As we know a poor prognosis is seen in locally advanced NSCLC treated with surgery, there have some consistencies and controversies found in a number of surgical studies. Consistency: Incomplete resection of tumor and central T3 tumor have poor 5-yr survival, T3 with N, has a worse long-term survival rate than with N0. Mediastinal lymph node metastasis N2 is known as the most important prognostic factor in stage Ⅲ NSCLC, multiple node stations, location and extra-capsular nodal extension of tumor are unfavorable prognostic indicatiors. Preoperative induction chemotherapy may improve the complete resection and survival of stage M NSCLC, but more multicenter randomized studies are needed to be further study. T4, N, Mb NSCLC are known as having quite a poor prognosis and low resectability. Controversy: Clinical image staging is a noninvasive method to look for intrathoracic lymph node, but it is not as accurate as mediastinoscopy. Post-operative radiotherapy has a lower relapse rate but no benefit to survival. Pre-operative radiotherapy of pancoast tumor has a higher complication rate. 30% of intrathoracic nodes have skip N2 metastasis, thus, careful dissection of all the nodes stations and sample it sent to pathology is necessary. Pneumonectomy is not beneficial to the survival of pN2. Carinaectomy is not suitable for those patients with N1, N2. Malignant pleural effusion is basically a nonsurgical disease.

As the largest microbial community in human body,gut microbiota is involved in many important physiological processes,and gut microbiota dysbiosis is associated with various diseases in humans.Due to the interaction and mutual effect between the liver and the gastrointestinal tract,gut microbiota plays an important role in the development and progression of hepatobiliary diseases.Metagenomic studies can achieve a comprehensive understanding of the features of gut microbiota and its effect on human health and diseases.This article introduces the research advances in the changes of gut microbiota among patients with nonalcoholic fatty liver disease,liver cirrhosis,hepatocellular carcinoma,and autoimmune liver diseases and related mechanisms of action.

With the progression of chemotherapy (CT)and radiotherapy (RT), multidisciplinary measures in surgical treatment of lung cancer has become a hot subject for research. The chairman of ASCO, Dr. Bunn, pointed out that all kinds of cancers should be treated with multidisciplinary methods. Neoadjuvant chemotherapy is standard for care of Ⅲa N 2 NSCLC in Europe and U.S.A., but a large randomized trial was needed to confirm this hypothesis. At the 2003 ASCO meeting, Dr. Le Chevalier reported the result of the randomized international adjuvant lung cancer trial for 1867 resected NSCLC. 2 and 5 yr survival rates, progression free survival (PFS) were superior for the adjuvant CT group. Shanghai Lung Cancer Team studied 211 cases of rescected NSCLC with multi variant cox analyses. The result shows post operation chemotherapy might be beneficial to survival. Besides, in the cases with ≥3 cycles of post operation CT have better survival rates than less cycles. Patients with stage Ⅲa NSCLC and clinical or pathologically confirmed N 2 nodes (pN 2) have a poor prognosis after surgery of RT. Surgical resection after induction CT or CT/RT yields encouraging results in phase Ⅱ trials, but its role is controversial. Dr. Albain reported 429 cases of resectable Ⅲa (pN 2)NSCLC divided into CT/RT/S and CT/RT groups. CT/RT followed by surgery yields superior MST, 3-year survival rates and PFS, but there were more non cancer deaths in CT/RT/S group. The benefit reported could prevent annually-7,000 deaths worldwide.

Objective:To explore the risk factors and clinical features of post ischemic stroke seizure in order to direct clinical intervention,optimal treatment and improve prognosis.Methods:There were 47 patients with post ischemic stroke seizure,50 ischemic stroke patients without secondary seizure.The clinical data of them were reviewed.Multivariate stepwise logistic model analysis was made after univariate analysis.Results:Univariate analysis showed that lesion location,ischemic stroke subtype,NIHSS were associated with the development of seizures after ischemic stroke.Multivariate logistic regression analysis showed that cardioembolic infarction,cortical location,high NIHSS were independent risk factors for seizures after ischemic stroke.Conclusion:Post ischemic stroke patients who have cardioembolic infarction,cortical location,high NIHSS are likely to develop seizures.

Malignant mesothelioma is an aggressive malig na ncy that may be caused by environmental carcinogens(asbestos),viruses(SV40),and genetic predisposition.Diagnosis relies on radiographic studies as well as patho logy and mdecular bidogy tests.Most such patients are not suitable for surgical or radiotherapy treatment,and cytotoxic agents are the only options.Historically ,no single or combinations of agents consistently yielded response rates over 20 %.Recently,pemetrexed,a folate-based inhibitor of thymidylate synthase,has been evaluated in phase Ⅰ,ⅡandⅢ clinical trials with promising results.Moreover, low-dose folic acid and vitamin B 12 supplementation significantly reduced the toxicity observed with the use of pemetrexed.In light of these data,it is l ikely that pemetrexed/cisplatin will soon be recommended for malignant pleural m esothelioma as first-line standard chemotherapy.

Objective To discuss the clinical distribution and antibiotic resistance of 1909 strains of Pseudomonas aeruginosa(PA)to 19 antibiotics.Methods To collect and isolate clinical specimens from Jan to Dec in 2007,and analysis the drug resistance of 1909 stains of PA.Results The top three departments of infection rnte are Senior Officials inpatient Ward(38.9%),Neurology Department(28.1%)and Pneumology Department(19.58%).The drug with the highest level of antibiotic resistance is Trimethoprin/Sulfa(96.3%),the second one is Tetracycline(95.3%),and drugs with low level antibiotic resistance are imipenem(39.8%),Ceftazidime(29%),Piperacillin/Tazobactam(28%),amikacin(14%),respectively.Conclusion PA is a main pathogenic bacteria for bedridden patients and critically ill patients in ICU.It's important to choose antibiotics reasonably,and it's necessary to acontrol the path of hospital-acquired infection.

Nonalcoholic fatty liver(NAFL)is characterized by the hepatocyte steatosis and lipid accumulation,and is a clinical syndrome of unrelated to excessive alcohol consumption. At present,patients with the syndrome obviously increase in the whole world. Sterol regulatory element-binding proteins (SREBPs) are the key transcription factors of controlling the biosynthesis of cholesterol,fatty acids and triglycerides,and adipocyte differentiation. In this paper,the regulation of SREBPs and its research progress in the development of NAFL were reviewed.