Colorectal cancer is one of the most commonly seen malignant tumors,and the metastatic colorectal cancer is of poor prognosis. The median overall survival for chemotherapy is only 1-1. 5 years. Recently,molecular targeted therapy targeting at vascular endothelial growth factor and epidermal growth factor receptor was used widely for metastatic colorectal cancer and becoming a hot spot of related researches. This article focused on the strategy and hypothesis of molecular targeted therapy for treatment of metastatic colorectal cancer.

Non-small cell lung cancer(NSCLC) is one of the most life-threatening human malignancies due to its high morbidity and mortality rates.Molecular targeted therapy is promising in treating some patients with NSCLC.However,it is still challenging to select proper candidates.The EML4-ALK fusion oncogene represents a novel molecular target which appears mainly in lung adenocarcinoma,and appears to be a potential biomarker associated with resistance to EGFR tyrosine kinase inhibitors.This review was intended to outline current status of preclinical and clinical research of this molecule.

Objective To investigate the clinical application value of fibrolarynogoscope in the diagnosis and treatment of otolaryngolgic diseases. Methods Olympus Type-T3 fibrolarynogoscope were used in diagnosis of 3 200 patients. Results 3 200 cases were examined by fibrolarynogoscope, and correct diagnosis was made. 263 cases of foreign bodies in hypopharynx or larynx were moved, 154 cases of nosebleed were treated with MTC-3 microwave therapy apparatus, CX-Ⅲ multifunctional ionization therapy apparatus. Conclusion Fibrolarynogoscope can be widely used in diagnosis and treatment of otolaryngolgic diseases and is an excellent instrument of diagnosis and treatment of otolaryngolgic diseases.

Objective To explore the surgical safety and clinical efficacy of combined anterograde and retrograde method exposing porta hepatis for the treatment of the intrahepatic cholangiocarcinoma invading porta hepatis.Methods The retrospective descriptive study was conducted.The clinicopathological data of 3 patients with left intrahepatic cholangiocarcinoma invading porta hepatis who were admitted to the Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine from February 2015 to May 2016 was collected.All the 3 patients underwent left hemihepatectomy combined with caudate lobectomy after preoperative lab and imaging examinations and the evaluations of liver function and residual liver volume.The surgical procedures followed as:anterograde dissection of porta hepatis,exposure of hilar plate,left hemihepatectomy combined with caudate lobectomy,right artery resection and reconstruction,hilar cholangioplasty and bilioenteric anastomosis.Observation indicators included:(1) surgical situations:operation time,time of hepatic artery~ anastomosis and volume of intraoperative blood loss;(2) postoperative pathological examinations;(3) postoperative situations:postoperative complications (biliary fistula,hemorrhage,abnormal liver function,gastroplegia) and postoperative chemotherapy;(4) follow-up:postoperative patients' survival and carcinoma occurrence.Follow-up was performed to by outpatient examination up to December 2016.The follow-up included clinical symptoms such as abdominal pain,chills,fever and jaundice,liver function and tumor marker examination,and color ultrasound Doppler or abdominal enhanced computed tomography (CT) was performed to detect carcinoma recurrence.Measurement data was represented as average (range).Results (1) Surgical situations:all the 3 patients underwent successful left hemihepatectomy combined with caudate lobectomy using combined antegrade and retrograde method exposing porta hepatis,including 1 combined with right hepatic artery resection and reconstruction,without perioperative death.The average operation time,average time of hepatic artery anastomosis and average volume of intraoperative blood loss of 3 patients were 493 minutes (range,430-570 minutes),11 minutes and 526 mL (range,450-600 mL),respectively.(2) Postoperative pathological examination showed 3 patients were diagnosed with cholangiocarcinoma,2 with nerve bundles invaded and 2 with No.12 lymph node metastasis,with negative margins of bile duct and hepatic artery.(3) Postoperative situations:3 patients are not complicated with biliary fistula and gastroplegia.One patient with postoperative liver dysfunction after right artery resection and reconstruction underwent anti-infection,hepatoprotection and anti-hepatic encephalopathy therapies,and then was improved and discharged from hospital at 4 weeks postoperatively.The other 2 patients recovered steadily without complications such as hypohepatia,and then respectively discharged from hospital at 17 and 20 days postoperatively.All the 3 patients underwent chemotherapy of gemcitabine combined with S-1 for 8 courses at week 4 or 5 postoperatively.(4) Follow-up:all the 3 patients were followed up for 7-20 months,with good general conditions and normal liver function and without cholangitis symptoms.One patient received right artery reconstruction,and CT reexamination at postoperative month 3 showed fine imaging of right hepatic artery.There was no sign of carcinoma recurrence.Conclusion The combined anterograde and retrograde method exposing porta hepatis for the treatment of the intrahepatic cholangiocarcinoma invading porta hepatis can increase the radical resection rate and surgical safety.

