Objective:To investigate the efficacy of postoperative chemotherapy in patients with early-stage pulmonary large cell neu-roendocrine carcinoma (LCNEC) after resection. Methods:A cohort of 50 patients who underwent resection and systematic nodal dissection for LCNEC between January 2008 and December 2014 in our institution was retrospectively reviewed. The patients were divided into adjuvant chemotherapy group (32 cases) and non-chemotherapy group (18 cases). Follow-up information was investigated. Results:The median survival and the 5-year survival rate were 48 months and 72.5%for the adjuvant chemotherapy group whereas 29 months and 35.6%for the non-adjuvant chemotherapy group, respectively. Univariate and multivariate analyses using Cox's proportional hazard models showed that postoperative chemotherapy was a signifi cant prognostic factor for OS (P=0.005;hazard ratio=0.281, P=0.008, respectively). Conclusion:Postoperative chemotherapy is beneficial to patients with early-stage pulmonary LCNEC after complete resection.

The effects of spindle afferents activated by stretching gastrocnemius on the nociceptive responses of WDR neurons were recorded extracellularly with microelectrode and observed in paralyzed rats. The results indicated that in 51/80, the spindle afferent activity activated by stretching can inhibit nociceptive responses of neurons. 16 out of 80 neurons no effects can be observed, in 13/80 the effects of spindle afferent activity can excite the nociceptive responses of WDR neurons. Among 51 units, which have inhibitory effects induced by stretching muscle, the inhibitory effects induced by instance and bilateral stretching are stronger than that induced by continuous and unilateral stretching. These results suggested that spindle afferent activity is possesaed of analgesic effects.

AIM: To analyze curative effect of four regulating-intestines prescriptions (Wumei Wan, Baitouweng Tang, Shenling Baizhu San and Tongxie Yao-fang) on the treatment of ulcerative colitis (UC) through summing up the previous animal experimental results.METHODS: We collected the conclusions in the papers related to four regulating-intestines prescriptions for the treatment of UC which were published recently, made comparisons from the aspectsof symptoms, physical sign, pathological change, cytokine and its protein expression, blood adhesion molecule, cell apoptosis and controlling gene and analyzed the pathogenesis of UC and action mechanism of four regulating-intestines prescriptions. Four regulating-intestines prescriptions included Wumei Wan,Baitouweng Tang, Shenling Baizhu San and Tongxie Yaofang. Wumei Wan is from Treatise on Exogenous Febrile Diseases and Synopsis of the Golden Chamber, which consists of dark plum, asarum herb, dried ginger, Chinese goldthread, Chinese angelica root, aconite root, pricklyash peel, cassia twig,ginseng (sun-dried ginseng) and bark of cork tree and has marked effect in treating colic caused by ascariasis and persistent dysentery. Baitouweng Tang, from Treatise on Exogenous Febrile Diseases, consists of medicinal herbs such as pulsatilla root, Chinese goldthread, bark of cork tree and ash bark, which has functions of clearing away the heat-evil, expelling superficial evils and relieving dysentery. In addition, it has marked effect in treating heat-type dysentery. Shenling Baizhu San, from Prescriptions of Peaceful benevolent Dispensary, consists of medicinal herbs such as pulp of lotus seed, coix seed, amomum fruit, balloon flower root, white hyacinth bean, poria, ginseng (sun-dried ginseng), glycyrrhiza, bighead atractylodes and rhizoma dioscoreae, which has the nature of replenishing qi to invigorate the spleen and eliminate wetness to arrest diarrhea and has marked effect on treating diarrhea due to the hypofunction of spleen. Tongxie Yao-fang which is from The Complete Works of Zhang Jingyue consists of four herbals of agehead atractylodes, root of herbaceous peony, dried tangerine peel and ledebouriella root and has the functions of soothing liver and invigorating spleen and stopping diarrhea, and has marked effect on treating liver sthenia and deficient spleen, borborygmus and abdominal pain and diarrhea.RFSULTS: ① Because UC is a chronic protracted dysentery with deficiency of vital energy and existing of evil energy, the vital energy will be harmed if its treatment is specialized in removing and dissolving the stagnation, evil energy will continue to exist and stagnation will continue to accumulate if its treatment is specialized in strengthening vital energy and inducing astringency. Only supporting healthy energy and expelling evil energy is the correct therapy method. This is in accordance with the main treatment of Wumei Wan ②Eliminating dampness and pathogenic heat from the blood to treat diarrhea is the main treatment method of Baitouweng Tang, and this is incompletely suitable for the treatment of UC.③Shenling Baizhu San had the effect on soothing liver and invigorating spleen and stopping diarrhea, and this is also incompletely suitable for the treatment of UC. ④ The prescription of Tongxie Yaofang is used for treating diarrhea caused by deficient spleen and liver sthenia, and spleen controlled by liver, and abnormal ascent and descent. It accords with main pathogenesis of UC, deficient spleen, excessive dampness of deficient spleen and it is weaker in invigorating the spleen in catabasis of UC than Shenling Baizhu San. Therefore, Wumei Wan has the best curative effect,Baitouweng Tang the second, Shengling Baizhu San the third and Tongxie Yaofang a little poor.CONCLUSION: UC belongs to recurrent dysentery, and its pathogenesis is in accordance with the main treatment of Wumei Wan, but not the other three prescriptions, so Wumei Wan is the most efficient prescription in treating ulcerative colitis. Diagnosis and treatment based on an overall analysis of signs and symptoms of TCM is the premise of obtaining the best curative effect. Modeling of animal tests must be consistent with the type of syndrome of the traditional Chinese medicine. Ating ulcerative colitis (UC) from aspects such as symptom, physical sign, pathological changes, adherence factor, cytokine and its protein expression, apoptosis and its controlling gene by means of modeling, which proves their functions and effects are different and their curative effect are also different due to their different ingredient though they all have the functions of treating. Results of this test show Wumei Wan has the best curative effect, Baitouweng Tang the second, Shenling Baizhu San the third and Tongxie Yaofang a little poor[1-11] Mechanism of four regulating-intestines prescription in the treatment of ulcerative colitis is discussed from the viewpoints of traditional Chinese medicine as follows.

