With the development of molecular biology of cancer,molecular targeted therapy which tar-geted the driver genes in lung cancer has become an inevitable part of the treatment of advanced lung cancer. The most successful examples of targeted therapy are targeting epidermal growth factor receptor (EGFR)and anaplastic lymphoma kinase (ALK).More and more driver genes have been discovered,including ROS1 gene fusion,fibroblast growth factor receptor 1 amplification,KRAS,BRAF,PIK3CA gene mutation and so on.It is meaningful for guiding the treatment of lung cancer that defines the mutation incidence and clinical significance of driver genes in lung cancer.

BACKGROUND: The total knee replacement is considered as one of the most effective and successful operations to cure terminal or severe gonarthritis. How to lower the revision rate as well as increace the effect of prostheses after the knee replacement should be solved urgently.OBJECTIVE: To retrospectively analyse the clinical applications and curative effects of different knee prostheses.DESIGN: Based on patients who accepted knee replacement, preoperative and postoperative condition was observed and compared so as to compare the postoperative effect of different types of knee prostheses replacements.SETTING: Department of Orthopedics, General Hospital of Chinese PLA.PARTICIPANTS: A total of 398 patients (523 knees) were selected from the Department of Orthopedics, General Hospital of Chinese PLA from January 2002 to January 2005, including 276 unilateral knee replacements (276 knees) and 122 bilateral knee replacements (244 knees). Patients were respectively diagnosed as osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis (AS), pigmented villonodular synovitis (PVNS), etc.METHODS: According to the pathogenetic condition, patients received total knee replacements with different knee prostheses. Types of knee prostheses: ① According to the replacing range, it could be divided into unicondylar prostheses and total condylar prostheses; total condylar prostheses could be subdivided into posterior cruciate ligament (PCL)-retaining and PCL-substituting prostheses. ②According to the degree of mechanical constraint, it could be divided into unconstrained, semiconstrained or fully constrained prostheses. ③ According to whether imitating meniscus-function, it could be divided into tibial plateau rotatable sliding type and fixed type. Follow-up was conducted on patients that mentioned above after half a year. Knee joints were scored by using knee joint scoring system of American special surgical hospital (HSS scoring with the total score of 100 points, those above 85 were considered as excellent; 70-84 as good;60-69 as fair; below 60 as poor). Feller scoring (total score of 30 points; the higher the points were, the better the symptom was) criteria was used in patellar scoring. Investigation and comparison on pain-degree of anterior region of knee,range of motion of knee joint and the stabilization were done during the follow-up, ap and lateral views of patella from 30 degrees and 90 degrees were taken in radiography.MAIN OUTCOME MEASURES: Preoperative and postoperative scores of HSS, patella, anterior pain of knee, function of patella, the maximum flexion and tibiofemoral angle.RESULTS: Follow-up was conducted in 372 patients (490 knees) with the follow-up rate of 93.4%. ①Therapeutic effect:Excellent and good rate of the operation was 89%. Pain and function of patients after operation were obviously ameliorated, effect on pain-amelioration and range of motion of knee joint activation were significant. ② Score of HSS, patellar,anterior pain of knee, function of patellar and the maximum flexion were markedly increased than those before operation (P ＜ 0.01). ③ There were no marked significances in comparison of score of HSS, patellar, anterior pain of knee, function of patellar, the maximum flexion and tibiofemoral angle on different knee prostheses replacements (P ＞ 0.05).CONCLUTION: Prostheses should be chosen carefully and appropriately according to the indications, contraindications,anticipated attainable functions, service life as well as pathogenetic conditions, and then satisfactory curative effect will accordingly be achieved.

Molecular targeted therapy plays an important role in the treatment of gastrointestinal cancer.In recent years,a large number of targeted drugs have been developed and tested in clinical trials to verify their efficacy and security.The better efficacy and security of targeted drugs represented by monoclonal antibodies and tyrosine kinase inhibitors have been demonstrated in each phase of clinical trials.

AIMTo explore the changes of mRNA and protein expressions of heart-type fatty acid binding protein (H-FABP) in rat ischemic myocardium at different intervals ischemia.

METHODS60 SD male rats weighing 250-350 g, were randomly divided into one sham-operated group and five study groups (group A1, A2, A3, A4, A5, the left coronary artery of rats has been ligated for 1 h, 2 h, 4 h, 6 h, 12 h respectively). Myocardil samples from infarct zone, ischemic and non-ischemic zone, were obtained for histology examination, and the mRNA for H-FABP in ischemic myocardial tissue were determined by RT-PCR. Serum free fatty acid(FFA) was determined by colorimetric method.

RESULTSCompared to sham hearts, H-FABP mRNA expression were significantly decreased in ischemia zone of AMI rat hearts (P < 0.05), especially in rats underwent 4 h ischemia and 6 h ischemia (P < 0.01). Serum FFA were significantly increased in AMI rats relative to sham rats (P < 0.05).

