6 patients were three-dimensionally reconstructed.Preoperative evaluation showed that 49 patients needed combined multivisceral resection,5 needed tumor resection,and the tumors of 2 patients were unresectable.Fourteen patients were diagnosed preoperatively,and 8 patients were diagnosed by intraoperative rapid frozen section examination,and the rest 34 patients were diagnosed by postoperative pathological examination.The surgical approaches including anterior median sacral approach combined with transperineal coccyx anterior approach (21 patients),anterior median sacral approach (11 patients),obturator approach (8 patients),retropubic approach (8 patients) and obturator approach combined with transperineal approach of coccyx (8 patients).Tumor and rectum resection was carried out on 18 patients,tumor and partial bladder resection on 12 patients,tumor,uterus and ovariectomization on 12 patients,tumor,part of the small intestine and colorectal resection on 10 patients,tumor and total pelvic exenteration on 4 patients.In all the 56 patients,53 achieved R0 resection,2 cases reached naked eye clean,1 case had residual tumor.The mean operation time was 100 minutes.Fifty patients recovered uneventfully.Six patients had postoperative complications,including 3 patients with intestinal obstruction (2 patients were cured by conservative treatment,and 1 patient was cured by surgery),2 patients with pelvic infection and 1 patient with colostomy hernia,and they were cured by drainage and nutritional support.One patient died of postoperative myocardial infarction.The results of postoperative pathologic study showed that 25 patients were with adenocarcinoma,16 with sarcoma and 15 with gastrointestinal stromal tumor.Forty-seven patients were followup to December 2012,and the 5-year survival rate was 26.7％ for patients with adenocarcinoma,18.9％ for patients with sarcoma,and 52.6％ for patients with gastrointestinal stromal tumor.Conclusion Preoperative assessment of resectability of huge pelvic tumor can reduce unnecessary laparotomy and improve the safety of operation.

Objective To discuss the treatment effect of retrograde intramedullary nails under the guide of arthroscope in treating supracondylar fractures of the femur. Methods A total of 24 su-pracondylar fractures of the femur were treated with retrograde intramedullary nails under the guide of ar-throscope. All the patients were followed up for a clinical evaluation. Results The follow up for mean 14 months in all patients showed that all fractures were healed, with mean healing duration for three months. All the patients obtained good or excellent results after operation. Conclusions In treatment of supracondylar fractures of the femur, retrograde intramedullary nail under the guide of arthroscope has the advantages of mierotrauma, accurate location, firm fixation and short fracture healing time that are beneficial to joint function recovery and is worthy of clinical application.