Gefitinib (iressa),an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor,has antitumor activity in non-small-cell lung cancer (NSCLC).Despite the dramatic response to this inhibitor,most patients nevertheless ultimately have relapses because of the secondary resistance.In human lung adenocar-cinomas with EGFR mutation,a second-site point mutation that substitutes methionine for threonine at position 790(T790M) is associated with approximately half of cases of secondary resistance to gefitinib.Other mecha-nisras that contribute to gefitinib resistance include EGFR receptor internalization and MET gene amplification.

Due to practical and ethical concerns associated with human experiments, animal models have been essential in cancer research.Vast resources are expended during the development of new cancer therapeutics, and selection of optimal in vivo models should improve this process.Genetically engineered mouse models ( GEMM) of cancer have progressively improved in technical sophistication and, accurately recapitulating the human cognate condition, have provided opportunities to accelerate the development of cancer drugs.In this article we consider the different types of animal models used for predicting the results of clinical trials of cancer drugs, and discuss the strengths and weaknesses of each in this regard.In addition, the methods of predicting in vivo models and clinical translation are discussed.

CALR mutations are discovered in classic myeloproliferative neoplasms (MPN) as a new biomarker very recently.CALR mutations occur in about 20 ％-35 ％ essential thrombocythemia and primary myelofibrosis and are associated with some clinical features and favorable prognostic impact.This article reviews biological characteristics and clinical implications of CALR mutations in classic MPN.

Airway obstruction in children is a rare,in recent years,with the development of CT technology and the development of fiber bronchoscopy,the number of cases of children with tracheal stenosis has increased year by year,but difficult clinical problem,with no clear agreement on optimal therapeutic approach.Stenting of the airway has been used successfully in adults,and is an attractive alternative in children.Fundamental differences of pediatric compared to adult use include the benign nature of most stenoses,the narrow and soft airways of children,the required long-term tolerance and adaptation to growth.So it is controversial in the indications.

Objective To investigate and analyze the residents′knowledge and satisfaction on basic public health services in five districts of Gansu ,to judge the implementation effect of the current policy ,in order to provide the suggestion to improve the effect of the implementation of the policy of basic public health services .Methods Based on typical sampling method ,1 688 rural and urban residents had been investigated coming from five counties in Gansu by using questionnaires to survey .Results The de‐gree of residents′knowledge about the policy was low (57 .23% );the residents could know about the policy through a variety of ways ,and mainly for medical staff to promote by approaching their homes ;91 .94% of surveyed residents thought that policy service was more convenient when they were accepting ;90 .99% of surveyed residents thought that they satisfied with the service attitude of staff ;82 .35% of surveyed residents believed that the policy service effects was obvious ;90 .11% of surveyed residents overall satisfied with the service of policy .The above results were different in proportion in various counties(P<0 .05) .Conclusion The degree of residents′knowledge and satisfaction on basic public health services in five districts of Gansu still needs to be improved .

Objective To study the risk factors of type 2 diabetes mellitus patients complicated with cerebral infarction.Methods 32 type 2 diabetes mellitus patients complicated with cerebral infarction(group A) and 30 type 2 diabetes mellitus patients (group B) were enrolled in the study. The living habit, history, blood lipids, blood glucose, body mass index and height were investigated, also common carotid artery intimal thickness (CCA-IMT) and plaque incidence rate were measured by two-dimensional color Doppler ultrasound, and the relationship between them was evaluated.Results There were significant differences between two groups in age, duration of smoking, course of diabetes, high density lipoprotein (HDL) and fasting blood glucose (FBG) (all P

Objective To observe the clinical efficacy of rigid gaspermeable contact lens (RGPCL) for correcting keratoconus and analyze the predictors for the base curve of RGPCL.Methods Data of 86 patients (143 eyes) with keratoconus fitted with RGPCL were retrospectively analyzed.All eyes were divided into the mild (n =18 eyes),moderate (n =73 eyes),advanced (n =34 eyes) and severe group (n =18 eyes).After evaluating the lens fitting,best corrected visual acuity of eyes wearing spectacle lenses and RGPCL among the 4 groups was statistically compared.And the correlation between the fitting guidance index and HL-K RGPCL base curve in each group was analyzed according to keratometry.Results All patients wearing RGPCL gained significantly better corrected vision in the mild (t =-3.336,P =0.004),moderate (t =-11.213,P ＜0.001),advanced (t =-13.959,P ＜0.001) and severe groups(t =-11.047,P ＜0.001) than those with spectacles.Equivalent spherical degree of spectacle lenses was lower than the diopter of HL-K RGPCL in the moderate (P =0.043) and severe group (P =0.006).The mean base curve of RGPCL was (50.52 ±5.64) diopter,and it was correlated with corneal curvature parameters.In mild group,the RGPCL base curve was correlated with the steep keratometry (P ＜ 0.001).The average K and relative steep K of 0.2 mm (Rm-0.2) were highly correlated with RGPCL base curve in moderate group (r =0.798,P ＜ 0.001;r =0.798,P ＜ 0.001),in advanced group (r =0.745,P ＜ 0.001;r =0.745,P ＜ 0.001) and in severe group (r =0.616,P =0.007;r =0.617,P =0.006).Conclusion Patients with keratoconus wearing HL-K RGPCL can obtain ideal corrected vision.Determination of RGPCL base curve by adjusting the corresponding indicators is conducive to improving the long-term wearing safety of the lens and enhancing the efficiency of lens fitting.

