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.

Purpose To investigate the presence of perineural invasion (PNI) and the expression of human epidermal growth factor receptor 2 (HER-2) in patients with advanced gastric cancer.To discuss the correlation between PNI and the expression of HER-2 and their prognostic significance.Methods Paraffin sections of surgical specimens from 100 patients who underwent gastric resection were selected,and then PNI were detected by HE staining and the expression of HER-2 were detected by immunohistochemical (IHC).The correlation of perineural invasion with the clinicopathological features and HER-2 expression were performed.Results PNI was positive in 42 cases of 100 patients (PNI positive rate was 42％),the occurrence of PNI has significantly related with lymph node metastases,infiltrating depth,tumor emboli,TNM stage and expression of HER2.The difference was statistically significant (P ＜ 0.05).Univariate analysis showed that total survival rate of advanced gastric cancer was associated with T stage,tumor emboli,N stage,TNM stage,PNI and HER-2 expression (P ＜ 0.05).The overall survival of the PNI-negative patients was 45.3 months on average,much better than the PNI positive patients who was 15.4months in average (P ＜ 0.05).The overall survival of the HER2-negative patients was 43.2 months on average,much better than the HER-2-positive patients who was 22.7 months in average (P ＜ 0.05).By muhivariable Cox proportional hazards model of overall smvival,the positivity of PNI and HER-2 appeared to be new independent prognostic factors (P ＜ 0.05).Conclusion The detection of PNI and HER-2 expression maybe helpful for the prognosis of patients with advanced gastric cancer.In addition,HER-2 may be responsible for the presence of perineural invasion.

P2 X7 receptor is a member of ATP-gated non-selective cation channels;and is one subtype family of the P2X purinergic receptor.Signaling pathways of P2X7 receptor couple with several key inflammatory molecules including IL-1β;IL-6 and COX-2;which suggests that P2 X7 receptor plays a key role in the development of dis-eases via increased inflammation;indicating its potential as a novel therapeutic target.Recent studies show that P2 X7 receptor has a relationship with renal diseases.This article reviews the effect of P2 X7 receptor on renal diseases and its mechanism.P2 X7 receptor may be a new drug target;and its selectivity antagonist may be a new therapeutic agent for the treatment of renal diseases.

Objective:To evaluate the application status and change trends of insulin and its analogs in Nanjing area during 2011 to 2013. Methods:The varieties, sales amount and DDDs of insulin and its analogs in 43 hospitals of Nanjing during 2011 to 2013 were analyzed. Results:The use of insulin and its analogs was increased year by year from 2011 to 2013 with the average annual growth rate of 16%. Glargine, pre-mixed insulin 30R, aspart 30, human insulin and aspart ranked the top five in the sum of money with the proportion above 80%. Pre-mixed insulin 30R, aspart 30, glargine, human insulin and common insulin ranked the top 5 in DDDs. Conclusion:The application of insulin and its analogs is wide in clinics, and the usage and sum of money both show rapid growth trend.

Objective To evaluate the effect of color Doppler ultrasound monitoring in artificial arteria-venous fistula in patients with uraemia.Methods 25 cases were examined with upper limbs arteriovenous fistulas with uremia and analysed by CDFI and 2D.The fistula and blood vessel was observe and hemodynamics changes were examined.Results Among 25 patients,18 cases showed good filling state of the vessel,3 cases with anastomoses stenosis,2cases with thrombus and 2cases with venous dilatations.Conclusion CDFI is an effective supplementary detective methods in treating hemodialysis patients with uremia.

Objective To explore the influence of ICAM-1 and LFA-1 on the breast cancer metastasis and provide scientific base for studying the molecular mechanism of breast cancer metastasis by observing the expression of ICAM-1(intercellular adhension molecule1) and LFA-1(Lymphocyte function related antigen 1) in different time different metastasis stage of breast cancer. Methods We observed the expression of ICAM-1 and LFA-1 in breast cancer tissue as well as the expression of ICAM-1、LFA-1 and VEGFR-3 in Lymphatic vessel endothelial cell of nearby the breast cancer tissues from the patients of the operation in the defferent stages with the methods of HE staining and immunohistochemistry staining. Results The positive rate of ICAM-1 and LFA-1 expression in cancer cell and cancer nest of breast cancer was increased gradually along with the increase of clinical stages and the occurrence of lymph node metastasis. And the positive rate of ICAM-1、LFA-1 and VEGFR-3 expression in lymphatic vessel endothelial cell of nearby the breast cancer tissues was increased gradually too along with the increase of clinical stages and the occurrence of lymph node metastasis,which has the positive correlation,and it has the positive correlation that the ICAM-1 and LFA-1 expressed in Lymphatic vessel endothelial cell of nearby the breast cancer tissues(P0.05).Conclusion The ICAM-1 and LFA-1 were related with breast cancer lymph metastasis,and the ICAM-1 and LFA-1 promoted breast cancer lymph metastasis through synergism each other.The increase or decrease of ICAM-1 and LFA-1 expression in the breast cancer tissue and lymphatic vessel endothelial cell of nearby the breast cancer tissues could as the data target to display certain instruction function for prevention and treatment of breast cancer lymph metastasis.The Lymphatic vessel quantity of nearby the breast cancer tissues was increased along with tumor progress, which may be related with breast cancer lymph metastasis.VEGFR-3 has the high specificity in the lymphatic vessel endothelial cell expression,and may act as the lymphatic vessel as the lymphatic vessel endothelial cell specific marker.

Following the reports of its teratogenicity,thalidomide was banned from the market in the 1960s.Later,researches discovered the teratogenicity was caused by inhibiting angiogenesis,and at that time the antiangiogenesis effect was considered an important factor in anti-tumour.Since then,many other anti-tumour mechanisms of thalidomide had been revealed and thalidomide was considered a kind of potential antitumor drug and was researched widely.This article focuses on the anti-tumour mechanisms of thalidomide and its use in combination therapy for the treatment of solid tumor.

Objective To investigate the relationship between hemicrania and negative living events or cerebral blood flow.Methods 59 patients were investigated with the negative living events and transcranial Doppler(TCD).The data were compared with those of healthy control.Results Among the patients with hemicrania,the negative living events were found in 52.5% of patients.Abnormity of cerebral artery was found in 72.9% of the patients.It is different from the control.Conclusion Hemicrania may be associated with the dysfunction of brain artery caused by strain.

The research of the falls and impairment in senior population were radically paid more attention nowadays. This article was gathering associated materials and documents to assess the fall risks and factors , and giving some efficient guideline and recommendation of the falls, in order to raise the awareness of the fall risk control and prevention , so as to develop te quality of life in their later life.

Acute Disease ; Humans ; Respiratory Tract Infections ; diagnosis ; etiology ; microbiology ; virology