With the development of the main tumor gene sequencing projects,driver mutations have been put into the highlight due to its significant meaning on the cancer occurrence,development as well as treatment.In the past decade,based on the finding of new driver mutations,the knowledge of non-small cell lung cancer (NSCLC) have been improved from the traditional pathological classification to the current molecular classification.Meanwhile,NSCLC patients are no longer looked as an assembly of the same type tumor but various individuals with different molecular biology behavior with the different sensitivity to the targeted drugs.This article focuses on the recent discovery advances of driver mutations in lung adenocarcinoma.

Asthenia in origin and asthenia in superficiality is the pathogenesis of dermatomyositis,deficiency of yang qi is the interior etiopathogenisis and the invasion of exogenous evil is the exterior etiopathogenisis.The treatment principles of dermatomyositis are strengthening healthy qi to eliminate pathogens and treating both manifestation and root cause of disease.The course includes acute stage,paracmasis and recovery stage.Based on syndrome differentiation,different treatment principles are used in clinic and achieve significant therapeutic effect.

Objective To investigate the relationship between plasma anti-β2-glycoprotein I (anti-β2-GP I )and cardiovascular disease (CVD) in systemic lupus erythematosus (SLE).Methods Eighty-onepatients with SLE [the mean age was (45±18) years old,among whom 73 were female and 8 were male] and20 controls [the mean age was (43±17) years old,among whom 14 were female,and 6 were male] wereenrolled.Plasma anti-β2-GP I was measured by ELLSA.The relationship between plasma anti-β2-GP I level and CVD in SLE patients was investigated with Logistic regression model.T-test,x2 test,Spearman's correlations and Logistic regression analysis were used for statistical analysis.Results Mean plasma anti-β2-GP I increased significantly in SLE group compared to control group [ (29± 19) vs (14±8) U/ml,t=2.035,P＜0.05].The plasma levels of anti-β2-GP I were higher in SLE patients with CVD than those without [(41±25)vs (18±12) U/ml,t=2.038,P＜0.05].Plasma anti-β2-GP I level was positively correlated with triglyceride (r=0.337,P＜0.05) and renal lesions (r=0.489,P＜0.01 ).Plasma anti-B2-GP [ level was negatively correlated with high density lipoproteins (r=-0.385,P＜0.05 ) and complement (r=-0.497,P＜0.05 ) level.Logistic regression analysis showed that plasma anti-β2-GP I (β=0.675,95％CI0.5070.816,P＜0.05) was an independent risk factor for CVD in SLE patients.Conclusion The level of plasma anti-β2-GP I in SLE patients with CVD is high,and it may play a role in the pathogenesis and progression of CVD in SLE patients.

Effective leadership is crucial for health organizations' performance and numerous western universities thus offer leadership courses or modules to their students.However,such education practice has not started in China.In order to optimize knowledge and skills of health service management practitioners,to content with requirements of health service organizations,to cope with dynamic organization environment,to implement health reform successfully and to realized sustainable development of health organizations,it is necessary to provide leadership course for students of health service management at Chinese universities.

Objective To investigate the characteristic, diagnosis and treatment of occult breast carcinoma(OBC). Methods The clinical data of 12 cases of OBC were analyzed retrospectively.Results All patients showed axillary node enlargement as the first sign and were operated on. The operation included axillary node excision (ANE) in 1 patient, axillary node excision plus simple mastectomy in another one, radical mastectomy in 6, and modified radical mastectomy in the other 4,respectively. Eleven patients (91.7%) were followed up for 1-15 years. During the follow up, 1 patient who underwent axillary node resection and 1 who received ANE plus simple mastectomy died of systemic metastasis,18 and 22 months after operation respectively;another case who subjected to radical mastectomy had axillary lymph node metastasis 3 years after the operation,and was re operated on,but the patient died of lung metastasis 4 years after the reoperation. And the others still survived, in which 2 have lived for over 3 years, 2 over 5 years, and 4 over 10 years. Conclusions For axillary mass which causes are uncertain, the possibility of OBC should be considered.Meanwhile excision and pathological examination are necessary. The metastatic histological structure of the axillary nodes usually provide important clue for the source of tumor. Radical or modified mastectomy is the best treatment,and post operative chemotherapy and/or radiotherapy should be done.

AIM: To investigate the effects of different phacoemulsification incision for tear film stability in cataract patients.
METHODS: From January 2014 to September 2015, 108 patients (144 eyes) who underwent cataract surgery were divided into two groups: group A with clear corneal incision ( 52 cases with 74 eyes), group B with scleral tunnel incision (56 cases with 70 eye). Two groups of patients were taken the same incision width. Symptoms of dry eye and tear film break - up time ( BUT) were observed 1d before and 1d, 1, 3wk, 1 and 3mo postoperatively.
RESULTS:After performing cataract phacoemulsification 1d, 1wk, symptoms score of dry eye of group A was less than that of group B, the difference was statistically significant (t = -6. 199, -2. 871, P<0. 01), while at other times after operation there were no significant differences ( t = - 1. 639, - 0. 829, - 0. 301, P >0. 05); at postoperative 1d, 1 and 3wk, BUT of group B was better than those of group A, there were a statistically significant differences ( t = - 3. 718, -2. 342,-2. 506, P<0. 05), there were no significant differences at other the time after operation (t= -0. 882,1. 225, P>0. 05).CONCLUSION: The difference on effect of two different incision on the tear film stability only last a short time, which disappeared at 1mo after operation. The clear corneal incision has stronger impacts on tear film stability than scleral tunnel incision, while with a lower score on symptoms of dry eye.