CONCLUSIONSignificant down-regulated heart-type fatty acid binding protein after myocardial ischemia might play an important role in myocardial injury and energy metabolism disorder.

Animals ; Down-Regulation ; Fatty Acid-Binding Proteins ; genetics ; metabolism ; Male ; Myocardial Infarction ; metabolism ; Myocytes, Cardiac ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVE To explore the advantage of exposure recurrent laryngeal nerve in thyroidectomy. METHODS Exposure the recurrent laryngeal nerve was performed deliberately in 452 cases during thyroidectomy. The larynx was examined with laryngoscope before and after operation. RESULTS Of the 452 cases with 748 exposed recurrent laryngeal nerve, only 14 cases (1.88%) occurred temporary recurrent laryngeal nerve palsy, and 2 cases (0.27%) occurred permanent recurrent laryngeal nerve palsy. CONCLUSION Exposure the recurrent laryngeal nerve during thyroidectomy can protect the nerve from surgery injury.

Purpose To study the clinical features,pathological manifestation and immunohistochemical phenotype and improve the diagnosis and treatment of myoepithelial carcinoma in salivary glands.Methods Histomorphology and immunohistochemical phenotype were analyzed after the sections were stained with routine HE and immunohistochemical methods,and the relevant literatures were reviewed.Results The tumours were predominantly composed of pale-stained clear cells.In some cases,plasma-like cells,epithelioid cells and spindle cells were also seen.The cells were arranged in nest,solid or cords.Mitosis was easily seen,cytological atypia was obvious and necrosis existed in 4 cases.The results of immunohistochemical staining showed that CK was expressed in all cases.EMA was expressed in 8 cases.p63 and CK5/6 were expressed in 11 cases.S-100 was expressed in 10 cases.vimentin was expressed in 4 cases.Calponin was expressed in 2 cases.SMA was expressed in one case.The proliferation index of Ki-67 was 5％ to 40％.Conclusion The histological changes of myoepithelial carcinoma cells are diverse,and pathological and immunohistochemical methods are helpful for improving the rate of right diagnosis.Sugery is the main treatment for myoepithelial carcinoma.

A case of a 69-year-old female patient, with cough, expectoration, chest tightness and shortness of breath for 10 days accompanied by left pleural effusion, was reported. Initially, a large number of suspected malignant lymphoma cells were found in the patient′s pleural effusion through routine cell morphological examination after admission, which was the direction of clinical diagnosis and treatment in the next step. Then the patient was diagnosed as primary pulmonary diffuse large B-cell lymphoma (DLBCL) through imaging, bone marrow and lung biopsy pathology. Finally, the patient was treated effectively with R-CHOP regimen, but she died of respiratory failure 9 weeks later, because she did not receive regular follow-up and treatment after the sixth chemotherapy cycle. Primary pulmonary DLBCL, an extremely rare extranodal lymphoma' lacks specificity clinical manifestations and is easy to be missed and misdiagnosed. DLBCL with a large number of malignant pleural effusion progresses rapidly and has a poor prognosis. The routine cell morphology examination of pleural effusion is simple and intuitive, which can capture key information in the shortest time, preliminarily provide clinical diagnosis and treatment ideas, and provide accurate basis for disease diagnosis.

BACKGROUND:Calcium phosphate(CaP)coatings are widely used to improve the integration of titanium implants into bone but these coatings are associated with risks of infection.It is thus desirable to confer antibacterial properties to CaP coatings. OBJECTIVE:To prepare CaP-MgO composite coatings by impregnating magnesium oxide(MgO)sol into CaP coatings and assess the in vitro antibacterial activities and cytocompatibility. METHODS:An electrolyte was determined by titration and used for CaP coating electrodeposition on titanium(referred to as Ti-CaP).MgO was impregnated into the coating by immersing in an MgO sol with different mass fractions(15%,30%,50%)and subsequently calcined to form MgO-CaP composite coatings,which were recorded as Ti-CaP-15Mg,Ti-CaP-30Mg and Ti-CaP-50Mg,respectively.Microstructure,tensile properties,critical load,and Mg2+ release of coatings in vitro were characterized.Antibacterial activity was assayed using spread plate method by culturing S.aureus on the pure titanium sheet surface and Ti-CaP,Ti-Cap-15mg,Ti-Cap-30mg and Ti-Cap-50mg surfaces for 24 and 48 hours.Mouse osteoblast suspension was inoculated on pure titanium sheets and Ti-CaP,Ti-CaP-15Mg,Ti-CaP-30Mg and Ti-CaP-50Mg coated titanium sheets,respectively.Cell proliferation was detected by CCK-8 assay,and cell survival rate was calculated.The morphology of composite coating soaked in DMEM was also observed. RESULTS AND CONCLUSION:(1)Homogeneous,microporous CaP coatings consisting of octacaclium phosphate crystal flakes were prepared on titanium by electrodeposition.After sol impregnation-calcination,MgO aggregates were filled into the inter-flake voids.The extent of MgO filling and Mg concentration in the coating increased with the number of sol impregnation procedures.When immersed in phosphate buffered saline,all composite coatings actively released Mg2+ within 1 day;subsequently,the Mg2+ release slowed down on day 3.A small amount of Mg2+ release was still detected on day 7.The yield strength,tensile strength and fracture growth rate of Ti-CaP-30Mg coated titanium were not significantly different from those of pure titanium(P>0.05).There was no significant difference in the critical load of Ti-CaP,Ti-CaP-15Mg,Ti-CaP-30Mg and Ti-CaP-50Mg groups(P>0.05).(2)Except that pure titanium sheet and Ti-CaP had no antibacterial properties,the other samples had good antibacterial properties,and the antibacterial rate increased with the increase of MgO content in the coating.(3)After 1 and 3 days of co-culture,the cell survival rate of Ti-CaP-15Mg,Ti-CaP-30Mg and Ti-CaP-50Mg groups was lower than that of pure titanium group and Ti-CaP group(P<0.05).After 5 and 7 days of culture,there was no significant difference in cell survival rate among five groups(P>0.05).The content of MgO in the coating decreased gradually with the time of immersion in the medium.(4)The MgO sol impregnation added antibacterial properties to the CaP coatings while retained their biocompatibility.

