Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is one of the most important targeted drugs for lung cancer patients carrying EGFR sensitive mutations.However,almost all patients that are effective to this treatment will eventually develop secondary resistance to EGFR-TKI.The most accepted mechanisms of resistance mainly include T790M mutation,MET amplification,PIK3CA mutation,down-regulation of PTEN expression and activation of Fas-transcription factor-κB.Recent years,many new drugs are developed to overcome this resistance.Although most of drugs are in the stages of cell or animal experiment,some new drugs get positive clinical results.

Objective To observe the influence of desmopressin acetate (DDAVP) on blood loss and hemostatic function after cardiac surgery with extracorpoteal circulation.Methods Forty-one patients undergoing congenital heart operations, were randomly allocated to double--blindly receiving 0.3ug/kg DDAVP in a 50 ml saline(group DDAVP, n = 20) and 50ml normal saline (group placebo, n = 21) over 15 min after protamine infusion. Blood samples were obtained before operation, immediately before studied drug administration and 1 h after the administration, to measure the hematocrit, platelet count and aggregation, Factor Ⅷ coagulant activity and von Willebrand factor (vWF) concentration. Results The first postoperative 24-hour blood loss was significantly lower in group DDAVP than in group placebo [ (178 ? 90) ml vs (291 ? 98 ) ml, P 0 .05); The plasma level of vWF and factor Ⅷ coagulant activity markedly increased 1h after DDAVP administration as compared with those in group placebo, before operation and after protamine infusion in group DDAVP (P

Researches show that exosome can take park in the development and progression of breast cancer by means of mediating the intercellular communication,which can promote cancer metastasis and drug resistance,thus influencing the treatment effect of patients with cancers.Exosome is closely related with clinical stage and prognosis of breast cancer,which has a potential value in the early diagnosis and biological therapy of breast cancer and provides a new hope for the treatment of breast cancer.

Aim To study the phytoestrogenic effect and its mechanism of isopsoralen in estrogen receptor (ER) positive T47D and ER negative MDA-MB231 breast cancer cell line.Methods The proliferation rate and cell cycle distribution of T47D and MDA-MB231 cells influenced by isopsoralen were analyzed by MTT and flow cytometry assay respectively.PS2 mRNA level in T47D cells was quantified by Real-time RT-PCR assay.PS2 expression was measured by flow cytometry.Estrogen receptor antagonist ICI180,782 was employed as a tool.Results The proliferation rates and indexes of T47D cells treated with 1?10-6 mol?L-1 and 1?10-7 mol?L-1 isopsoralen were increased.These effects could be blocked by ICI182,780.Meanwhile,isopsoralen didn't show stimulative effects on proliferation rate of MDA-MB231 cells.Real-time RT-PCR and flow cytometry results showed that isopsoralen at 1?10-6 mol?L-1 and 1?10-7 mol?L-1 could induce elevation of pS2 mRNA and protein expression level in T47D cells.These effects could be partly blocked by ICI182,780.Conclusion Isopsoralen has phytoestrogenic effect and its effect is attained mainly via ER pathway.

Objective To investigate the value of ischemia modified albumin (IMA) detection in preliminary diagnosis of acute myocardial infarction (AMI).Methods The levels and variations of IMA,cTnI and CK-MB in 103 patients with acute chest pain were measured continuously at 0,4,6,12,24 hours after admission respectively.Thirty healthy subjects were observed as normal controls.Results Twenty three patients were diagnosed as AMI in the end,the sensitivity and specificity rates right after admission were 89.3％ and91.3％ for IMA,48.4％ and 92.3％ for CK-MB,30.6％ and 93.7％ for cTnI respectively.The sensitivity values at the 6th hours after admission were 91.3％ for IMA,52.2％ for CTnI and 34.8％ for CK-MB respectively.The specificity was 100.0％ when the IMA was detected in combination with CK-MB or cTnI.The sensitivity of co-detection was significantly higher than that any single detection at sixth hours after admission (x2 =15.99,P ＜ 0.01 ).Conclusion Plasma IMA assessment is helpful for early diagnosis of AMI,and will significantly improve the sensitivity early diagnosis of AMI.The co-detection of IMA and CK-MB or cTnI obviously surpasses any single detection,and has extremely vital clinical significance.

