Objective To study the analysis of non-small cell lung cancer patients with multiple brain metastases with erlotinib combined with whole brain radiation therapy clinical observation and effect of C on vascular endothelial growth factor level. Methods 40 cases of non - small cell lung cancer patients with multiple brain metastases treated in Taizhou tumor hospital from January 2015 to April 2016 were selected and randomly divided into the control group and the experimental group, with 20 patients in each group. The control group and the experimental group patients were given clinical treatment of whole brain radiotherapy, the control group was given routine treatment, the experimental group received erlotinib. The clinical effects of the 2 groups were compared and analyzed. Results After the corresponding treatment, the experimental group of 20 patients, 8 cases of complete remission, 7 cases of partial remission, the number of effective treatment for 15 cases, the treatment rate was 75.0％. Of the patients in the control group, 6patients had complete remission, and 4 patients had partial remission. The effective rate was 50％. Available, the effective rate of the treatment group (75.0％) was significantly higher than that of the control group (50.0％), with statistical difference (P<0.05). The survival rate of the experimental group after one year (80.0％) was significantly higher than that of the control group (60.0％), with statistical difference (P<0.05). The level of vascular endothelial growth factor (C) in the experimental group was significantly lower than that in the control group (P<0.05). Conclusion Non small cell lung cancer patients with multiple brain metastases with erlotinib combined with radiotherapy in the clinical treatment effect of whole brain is better, can improve the survival rate in a large extent, improve the endothelial growth factor C levels, with the further promotion of the clinical significance.

Objective To analyze and discuss the clinical effect of sequential radiotherapy and chemotherapy in 40 patients with advanced gastric cancer after operation.Methods 80 postoperative gastric cancer patients who received sequential radiotherapy and chemotherapy in our hospital were prospectively analyzed.According to the order of admission,80 patients were divided into two groups,40 cases of the control group(chemotherapy)and 40 cases of the observation group(sequential chemotherapy).The clinical effects of the two groups were compared.Results In the observation group,1 year survival rate and 2-year survival rate(77.50%,47.50%)were higher than those in the control group(50.00%,25.00%),there were statistically significant differences between the two groups(x2=19.20,32.65,all P<0.05).The incidence rate of adverse reactions of the control group was 12.50%,which was lower than 30.00% of the observation group,there was statistically significant difference between the two groups(x2=9.15,P<0.05).The mortality rate of the observation group was 32.50%,which was lower than 45.00% of the control group,the difference was statistically significant(x2=5.29,P<0.05).Conclusion Compared with the simple chemotherapy after the operation of gastric cancer,sequential radiotherapy and chemotherapy can effectively improve the clinical efficacy,significantly reduce the rate of postoperative metastasis and recurrence of gastric cancer,and it is worthy of promoting.

Objective To study the effect of gemcitabine combined with cisplatin in the treatment of non-small cell lung cancer.Methods 100 cases of non-small cell lung cancer patients who were treated in our hospital from March 2015 to August 2016 were selected as the subjects in this study.They were randomly divided into the control group and the experimental group, with 50 cases in each group.The control group were treated with gemcitabine combined with cisplatin, and routine nursing care was used.The experimental group were given psychological intervention on the basis of gemcitabine combined with cisplatin treatment, pay attention to the psychological status of patients, medical staff should strengthen communication, inform the relevant knowledge of disease, eliminate the negative emotions, improve the treatment compliance.Anxiety scores and satisfaction between the experimental group and the control group were compared.Results After the corresponding nursing, the treatment satisfaction of the control group was 72.0%, which was lower than that of the experimental group, and the satisfaction rate was 92.0%, the difference was statistically significant (P<0.05).After the intervention, the anxiety score of the experimental group(36.83±4.23)was significantly lower than that of the control group(42.12±3.41), and the difference was statistically significant (P<0.05).There was no significant difference in survival rate between the two groups after a follow-up of 1 years.Conclusion Gemcitabine Combined with cisplatin in the treatment of non-small cell lung cancer, the application of psychological intervention nursing can help patients to eliminate anxiety in a large extent, improve patient satisfaction, with further clinical promotion and application significance.

