Objective:To analyze domestic and foreign literatures which carried the reports of neurotoxicity induced by cefepime in order to warn the clinic to pay attention to its possible neurotoxicity and to avoid the occurrence of its serious adverse drug effects.Method:The literatures were searched for on www.cnki.net and PUBMED which reported the neurotoxicity induced by cefepime from 1999 to 2009 and the rules and characteristics of neurotoxicity induced by cefepime were analyzed.Result:71 articles including 53 Chinese articles and 18 English articles about neurotoxicity due to cefepime were collected.There were 36 case reports in these articles.The median age was 64.5 years and there was one death case, the mortality being 2.8%.Conclusion:The neurotoxicity induced by cefepime is closely related to patients' ages and kidney functions,but has little relationship to patients' genders and drug dosages.

Objective To determine the clinical manifestation,pathologic behavior,therapy and related factors of rare aggressive fibromatosis.Methods Canceration from aggressive fibromatosis to fibrosarcoma in one case of aggressive fibromatosis was analyzed and relevant literatures were reviewed.Results Aggressive fibromatosis was a benign or semimaligrant,non-metastatic proliferations of fibrous tissue that infiltrated surrounding tissues and tended to recur after surgical resection.Pathology showed fibroblastic monoconal proliferation between the cellular center and the collagen periphery.Electron microscope showed an abundant collagen network enclosing a pelymorphous cellular proliferation.Immunohistochemistry defined vimentin and actin positive desmoid tumors.Complete surgical excision was a chief treatment.Several operations were needed in most cases.Recurrence rates may be as high as 10%～70%.Chemotherapy and radiotherapy may be used together with surgery in recurrence or unsatisfactory surgical margin.The disease recurred after operation and one radiation therapy,reoperation and pathology showed fibrosarcoma.Conclusion Aggressive fibromatosis is a rare benign,non-metastatic proliferation tumour of fibrous tissue with a tendency of local recurrent after surgical resection.The cornerstone of therapy is surgery.Radiation therapy and chemotherapy can be used as adjuvant therapy.It is scarce that aggressive fibromatosis cancerates to fibrosarcoma.Maybe surgical stimulus and radiation therapy are the main factors to promote it to cancerate.

Objective:To explore the effectiveness of the Exowalk gait training robot in improving the walking ability of stroke survivors.Methods:Forty stroke survivors were randomly divided into a control group and an experimental group, each of 20. In their rehabilitation, the control group was given routine walking training, while the experimental group′s training was assisted with the Exowalk robot. Both groups trained for 60 minutes a day, five days a week for four weeks. Before as well as after 2 and 4 weeks of training functional ambulatory categories (FACs), the Berg balance scale (BBS), the 6-minute walking test (6MWT), the 10-minute walking test (10MWT), the Rivermead mobility index and an exercise index were used to evaluate those in both groups.Results:After 2 weeks significant improvement was observed in the average FAC, BBS, 6MWT and 10MWT results of both groups, without significant differences between them. After 4 weeks there was still no significant difference in the groups′ average BBS scores. However, the average FAC rating in the experimental group had improved significantly while there was no significant increase in the control group′s average score.Conclusions:The Exowalk robot can help to improve the balance and walking ability of hemiplegic stroke survivors.

Objective To analyze the infiltration of inflammatory cells under the mucosa of female cystitis glandularis and the different inflammatory infiltration in different clinical pathological types of cystitis glandularis.Methods Immunohistochemical method was used to detect the bladder mucosal tissue samples of 10 female patients confirmed cystitis glandularis admitted from June 2016 to October 2016.The results of immunohistochemical staining were collected and statistically analyzed by the automatic microscopy and image analysis system.In addition,the clinical data and tissue sample of 49 cases of cystitis glandularis treated from December 2006 to August 2017 were collected.Age of 49 patients was (34.4 ±7.5) years old and BMI was (21.9 ± 4.2) kg/m2.There were 19 cases of hypertension and 18 cases of diabetes.According to the cystoscopic manifestations,follicular edema type,papilloma type,and intestinal adenomatosis type were defined as high risk.Chronic inflammatory type and mucosa unchanged type were defined as low risk.Immunohistochemical staining was used to detect tissue samples,to compare the general data of different types of cystitis glandularis and the degree of infiltration of bladder mucosal inflammatory cells.Results T lymphocytes were highly expressed in 10 patients,and B lymphocytes and plasma cells were not expressed or extremely low (P ＜ 0.01).Of the 49 patients,29 were high risk type cystitis glandularis (follicular edema type,papilloma type,and intestinal adenomatosis type),and 21 were low risk type (chronic inflammatory type and mucosa unchanged type).The age of the high-risk group was (34.4 ± 7.5) years old with BMI of (21.9 ±4.2) kg/m2,8 cases of hypertension and 8 cases of diabetes.The age of the low-risk group was (38.2 ±8.5) years old with BMI of (20.8 ±4.0) kg/m2,11 cases of hypertension and 10 cases of diabetes.There was no statistically significant difference between two groups (P ＞ 0.05).The OABSS of high-risk group(10.4 ± 2.6) was significantly higher than that of low-risk group (7.1 ± 2.1,P ＜ 0.01).QOL of high-risk group (4.9 ± 0.9) was significantly higher than that of low-risk group (4.1 ± 0.8,P ＜ 0.01).Qmax of high-risk group was (11.4 ± 3.6) ml/s,significantly lower than that of low-risk group[(15.8 ±3.8) ml/s,P ＜0.01].The positive number of T lymphocytes of high-risk group was (173.5 ± 26.8),which was significantly higher than that of low-risk group(119.5 ± 21.2,P ＜ 0.01).Conclusions T lymphocytes infiltration is the major phenomenon in bladder submucosa of female patients with cystitis glandularis.The inflammatory infiltration by T lymphocytes could be associated with patient's symptom and bladder's pathological changes.

