A data processing method for the sound power of the medical ultrasonic diagnostic equipment is introduced in this paper. The sound power for the transducer of a medical ultrasonic diagnostic equipment is measured for many times, and then the mathematical model based on the measurement data above is processed with Kalman filter.The output fluctuations for sound power of the equipment and its transducer as well as the measurement errors of sound power meter are eliminated to achieve the true value of sound power. Compared with other mean methods, the method above can improve the dicreteness of the measurements, and thus is worth being applied to processing other measured data.

Objective To evaluate the impact of chronic hepatitis B virus (HBV) infection on the outcome following resection for intrahepatic cholangiocarcinoma (ICC) patients.Methods The clinicpathological data of 60 consecutive operated ICC patients were collected.These patients were divided into group A with HBV infection,represented by serum positive hepatitis B surface antigen (HBsAg),group B with hepatitis B surface antibody (HBsAb) positive,and group C with all serum marker of HBV negative.The overall survival rate was evaluated.Results The 1-and 3-year overall survival rate and median survival of three groups were 50％ vs 53％ vs 29％ ; 22％ vs 18％ vs O; and 12.0 m vs 12.0 m vs 6 m,respectively.The difference was statistically significant(P =0.037).Multivariate analyses revealed that the preoperative serum level of TIBL,tumor location,HBV infection or injection of hepatitis B vaccine,hepatolithiasis and adjuvant chemotherapy were related to the prognosis.Conclusions HBV infection or injection of hepatitis B vaccine is favorable independent factor for prognosis of patients with intrahepatic cholangiocarcinoma after resection.

[Summary] The neuropeptides orexin A and orexin B are involved in numerous central regulation processes such as energy homeostasis,sleeping behaviour,and neuroendocrine activities.Orexin receptors are expressed in a variety of tissues besides the brain,adrenal gland for example.The article reviews the effect of orexin on adrenal gland function.

Objective:To investigate the protective effects of Huoxue Rongluo Decoction on hypoxic-ischemic brain damage (HIBD) rats; To clarify the expression of AMPK signaling pathway during HIBD injury and repair.Methods:On the basis of the hypoxia ischemia reperfusion model, an improved hypoxia bottle was used to establish a full-term HIBD rat model. Totally 60 successfully modeled mice were divided into model group and TCM group using a random number table method, with 30 mice in each group and 30 mice in a control group. Two hours before surgery, TCM group was orally administered with Huoxue Rongluo Decoction 1.17 g/100 g (equivalent dose). The control group and model group were orally administered with equal volume of physiological saline. Two hours after surgery, it was orally administered again, twice a day, for consecutive 5 d. Behavioral tests (convulsion assessment, Longa score, suspension test, water maze test) were used to evaluate the motor nerve function and long-term learning ability of young rats in different groups. HE staining and electron microscopy were used to observe the pathological changes of brain tissue and mitochondrial damage. Evans blue (EB) staining and brain water content measurement were used to detect blood-brain barrier permeability and brain edema. The expression of AMPK signaling pathway related genes in brain tissues of different groups of young rats was detected by PCR array technique.Results:Compared with the model group, the convulsions of the rats in the TCM group were improved, the Longa score was significantly reduced, the grip strength test score and suspension time were significantly improved, the escape latency was significantly shortened, and the number of crossing platforms significantly increased ( P<0.05); the degree of neuronal and mitochondrial damage in the TCM group was reduced, and cerebral vascular permeability and brain water content were significantly reduced ( P<0.01). The results of PCR array showed that compared with the control group, 2 genes were significantly up-regulated and 12 genes were significantly down-regulated in the brain tissue of the model group; compared with TCM group, 15 genes were relatively down-regulated in the model group. Conclusion:Huoxue Rongluo Decoction can significantly reduce the degree of brain injury after HIBD, improve the motor nerve function and long-term learning and cognitive ability of model rats, and its damage repair mechanism is related to the expression regulation of AMPK signaling pathway related genes.