In the era of outbreaking of antibiotic resistance, the discovery of new antibacterial drugs is emergent.Antimicrobial peptides are important components of the natural defenses of most living organisms against invading pathogens.The unique antibacterial mechanism, direct bactericidal effect, relatively slow of resistance acquirement, and can used alone or combined with antibiotics, make antimicrobial peptides be attractive potential antibacterial drugs.In this paper, we review the physicochemical property of antibacterial peptides, action mechanism and design of antimicrobial peptides, and give a brief introduction of several promising antimicrobial peptides.

Objective:To investigate the prognostic factors and survival of patients with combined small cell lung cancer (C-SCLC) after they underwent complete resection. Methods:The clinical records of C-SCLC patients who were subjected to complete resection and systematic nodal dissection in one institution between January 2010 and December 2014 were retrospectively reviewed. Results:Sev-enty-eight patients with histologically diagnosed C-SCLC were identified. The most common combined component was large cell neuro-endocrine carcinoma (LCNEC) (n=42), followed by squamous cell carcinoma (SCC) (n=18), adenocarcinoma (AC) (n=10), and adenosqua-mous carcinoma (ASC) (n=8). The overall survival (OS) rate of the entire cohort was 39.1%. Multivariate analyses using Cox's propor-tional hazard models revealed that size [<3 cm vs.>3 cm;hazard ratio (HR)=0.406;95%confidence interval (CI)=0.202-0.816;P=0.011], performance status (<2 vs.>2;HR=0.113;95%CI=0.202-0.631;P=0.013), combined non-small cell lung cancer (NSCLC) components (LCNEC vs. non-LCNEC, HR=3.00;95%CI=0.096-0.483;P<0.001), stage Ⅲ A vs.Ⅰ;HR=0.195, 95%CI:0.063-0.602;P=0.004) and adju-vant therapy (yes vs. no, HR=0.402;95%CI=0.195-0.831;P=0.014) were significant prognostic factors of OS. Conclusion:The mixed NSCLC components within C-SCLC significantly influence survival. Adjuvant therapy is beneficial for patients with complete resection of C-SCLC.

