Thoracic radiotherapy is an important means of local treatment for non -small cell lung cancer (NSCLC).Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs)have the effect of systemic therapy.Studies have shown that NSCLC patients with EGFR exons 19,21 mutation have a synergistic effect in the combination therapy .Radiotherapy activates EGFR signaling pathway ,inducing cell proliferation and DNA damage repair,leading to radiation resistance .Therefore,EGFR-TKIs have the effect in increasing radiosensitivity .Lung injury is one of the most common side effects when the two therapies combined .Studies suggest that radiotherapy combined with EGFR-TKIs may have conflicting functions in the development of pulmonary fibrosis ,the discrep-ancy between these studies may depend on the differences in the experimental systems ,the differences in pulmo-nary fibrosis models,as well as the differences between different species and individuals .Therefore,a more com-plete understanding of the etiology for pulmonary fibrosis is necessary to the development of improved treatments .

Objective To evaluate the causes,prevention and treatment of mesh infection after abdominal wall hernia mesh repair.Methods The clinical data of 14 mesh infections admitted from De-cember 1997 to December 2013 were analyzed retrospectively.There were one case of inguinal hernia with Lichtenstein repair,eleven cases of inguinal hernia with preperitoneal repair,one case of incisional hernia with Bard Composix Mesh and 1 case of parastomal hernia with mesh repair above the abdominal muscle. Based on prothetic materials and infection status,the infection meshes were removed in 4 cases and open dressing change were operated in 10 cases.Results All patients were healed and discharged without peri-operative death.There was no hemorrhage and bladder injury during the procedures.The time of dressing change ranged from 3 weeks to 6 months,with a median of 4 weeks.All patients were followed up for 8 to 64 months.One patient had a recurrence of abdominal incisional hernia.Conclusion There are many fac-tors related to mesh infection after mesh repair and preventing mesh infection is the most important.Once the infection occurs,the management should be individualized.Antibiotic treatment and surgical drainage can be effective in most polypropylene mesh(PPM)infection However,infected expanded polytetrafluoro-ethylene(ePTFE)mesh should be removed completely.

Radiation therapy is one of the main therapeutic means of thoracic malignant tumors .When re-ceived certain radiation ,lung may cause the common complication of chest tumor radiotherapy -Radiation -in-duced Lung Injury ( RILI) ,which restricts the radiation dose for the tumor region and may affect patient outcomes . RILI is closely associated with multiple cytokines ,such as interleukin family,tumor necrosis factor,transforming growth factor,etc.Currently,research on RILI control methods has also made some breakthrough ,this article elab-orates on this individually .

Digitalization is an important method for the objectification and quantification of quality control on Chi-nese herbal medicine. To solve the problem of texture online visualization of Chinese herbal medicine and the estab-lishment of automatic identification method based on the texture, 12 Chinese herbal medicines were selected to cap-ture the images of their transverse sections. A total of 11 features were extracted from images using Gray-level Co-occurrence Matrix (GLCM) method. Through analyzing the influence of distances and angles between pixels on identi-fication results, it was concluded that when the distance was d = 3 and the angle was ? = 0o, the features extracted were suitable for expressing the texture of the transverse sections. The results indicated the feasibility of establishing the automatic identification method on Chinese herbal medicine based on image of transverse section. It will provide new technologies for the objectification and quantification of identification on Chinese herbal medicine.

Objective To explore the relationships between the sleep/wake-up patterns and temperament in preterm infants.Methods The developmental characteristics of sleep/wake-up patterns and temperament in preterm infants aged 4 months at corrected gestational age in their own home environments were described.The 23 relatively low-risk preterm infants were enrolled in this study.The sleep/wake-up data was collected with actigraphy.The temperament was assessed by Chinese Infant Temperament Questionnaire.Results Among the 23 infants,there were 13 coordinated difficult(D) type and 10 coordinated easy(E) type.The number of night wake-up in the coordinated D-type preterm infants[(2.78 ±0.01) times] were significantly more than that of coordinated E-type ones[(2.60 ± 0.03) times] (t =3.285,P =0.001).The longest continuous sleep time of coordinated D-type preterm infants [(4.20 ± 1.21) h] was significantly less than that of coordinated E-type ones[(4.41 ± 1.14) h] (t =3.374,P =0.001).There were no significant differences in daytime sleep duration,the number of naps,bedtime,sleep latency,nighttime sleep duration,the 24 hour sleep duration and morning awaking time between the two groups (all P ＞ 0.05).After the sex factor was controlled,there was a positive correlation between emotional nature and sleep latency at night (r =0.599,P =0.032).There was also positive correlation between persistence and the number of naps in daytime (r =0.439,P =0.035).Conclusions Preterm infants with different temperament types have different number of night wake-ups and the longest continuous sleep time.The emotional nature and persistence are associated with sleep latency at night and number of naps in daytime respectively.The parents of preterm infants should change their child rearing behaviors to improve sleep quality of the preterm infants.