Background and objective Anaplastic lymphoma kinase (ALK) is one of the major driver genes of non-small cell lung cancer (NSCLC). Several studies have shown that the e?cacy of pemetrexed in ALK-positive lung cancer is controversial. The aim of this study is to explore the e?cacy of pemetrexed-based chemotherapy in patients with ALK-positive and negative lung adenocarcinoma. Methods The clinical data of 98 cases of epidermal growth factor receptor (EGFR), kirsten rat sarcoma viral oncogene (KRAS), V-rafmurine sarcoma viral oncogene homolog B1 (BRAF)-negative patients with advanced lung adenocarcinoma patients who diagnosed by histopathology from January 2015 to April 2016 in the First A?liated Hos-pital of Zhengzhou University were collected. The relationships between ALK gene status, clinical characteristics and response and progression-free survival (PFS) were analyzed. Results All of the 98 patients' ALK status were determined. ALK gene fracture fusion occured in 34 cases (34.7%), no fracture fusion in 64 cases (65.3%). All patients underwent first-line peme-trexed and platinum-based chemotherapy, the objective response rate (ORR) was 21.4% and the disease control rate (DCR) was 84.7%. The ORR and DCR of patients with ALK fracture fusion were higher than those without fracture fusion (41.2% vs 10.9%, χ2=23.389, P<0.001; 91.2% vs 81.3%, χ2=4.153, P=0.042), the difference was statistically significant. ALK gene status was not related to age, gender, smoking history and clinical stage. The median PFS of ALK-positive lung adenocarcinoma was 7.1 months (95%CI: 6.1-8.1) and negative was 4.7 months (95%CI: 3.818-5.582), and the difference was statistically significant (χ2=13.269, P<0.001). Cox multivariate analysis indicates that PFS of pemetrexed combined with platinum chemotherapy was independent of gender, age, smoking, staging and platinum. ALK gene fracture fusion is an independent factor affecting PFS (HR=0.392, 95%CI: 0.243-0.634, P<0.001). Conclusion ALK-positive lung adenocarcinoma patients with first-line peme-trexed-based chemotherapy have greater clinical benefit than ALK-negative patients.

Objective:To explore disorienting dilemmas during postgraduate study period experienced by postgraduates with master of nursing specialist who participated in the national postgraduate entrance examination and provide a basis for teaching reform based on transformative learning theory.Methods:Using the purposive sampling method and the maximum difference method, 23 full-time masters of nursing specialist who participated in the national postgraduate entrance examination from 3 universities of Jiangsu Province were selected as the research objects from March to June 2019. The descriptive qualitative research method was used to conduct semi-structured interviews, and the traditional content analysis method was used to analyze the interview data.Results:Four themes of disorienting dilemmas of masters of nursing specialist were extracted: the expected hypothesis of challenges of new environment in course learning, a gap between scientific research ability and training target, adjustment of self-positioning in clinical practice and insufficient preparations for graduation of master of nursing specialist.Conclusions:Master of nursing specialist have disorienting dilemmas in course study, scientific research, clinical practice and graduation preparation, and nursing educators can use this as a trigger point to carry out teaching reform based on transformative learning theory.

Objective: To investigate the clinicopathological characteristics, therapy and prognosis of patients with pulmonary mucoepidermoid carcinoma. Methods: The clinical data of 87 patients diagnosed as pulmonary mucoepidermoid carcinoma at The First Affiliated Hospital of Zhengzhou University from April 2011 to May 2016 were retrospectively analyzed. The clinicopathological features were summarized and the prognoses were analyzed. Results: Among the 87 patients with lung mucoepidermoid carcinoma, 53 were male and 34 were female, the gender ratio between men and women was 1.56∶1.The ages of patients were from 16 to 79 years and the median age was 52.5 years. Seventeen cases were diagnosed as stage Ⅰ, 28 cases were stage Ⅱ, 26 cases were stage Ⅲ, 16 cases were stage Ⅳ.Thirty-six patients were examined by immunohistochemistry, of which 29 cases were cytokeratin (CK) 5/6 positive, 29 cases were CK7 positive, 10 cases were CK positive, 28 cases were p63 positive, 14 cases were p40 positive, 17 cases were thyroid transcription factor-1 (TTF-1) positive, 11 cases were NapsinA positive, 2 cases were epithelial membrane antigen (EMA) positive, 4 cases were CK8/18 positive, 3 cases were surfactant proteins A (SPA) positive, 1 case was CAM5.2 positive and 1 case was CK14 positive. Among the 87 patients, 34 cases were treated by operation alone, 23 cases were treated by operation combined with chemotherapy, 5 cases were treated by radiotherapy combined with chemotherapy, 14 cases were treated by chemotherapy alone, 2 cases were treated by particle implantation combined with chemotherapy, 2 cases were treated by local radiofrequency hyperthermia combined with chemotherapy, and 7 cases without special treatment.Five patients with brain metastasis were treated with cerebral radiotherapy combined with sequential chemotherapy. The 1-year, 2-year and 5-year survival rates of 87 patients were 90.7%, 81.6% and 46.3%, respectively. The median survival time was 60 months. The prognoses of patients with lung mucoepidermoid carcinoma were related with the clinical stage, smoking and operative therapy (all P<0.05). Conclusions The age distribution of patients with pulmonary mucoepidermoid is a wide range, the incidence of male is higher than that of female. The diagnosis of pulmonary mucoepidermoid carcinoma mainly relies on the morphological diagnosis and the immunohistochemical detection is non-specific. The prognoses of patients with lung mucoepidermoid carcinoma are related with clinical stage, smoking and operative therapy. For patients who are inoperable and with single distant metastasis, local radiotherapy, other local treatment and chemotherapy can significantly improve their prognoses.

