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As the efficacies of chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC) have reached a plateau, the molecularly targeted therapy becomes a new method to improve curative effects.The molecular targeted drugs include epidermal growth factor receptor inhibitors, anti-angiogenesis drugs, etc.As one of the representative drugs of EGFR inhibitors, Gefitinib, has a low clinical benefit index.Erlotinib, the first EGFRTK inhibitor, can enhance the survival of patients, and may serve as a potential choice for the first-line treatment of advanced NSCLC.Bevacizumab combined with chemotherapy has shown a favorable clinical effect in the first-line treatment, and it is also the first anti-angiogenesis drug approved by the FDA that can be used in cancer treatment.These drugs, together with clinical and experimental progress in many other targeted drugs, have shown a favorable prospect for targeted drugs in the treatment of advanced non-small cell lung cancer.

Objective To observe the expression of DR5 in the ocular tissues of uveitis rats induced by endotoxin,and study the relationship between the apoptosis of inflammatory cells and expression of TRAIL / DR5.Methods SD rats were randomly divided into 3 groups:Blank control group,normal saline injection group and endotoxin injection group.The endotoxin injection group was injected with lipopolysaccharide into the rat posterior foot pad to make endotoxin-induced uveitis animal model.There were no operations in the blank control group,and the subgroups were divided into 6 hours,12 hours,24 hours and 48 hours groups according to the time of injection.The ultrastructural changes of inflammatory cells and endothelial cells in iris capillaries were observed by transmission electron microscopy (TEM).The expression of DtR5 protein on inflammatory cells at different time after endotoxin induction was detected by SABC method.Results TEM showed that the microvilli of the capillary endothelial cells in the iris tissue of the blank control group and saline injection group had more obvious vesicles with no obvious abnormal structure and shape.The number of swallowed vesicles in the capillary endothelial cells injected with endotoxin was decreased at 6 hours group,and the number of vesicles in the infiltrating neutrophils and lymphocytes decreased.Neutrophils and lymphocytes appear chromatin condensation,vacuolar changes in the expression of apoptosis.Immunohistochemistry showed that the DR5 protein was negative in the iridocular epithelium of the blank control group and saline injection group.In the endotoxin injection group,the DR5 protein was weakly colored in the iris pigment epithelium and appeared on the inflammatory cells.The number of staining and the intensity of coloring in the 24 hours group were significantly higher than those in the 6 hours group,and the color density was 0.085 9 ± 0.019 6,there were statistical differences compared with 6 hours group,12 hours group and 48 hours group (all P ＜ 0.05).Conclusion TRAIL and its receptor DR5 may be involved in the apoptosis of inflammatory cells in endotoxin-induced uveitis.

OBJECTIVETo provide quantitative foundation for the diagnosis of atlanto-axial rotatory subluxation by analyzing the various imaging features of normal atlanto-axial joints in neutral position and rotary functional position on the MSCT images.

METHODSForty-one normal volunteers were examined by CT on the atlanto-axial joint in neutral position and rotary functional position. By the observation and measurement of atlanto-dental interval (ADI), lateral atlanta-dental space (LADS), VBLADS and rotating angle of atlas on dentate (RAAD), the imaging manifestations and anatomical characteristics were analyzed and compared. In order to compare VBLADS and RAAD and make a correlation analysis between different age groups, 51 normal volunteers were divided into two groups: age younger than 45 years old group and age older than or equal to 45 years old group.

RESULTSThe dens in neutral position deviated in an angle range of (3.22±0.89)°. The articular facets of lateral atlantoaxial joint in rotary functional position had rotatory displacement and the range of the relative rotation angle was (33.85± 2.79)°. Through the correlation analysis of matching data, it could be concluded that there was no correlation between atlantoaxial relative rotation angle and VBLADS within a certain range. There were statistically differences of atlantoaxial relative rotation angle in rotary functional position between two groups.

CONCLUSIONMSCT imaging in rotary functional position can clearly show the anatomical structure and rotation function of a normal atlanto-axial joint, so as to provide a theoretical basis for the diagnosis of atlanto axial rotatory subluxation.

Adult ; Aged ; Atlanto-Axial Joint ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; methods ; Rotation

