Targeted agents for small cell lung cancer (SCLC)include inhibitors of angiogenesis,tyro-sine kinase inhibitors and signal transduction pathway inhibitors.Bevacizumab,a class of antiangiogenic agent, tends to have no effects on patients.The tyrosine kinase inhibitor,for example sunitinib,may be used as a monotherapy.Signaling inhibitors including Amuvatinib and LDE225 are undergoing phaseⅠand Ⅱ trials.Pri-mary data show that SCLC is not sensitive to targeted therapy,needing more selection,so further studies are requested.

ObjectiveTo explore the value of acupuncture in treating insomnia due to stagnated liverqi transforming into fire and its theoretical foundation, by observing the treatment effect of acupuncture in treating insomnia due to stagnated liverqi transforming into fire and its influence on 5-hydroxy tryptamine (5-HT) content.MethodTotally 187patients with insomnia due to stagnated liver qi transforming into fire were selected and randomized into two groups. The 93 cases in the control group were intervened by orally taking Trazodone, 100 mg for each dose, twice a day, 10 d as a course, totallyfor 2 courses; the 94 cases in the observation group were intervened by acupuncture at Shenmen (HT7), Baihui (GV20), Yintang (GV29), Hegu (LI 4), and Taichong (LR 3), once a day, 10 d as a treatment course, totally for 2 courses. Peripheral blood was collected from the two groups before and after intervention to detect the change of 5-HT content. Meanwhile, the Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD, 24-item version), Asberg Rating Scale for Side Effects (SERS), and clinicalefficacies were assessed.ResultThe difference in 5-HT content between the two groups was statistically insignificant before intervention (P>0.05); 5-HT contents were significantly increased in both groups after intervention (P<0.05), while the content in the observation group was markedly higher than that in the control group (P<0.05); after treatment, the PSQI and HAMD scores were decreasedin both groups (P<0.05), while the PSQI, HAMD, and SERS scores in the observation group were markedly lower than those in the control group (P<0.05);the total effective rate was 92.6% in the observation group, significantly higher than 81,7% in the control group (P<0.05). ConclusionAcupuncture can significantly down-regulate 5-HT content in insomnia patients, and its total effective rate is higher than that of medication.

Objective To explore the association of IL-10-592A/C polymorphism with the susceptibility to respiratory syncytial virus(RSV) bronchiolitis and disease severity,and to explore the impact of IL10-592A/C polymorphism upon total serum IL-10 levels in children with RSV bronchiolitis. Methods One hundred children (patients group) admitted to hospital with RSV bronchiolitis and 100 healthy children (control group) were recruited. PCR restriction length fragment polymorphism assay was used to detect the single nucleotide polymorphisms of IL-10-592A/C. Total serum IL-10 levels in patients group were assayed with ELISA. Results The genotype frequency of IL-10-592A/C were AA 44% ,AC 38% ,CC 18% in patients group ,and AA 41% ,AC 42% ,CC 17% in the control group,it showed no significant difference between two groups (χ2= 0. 33, P > 0. 05) . The frequency of each allele were A 63%, C 37 % in patient group, and A 64% ,C 36% in the control group,there was no significant difference in allele frequency between two groups (χ2=0. 43 ,P >0. 05) . There was no significant difference in total serum IL-10 levels between different genotype of IL-10-592A/C (F = 0. 87, P > 0. 05) . The differences in genotype frequency of IL-10-592A/C were not significant between mild and moderate to severe cases (χ2= 2. 67, P > 0. 05) . Conclusion IL-10-592A/C gene polymorphisms do not correlated with RSV bronchiolitis.

Objective To sum up the experience of donor hepatectomy in living-related liver transplantation.Methods From 1997 to 2001, donor hepatectomy was performed on 3 cases of left lateral segmentectomy at Xijing Hospital, Xi'an. Two living-related liver transplantations and one living-related auxiliary partial orthotopic liver transplantation were carried out. The surgical technique of donor operations consisted of mobilization of the liver lobe, hilar dissection, transection of the liver using ultrasonic dissector without inflow or outflow vascular occlusion. Results The donor operation took 5.0?h to 6.5?h. The blood loss was 200?ml to 400?ml. No complication occurred in all donors. The function of the donor liver in all donors were normal. Conclusions Donor hepatectomy of left lateral segment can be a safe operation provided. Good surgical technique and appropriate preservation are key points to success of the liver transplantation.

