Epidermalgrowthfactorreceptor-tyrosinekinaseinhibitor(EGFR-TKI)resistanceinnon-small cell lung cancer(NSCLC)has become more and more common,which includes primary and secondary resistance.The primary resistance is mainly related with EGFR gene mutation,and the secondary resistant is mainly related with T790M,MET and other genes.

Objective To compare the clinical characteristics in primary hyperparathyroidism of different pathologic types through retrospective analysis of 280 cases diagnosed in PUMCH during 1958 to 2005.Methods Totally 280 patients were diagnosed as PHPT biochemically and proved by pathology.Serum PTH,TCa,P,25(OH)D,TRAP,plasma ICa,24 h urinary Ca and HOP were measured.Results M/F ratio was higher in carcinoma group(P

Objective Target-controlIed-infusion(TCI) system makes administration of intravenous anesthetics simpler, more accurate and adjustable. Bispectral index (BIS) is generally accepted as a measurement of depth of sedation and anesthesia. The aim of this study was to evaluate the usefulness of BIS as a feedback control in propofol anesthesia with TCI for patients undergoing laparoscopic cholecystectomy. Methods Forty ASA Ⅰ - Ⅱ patients (12 male, 28 female) aged between 20-70 yr were randomly allocated to one of two groups of twenty each: feedback TCI group and TCI group. In feedback TCI group, BIS value of 50 was set as the control variable. A bolus of 3 ?g?kg-1 fentanyl was given Ⅳ 3 min before induction. The target concentration of propofol was set at 3 ?g?ml-1 throughout anesthesia. Real time BIS, the highest and lowest systolic and diastolic pressure during operation, doses of adjunctive drugs, time for emergence and orientation, awareness during operation and the standardized unit dose of propofol were recorded and compared between groups. Results Total dose of propofol was statistically lower in the feedback TCI group than that in TCI group(P

Conventional diagnostic methods used for pathologic nipple discharge (PND) include color ultrasound, mammary mo-lybdenum target X-ray radiography (mammography), nipple cytologic smears, and ductography. Diagnosis of PND through inspection yields indirect signs and has low positive rate. Fiberoptic ductoscopy (FDS) allows direct visualization of intra-ductal lesions, evaluates etiology of PND, and accurately locates intraductal lesions through wire marking. FDS is a valuable test for the early diagnosis of breast cancer and can help identify appropriate location for surgical excision. Interventional treatment for ductal ectasia and inflamma-tion is also efficient. Our study discusses FDS as a novel diagnosis and treatment method for PND patients.

Diabetes mellitus increases the risk of breast cancer and affects the prognosis of breast cancer patients. Metformin, an anti-diabetic drug, decreases blood glucose level and has a role in suppressing various cancers. In addition, metformin has a unique in-hibitory effect on breast cancer, i.e., it can inhibit breast cancer cells in vivo and in vitro. Moreover, metformin exerts its anti-tumor ef-fect on epidermal growth factor receptor 2 (HER-2) positive and monoclonal antibody trastuzumab-resistant breast cancer cell lines, breast cancer stem cells, and triple negative breast cancer cells. Metformin can reduce the risk of the breast cancer in patients with dia-betes, lower histologic grade, and increase expression of estrogen and progesterone receptors. Furthermore, metformin has certain effect on neo-adjuvant chemotherapy for breast cancer. This review aims to clarify the mechanism of metformin in restraining breast cancer based on basic and clinical study results.

Objective To evaluate the influence of preoperative quitting time on coronary artery bypass grafting (CABG) patients with postoperative hypoxemia incidence.Methods 151 patients with coronary bypass surgery and preoperative history of smoking who preparation of CABG in hospital were recruited from September 2011 to September 2013.According to the preoperative smoking cessation time patients were divided into five groups:0 days,1-30 days,31-60 days,61-90 days,more than 90 days.Single factor regression and Logistic analysis were used to analyse the influence of preoperative quitting time on CABG patients with postoperative hypoxemia incidence.Results Age,weight,smoking habit,quitting time,hypertension,diabetes mellitus were risk factors of hypoxemia after coronary artery bypass grafting.Logistic regression analysis showed that age,body weight,smoking habit,smoking time were independent risk factors of hypoxemia after coronary artery bypass grafting.The incidences of hypoxemia of the five groups 0 days,1-30 days,31-60 days,61-90 days and more than 90 days were 55.56％ (15/27),59.26％ (16/27),27.58％ (8/29),22.73％ (5/22),15.63％ (5/32).The incidence of hypoxemia had significant difference (x2=19.212,P ＜ 0.05).Conclusions Age,weight,smoking habit,quitting time were independent risk factors of hypoxemia after CABG.With the quitting time increase,hypoxemia after CABG overall downward trend.Difference quitting time before the operation,the hypoxemia occurred difference rate influence,On the preoperative smoking CABG patients were smoking cessation intervention timely helps to reduce the occurrence of postoperative hypoxemia.