Objective To investigate the distribution and drug resistance situation of clinical isolated bacteria in our hospital to provide the basis for rational selection of antibacterial drugs in clinic .Methods The pathogenic bacteria isolated from the clinical sepcimens in our hospital from January 2012 to December 2013 were performed the idenitification and drug susceptibility test by a‐dopting the the bioMerieux VITEK‐2 compact automatic bacterial analyzer .The detection results were judged according to the standard of the Clinical and Laboratory Standard Institute (CLSI) .The WHONET5 .6 software was used for conducting the statisti‐cal analysis .Results 2 274 strains were isolated during 2012-2013 ,in which 1986 strains (72 .4% ) were Gram‐negative bacteria , 675 strains(24 .6% )were Gram‐positive bacteria and 94 ccases(3 .0 % ) were fungi .The top 3 of Gram‐negative bacteria were Esch‐erichia coli(694 strains ,25 .3% ) ,Klebsiella pneumoniae (303 strains ,11 .0% ) and Pseudomonas aeruginosa (266 strains ,9 .7 % ) respectivley .The top 3 of Gram‐‐positive bacteria were Staphylococcus aureus (184 strians ,.6 .7% ) ,coagulase negative staphylococ‐cus(146 strains ,5 .3% )and enterococcus faecium (119 strians ,4 .3% ) .The respiratory tract infection ,urinary tract infection and blood infection were predominant .The detection rate of methicillin‐resistant Staphylococcus aureus (MRSA) was 45 .7% ,while which of methicillin‐resistant coagulase negative Staphylococcus (MRCNS) was 84 .6% .MRSA showed the multiple resistance to fluoroquinolones and aminoglycosides antibcatieral drugs ,the resistance rate> 90 .00% ,but resistance rate macrolide antibiotic was<50 .0% ;no vancomycin‐and linezolid‐resistant Staphylococcus was found ;the resistance rate of enterococcus faecium to vancomy‐cin was 1 .7% and no linezolid‐resistant enterococcus faecium was detected .The detection rates of extended‐spectrum β‐lactamase‐producing K .pneumoniae and E .coli were 65 .2% and 39 .9% respectively ,and which of E .coli and K .pneumoniae to imipenem were 0% and 6 .3% respectively .The resistance rate of Acinetobacter baumannii to commonly used antibacterial drugs was more than 50% .The resistant rate of pseudomonas aeruginosa to common antipseudomonal drugs was <40 .0% .Conclusion The drug resistance phenomena of pathogenic bacteria isolated from our hospital is relatively universal ,especially multi‐drug resistant non‐fer‐mentative bacteria ;the enzyme‐producing mechanism leads to increase the detection rate of multi‐antibacterial resistant Enterobacte‐riaceae bacteria ,which causes the enormous difficulty for clinical anti‐infection therapy .Conducting the bacterial drug‐resistance mo‐nitoring has an important significance for guiding clinically rational drug use ,reducing the nosocomial infection rate and controlling the bacterial drug resistance .

Objective To study the procoagulant activity of microparticles (MP) in patients with acute in-tracerebral hemorrhage (ICH) and to evaluate the correlation between procoagulant activity of MPs and disease out-come. Method From August 2006 through August 2008, 83 consecutive patients with history of hypertension ad-mitted for spontaneous basal ganglia hemorrhage including 54 male and 29 female, aged (60.9±9.7) years ranged from 41 to 79 years, were enrolled into this study. The control group was consisted of 30 age- and sex-matched (P= 0.429; P = 0.415) patients admitted for mild soft tissue injury. Patients with history of head trauma or previ-ous stroke, under the antiplatelet or anticoagulant medication, severe infection, or presence of previous cerebrovas-cttlar disease were excluded. Venous blood sample was kaken within the first 24 hours after disease onset. The MPs procoaulant potential was measured with a prothrombinase assay, and the levels of IL-6,TNF-α, D-dimer (DD)and thrombin-antithrombin Ⅲ complex (TAT) in plasma were measured with enzyme-linked immunosorbent assay. The multivariate analysis was made with forward stepwise logistic regression to determined the predictors of one. month mortality. The plasma levels of MPs were compared between ICH group and control group, between patients with intraventricular hemorrhage (IVH) and those without IVH,and between survivors and non-survivors with the Mann-Whitney U-test. The Spearman' s rank correlation coefficient was used to analyze the correlations between the plasma levels of MPs and ICH volume, Glasgow coma scale (GCS), and plasma levels of IL-6, TNF-α, DD and TAT. A receiver operating characteristic curve (ROC curve) identified the plasma MPs cutoff levels that predicted one-month mortality of patients. Under ROC curve, z statistic analysis was used to compare the area under curves (AUCs) between plasma IMPs and Glasgow coma scale, ICH volumes, and plasma levels of IL-6, TNF-α, DD and TAT for one-month mortality. Results Thirty-six patients (43.4%) died of ICH in a month. The multivariate analyses sorted out the GCS (odds ratio = 0.558, 95%CI:0.367-0.850, P = 0.007), Hematoma volume (odds ratio= 1.061, 95%C1:1.012- 1.113, P = 0.015) and IVH (odds ratio= 5.537, 95%CI:1.035-29.629, P = 0.045) as the independent pcedictors for one-week mortality. The MPs procoagulant activity in the ICH group (6.72±3.26 U/mL) was significantly higher than that in control group (1.84±0.82) U/mL (P = 0.000). The IMPs procoagulant activity in the non-survival group (8.51±3.45) U/mL was significantly higher than that in the survival group (5.35±2.33) U/mL (P = 0.000). The MPs procoagulant activity in the IVH group (7.66±3.39) U/mL was significantly higher than that in the non-lVH group (5.36±2.53) U/mL (P = 0.001). The MPs procoagulant activity was highly associated with GCS scores (r = -0.690, P = 0.000), ICH volumes (r =0.590, P = 0.000), and plasma IL-6 (r = 0.465, P = 0.015), TNF-α (r = 0.464, P = 0.016), DD(r= 0.567, P = 0.001) and TAT(r = 0.469, P = 0.014) in ICH. The ROC curve identified cutoff levels of MPs procoagulant activity to be 7.47 U/mL that predicted one-month mortality of patients with high sensitivity (77.8%) and specificity values (76.6%). Areas under curves (AUCs) of MPs procoagulant activity (AUC =0.825±0.048) were significantly larger than those of plasma IL-6 (AUC = 0.685±0.060, P = 0.042), TNF-α(AUC = 0.681±0.060, P =0.036) and TAT (AUC = 0.644±0.062, P =0.008).The AUCs ofMPs procoag-ulant activity were larger than those of plasma DD (AUC = 0.743±0.056), but this difference was not statistical significance (p = 0.226). Conclusions The procoagulant activity of MPs may contribute to the pathophysiology of ICH. The propcoagulant activity of MPs after spontaneous onset of ICH seems to correlate with clinical outcome in these patients. Its procoagulant activity can be used as an useful clinical marker for evaluating the prognosis of ICH.