BACKGROUND:Restenosis after angioplasty severely limited the application and long-period therapeutic effects of percutaneous coronary intervention. Changes in smooth muscle cel phenotype and their proliferation are important mechanisms of restenosis after angioplasty.
OBJECTIVE:To use bal oon in vivo transduction of osteopontin short hairpin RNA (OPN-shRNA), to inhibit osteopontin expression at the injured blood vessels of a rabbit model of experimental atherosclerosis, and to prevent restenosis after angioplasty.
METHODS:A total of 20 rabbit models of atherosclerosis were established and randomly equal y assigned to empty plasmid group and OPN-shRNA plasmid group. The plasmid recombinant OPN-shRNA and empty plasmid were transferred to the ventral aorta by bal oon.
RESULTS AND CONCLUSION:After bal oon dilatation, specific green fluorescence was detected in the layer of vascular smooth muscle in the two groups. Moreover, with prolonged time of transfection, fluorescence intensity gradual y decreased. Compared with the empty plasmid group, the expanded artery lumen area obviously increased in the OPN-shRNA plasmid group, and plaque burden evidently reduced. Results indicated that bal oon catheter used in regional blood vessels in rabbit models of atherosclerosis could successful y transduce OPN-shRNA plasmid. The restenosis of the expanded blood vessels lessened, and thrombus burden relieved. It is of great importance to prevent the occurrence of restenosis after angioplasty in rabbit models.

Objective:To observe and analyze the clinical characteristics and correlation between the eye and nervous system in children with infantile gangliosideosis.Methods:From November 2018 to January 2021, 3 children with infantile ganglion lipidosis diagnosed by genetic examination in the Department of Ophthalmology and Neurology, Beijing Children's Hospital of Capital Medical University, and through China National Knowledge Infrastructure and Wanfang database and The National Library of Medicine of the United States (PubMed) were searched, and 53 cases of Chinese infantile gangliosideosis diagnosed by gene, enzyme activity or pathological examination were selected and a total of 56 cases were included in the study. The searching time was from the establishment of the database to February 2021, and the search keywords are"gangliosideosis", "cherry-spot" macula and "Chinese". The demographic characteristics of 56 cases of children and other system manifestations were analyzed such as eyes, nervous system, skin, bones. According to the presence or absence of cherry-spot (CS) on the fundus examination, the children were divided into a fundus CS group (group A) and a fundus without CS group (group B), with 20 and 27 cases, respectively. The age of onset, gender, different types and neurological manifestations of the two groups of children were compared and analyzed. The non-parametric rank sum test was used for age comparison between groups; the χ2 test or Fisher's exact test were used for the comparison of gender, disease type and incidence between groups. Results:Among the 56 children, 27 were males and 29 were females; the median age of onset was 7.0 months. There were 33 and 23 cases of GM1 and GM2, respectively. Among 44 children with visual function examination records, 41 cases (93.2%, 41/44) were unable to follow the visual object. Of 47 children who underwent ocular fundus examination, 20 cases (42.6%, 20/47) had CS on the fundus. The main manifestations of the nervous system are neuromotor development regression or retardation (100%, 56/56), convulsions (58.1%, 25/43), and "startle" phenomena (89.7%, 26/29). Among 42 patients with brain magnetic resonance imaging examination records, 39 cases (92.9%) were abnormal. The incidence of "startle" and seizures in group A was higher than that in group B, and the difference was statistically significant ( χ2=5.815, 6.182, P=0.021, 0.013). Conclusios:Chinese infantile gangliosideosis is more common in GM1 type. Ocular visual impairment is the visual object as the main manifestation, the incidence of fundus CS is 42.6%, and the symptoms of neurological damage in children with CS are more severe.

