Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) show good efficacy for the lung cancer patients with EGFR mutations.Chemotherapy drugs are the first choices for the lung cancer patients with EGFR wild-type.In basic research,EGFR-TKIs combination with chemotherapy drugs show good synergy.But in clinical research,the timing of EGFR-TKIs combination with chemotherapy drugs is related to the efficacy.

BACKGROUND:Clinical studies have shown that early use of methylprednisolone can promote neurological functional recovery, reasonable initial dose, interval time and treatment duration are the key to the methylprednisolone treatment of acute spinal cord injury. OBJECTIVE:To observe the differential protein expression profile in spinal cord tissue after intrathecal injection of high-dose methylprednisolone was given in rat model of acute spinal cord injury. METHODS:Eight Sprague-Dawley rats were included in this study to establish acute spinal cord injury model and the models were randomly divided into two groups, receiving intrathecal injection of methylprednisolone 7.5 mg/kg at 0 and 8 hours after modeling. The injured spinal cord tissue was harvested after 24 hours of injection. The differentialy expressed proteins and nerve regeneration-related differential proteins in two groups were analyzed using isotope labeling and quantitative technical analysis. RESULTS AND CONCLUSION: Totaly 87 differentialy expressed proteins were identified in this study. Compared with 0 hour group, there were 43 up-regulated differential proteins and 44 down-regulated differential proteins in the 8-hour group. Eighteen differential proteins were related to neural regeneration, including 8 up-regulation proteins and 10 down-regulation proteins. OMgp as a potential neural axon growth inhibitory factor specificaly bound with NgR/P75/TROY/Lingo-1 to form receptor complexes and activated RhoA through the second messenger cAMP, thus inhibiting the colapse of axon growth cone. Folowing intrathecal injection of methylprednisolone for treatment of acute spinal cord injury in rats, differential proteins and nerve regeneration-related factors in spinal cord are identified and analyzed for protein database retrieval and protein function analysis, their expression may serve as the indicator of monitoring nerve regeneration after acute spinal cord injury.

Objective To analyze the survey results of iodine nutritional level among women of childbearing age,pregnant,lactating women and infants before and after the adjustment of iodine concentration in salt of Zibo City,in order to provide a scientific basis for reasonable iodine supplement.Methods The iodine content in the residents' edible salt samples was determined in 2011 and 2015.Four groups of target populations including women of childbearing age,pregnant,lactating women and infants from 7 districts and towns of Zibo were investigated to test their urinary iodine level in 2011 and 2015.The monitoring results of the two years were compared and analyzed.Results A total of 2 100 and 2 160 residents edible salt were monitored in 2011 and 2015,and the median of salt iodine were 30.2 and 22.7 mg/kg,there was statistically significant difference in the constitute of salt iodine level between the two years (x2 =141.90,P ＜ 0.01).A total of 354,402,403,362 urine samples of women of childbearing age,pregnant,lactating women and infants' were detected and the median urinary iodine were 161.80,127.20,138.80,147.10 μg/L in 2011,and 350,706,350 and 352 of the corresponding target population's urine samples were detected and the median urinary iodine were 127.80,129.95,70.20 and 152.35 μg/L in 2015.Conclusions The salt iodine median has reduced and the urinary iodine in childbearing age women and infant is in the appropriate level,while it is insufficient in the pregnant women and lactating women after the adjustment of iodized salt concentration in Zibo.It is necessary to promote health education and instruct pregnant women and lactating women to supplement iodine,additionally,surveillance of the iodine nutrition status of the targeted populations should be strengthened.