Objective To provide theoretic base by studying the nature and characteristic of infrared ther- mograph in lower limbs area of the healthy young man.Methods Collecting infrared thermograph in lower limbs ar- ea by TIP medical infrared thermograpb instrument (TIP,made in USA) ,the average temperature of each unit area of both lower limbs was measured.Results (1) The average temperature of each corresponding unit area in both side of lower limbs was adjacent (P＜0.05 ).(2) The temperature of both lower limbs (especial front and back side) distributinged in some rule.Conclusion The study provided parameter and characteristic of infrared therrnograph for clinical diagnosis and guideline of rehabilitation therapy by infrared thermograph instrument.

Objective To provide an observational baseline by studying the nature and characteristics of in- frared thermograms of the spine area of the healthy young men.Methods Infrared thermograms of the spine area were collected using a TIP medical infrared thermograph.The average temperature of each unit area in the middle and on the two sides of the spine was measured.Results (1)Except certain unit areas in the cervical thorax and lum- bar sacral segments,the average temperature of each unit area in the middle of the spine was significantly higher than on the two sides.In the middle of the spine,the average temperature of the cervical thorax and lumbar sacral seg- ments was insignificantly higher than adjacent areas.The shape of the infrared thermograms of the cervical thorax and lumbar sacral segments resembled a triangle and a rhomboid,respectively.Conclusion The study provided para- meters and characteristics of infrared thermograms for clinical diagnosis and guidelines for rehabilitation therapy using an infrared thermograph.

Objective To investigate the difference of surgical efficacy between extended lymph node dissection and standard lymph node dissection in laparoscopic radical cystectomy.Methods We retrospectively analyzed 62 bladder cancer cases,icluding 52 males and 10 females patients in our hospital from January 2011 to October 2016,who underwent laparoscopic radical cystectomy and pelvic lymph node dissection.Their mean age was (62.5 ± 9.6) years,ranged from 42 to 83 years.27 cases were underwent extended lymph node dissection and 35 cases were underwent standard lymph node dissection respectively.The basic characters,operative time,intraoperative blood loss,intraoperative and postoperative complications,postoperative eating time,postoperative activity time,postoperative hospital stay,lymph nodes positive rate,lymph node density,and cancer-free survival were evaluated.Results All patients were underwent successful operation.There was no significant difference in operation time [(326.2 ± 77.5) min vs.(345.5 ± 66.8) min,P =0.297],blood loss [(198.2 ± 77.5) ml vs.(213.7 ± 160.0) ml,P =0.590],intraoperative complications (0/27 vs.5/35,F =0.063),postoperative complications (8/27 and 9/35,P =0.732),postoperative eating time[(4.8 ±2.2)d vs.(4.6 ± 1.9)d,P =0.817],postoperative activity time[(1.9 ± 0.8) d vs.(1.9 ± 0.9) d,P =0.838] and postoperative hospital stay[(15.6 ± 7.5) d vs.(16.0 ± 5.9)d,P =0.483].In this study,994 lymph nodes and 100 positive lymph nodes were dissected.There were significant differences in the number of lymph nodes dissected in the two groups (23.2 ±6.6 vs.10.5 ±3.6,P ＜0.01).40.74％ (11/27) of cases in ePLND were lymph node positive and the lymph node density was 11.7％ (73/626),which was higher than that of the sPLND group (28.57％ vs.7.34％,respectively).In regard to prognosis,the cancer-free survival rate (DFS) of ePLND group was 96％,91％,80％ and 71％ at 3,6,12 and 24 months follow-up respectively.The other group was 97％ 94％,84％,80％ correspondingly.And no significant difference was detected (P =0.546).Although there was no significant difference (P ＞ 0.05),DFS of ePLND group tended to be higher than that of sPLND group in lymph node positive subgroups.Conclusions Extended lymph node dissection and standard lymph node dissection have similar surgical safety and prognosis,and appropriate surgical procedures should be selected according to the patient's condition.

Objective:To extract, separate and identify the flavonoids in Humulus Scandens and detect their cytotoxic effect on cells HepG2. Methods: After Humulus scandens bing was extracted by alcohol, luteolin-7-O-β-D-glucoside ( LGL) and cosmoiin ( AGL) were obtained by using column chromatography and identified by spectral analysis. The inhibitory effects of LGL and AGL on HepG2 cells were detected by a typan blue dye method. Results:The main flavonoids in Humulus Scandens were LGL and AGL. When the concentration of LGL and AGL was increased from 6. 25 μmol·L-1 to 100. 0 μmol·L-1 , the inhibition rate of LGL was increased from 28. 8% to 95. 2% and that of AGL was increased from 3. 6% to 21. 3%. Conclusion: LGL has notable inhibitory effect on HepG2 cells in a dose-dependent manner, while the inhibitory effect of AGL is not obvious.