Objective To compare the effect of different general anesthesia method on preoperation cognitive function in elderly patients.Methods According to the digital table,82 elderly patients(non cardiac surgical operation) were selected and divided into the two groups,each group 41 cases.The group A was given to sufentanil combined with propofol intravenous injection anesthesia,and the group B was given to sevoflurane inhalation anesthesia.The cognitive function of patients of two groups in preoperative,postoperative 3h,6h,24h were assessed by simple intelligence scale(MMSE),and the indicators of postoperative recovery were evaluated.Results The postoperative sleep time [(6.9 ± 1.2) min],language ability recovery time [(9.8 ± 2.2) min] in the group A were all higher than those of group B (t =6.687,5.640,all P ＜ 0.01).The MMSE scores in group A after 3h [(17.1 ± 2.2) points],6h [(19.6 ±2.7)points],24h[(22.4 ±2.3) points] were lower than those of group B(t =10.026,6.229,5.082,all P＜0.01).And the PCOD rate in group A after 24h was 36.6％,which was higher than 17.1％ in group B(x2 =3.98,P ＜ 0.05).Conclusion The inhalational anesthetic methods has more quickly postoperative recovery,lower incidence of cognitive dysfunction,better clinical effects.

Objective To explore the morbidity and clinical characteristics of knee osteoarthritis (OA) complicated with metabolic syndrome (MS).Methods Four hundred and ten patients with knee OA were enrolled into this survey.The subjects were divided into two groups:those with knee OA only:those with both OA and MS.Clinical data in the two groups were evaluated.Results The prevalence of MS was 40.2％ in all knee OA patients,there was significant difference between the two groups according to the ratio of male to female (x2=5.853,P=0.001),but no difference between the two groups according to age distribution respectively (P＞0.05).For metabolic parameters,waist circumference,triglyceride (TG),low density lipoprotein cholesterol (LDL-C),systolic blood pressure and glycosylated hemoglobin (HbA1c) were significantly increased in the group with both of the two diseases (OA and MS),comparing with those with knee OA only (t=3.123,4.679,2.818,3.697,2.632,2.907,P＜0.05).However,there was no difference in both group in serum total cholesterol (TC),high density lipoprotein cholesterol (HDL-C) and fasting plasma glucose level (P＞0.05).Incidence of coronary heart disease,diabetes mellitus and hypertension was higher in the group with both OA and MS than that in knee OA only group (x2=6.676 and 104.12,P＜0.05).The incidence of diabetes mellitus was not different between the two groups (P＞0.05).Conclusion The incidence of metabolic syndrome in knee OA patients is relatively high.Effective treatment should be invited to treat knee OA with MS.

The Componential Framework of Creativity,advanced by Amabile,one of significant figures on the social psychology of creativity,comprehensively interpreted the nature and the construct components of creativity.Inspiring by the ideology of Amabile's Componential Framework of Creativity,this study examined whether the science research human resource management practices in today's Chinese science research institutions follow the nature of science research and whether the policy and operation inhibit creativity.It identified the common misconducts happened in human resource selection,development and performance management,and the causes and countermeasures of those misconducts were also explored.The findings will be a source of reference for human resource management practitioners at the science research field of China.

Objective To observe the hemodynamic parameters of retrobulbar vessels of eyes with primary open-angle glaucoma (POAG) by using color Doppler imaging (CDI) technique.Methods Pertinent publications were retrieved from the PubMed of The National Library of Medicine,the ISI Web of Knowledge of The Institute for Scientific Information,and Cochrane Central Register of Controlled Trials.Case control studies involved POAG patients were included.Changes in retrobulbar blood flow parameters including peak systolic velocity (PSV),end diastolic velocity (EDV) and resistive index (RI) of the ophthalmic artery (OA),central retinal artery (CRA) and short posterior ciliary artery (SPCA) were evaluated by CDI.The searching time was from the data base established up to April,2014.Meta analysis was used on the included articles,the mean difference (MD) along with 95 ％ confidence interval (95 ％ CI) of the blood flow parameters were calculated.Results Twenty-four articles were retrieved,including 1336 eyes as cases,1102 eyes as controls.PSV of POAG eyes was statistically signiflcantly lower than controls in theOA (MD=-3.05,95％CI:-4.49--1.61,P＜0.001),CRA (MD=-1.66,95％CI:-1.95--1.38,P＜0.001),SPCA (MD=-0.87,95％ CI:-1.49--0.26,P=0.005).EDV of POAG eyes was statistically significantly reduced than controls in the OA (MD=-1.78,95％CI:-2.14--1.41,P＜0.001),CRA (MD=-0.95,95％CI:-1.17--0.74,P＜0.001),SPCA (MD=-0.53,95％CI:--0.71--0.36,P＜0.001).Statistically significant increases in RI of POAG eyes than controls in the OA (MD=0.04,95％CI:0.03-0.05,P＜0.001),CRA (MD=0.06,95％CI:0.05-0.07,P＜0.001),SPCA (MD=0.04,95％CI:0.03-0.06,P＜0.001).Conclusion This meta-analysis suggests that significant decreased velocity and increased resistance of retrobulbar blood flow are found in POAG eyes.