Bone Marrow Examination ; Chediak-Higashi Syndrome ; complications ; diagnosis ; pathology ; Cough ; etiology ; Diagnosis, Differential ; Fatal Outcome ; Female ; Fever ; etiology ; Humans ; Infant ; Leukocytes ; pathology

Objective To summarize the experiences on clinical application of flexible cystoscopy,and evaluate the significance of applying flexible cystoscopy in urologists' daily practice.Methods A total of 379 patients underwent examination with flexible cystoscopy,of them 74 patients were with the aim of therapy or related operation.The operation time was counted and the patients' discomfortableness was recorded according to a visual analog scale(VAS).What's more,a satisfaction questionnaire was made by no doctor presenting to check the patients' response to cystoscopy operation.36 male patients were undergone both rigid and flexible cystoscopy operation.The statistical significance of the differences was analyzed after reading the VAS scores and the results of questionnaires were evaluated.Results 223 patients were found to have relative diseases by the examination of flexible cystoscopy.The mean operation time in using flexible cystoscopy was 7.8?0.27 minutes.The median pain scores of male and female patients were 2.9 and 1.3,respectively.The maximum pain was felt by male patients when the cystoscopy went through the membran of urethra.Satisfactory rate in male patients was 99%,and it was 100% when evaluating the questionnaires answered by female patients.For the 36 male patients undergone both rigid and flexible cystoscopy operation,the median pain score was 2.1(0.5-4.5) for flexible cystoscopy,and was 5.7(1.0-10.0) for rigid cystoscopy.After flexible cystoscopy examination,all the 36 patients were satisfied by the operation.However,only 61.1%(22/36) patients were satisfied by the rigid cystoscopy operation.Statistical analysis showed significant difference(P

OBJECTIVE To look into and analyze the application of antibacterial used in our hospital in order to enhance the rationality of clinical usage. METHODS We conducted the survey by means of picking out examples in numbers within a definite range,looking back at the records with regard to it from Jan 2004 to Dec 2004. RESULTS Altogether there were 5 302 medical records.The percentage of using antibacterial was 70.24%,from which 45.22-36.68% were used two kinds and 8.54% were used more than two kinds.As to the basis,preventive use taken up a large proportion,accounted for 48.93%;the main route was by intravenous injection,which added up to 74.03%.Of the antibacterials applied,the first three were penicillins;aminoglycosides;cephalosporins.The percentage for surgical application was 94.49%,from them 57.14% used 2 or more kinds for treatment of incision of type Ⅰ. CONCLUSIONS It is very necessary and urgent to supervise the management of the rational application of antibacterial.

Objective To discuss the clinical efficacy of point-injection with nerve growth factor (NGF) in treatment of infantile cerebral palsy.Methods According to the time order,50 cases with cerebral palsy were randomly divided into the treatment group(30 cases) and the control group (20 cases).Both groups were given the conventional treatment of Bobath mainly exercise therapy,homework therapy and the language therapy.In addition,the treatment group was given the treatment of point-injection with NGF.Gesell scale was used to evaluate all the patients before and after treatment.Results After treatment,the Gesell evaluation of the treatment group was higher than control group,and the difference was statistically significant (t =-2.096,-2.187,-2.048,-2.053,-2.225,all P ＜0.05).Conclusion On the basis of rehabilitation training,point-injection with NGF could improve intelligence,motor function and language in children with cerebral palsy,and the efficacy was obvious.