With the rapid development of molecular biology,molecular targeted therapy has become an important tumor therapy after surgery,radiotherapy and chemotherapy.It plays an increasingly important role in tumor therapy.Molecular targeted therapy reflects that the clinical medicine tends to precision,but also contains a profound philosophical thought and philosophical basis.On the one hand,the clinical application of molecular targeted therapy reflects the profound philosophical thoughts of the universality of the connection,the universality and theparticularity,and the whole and the part.On the other hand,the further application and development of molecular targeted therapy also need the guidance of philosophical theory.

Objective To investigate the efficacy of initial polytherapy in the patients with newly diagnosed infantile spasm by evaluating the ambulatory electronecephalogram (EEG) profiles and serum neuron specific enolase ( NSE ) level.Methods Data from 108 cases of newly diagnosed infantile spasm from Sep.2007 to Nov.2010 in the Department of Pediatrics,the First Hospital of Jilin University,were respectively analyzed for the EEG profiles and serum NSE level.The patients were treated with multiple drugs.Results ( 1 )After treatment,EEG showed normal shape in 56 cases ( 62.2％ ),sporadic sharp and slow waves without hypsarrhythmia in 32 cases( 35.6％ ),and hypsarrhythmia in 2 cases (2.2％).The overall effective rate was 97.8％.(2) Serum NSE in 35 seizure-free cases were examined at the time points of hospital admission,48 hours and one month after seizure cessation,respectively.NSE level was significantly decreased at 48 hours after seizure control than that at hospital admission ( t =6.54,P ＜ 0.05 ) ; NSE at one month after seizure free was further decreased compared with that at admission point ( t =9.29,P ＜ 0.05 ).Conclusion Polytherapy for infantile spasms can ameliorate the abnormal EEGs.NSE level is decreased after seizure cessation.Intelligence is improved 6 months after seizure free and polytherapy may improve the prognosis of the children with infantile spasms.

Objective To understand the characteristics of pathogenic bacteria and drug resistance of ventilator-associated pneu-monia(VAP)in neonatal intensive care unit (NICU),and to explore the corresponding prevention and control measures,and to pro-vide the basis for the VAP antibiotic treatment.Methods A total of 80 children with respiratory failure and ventilator assisted breathing were selected from the NICU as objects in this study.The clinical data,pathogenic bacteria and drug resistance were ana-lyzed retrospectively.Results In 80 cases,the incidence of VAP was 43.75% (35/80),a total of 70 strains of pathogenic bacteria were isolated,gram negative bacilli accounted for the highest proportion,accounting for 81.43% (57/70).Pseudomonas aeruginosa, Klebsiella pneumoniae were the most common gram negative bacilli.Gram positive cocci accounted for 8.57% (13/70),which domi-nated by methicillin resistant Staphylococcus aureus,in addition to susceptible to vancomycin,but resistant to the other antibiotics. Conclusion Gram negative bacillus are the main bacteria in VAP cases,and which are multiple drug-resistant pathogens.

Objective To investigate the MRI features of primary hepatic neuroendocrine tumor (PHNET). Methods Clinical information and MR imaging features of 13 histopathologically confirmed PHNET patients were retrospectively reviewed. All patients underwent routine MRI examination including T2WI and chemical shift imaging, diffusion weighted imaging (DWI) and dynamic contrast-enhanced imaging. All lesions were divided into two groups according to the maximum diameter (≥ 30 mm for large lesion group and<30 mm for small lesion group). The following MRI features of lesions were evaluated:location, size, growth pattern, signal intensity (T1WI, T2WI, DWI, in-and opposed-phase) and dynamic contrast-enhancement pattern. The pathologic features were also analyzed. Results The PHNET can be single lesion(n=7)or multiple lesions(n=6)in which 4 cases showed diffuse pattern.One hundred and six lesions in 13 patients were detected.The median diameter of all lesions was 20 mm(ranging from 3 to 200 mm).Fourteen lesions were found in≥30 mm group and 92 lesions in<30 mm group.(1)In≥30 mm group,all lesions had well-defined margin,heterogeneous hyperintensity on T2WI,heterogeneous hypointensity on T1WI and halo sign on DWI. All lesions showed cystic degeneration, necrosis and pseudo-capsule. Three lesions showed dilation of bile duct around the lesion, and three lesions hemorrhaged and three lesions signal dropped on out-of-phase.On arterial phase,7 lesions showed ring-like enhancement,and the other 7 lesions showed heterogeneous enhancement;then on portal venous phase and delayed phase, 8 lesions showed persistent enhancement and the other 6 lesions showed"wash-out"appearance.Three cases showed lymphadenopathy in the peritoneum and liver hilum. (2) In<30 mm group, 76 lesions showed well-circumscribed edge and the other 16 lesions had ill-defined margin. Eighty two lesions showed relatively homogeneous hyperintensity on T2WI and relatively homogeneous hypointensity on T1WI. One lesion showed heterogeneous hyperintensity on T2WI and heterogeneous hypointensity on T1WI.Nine lesions showed halo and nodular hyperintensity and the other 83 lesions nodular hyperintensity on DWI.Ten lesions demonstrated cystic degeneration and necrosis. Ten lesions showed pseudocapsule. All lesions showed no dilation of bile duct, hemorrhage and signal drop on out-of-phase. On arterial phase, 31 lesions showed ring-like enhancement, 3 lesions showed heterogeneous enhancement and 58 lesions showed homogeneous enhancement;on portal venous phase and delayed phase,62 lesions showed persistent enhancement and 30 lesions showed"wash-out"sign. No lymphadenopathy was found in this group. In the pathologic analysis, hemorrhage and central necrosis were detected in the gross specimens.And in the 13 cases of PHNET,1,3 and 9 cases were classified into G1, G2 and G3 grade, respectively. Conclusions The PHNET can be single or multiple with various sizes. The large lesions often show heterogeneous signal intensity on T2WI and T1WI with cystic degeneration, necrosis, hemorrhage, pseudo-capsule and dilated bile duct, peripheral hyperintensity on DWI, ring-enhancement or heterogeneous slight enhancement in arterial phase, while small lesions often show ring-enhancement or homogeneous obvious enhancement in arterial phase.