Background:Ulcerative colitis(UC)is a chronic and nonspecific intestinal inflammatory disease and its pathogenic mechanism has not yet been clarified. Intestinal mucosal immune function disorder may play a key role in the pathogenesis of UC. Aims:To investigate the effects of Wumeiwan on expressions of δ-opioid receptor(DOR),β-arrestin1 and Bcl-2 in rats with colitis. Methods:Fifty-six Sprague-Dawley rats were randomly divided into model group,Wumeiwan group, mesalazine group and blank group. Rats in model group,Wumeiwan group and mesalazine group were administered intrarectally with 5% TNBS and 50% ethanol to induce experimental colitis. After colitis models were established,rats in Wumeiwan group and mesalazine group were administered intragastrically with Wumeiwan and mesalazine suspension, respectively,and rats in model group and blank group were given intragastrically with 0. 9% NaCl solution,all for 15 days. On day 16,all the rats were sacrificed and colon samples were obtained. Protein and mRNA expressions of DOR,β-arrestin1 and Bcl-2 in colonic tissue were determined by immunohistochemistry and real-time PCR,respectively. Results:The inflammatory injury in colonic tissue of rats with experimental colitis was significantly attenuated when treated with Wumeiwan,Protein and mRNA expressions of DOR,β-arrestin1 and Bcl-2 in colonic tissue of model group were significantly higher than those of blank group(P < 0. 05). Protein and mRNA expressions of DOR,β-arrestin1 and Bcl-2 in colonic tissue of Wumeiwan group and mesalazine group were significantly lower than those of model group(P < 0. 05), however,no significant differences were found between the two groups(P > 0. 05). Conclusions:DOR-β-arrestin1-Bcl-2 signal transduction pathway may play a central role in the pathogenesis of UC. Intervening this signaling pathway may be one of the mechanisms of attenuating UC by Wumeiwan.

Objective:To investigate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in adenosqua-mous carcinoma (ASC) of the lung after resection. Methods:Clinical data of patients suffering from ASC and receiving EGFR-TKI treat-ment at one institution between January 2006 and December 2014 were retrospectively reviewed. Results:A total of 27 EGFR muta-tion-positive patients with ASC subjected to EGFR-TKI therapy were enrolled in this study. EGFR mutations included deletion in exon 19 in 15 cases and point mutation at codon 858 in exon 21 in 12 cases. Of the 27 ASC patients who received EGFR-TKI treatment, 9 exhibit-ed a partial response and 11 manifested a stable disease, and these patients accounted for a disease control rate of 74.1%(20/27). The median overall survival (OS), median progression-free survival, and median relapse OS of the EGFR mutation-positive patients who underwent TKI therapy were 39 months [95%confidence interval (CI)=25.6-52.4], 15 months (95%CI=12.9-17.1), and 19 months (95%CI=0.9-37.1), respectively. The 3-and 5-year survival rates of these patients after operation were 51.9%and 15.3%, respectively. Con-clusion:The survival of EGFR mutation-positive ASC patients treated with EGFR-TKIs was satisfactory. EGFR testing was recommended for ASCs and EGFR-TKI treatment was suitable for ASCs with EGFR-sensitizing mutation.

Objective:To investigate the correlation between the CTLA-4 expression in the peripheral blood CD4+ and CD8+T cells in the patients with glioma and glioma WHO classification and operation,and to clarify the clinical significances of CTLA-4.Methods:60 patients with glioma from our hospital were selected as glioma group, and 46 healthy volunteers were used as control group.Then the CTLA-4 expression levels in the peripheral blood CD4+ and CD8+T cells of the subj ects in glioma group and control group were detected by fluorescence-activated cell sorting (FACS)and the relationship between CTLA-4 and glioma WHO classification and surgery was analyzed. Results:The CTLA-4 expression levels in CD4+ and CD8+T cells in peripheral blood of the patients in glioma group were higher than those in control group (P<0.01).The CTLA-4 expression level in the patients with gradeⅣ glioma was the highest, the expression level of the patients with grade Ⅳ glioma was higher than that of the patients with grade Ⅲ glioma (P<0.01),and the expression level of grade Ⅲ the patients with was higher than that of the patients with grade Ⅱ (P<0.01).The expression level of CTLA 4 in CD4+ and CD8+T cells of the patients with glioma after operation was lower than before operation (P<0.01 ). Conclusion:The CTLA-4 expression levels in the peripheral blood CD4+ and CD8+T cells are increased with the increasing of malignancy degree of the patients with glioma,and it has a promotion role in the occurrence of development of glioma.