Objective To investigate Hospital-acquired infections in patients with liver cirrhosis caused by relevant factors.Methods From Jul.2006 to Jan.2011 the clinical data of 476 cases of hospital-acquired infections in patients with decompensate cirrhosis were retrospectively analyzed by case-control study for the effective factors.Results By logistic regression analysis,17 factors are found to affect Hospital-acquired infections ; 16 risk factors:Occupation in manual labor ( OR =4.119,95 ％ CI:2.631-6.325 ) ; Age ( OR =3.014,95 ％ CI:1.163-7.136) ; The cirrhosis disease history ( OR =1.761,95 ％ CI:1.439-2.130) ; Length of stay in hospital (OR =17.354,95 ％ CI:2.539-101.304) ; Interventional procedures ( OR =5.379,95％ CI:2.354-17.594) ;Peotein intake ( OR =3.201,95％ CI:1.539-4.528) ; Alcohol drinking history ( OR =3.158,95％CI:2.274-7.153 ) ; Development of complication ( OR =8.367,95 ％ CI:2.023-11.736 ) ; ALB ( OR =4.613,95％ CI:2.157-9.936 ) ; PCR-HBV DNA quantitative ( OR =3.628,95％ CI:2.245-7.129 ) ; WBC ( OR =3.758,95％ CI:2.276-7.018 ) ; CHE ( OR =3.148,95％ CI:2.202-6.038 ) ; TC ( OR =3.210,95％ CI:2.102-5.107) ;TBIL(OR =2.748,95％ CI:1.283-3.153) ; Antiviral agents (OR =0.257,95％ CI:0.145-0.382 ) ; Preventive application of antibiotics ( OR =3.147,95％ CI:2.236-7.182 ) ; PTA ( OR =2.798,95％CI:1.293-4.182) ;Liver function of Child B and C (OR =4.164,95％ CI:2.236-6.761 ).Conclusion Age,length of stay in hospital,interventional procedures,alcohol drinking history,development of complication,ALB,PCR-HBVDNA quantitative,WBC,TC,Preventive application of antibiotics,liver function of Child are risk factors.Use of anti-virus drug are protective factors.

Objective To evaluate effect of humanized nursing on psychological state of patients with chronic urticaria receiving autohemotherapy. Methods 58 cases with chronic urticaria in our hos-pital were randomly divided into the observation group and the control group with 29 cases in each group, the control group was treated with conventional care, the observation group received conventional care combined with humanized nursing. The anxiety, depression and satisfaction degree were compared for these two groups and the data went through χ2 test and t test. Results The score of self- rating anxiety scale (SAS) and serf-rating depression scale (SDS) of the observation group was significantly lower than that of the control group, the satisfaction rate of the observation group was significantly higher than that of the con-trol group. Conclusions Application of humanized nursing in patients with chronic urticaria receiving autohemotherapy can reduce their anxiety and depression and has pivotal significance on treatment of pa-tients with chronic urticaria.

Aged ; Carcinoma, Non-Small-Cell Lung ; pathology ; therapy ; Humans ; Lung Neoplasms ; pathology ; therapy

Objective To establish the adventitious root induction and culture system ofAconitum pendulum Busch.Methods The influence of different explants and plant growth substances on adventitious induction proliferation ofAconitum pendulumBusch were investigated through tissue culturing.Results Explants induction ability was: root>stem>leaf. 2.5 mg/L IBA was in favor of induction and multiplication adventitious root ofAconitum pendulumBusch.ConclusionThe culture system of induction and proliferation adventitious roots ofAconitum pendulum Busch was preliminary established, which provides a new way for resource exploitation and utilization of Aconitum pendulum Busch.

Objective To explore the effect and mechanism of intrathecal injecting κ-opioid receptor agonist U50, 488H on the rats with myocardial ischemia/reperfusion injury.Methods 50 Sprague–Dawley rats were randomly divided into five groups (n=10): sham group (Sham), ischemia/reperfusion group (IR), high-dose intravenous injection group (IV1), low-dose intravenous injection group (IV2), and intrathecal injection group (IT).In sham group the rats were followed by the modeling step without ligation of the left coronary and no drug injection by intravenous or intrathecal; in IR group the rats were underwent 30 minutes of myocardial ischemia followed by 120 minutes of reperfusion, and were not treated with any drug.All the rats in IV1, IV2 and IT groups were intravenous injected with U50, 488H at 1 hour before they were underwent myocardial ischemia/reperfusion as in IR group.IV1 and IV2 groups were intravenous injected with U50, 488H respectively at the dose of 0.1 mg/kg and 0.01 mg/kg, while the IT group was intrathecal injected with U50, 488H at the dose of 0.01mg/kg.All the rats from 5 groups were observed with cardiac ultrasound, myocardial sirius staining, serum CGRP and ET level.Results Compared to IR group(EF%=35.4 ±1.1,FS% =21.1 ±1.1), the rats in IT group (EF%=49.1 ±1.2,FS%=27.1 ±1.0) and IV1 group (EF%=46.3 ±2.2,FS%=26.6 ±0.6) showed better myocardial contraction (P<0.05) and reduced myocardial fibrosis (P<0.05).IT group and IV1 group also showed reduced ET but increased CGRP in the serum (P<0.05).There were no difference between IV2 group and IR group in both observation.Conclusion Pretreatment with intrathecal injection of opium κ-receptor stimulant U50, 488H not only protected the myocardial function from myocardial ischemia/reperfusion injury, but also repressed myocardial fibrosis.The protection may result from modulation of CGRP and ET.

Objective · To study the metabolite profiles on patients of ischemic stroke using metabonomics approach. Methods · The serum samples from the 29 patients with ischemic stroke and 31 healthy controls were analyzed by gas chromatography time-of-flight mass spectrometry (GC-TOFMS) coupled multi-dimensional statistical methods to find differential metabolites in two groups. Results · Orthogonal partial least squares analysis (OPLS) model was generated based on identified metabolites and shown clear discrimination from patients and healthy controls. Some serum metabolite levels were significantly altered in patients. Six up-regulated metabolites included γ- aminobutyric acid, glutaric acid, glyceric acid, gluconic acid, lactobionic acid, and cholesterol, and nineteen down-regulated metabolites included citric acid, aconitic acid, malic acid, succinic acid, β-alanine, and glycerol-3-phosphate. Conclusion · Amino acid metabolism, glycometabolism and tricarboxylic acid (TCA) cycle are disturbed in patient of ischemic stroke. The metabonomic approach has great potential to understand the underlying mechanisms of stroke in ischemic patients.