Objective The study aimed to analyze the clinical data of patients with pulmonary embolism and summarize the clinical characteristics of pulmonary embolism,in order to improve the correct diagnostic rate and the prognosis. Methods Data of 178 patients who were cured in our hospital from January 2011 to December 2014 were analyzed retrospectively,including relative risk factors,clinical behaviors,examination data,misdiagnosis and prognosis. Results Patients with pulmonary embolism had related basic diseases and risk factors. Their clinical symptoms,signs and ordinary detection methods indicated pneumatorexis and cardiovascular injury,but lacked of specificity. The misdiagnosis rate of the first diagnosis was 48.88%,including 22 cases of the misdiagnosis to COPD, 18 cases to pneumonia and 16 cases to coronary heart disease. The misdiagnosis rate of elderly patients was 56.36%, while that of the young and middle-aged patients was 36.80%,the difference was statistically significant,P < 0.05. Computed tomography pulmonary angiography(CTPA)could accurately observe the pathological changes of pulmonary embolism,and all the patients were diagnosed by CTPA in the research. 11 cases(10%)of elderly patients died,while 2 cases(2.9%)happened in young and middle-aged patients. There was no statistical significant difference(P > 0.05). Conclusion Although the related risk factors of pulmonary embolism in patients existed,the misdiagnosed rate of the disease was high and prognosis was poor due to many confusing basic diseases. And the symptoms,signs and ordinary inspection of the patients lacked specificity. CTPA,being utilized to diagnose pulmonary embolism reliably,should be promoted.

Objective To study the antitumor activity of Xerophilusin G on S180 cells,and Its mechanism.Methods Modified MTT assay was used to test the effect of Xerophilusin G on the proliferation of S180 tumor cell strain.The influences on tumor growth and immune organs of mice with transplanted sarcoma (S180) were observed.The cell cycle of S180 cell lines and mouse sarcoma (S180) was analyzed by flow cytometry.The lymphocyte proliferation activity of spleen stimulating was tested.The level of IL-2 in serum of mice with transplanted sarcoma (S180) was measured by ELISA.Results The IC50 of Xerophilusin G in S180 cell lines was 19.80 μg·mL-1,the LD50 in mouse for Xerophilusin G was 121.11 mg·kg-1 through intraperitoneal injection.The tumor inhibition rate of Xerophilusin G was 32.11％ and 41.60％,respectively at the doses of 3 and 6 mg · kg-1 (P ＜ 0.05).Compared with the control,the thymus,kidney and cardiac index were decreased.The cell proportion at G0/G1 phase of mouse sarcoma (S180) was increased.T and B cell proliferation activities in tumor-bearing mice were enhanced (P ＜ 0.05).As compared with control group,the serum level of IL-2 was decreased 90.9％ and 77.1％ in low-and medium-dose groups,respectively (P ＜ 0.05).Conclusion Xerophilusin G has remarkable effects in sarcoma (S180) bearing mice.The antitumor mechanism of Xerophilusin G might be related with G0/G1 phase arrest of mouse sarcoma (S180) cells and enhancing the activity of T and B cell but not related with increasing the secreting of IL-2.

Experimental animal plasma lipid and metabolite p roduct obviously decreased against the control group． The result is shown as fo llows:in Rbl group total cholesterol (TC) 51.20%, P<0.01,triglyceride (TG) 35.45% P<0.05; Malouylaldehyd(MDA) 47.0 %P<0.01;but in Rg1 group TC 38.5;TG 26.28% P <0.05; MDA 25.9% P<0.05．