Background Previous studies showed that the pathogenesis of uveitis is related to γδ T cells.However,it remains unclear that how these cells are involved in experimental autoimmune uveitis (EAU).Objective This study aimed to observe the dynamic changes of γδ T cells in EAU and explore the role of γδ T cells in the pathological process of EAU.Methods Forty-five C57BL/6(B6) mice were assigned to the normal control group (six mice) and EAU model group (thirty-nine mice).The mice were immunized subcutaneously at 6 spots on the footpads,tail base,and flank with emulsion containing human interphotoreceptor retinoid binding protein1-20 (IRBP1-20) emulsified in complete Freund's adjuvant.After immunization,the mice were examined for clinical signs of EAU by using a Genesis-D camera.The changes of histopathology were compared by hematoxylin and eosin staining.Mouse lymphocytes were isolated and purified from the spleens of IRBP1-20-immunized or normal B6 mice by using a γδ T-cell isolation kit.Flow cytometry was used to detect the changes of intracellular expression of interleukin-17A (IL-17A),and then transferred the activated γδ T cells into EAU models to analyze the changes of clinical signs and histopathology of EAU.Experimental study program as well as the use and feeding of the animals were authorized by the Animal Management and Use Committee of Shandong Traditional Chinese Medicine University.Results The inflammatory symptoms in mouse eyes appeared on day 12 after modeling.The initial changes were fundal blood vessel thickening and minimal inflammatory cell infiltration.Then,multifocal chorioretinal lesions,serious vasculitis and linear lesions were observed on days 16-20,along with abundant lymphocyte infiltration in the vitreous and retinal disorganization.The inflammation symptom scores and the pathological inflammation scores at different time points after modeling had statistically significant differences (F =51.399,P =0.000;F =47.342,P =0.000).The inflammatory symptoms in the eyes began to abate from day 28 onwards.The number of γδ T cells was obviously increased during the inflammation phase of EAU at day 16-20 after modeling,with the number of γδ T cells was (5.67 ±-0.49) ％ and (5.78 ±±0.55) ％,respectively,which was significantly higher than (1.53 ± 0.14) ％ before modeling,with significant differences between them (both at P＜0.05),meanwhile CD69 levels and the integrin lymphocyte function-associated antigen-1 (LFA-1) and secreted IL-17A were elavated.The secretion level of IL-17A was (13.40±0.50)％ and (17.80±2.37)％ on day 16 and day 20 after modeling,respectively,which was significantly higher than (1.53 ± 0.19) ％ before modeling,with significant differences between them (P =0.000,0.001).The activated γδ T cells were transferred into EAU model,the inflammation symptom scores were 1.00 (1.00,2.00) after activated γδ T cells were transferred into EAU model,which was significantly higher than 0.75 (0.05,1.00) of the untransferred group (Z =27.00,P =0.03),and the symptoms of EAU were aggravated.Conclusions The proportion of γδ T cells reaches peak in inflammation of EAU,and the cells are activated.The activated γδ T cells in the EAU model play a immune regulation role by secreting IL-17A.

Objective:To evaluate the status quo and influencing factors of hyperlipidemia management in patients with contracted family doctor service in the community.Method:The baseline data and blood lipid testing results of 752 hyperlipidemia patients (334 males and 418 females) with contracted family doctor service in Yuetan Community Health Service Center from November?2019 to May 2020 were collected. The hyperlipidemic patients were managed by family doctors based on atherosclerotic cardiovascular diseases(ASCVD) riks assessment. The ASCVD risk levels and low-density lipoprotein cholesterol (LDL-C) compliance rate of patients with different general data were compared, and the influencing factors of LDL-C control failure were analyzed by logistic regression.Results:The ASCVD risk assessment showed that among 752 patients there were 172 cases of low risk(22.87%), 167 cases of moderate risk(22.21%),352 cases of high risk(46.81%) and 61 cases of extremely high risk(8.11%). A significant difference was detected in sex,rate of smoking,incidence of overweight or obesity among patients with different ASCVD risk levels ( P<0.05).The overall control rate of LDL-C was 48.8% (367/752), that for low, moderate, high and extremely high risk patients were 83.73% (144/172), 53.89% (90/167), 34.38% (121/352) and 19.67%(12/61), respectively. A significant difference was detected in sex(female: 52.87%, 221/418),age(aged over 80: 58.82%, 110/187), rate of smoking (non-smoking:52.40%, 327/624) and medication compliance (good compliance:52.87%,221/418) between LDL-C control and uncontrol groups (χ2=6.323,11.816,19.022,25.274; P<0.05). Multiple logistic regression analysis revealed that male gender ( OR=1.800,95% CI:1.325-2.419), smoking ( OR=2.630,95% CI:1.726-4.007) and poor medication compliance ( OR= 2.179, 95% CI: 1.581-3.003) were independent risk factors for uncontrolled LDL-C levels. Conclusion:Patients with hyperlipidemia have a relatively high risk of cardiovascular diseases, and their blood lipids are not well controlled. The management of blood lipid should be enhanced in patients with chronic diseases, particularly for male patients with smoking and poor medication compliance.

Objective To analyze the changes in peripheral blood monocyte subpopulations in patients with primary, secondary and latent syphilis. Methods Flow cytometry was used to detect CD14highCD16- and CD14+CD16+ monocyte subpopulations in peripheral blood from 58 patients with untreated syphilis, including 36 cases of latent syphilis,8 cases of primary syphilis and 14 cases of secondary syphilis, as well as from 65 normal human controls. Restflts Compared with the normal controls, the proportion of CD14+CD16+ monocytes among total monocytes was significantly elevated (12.0% ± 5.0% vs 6.0% ± 3.3%, t = 7.25, P < 0.01), while that of CD14highCD16- monocytes was down-regulated (88.0% ± 5.1% vs 94.0% ± 3.5%, t = -7.20, P < 0.01). No statistical difference was observed in the proportion of CD14+CD16+ or CD14hhighCD16- monocytes among the patients with primary syphilis, secondary syphilis and those with latent syphilis (all P > 0.05). Conclusions The changes in peripheral blood monocyte subpopulation in patients with untreated syphilis may be associated with the permanent infection of Treponema pallidum, but have no obvious correlation with clinical stage of syphilis.