Objective To evaluate the efficacy of superficial temporal artery(STA)pressure-guided selective cerebral perfusion(SCP)during deep hypothermic circulatory arrest(DHCA)in patients undergoing aortic arch surgery.Methods Ninety-six patients of both sexes,aged 35-64 yr,with body mass index of 19-23kg/m2,of American Society of Anesthesiologists physical status Ⅲ or Ⅳ,undergoing aortic arch surgery,were divided into STA pressure group(group A)and clinical experience group(group B)using a random number table,with 48 patients in each group.In group A,STA catheterization was performed after tracheal intubation,and arterial pressure was monitored.SCP flow was adjusted to maintain the target value of STA pressure between 30 and 40mmHg during DHCA in group A.SCP flow rate was set at 5-10ml·kg-1·min-1 according to clinical experience in group B.The volume of fluid perfused during SCP,emergence time,extubation time and duration of intensive care unit stay were recorded.Neurological function was evaluated during length of hospitalization after surgery,and the development of permanent and transient neurological dysfunction and mortality in hospital were recorded.Results Compared with group B,the volume of fluid perfused during SCP was significantly decreased,the emergence time,extubation time and duration of intensive care unit stay were shortened,the incidence of permanent and transient neurological dysfunction(2% and 4%,respectively)was decreased(P < 0.05),and no significant change was found in the mortality rate in hospital in group A(P>0.05).Conclusion Maintaining STA pressure at 30-40mmHg is a reliable method for guiding SCP during DHCA in patients undergoing aortic arch surgery.

【Objective】 To investigate the effect of mitochondrial unfolded protein response (UPR^mt) on lipid metabolism in human kidney 2 (HK-2) cells . 【Methods】 Lipid accumulation was induced by palmitic acid (PA) in HK-2 cells. The cells were pretreated with siRNA or CDDO respectively. The intracellular lipid accumulation was observed by oil red staining; mitochondrial membrane potential (MMP) was measured by JC-1.The contents of reactive oxygen species (ROS) in mitochondria were measured by Mito-SOX, and the expressions of HSP60, LONP1, CLPP, ACOX1, PPARα, PGC1α and CPT1α were detected by Western blotting. 【Results】 PA induced lipid aggregation, MMP decrease, ROS generation in mitochondria and the decreased expression of UPR^mt proteins (e. g., HSP60 and LONP1) in HK-2 cells. Pretreatment of HK-2 cells with siRNA could aggravate lipid aggregation, MMP decrease and ROS generation induced by PA, and further decrease the expression of HSP 60and LONP1.Pretreatment of HK-2 cells with CDDO alleviated lipid aggregation, MMP decrease, ROS generation and decreased HSP60 and LONP1 expressions induced by PA. 【Conclusion】 Lipid aggregation in HK-2 cells induced by PA may be related to mitochondrial dysfunction and UPR^mt has a protective effect on HK-2 cells in the process.

Objective:To evaluate the diagnostic performance of radiomics model based on contrast-enhanced ultrasound(CEUS) in predicting pathological complete response(pCR) after neoadjuvant chemoradiotherapy(nCRT) in patients with locally advanced rectal cancer(LARC).Methods:One hundred and six patients with LARC who underwent total mesorectal excision after nCRT between April 2018 and April 2023 in the First Affiliated Hospital of Guangxi Medical University were retrospectively included, the patients were randomly divided into a training set of 63(14 pCR patients) and a validation set of 43(12 pCR patients) in a 6∶4 ratios. Radiomics features were extracted from the tumors′ region of interest of CEUS images based on PyRadiomics. Intra-class correlation coefficient(ICC), Mann-Whitney U test, and least absolute shrinkage and selection operator(LASSO) algorithms were used to reduce features dimension. Finally, 7 radiomics features relevanted to pCR were selected to construct an ultrasomics model using elastic network regression, based on the R language. A combined model was constructed by jointing clinical feature. The performance of the models was assessed with the area under the ROC curve(AUC). Results:The AUC of the ultrasomics model and the combined model was 0.695(95% CI=0.532-0.859) and 0.726(95% CI=0.584-0.868) respectively in the training set. The AUC of the ultrasomics model and the combined model was 0.763(95% CI=0.625-0.902) and 0.790(95% CI=0.653-0.928) respectively in the validation set. Both univariate and multivariate Logistic regression analyses showed that CA199( P<0.05) and ultrasomics score( P<0.001) could be an independent predictor of pCR after nCRT in patients with LARC. Conclusions:The CEUS-based radiomics scores has certain predictive value for whether LARC patients achieve pCR after nCRT, and may provide a non-invasive imaging biomarker for predicting LARC patients achieve pCR after nCRT.