Objective To explore the rehabilitation outcome and influencing factors of functional recovery in patients with nontraumatic spinal cord injury (NTSCI). Methods A retrospective analysis was done on 49 cases suffering from NTSCI who recepted rehabilitation therapy from December 2014 to November 2016. The main indicator of the rehabilitation effect was Modified Barthel Index (MBI). A total of 49 cases were divided into two groups, effective group (31 cases) and ineffective group (18 cases) according to whether their MBI on discharge had beated the target setted on admission. The following factors:ages, gender, injury causes, injury level, injury grade, injury severity, the types of paralysis, hospitalization time, sick time, complications number, MBI on admission and discharge, operation, early rehabilitation were evaluated by Univarite analysis and Logistic stepwise regression to assess how they influenced rehabilitation outcome. Results After systematically rehabilitation training, MBI had apparent improvement, from (38.98 ± 24.90) score on admission to (56.35 ± 22.69) score on discharge and had statistical significance(Z=-4.95, P=0.00), which showed that rehabilitation training can effectively improve patients′ self-care ability of daily living. Regression analysis found that the MBI on admission (OR=1.044, P=0.010) and hospitalization time(OR=1.044, P=0.039) had a noticeable effect on the rehabilitation outcome, while all the other factors, such as age, sex, injury grade, injury level, injury severity, complications number hadn′t show concrete effect on rehabilitation outcome. Conclusions Patients with NTSCI should have early rehabilitation, medical staff should assess their admission MBI, make a strict rehabilitation training plan to improve rehabilitation efficiency, shorten hospitalization time, improve the patients quality of life.

Objective To compare the efficacy of tamsulosin and nifedipine for the adjunctive expulsive therapy in patients with lower ureteral stones. Methods A total of 180 patients with stones (0.4-1.0 cm in diameter) located in the lower ureter (juxtavesical or intramural tract) were randomly divided into 3 groups (60 cases in each group). Group 1 served as controls; group 2 received nifedipine (10mg, 3 times daily) ; and group 3 received tamsulosin (0.4 mg, once daily). All patients were observed for 2 weeks. Results During 2 weeks, expulsion of stones was observed in 26 cases (43. 3% ) of group 1, in 44 (73. 3% ) of group 2, and 49 (81. 1% ) of group 3. The difference in expulsion rates between groups 2, 3 and group 1 was statistically significant (P 0. 05). In groups 1 , 2 and 3, renal colic recurred within 2 weeks and analgesics were used in 5 cases (8.3%), 1 (1.7% ) and 0, respectively, with significant difference between the groups (P

Objective: To compare the effect of urapidil at different doses on blood pressure and prognosis of patients with acute ischemic stroke (AIS) so as to provide data evidence for its clinical use.Methods: Totally 62 patients with AIS were divided into 3 groups in a prospective study: 20 cases in high dosage group, 21 cases in middle dosage group and 21 cases in low dosage group.All the patients were treated with urapidil and urokinase, and the initial dose of urapidil was 25 mg, 15 mg and 5 mg, respectively.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients before and after the treatment were observed, and the US national institutes of health stroke scale (NIHSS), modified Rankin scale (mRS) and activity of daily living scale (ADL) were also evaluated in the follow-ups.Results: The time of blood pressure up to standard in the middle dosage group and low dosage group was longer than that in the high dosage group.At the same time, the time of blood pressure up to standard in the low dosage group was longer than that in the middle dosage group, and the difference had statistical significance (P＜0.05).After the treatment, SBP and DBP at T1 in all the groups were notable lower than those at T0,and those at T2 and T3 were lower than those at T1, and the differences had statistical significance (P＜0.05).After the treatment, the SBP and DBP levels in the high dosage group were lower than those in the middle dosage group and low dosage group, and those in the middle dosage group were lower than those in the low dosage group, and the differences had statistical significance (P＜0.05).The NIHSS, mRS and ADL scores of the middle dosage group were lower than those of the low dosage and the high dosage group (P＜0.05), and there was no significant difference between the latter two groups (P＞0.05).Conclusion: With the initial dose of 15 mg, urapidil can ensure good prognosis on the premise of effective decompression.