Objective To investigate the effects of intrathecally coadministered dexamethasone and spironolactone in trathecally on radicular pain behaviors.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion (CCD) ,48 male SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into Sham-operation group (Sham group, n= 12),Control group ( C group, n = 12 ), Dexamethasone group ( D group, n = 8 ), Spironolactone group ( S group, n = 8 )and Dexamethasone plus spironolactone group (DS group, n=8).Rats in D group,S group or DS group were intrathecally treated with dexamethasone 4 μg, spironolactone 3 μg or dexamethasone 4 μg plus spironolactone 3 μg twice daily on day 2 ～4 after CCD respectively,while rats in C and Sham group received 10μl 10% alcohol.Paw withdrawal mechanical threshold(PWMT) and paw withdrawal thermal latency (PWTL) were tested on day 1 before CCD and day 1,4,7,10,14,17 and 21 after CCD.Results Compared with Sham group, both PWMT and PWTL were significantly decreased after CCD surgery on the ipsilateral side(P＜0.01 ＝.Intrathecally administrated with dexamethasone significantly improved pain behaviors (P＜0.01 ＝ and these therapeutic effects lasted up to 10 days after CCD surgery.As with dexamethasone,intrathecal spironolactone also significantly attenuated PWMT (P＜0.01 ＝ and PWTL (P＜0.01 ＝ and the change lasted up to 7 days after CCD surgery.Coadministration spironolactone and dexamethasone exhibited significant synergies( PWMT: ( 13.52 ± 0.72) g vs ( 11.58 ± 1.38 ) g, P ＜0.01; PWTL: ( 19.63 ± 1.68) s vs ( 14.14 ± 1.52) s, P ＜ 0.01 ＝.These effects lasted up to at least 10 days.Conclusion Both dexamethasone and spironolactone intrathecally have therapeutic effects on radicular pain behaviors, combination injection of these two drugs could generate significant synergies.

Objective To investigate the analgesic effects of intraperitoneal lithium chloride injection on radicular pain behaviors in rats.Methods Using rat model of radicular pain induced by chronic compression of dorsal root ganglion(CCD) ,40 male SD rats were randomly divided into model group and Sham-operation group (group S, n= 12) of radicular pain were established.The rats in the model group were subdivided randomly into Control group(group C, n= 12) ,Early treatment group(group E, n=8) and Later treatment group(group L, n= 8 ).Rats in group E were intraperitoneal injected with lithium chloride once daily on day 2 ～ 4 after CCD respectively,while rats in L,group C and S treated with Vehicle(0.9% NaCl).Rats in L group were intraperitoneal treated with lithium chloride on day 12 ～ 14 after CCD respectively,while rats in E,group C and S received Vehicle.The pain ethology indexes such as paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were tested on day 1 before operation and day 1,4,7,10, 14, 17 and 21 after operation.Results Compared to S group and preoperative level, PWMT and PWTL decreased at Day 1 postoperative in group C (P＜0.05).At day 4 after the operation,compared with group C(7.712 ±0.237)g and (8.190 ±0.382) s,PWMT and PWTL of E group increased to ( 14.607 ± 0,280) g and ( 19.940 ± 0.933 ) s (P ＜ 0.05 ) after intraperitoneal injected lithium chloride.At day 14, compared with group C ( 6.788 ± 0.331 ) g and ( 7.301 ± 0.481 ) s, PWMT and PWTL of group L increased to ( 11.700 ± 0.379) 8 and ( 18.524 ± 1.060) s (P ＜ 0.05 ).This analgesic effect of lithium chloride continued to exist at day 21.However, there was still a significant difference between S group and E,group L(P＜0.05).Conclusion Intraperitoneal lithium chloride injection alleviates pain behavior on radicular pain in rats.

Recently , the country actively explores the pattern of an integrated healthcare which enables the as-sociation among hospitals of different levels , aimed to achieve maximum utilization of medical resources and lead a reasonable distribution of the patients .By reviewing the practices related to the integration of healthcare in Beijing , Shanghai , Zhenjiang and Wuhan city , this paper sums up in five typical mechanisms , i.e.organization and manage-ment mechanism , human resource management mechanism , interest distribution mechanism , service continuity and resources sharing mechanism .The effects of these practices were analyzed and the faced challenges were discussed . The following points were made clear during analysis and discussion:the sustainability of the collaboration mode and organization structure , human resource supports and incentive methods , health insurance guidance for hospitals and patients , two-way referral system and supporting measures , and building of information system .Then we put forward some suggestions , hoping to offer some references to the establishment of integrated healthcare in other regions .

Coloring Agents ; Diagnostic Uses of Chemicals ; Esophageal Neoplasms ; diagnosis ; Esophagoscopy ; Esophagus ; pathology ; Humans ; Iodine