BACKGROUND: Human epidermal growth factor receptor 2 (HER2) is one of the driver genes of non-small cell lung cancer (NSCLC). Several studies have shown that the efficacy of pemetrexed in HER2-mutant NSCLC is controversial. The aim of this study is to investigate the efficacy of pemetrexed combined with platinum chemotherapy in patients with HER2-mutant and HER2 wild-type lung adenocarcinoma. METHODS: The clinical data of 106 cases of EGFR, ALK, ROS-1, KRAS, BRAF, RET and MET-negative patients with advanced lung adenocarcinoma patients who diagnosed by histopathology in the First Affiliated Hospital of Zhengzhou University were retrospectively reviewed. The relationships between HER2 gene status, clinical characteristics and response and progression-free survival (PFS) were analyzed. RESULTS: All of the 106 patients' HER2 status were determined. HER2 mutations occurred in 32 cases (30.2%), no mutations in 74 cases (69.8%). HER2 mutations were common in young, non-smoking and female patients. All patients received first-line pemetrexed and platinum-based chemotherapy. The objective response rate (ORR) and disease control rate (DCR) of patients with HER2-mutant lung adenocarcinoma were significantly higher than those without HER2 mutations (40.6% vs 14.9%, χ²=8.464, P=0.004; 93.8% vs 68.9%, χ²=6.327, P=0.012), and the difference was statistically significant. According to univariate analysis, the PFS was significantly associated with the brain metastases, maintenance chemotherapy and HER2 gene status (P<0.05), but not with age, gender, smoking history, oligometastases, liver metastases and type of platinum (P>0.05). Cox multivariate analysis indicated that HER2 mutation was an independent positive prognostic factor of PFS (P=0.038). CONCLUSIONS HER2-mutant lung adenocarcinoma patients with first-line pemetrexed combined with platinum chemotherapy have greater clinical benefit than HER2 wild-type patients.
Adenocarcinoma of Lung ; drug therapy ; genetics ; pathology ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Disease-Free Survival ; Female ; Genes, erbB-2 ; genetics ; Humans ; Male ; Middle Aged ; Mutation ; Pemetrexed ; therapeutic use ; Platinum ; therapeutic use ; Retrospective Studies ; Treatment Outcome

BACKGROUND: Adenocarcinoma is the most common type of lung cancer. It has been clinically evaluated that therapiestargeting against the epidermal growth factor receptor (EGFR) as the clinical standard first-line treatment. The response and outcome of EGFR-tyrosine kinase inhibitors (TKIs) in patients harboring common mutations in EGFR kinase domain (deletion in exon19 and L858R in exon 21) has been well demonstrated, but not in rare or complex mutations. METHODS: A total of 150 patients that harbored rare or complex mutations in EGFR diagnosed by histopathology were included in this retrospective study. The clinical-pathological characteristics of all 150 patients as well as the response and progression-free survival (PFS) in 48 patients that received EGFR-TKIs in first/second/third line treatments weredescribed and analyzed. RESULTS: Patients were divided into four groups based on the mutation types: single G719X point mutation in exon 18 (n=46, 30.7%), single L861Q point mutation in exon 21 (n=45, 30.0%), other single rare mutation (n=14, 9.3%) and complex mutations (n=45, 30.0%). The result indicated thatthere was no correlation of EGFR mutation typeswith other parameters such as gender, age, clinical stage, pathology and smoking history. For the 48 patients that received EGFR-TKIs treatment, there were no significant differencesamong 4 groups in terms of objective response rate (ORR) and disease control rate (DCR) (54.5% vs 30.0% vs 0.0% vs 35.7%, χ²=3.200, P=0.34; 90.9% vs 85.0% vs 66.7% vs 92.9%, χ²=2.162, P=0.59). The median progress-free survival (mPFS) was 11.0 months (95%CI: 4.4-17.6), and in each group of different EGFR mutation types are 15.8 months (95%CI: 9.5-22.2), 8.0 months (95%CI: 5.1-11.0), 4.9 months (95%CI: 1.4-8.4) and 23.1 months (95%CI: 15.8-30.4)(χ²=7.876, P=0.049). CONCLUSIONS The efficiency of targeting EGFR-TKIs on different types of rare or complex mutations was heterogeneous. The PFS may be better in patients that harbored complex mutations than those with single rare mutations. Further studies with larger sample size are necessary. Moreover, to discover novel therapeutic targets and develop new drugs are imminentfor those patientswith no response to the existing treatments.
Carcinoma, Non-Small-Cell Lung ; drug therapy ; genetics ; Disease-Free Survival ; ErbB Receptors ; antagonists & inhibitors ; genetics ; Exons ; genetics ; Female ; Humans ; Lung Neoplasms ; drug therapy ; genetics ; Male ; Middle Aged ; Mutation ; Protein Kinase Inhibitors ; pharmacology ; therapeutic use ; Retrospective Studies ; Treatment Outcome