ObjectiveTo study the mechanism of differentiation of mesenchymal stem cells(MSCs) into neuron-like cells in vitro.MethodsMSCs of Wistar rats were separated and cultured, and then induced with DMSO and BHA in vitro. The specific marking proteins of neurons, glia and neural stem cells were detected before preinduction, at 24h after preinduction, at 6h, 24h, and 48h after neuronal induction.ResultsAfter the inducement, many MSCs turned into bipolar,multipolar and taper,and then intersected as network structure. Nestin was strong positive at 6h after neuronal induction, and decreased at 24h, 48h after the induction. NeuN was present at 6 h after neuronal induction, and increased at 24h, 48h after the induction.ConclusionMSCs can be induced into neural stem cells(NSCs) at first, and then differentiate into neuron-like cells in vitro.

Objective To evaluate the quality of life(QOL)of postpartum women within six months after delivery in Pudong New Area in Shanghai.Methods From January 1st to June 30th in 2011,435 postpartum women,discharged from Children and Women's Health Care Hospital in Pudong New Area,Gaoqiao Community Health Service Center and Lujiazui Community Health Service Center in Pudong New Area,were investigated by SF 36 questionaire including eight items [physical functioning (PF),role limitations due to physical problems (RP),bodily pain (BP),general health (GH),vitality (VT),social functioning (SF),role limitations due to emotional problems (RE) and mental health (MH)] and divided into three subgroups according to the duration after delivery (8-42,43-119 and 120 180 d).The SF-36 scores were compared with the control (baseline data of 25 to 36-year-old young women in Pudong New Area) or within the three groups.Statistical methods,such as t-test and analysis of variance,were applied.Results (1) The tota lscore and the scores of the seven items in SF-36 were lower than those of control (total score:74.2±11.7 vs 80.5,PF:79.0±19.0 vs 94.6,RP:47.5±12.2 vs 85.7,BP:74.0±18.7 vs 78.4,GH:73.9±13.1 vs 71.0,VT:69.8±16.2 vs 75.0,SF:78.3±20.1 vs 86.9,RE:63.4±21.7 vs 83.5,t=-11.225,-17.105,-18.914,-4.893,3.688,-6.642,-8.881 and-10.076,all P＜0.05) and no significant difference was found in MH score between the postpartum women and the control (78.3±15.0 vs 77.8,t=0.629,P＞0.05).Compared the SF-36 scores in three subgroups (8 42,43-119 and 120 180 d postpartum),the differences on PF score(73.0±19.1,86.3± 17.1,89.1±12.9),RP score(32.4±18.6,57.7±19.1,79.9±12.0),BP score(70.7±18.0,75.6±19.0,81.6±17.3),SF score(76.3±19.6,78.2±21.7,83.9±19.3),RE score(58.5±12.9,71.4± 18.3,70.1± 19.5) and SF-36 total score (72.2± 11.1,76.1± 12.8,78.0± 11.1) were all significant (F=37.744,60.640,13.137,5.185,4.577 and 10.548,allP＜0.05).The PF,VT,RE and total score of postpartum women at 120-180 days after delivery were still lower than those of the control group(t=-4.174,-2.353,-3.341 and-2.166,all P＜0.05).Conclusions The QOL of postpartum women within six months after delivery is not good enough.Up to 120-180 days after delivery,the QOL remains.More efforts should be made to improve the QOL of postpartum women by the whole society.