OBJECTIVETo study the prevalence of ALK, ROS1 and RET fusion genes in non-small cell lung cancer (NSCLC), and its correlation with clinicopathologic features.

METHODSFormalin-fixed and paraffin-embedded tissue sections from samples of 302 patients with NSCLC were screened for ALK, ROS1, RET fusions by real-time polymerase chain reaction (PCR). All of the cases were validated by Sanger DNA sequencing. The relationship between ALK, ROS1, RET fusion genes and clinicopathologic features were analyzed.

RESULTSIn the cohort of 302 NSCLC samples, 3.97% (12/302) were found to contain ALK fusion genes, including 3 cases with E13; A20 gene fusion, 3 cases with E6; A20 gene fusion and 3 cases with E20; A20 gene fusion. There was no statistically significant difference in patient's gender, age, smoking history and histologic type. Moreover, in the 302 NSCLC samples studied, 3.97% (12/302) were found to contain ROS1 fusion genes, with CD74-ROS1 fusion identified in 9 cases. There was no statistically significant difference in patients' gender, age, smoking history and histologic type. One non-smoking elderly female patient with pulmonary adenocarcinoma had RET gene fusion. None of the cases studied had concurrent ALK, ROS1 and RET mutations.

CONCLUSIONSThe ALK, ROS1 and RET fusion gene mutation rates in NSCLC are low, they represent some specific molecular subtypes of NSCLC. Genetic testing has significant meaning to guide clinical targeted therapy.

Adenocarcinoma ; Aged ; Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; Female ; Gene Fusion ; Genetic Testing ; Humans ; Lung Neoplasms ; Mutation ; Oncogene Proteins, Fusion ; genetics ; metabolism ; Protein-Tyrosine Kinases ; genetics ; metabolism ; Proto-Oncogene Proteins ; genetics ; metabolism ; Proto-Oncogene Proteins c-ret ; genetics ; metabolism ; Real-Time Polymerase Chain Reaction ; Receptor Protein-Tyrosine Kinases ; genetics ; metabolism ; Sequence Analysis, DNA ; Smoking

Objective: To investigate the pathological features and clinical manifestation of pediatric nodal marginal zone lymphoma(NMZL). Methods: Histological morphology and immunophenotype of 7 cases of pediatric NMZL were retrospectively reviewed at Beijing Friendship Hospital Affiliated to Medical University between January 2008 to October 2018. Clonal rearrangement analysis was performed. Clinical information including patient follow-up data were analyzed. Results: All 7 patients were male with a median age of 15 years aged from 10 to 26 years. All patients presented with only lymph node enlargement without B symptoms, including cervical lymph node (5 cases), preauricular lymph node (1 case) and retroauricular lymph node (1 case). Histologically, all cases showed irregular large follicles on the edges with widened marginal areas and intervesicular areas, and lesional cells were uniform with progressive transformation of germinal center centers along with a small amount of intrinsic lymphoid tissue. All 7 cases showed diffuse CD20 positivity both follicle and interfollicular region along with 30%-40% positivity in the interfollicular region (pathological region). Markers of other B-cell lymphomas werenot expressed. All 7 cases were positive for immunoglobulin(Ig) gene rearrangement. None of the patients showed no recurrence up on after follow-up for an average of 13 months. Conclusions Pediatric NMZL is a rare type of lymphoma that has a unique morphology and occurs almost exclusively in male children and young adults and often in head and neck lymph nodes. It has an excellent prognosis. Therefore, awareness of the disease with accurate diagnosis is important.