Objective To make a better understanding of the molecular mechanisms involved in recurrence and metastasis of the hepatocellular carcinoma (HCC), some invasion related oncogenes, and growth factors have been investigated. Methods The studies were seperately carried out, the results of which were summarized in this article with relation to tumor size and invasiveness of HCC.Results The aberration rates of p53 and CDKN2 in HCC were 45.9% and 36.4% respectively, which were higher in invasive HCC compared with non-invasive HCC. H-ras expression was positive in 29.3% of HCC, which was associated with recurrence and extrahepatic metastasis of HCC. Intralesional injection of H-ras antisense gene markedly inhibited the tumor growth and metastasis of HCC in nude mice. The positive rates of transforming growth factor (TGF)-alpha, epidermal growth factor receptor (EGFR) and c-erbB-2 were 45.7%, 47.1% and 92.3% respectively. The expression of EGFR was closely related to TGF-alpha, which was related to HCC recurrence. But no obvious difference of TGF-alpha or c-erbB-2 expression was found between HCC with and without recurrence, or with and without extrahepatic metastasis. Expression of nm23 / tissue inhibitor of metalloproteinase (TIMP)-2 was positively associated with the prognosis of HCC patients (Log-rank, P<0.001). The alterative rates of above-mentioned genes and growth factors in small HCC were slightly lower than that in large ones, but no significant difference was shown except the p53 mutation.Conclusions The p53/CDKN2 mutation, overexpression of H-ras/EGFR, were associated with the invasiveness and recurrence of HCC. H-ras antisense gene might be of potential implication in the control of HCC recurrence and metastasis. Expression of nm23/TIMP-2 was closely related to the prognosis of HCC patients. Biological characteristics remained critical points to the prognosis even in small HCC.

OBJECTIVE：To systematicall y evaluate the efficacy and safety of a new oral anticoagulant Ⅹ a inhibitor （apixaban，rivaroxaban，edoxaban）in the prevention and treatment of venous thromboembolism （VTE）in cancer patients ，and to provide evidence-based reference for rational use of drugs in clinic. METHODS ：Retrieved from Cochrane Library ，PubMed， Embase，CBM，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about Ⅹa inhibitor （trial group ）versus routine treatment or placebo （control group ）in the prevention and treatment of VTE in cancer patients were collected. After literature screening ，data extraction and quality evaluation was evaluated by using biasrisk evaluation tool recommended by Cochrane System Evaluator M anual 5.1.0，and Meta-analysis was conducted by using Rev Man 5.3 software. RESULTS ：A total of 7 RCTs were included ，including 5 666 patients. Meta-analysis showed that recurrent rate of VTE in trial group was significantly lower than control group [RR ＝0.58，95％CI（0.47，0.71），P＜0.000 01]；there was no statistical significance in the incidence of major bleeding [RR ＝1.12，95％CI（0.67，1.85），P＝0.67] and clinically relevant non-major bleeding [RR ＝1.06，95％CI（0.72，1.55）， P＝0.77] between 2 groups. CONCLUSIONS ：Ⅹa inhibitors can effectively reduce the recurrent risk of VTE in cancer patients ， safety comparable with routine treatment （placebo）.

OBJECTIVE：To systematically evaluate therapeutic efficacy and safety of Breviscapine injection combined with routine treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD），and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase，CBMdisc，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about Breviscapine injection combined with routine treatment （trial group ） versus routine treatment （control group ）in the treatment of AECOPD were collected. After literature screening and data extraction ， the qualities of literatures were evaluated with modified Jadad scale ；Meta-analysis was performed by using Rev Man 5.2 statistical software. RESULTS ：A total of 19 RCTs were included ，involving 1 930 patients. Results of Meta-analysis showed that total response rate [OR ＝2.80，95％ CI （1.96，4.01），P＜0.000 01]，FEV1[MD＝0.65，95％ CI（0.57，0.72），P＜0.000 01]， FEV1％[MD＝5.33，95％CI（0.31，10.35），P＝0.04]，FVC[MD＝0.69，95％CI（0.23，1.16），P＝0.004]， FEV1/FVC [MD ＝ 4.83，95％CI（0.98，8.67），P＝0.01]，PEF [M D＝0.95，95％CI （0.57，1.33），P＜0.001]，PaO2 [MD＝4.70，95％CI（2.02， No.81402991） + 7.37），P＜0.001]，CD3 level [MD ＝5.11，95％ CI（3.04， 7.18），P＜0.001] and CD 4+ level [MD ＝2.62，95％CI（1.78， qq.com 3.47），P＜0.001] of trial group were significantly higher than those of control group ；PaCO2 [MD＝－3.33，95％CI（－5.02， －1.65），P＜0.001]，CD8+ level [MD ＝－2.55，95％CI（－4.28，－0.82），P＜0.004]，cough relief time [MD ＝－1.93，95％CI （－2.24，－1.63），P＜0.001]，sputum remission time [MD ＝－2.19，95％CI（－2.48，－1.89），P＜0.001]，wheezing remission time [MD ＝－1.59，95％CI（－1.86，－1.32），P＜0.001] and hospital stay [MD ＝－1.73，95％CI（－2.06，－1.39），P＜0.001] of trial groups were significantly lower or shorter than those of control group ；there was no statistical significance in CD 4+/CD8+ between 2 groups [MD ＝－0.11，95％CI（－0.23，0.01），P＝0.06]. In terms of safety ，3 studies reported the occurrence of ADR ， and no serious ADR occurred. CONCLUSIONS ：Breviscapine injection can improve clinical efficacy and lung function ，enhance immunity in patients with AECOPD with good safety.