Objective To discuss the value of ischemia modified albumin (IMA) in the early diagnosis of acute coronary syndrome (ACS). Methods The IMA,cTnI, CK-MB and ECG were detected in 103 patients with suspected ACS (45 cases of NICP and 58 cases of ACS) within 5 hours of acute chest pain onset respectively. 30 healthy subjects were served as normal controls. Receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS from non-ischemic individuals (nonischemic chest pain, NICP). Results of IMA,cTnI,CK-MB and ECG were correlated with the final diagnosis and their diagnostic sensitivities for ACS were evaluated. Results The results suggested that acute phase IMA values between those with ACS and NICP were (89.66 ± 25.82) U/ml, (46.79 ± 17.20) U/ml respectively and showed significant difference. Area under the curve (AUC) of the ROC was 0.935. As the Cut-off point was 71.6 U/ml, the sensitivity, specificity, PPV and NPV of IMA were 90.6%, 71.4% , 82.8% and 83.3%, respectively. The simutanious positive rate of IMA for ischemia origin were 29.3% of cTnI,27.6% of CK-MB and 48.3% of ECG(P＜ 0.01). Conclusions Plasma IMA assessment is valuable for early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity of ACS significantly.

Objective To observe the features of the full field electroretinogram (FF-ERG) in type 1 diabetes (T1D) children without diabetic retinopathy (DR).Methods Retrospective case study.Forty-one T1D children and 25 age-matched normal controls underwent a complete ophthalmic examination,including best-corrected visual acuity,refraction,intraocular pressure,slit lamp,fundus photography,indirect ophthalmoscopy,and spectral domain optical coherence tomography to exclude DR.All FF-ERG tests were performed by an experienced technician.The ERG series includes six protocols:dark-adapted 0.01 ERG (r-b 0.01);dark-adapted 3 ERG (mix-a 3.0,mix-b 3.0);dark-adapted 10 ERG (mix-a 10.0,mix-b 10.0);dark-adapted oscillatory potentials (OPS);light-adapted 3 ERG (c-a 3.0,c-b 3.0);light-adapted 30 Hz flicker (30 Hz FP) ERG.To compare the amplitudes and implicit times of the FF-ERG between the T1D and control group children.Results Compared with the control subjects,the FF-ERG amplitudes decreased and the implicit times increased in T1D.Except for r-b 0.01 (t =-0.228,P＞0.05),the amplitudes of other FF-ERGs were all significantly attenuated (t =-1.664,-3.645,-4.324,-6.123,-5.846,-12.9,-14.4,-5.23;P＜0.05) in T1D children.The implicit times of mix-b 3.0,mix-b 10.0,c-b 3.0 and OP2 significantly increased (t=5.242,2.879,5.378,3.506;P＜0.05).The implicit times of r-b 0.01,mix-a 3.0,mix-a 10.0,c-a 3.0 and 30Hz FP changes were not significantly (t=2.331,1.677,0.557,0.84,0.064;P ＞ 0.05).Conclusion The FF-ERG amplitudes decreased and implicit times increased in T1D children compared with the control normal subjects.

This study was aimed to explore the relationship between the Shen-Gui-Fang(SGF) formula of different proportions and treatments for diseases with the method of bibliometrics. A total of 49 formulae of SGF from ancient books of traditional Chinese medicine (TCM) were retrieved and the database was established in order to analyze the origin of herbal medicine and the relationship with the ratio of the key medicinal material, as well as the treatment for major diseases. The results showed that 49 SGF formulae were mainly used in the treatment of internal disorders for 16 times (32.65%), gynecological disorders for 17 times (34.69%) and pediatric disorders for 8 times (16.32%). Guistanded forAngelica sinensis. There were 3 types ofShen, which werePanax ginsengfor 40 times,Codonopsis pilosulafor 8 times, andSophora flavescensfor 1 time. The ratio betweenP. ginsengandA. sinensiswas less or equal to 1. The ratio betweenC. pilosulaandA. sinensiswas usually more than 1. The formulae with the highest frequency were in the treatment of internal medicine and gynecological diseases. Statistical analysis was used to find the application features and rules of the combination ofP. ginsengandA. sinensisin SGF formula, in order to provide theoretical evidences and references for clinical medication selection and new medication research.