Objective To investigate the protection of Liuwei Dihuang Jiawei Capsula(LDJ Capsula,Rehmanniae Capsula of Six Ingredients) on diabetic nephropathy(DN) rats′ kidney and effect on renal protein kinase C(PKC) activity and connective tissue growth factor(CTGF) of DN rats.Methods The DN rat models were induced by ip injection of streptozotocin(STZ).The rats were randomly divided into five groups: control group; DN model group;Lotensin group;LDJ Capsula group;and Lotensis and LDJ Capsula combination group.Drug intervention term was 12 weeks.Renal ultrastructure was observed by transmission electron microscope and Masson staining.Relative kidney weight,blood glucose level,serum and urine creatinine content,creatinine clearance,excretion rate of the 24 hour urine protein,renal PKC activity,and CTGF expression in renal cortex were measured by immunohistochemistry.Results Deposition of collagen in renal of DN rats was conspicuous.Relative kidney weight,blood glucose level,serum and urine creatinine content,creatinine clearance,excretion rate of 24 h urine protein,renal PKC activity and CTGF expression of DN rats increased obviously.All Lotensin,LDJ Capsula,and the combination of these two drugs could decrease renal PKC activity and CTGF expression and ameliorate proteinuria and renal function of DN rats.At the same time they all could abate the deposition of collagen in renal of DN rats.Combination of these two drugs could decrease renal PKC activity and CTGF expression more ob-viously and at the same time had more notable protective effect on kidney of DN rats.Conclusion All Lotensin,LDJ Capsula,and the combination of these two drugs could protect kidney of DN rats.The combination of these two drugs has more obviously protective effect than using Lotensin only.

Objective To investigate the effect of Octreotide on pancreatic head carcinoma patients with obstructive jaundice who underwent endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic stent placement.Methods Niney-nine patients hospitalized in Department of Gastroenterology of Wuhan Central Hospital from Jan 2006 to Dec 2011 were included in this study.All the patients were diagnosed as pancreatic head carcinoma with obstructive jaundice.The patients were randomly divided into the Octreotide treatment group and the control group.Both groups underwent ERCP with pancreatic duct stent placement for malignant biliary obstruction.The patients in Octreotide treatment group were injected with subcutaneous Octreotide at a dose of 0.1 mg twice per day for more than 90 day till death.The changes of serum total bilirubin before and after treatment were compared.The improvement of symptoms of nausea,vomiting,abdominal pain,diarrhea and anorexia was compared.The complication rates and survival were also determined.Results Postoperative recurrence of jaundice was observed in six patients in control group,and the cause may be stent occlusion,and 3 of the 6 patients underwent a second ERCP and stent placement,then jaundice was relieved,the other 3 patients did not receive a second ERCP.The serum bilirubin level in the remaining 45 patients returned to basically normal value (below 2 times of the normal value).The prevalence of nausea,vomiting,abdominal pain,diarrhea and anorexia in the 2 groups was not statistically different before treatment,and after treatment the prevalence of symptoms in the 2 groups was significantly decreased except for diarrhea.The decrease in Octreotide treatment group was more obvious than that in control group,and the difference between the two groups was statistically significant (P ＜ 0.01).In the control group,post-ERCP pancreatitis occurred in three patients,and all were cured after treatment.There was no post-ERCP pancreatitis occurred in the Octreotide treatment group.Minor pain at the injection site was noted in three patients in the Octreotide treatment group.Pain was relieved after changing the injection site.The survival was significantly longer in the Octreotide group than that in control group [(14.4 ± 8.7) months vs (7.3 ± 5.3) months,P ＜ 0.05),and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Octreotide can improve the quality of life and increase the survival of patients with pancreatic head carcinoma who undergo ERCP with pancreatic duct stent placement.