OBJECTIVE To evaluate the cost-effectiveness of adebrelimab combined with chemotherapy versus chemotherapy alone in the first-line treatment of extensive stage small cell lung cancer from Chinese healthcare system perspective. METHODS Using the data obtained from the CAPSTONE-1 trial(230 cases for adebrelimab group, and 232 cases for chemotherapy group), Markov model was created for simulation of the disease development process of the extensive stage small cell lung cancer. The total costs, quality-adjusted life-years(QALYs) and incremental cost-effectiveness ratio(ICER) in each group were calculated. The sensitivity of key parameters was analyzed. RESULTS Compared with pure chemotherapy(etoposide plus carboplatin chemotherapy), the ICER of adebrelimab combined with chemotherapy was 157128.79 yuan·QALY−1 under the situation of charity assistance, and 351367.27 yuan·QALY −1 in the environment of no charity assistance. Sensitivity analysis showed that the utility and the cost of adebrelimab were the main influence parameter. CONCLUSION Adebrelimab combined with chemotherapy regimen has no cost-effective advantage versus chemotherapy alone in the treatment of extensive stage small cell lung cancer under the current economic level of China; the probability of adebrelimab combined with chemotherapy being cost- effectiveness was 44.5% under the situation of charity assistan.

OBJECTIVE： To systematically evaluate the effects of roflumilast on lung function of Asian patients with chronic obstructive pulmonary disease （COPD）， and to provide evidence-based reference for rational drug use in the clinic. METHODS： Retrieved from Cochrane library， PubMed， Embase， CBM， CNKI， VIP and Wanfang database， RCTs about roflumilast or roflumilast combined with routine treatment or placebo （trial group） versus routine treatment or placebo （control group） in the treatment of Asian COPD patients were collected. After literature screening， data extraction and quality evaluation with Cochrane bias risk evaluation tool， Meta-analysis was conducted by using Rev Man 5.2 software. RESULTS： Totally 6 RCTs were included， involving 1 494 patients. Meta-analysis showed that pre-bronchodilator FEV1 （pre-FEV1） [MD＝75.19， 95％CI（53.21， 97.17）， P＜0.000 01]， post-bronchodilator FEV1 （post-FEV1） [MD＝56.60， 95％CI（27.56， 85.63）， P＝0.000 1]， forced vital capacity （FVC） [MD＝43.67， 95％CI （15.91，71.43）， P＝0.002]， average flow rate of post-bronchodilator 25％-75％ of forced vital capacity （post-FEF25％-75％） [MD＝14.58， 95％CI （8.43， 20.73）， P＜0.001]， the incidence of diarrhea [RR＝5.06， 95％CI （1.26，20.27）， P＝0.02]， respiratory infection [RR＝1.94， 95％CI （1.30，2.90）， P＝0.001]， decreased appetite [RR＝7.43， 95％CI （2.94，18.79）， P＝0.001]， body weight decrease [RR＝5.46， 95％CI （2.12，14.03）， P＝0.001]， headache [RR＝7.73， 95％CI （1.42，42.16）， P＝0.02]， dizziness [RR＝3.44， 95％CI （1.28，9.27）， P＝0.01]， gastritis [RR＝5.09， 95％CI （1.49， 17.45）， P＝0.01] and anorexia [RR＝5.06， 95％CI （1.97， 13.00）， P＝0.001] in trial group were significantly higher than control group； St. George’s Respiratory Questionnaire （SGRQ） total score [MD＝－5.82， 95％CI（－7.77， －3.87）， P＜0.001]， respiratory symptom score [MD＝－1.67， 95％CI （－2.51，  －0.84）， P＜0.001]， activity limited score [MD＝－1.55，   95％CI （－2.14， －0.97）， P＜0.001] and disease impact score [MD＝－2.59， 95％CI （－3.40，－1.79）， P＜0.001] of trial group were significantly lower than those of control group. CONCLUSIONS： Roflumilast can improve lung function and dyspnea in Asian COPD patients， but it can increase the risk of ADR.