Objective To investigate the clinical features of neuromyelitis optica (NMO) and NMO spectrum disorders (NMOSD) with primary Sj(o)gren' s syndrome (pSS).Methods Eleven inpatients diagnosed as NMO secondary to pSS in Peking Union Medical College Hospital were retrospectively analyzed.Results Eleven patients of pSS with NMO were enrolled in this study,including 10 females and 1 male.The mean age was(35 ± 15)years old.The course of disease ranged from one month to 16 years,with a median of 10 months.The interval between optic nerve and spinal cord involvement was 3 months to 2 years.Eight patients had NMOSD as initial presentations of pSS.Eight patients had history of optic neuropathy.The most frequently involved spinal segment was cervical cord (10 cases) shown by magnetic resonance.Serum NMO-IgG antibodies were tested in 7 patients and 6 of them were positive.Conclusion NMOSD may present as an important and initial clinical manifestation of pSS,which suggesting the involvement of central nervous system.Autoimmune antibodies,NMO-IgG and imaging were supposed to be done for further evaluation of prognosis and therapy regimens.

Objective To explore the function of infliximab in inducing remission in Crohn's disease and the effect of the inducing remission were followed up. Methods Ten patients with Crohn's disease received a infliximab, 5-aminosalicylic acid (5-ASA) and Azathioprine (AZA) therapy for inducing and maintenance remission. Crohn' s disease activity index (CDAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alanine aminotransferase (ALT), apartate aminotransferase, (AST), total bilirubin (TBil), conjugated bilirubin, (CB), creatinine (Scr) were evaluated at week 0, 10, 22 and 50. Simple endoscopic score for Crohn's disease (SES-CD) were evaluated at week 0, 10 and 50. Adverse reactions were also evaluated. Results At week 10, all patients achieved remission. The indicators of CDAI, CRP, ESR and SES-CD were significantly declined than those at week 0 (P＜0.01). The follow-up was terminated in one patient due to the relapse at week 30. At week 50, the indicators of CDAI, CRP, ESR and SES-CD in six patients a little bit increased compared with those at week 10, but no statistic significant (P=0. 2001、0. 0600、0. 1328、0. 4230 respectively), but significantly declined compared with those at week 0 (P =0.0005、0.0087、0.0054、0. 0163 respectively). No severe adverse reaction was observed in all patients.Conclusions Infliximab showed an exact efficacy in inducing remission in Crohn's disease. And 5-ASA and AZA were effective for maintenance remission in part of the patients after infliximab induced remission.

OBJECTIVETo explore the Chinese medicine syndrome type distribution in patients with polycystic ovary syndrome (PCOS) and its relationship with sexual hormones.

METHODSChinese medicine syndrome types of 212 PCOS patients were differentiated and sorted by adopting fuzzy mean C clustering method, and their relationship with the indices of sexual hormones detected on the 3rd to 5th day of menstrual cycle was analyzed, with the values got from 20 healthy women for controls.

RESULTSIntermingling syndromes were commonly seen in PCOS patients. Shen-deficiency syndrome (presented in 64 patients) and Gan-qi stagnancy syndrome (61 patients) were the dominance, accounting for 30.2% and 28.8% respectively, significantly higher than that of other syndromes (P < 0.05), which were Pi-deficiency syndrome (41 patients, 19.3%), phlegm-dampness syndrome (33 patients, 15.6%) and blood stasis syndrome (13 patients, 6.1%). Levels of estradiol (E2), testosterone (T), luteinzing hormone (LH), dehydroiso-androsterone (DHEA-S) and prolactin (PRL) were higher, while the level of sexual hormone binding protein (SHBG) was lower in PCOS patients than those in control, follicular stimulating hormone (FSH) level in patients of Shen-deficiency syndrome and phlegm-dampness syndrome was high than that in control (P < 0.05 and P < 0.01). However, no significant differences were found in comparing the various sexual endocrinal indices between patients with different syndrome types (P > 0.05). Besides, the level of PRL was positively correlated with LH and E2 levels in patients.

CONCLUSIONChinese medicine syndromes presented in patients with PCOS are mostly intermingling, Shen-deficiency and Gan-stagnancy are the basic syndromes, and there is some correlation between syndrome type and sexual hormone levels.

Adolescent ; Adult ; Diagnosis, Differential ; Estradiol ; blood ; Female ; Humans ; Luteinizing Hormone ; blood ; Medicine, Chinese Traditional ; Polycystic Ovary Syndrome ; blood ; diagnosis ; Young Adult