【Objective】 To analyze the HIV-, HCV- and HBV- NAT yield rate in different areas of Henan province, so as to provide the basis for disease prevention and control as well as the establishment of a unified quality control standard for nucleic acid testing(NAT) in the Henan province. 【Methods】 The number and prevalence of NAT yielding samples with isolated infectious virus, namely HIV, HCV and HBV, in 18 blood stations in Henan province from 2017~2019, as well as the trends were analyzed. The NAT quality of each laboratory and each testing system was analyzed according to the ratio of reactive individual donation(ID) results to reactive minipools(MP). 【Results】 The HBV, HCV and HIV ID-NAT yield numbers in 3 501 251 blood donations were HBV 2 606(74/100 000), HCV 21 (0.63/100 000), and HIV 34(1.00/100 000). The HBV ID-NAT yield rate showed an upward trend in the whole province from 2017 to 2019, while the prevalence of HIV and HCV ID-NAT yield didn′t differ significantly during three years. 5 kinds of NAT detection systems were applied in 18 blood centers. among which Ⅰ, Ⅱ, Ⅳ and Ⅴ were triplex detection systems. 2661 ID-reactive samples were implicated in 5 595 MP-reactive samples, with a resolution rate of 47.56%. The resolution rate of triplex NAT system Ⅰ, Ⅱ, Ⅳ and Ⅳ was 39.63%~47.95%, 40.43%~54.36%, 51.61% and 70.00%~45.45%, respectively. An upward trend in triplex NAT resolution rate was observed in 8 laboratories, i. e.B, D, E, F, I, K, L and Q, and an descending trend in A and C. The NAT system Ⅲ, a ID-NAT system, was used only by laboratory C, presenting a NAT-yield rate of 0.19% (282/145 474) and resolution rate of 46.45% (131/282). 【Conclusion】 The majority of NAT-yield of one infectious virus in Henan province is HBV, presenting annual increasing trend. The quality management of NAT laboratories should be strengthened as the divergence was seen in the performance of different NAT laboratories.

【Objective】 To analyze the cause of single-ELISA reactive of four blood screening items in 18 blood stations in Henan, so as to provide the basis for improving the quality of blood screening. 【Methods】 The single-ELISA reactive rate of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP of 18 blood station laboratories in Henan throughout 2019 was calculated, and the causes were analyzed according to different ELISA reagent combinations and gray area settings in each laboratory. 【Results】 The overall single-ELISA reactive rates of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP were 1.740(2 154/1 237 789), 0.564‰(698/1 237 789), 1.421‰(1 759/1 237 789) and 1.561‰(1 932/1 237 789), respectively, showing significant differences by detection items (P <0.05). Person correlation analysis showed that the single-ELISA reactive rate was independent of the gray area settings.but dependent on laboratories and reagent combinations. The single-ELISA reactive rate of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP in D laboratory was the highest and higher than that in other labs using the same reagent.The laboratories with high HBsAg single-ELISA reactive rate were mostly those using a combination of imported reagents and domestic reagents, including the top 6 laboratories. The laboratories with high anti-HCV single-ELISA reactive rate were mostly those using certain domestic reagents. No obvious rules was noticed by single-ELISA reactive for anti-HIV. Laboratories with high anti-TP single-ELISA reactive rate were mostly those using combination 4. 【Conclusion】 The HBsAg single-ELISA reactive rate was the highest in the four blood screening items of blood station laboratories in Henan. The single-ELISA reactive rate is related to the laboratory itself and the reagent manufacturer, suggesting that laboratory quality control should be strengthened and proper reagent combination should be selected to reduce the waste of blood.