Objective To review the safety and efficacy of fast track surgery in gastrectomy for gastric cancer.Methods The computer retrieved databases, including Pubmed, Medline, Cochrane library and Web of science, to collect randomized controlled trials (RCT) or controlled clinical trials (CCTS) on FTS was used in gastrectomy for gastric cancer between January 1994 and march 2014, and manual retrieval in Google.Using RevMan5.0 software analysis data that extract from collect literature.Results A total of five RCTs and two CCTs, involving 636 patients,were included, there were 309 cases in experimental group (FTS group) and 327 cases in control group.Meta-analysis showed: the FTS group had earlier postoperative flatus [WMD =-18.74, 95％ CI (-34.31,-3.17), P ＜ 0.05], shorter postoperative hospital stay [WMD =-2.46, 95％ CI (-3.75,-1.17), P=0.000 2], and lower hospital charge [SMD =-0.67, 95％ CI (-1.00,-0.34), P ＜ 0.000 1].However, there were no statistically significant differences in operation time, intraoperative blood loss, the number of retrieved lymph node intraoperative, the time of catheter removal and postoperative complication rate (P ＞ 0.05).Conclusion FTS in gastrectomy for gastric cancer can promote postoperative bowel function recovery, decrease postoperative hospital stay and reduce hospital charge.

OBJECTIVETo compare the difference in the efficacy between acupuncture and oral administration of trazodone and the expressions of neurotransmitters in patients of insomnia differentiated as liver stagnation transforming into fire.

METHODSSeventy patients of insomnia differentiated as liver stagnation transforming into fire were randomized into an observation group and a control group, 35 cases in each one. In the observation group, acupuncture therapy was adopted at Shenmen (HT 7), Baihui (GV 20), Yintang (GV 29), Hegu (LI 4), Taichong (LR 3), etc. The needles were retained for 20 min each time. The treatment was given once a day, the treatment of 2 weeks made one session. In the control group, trazodone, 100 mg, oral administration, once a day, the treatment of 2 weeks made one session. Two sessions were required in the two groups. The scores in Pittsburgh sleep quality index (PSQI) and Asberg rating scale for side effects (SERS), the levels of neurotransmitters such as 5-hydroxy tryptamine (5-HT) and norepinephrine (NE) and the expressions of protein kinase C (PKC) and brain-derived neurotrophic factor (BDNF) in peripheral blood were observed before and after treatment in the two groups.

RESULTSPSQI score and SERS score after treatment were all decreased compared with those in both groups before treatment (both P<0. 05). After treatment, PSQI score and SERS score in the observation group were lower apparently than those in the control group (both P<0. 05). After treatment NE content and PKC level were decreased; 5-HT content and BDNF mRNA were increased compared with those in both groups before treatment (all P<0. 05). NE content and PKC level in the observation group were lower apparently than those in the control group (both P<0. 05). The serum 5-HT content and BDNF mRNA expression in the observation group were higher than those in the control group separately (both P<0. 05).

CONCLUSIONAcupuncture therapy improves the sleeping quality of patients of insomnia differentiated as liver stagnation transforming into fire, and reduces serum NE level and increases 5-HT content and BDNF expression, which achieves the better efficacy as compared with the oral administration of trazodone. It is one of the effective approaches to the treatment of insomnia differentiated as liver stagnation transforming into fire.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Brain-Derived Neurotrophic Factor ; genetics ; metabolism ; Female ; Humans ; Liver ; physiopathology ; Male ; Neurotransmitter Agents ; genetics ; metabolism ; Norepinephrine ; genetics ; metabolism ; Serotonin ; metabolism ; Sleep Initiation and Maintenance Disorders ; genetics ; metabolism ; physiopathology ; therapy ; Treatment Outcome

Objective To explore the reason for remedy radical operation after endoscopic submucosal dissection (ESD) for early gastric cancer.Methods The clinical data of 26 early gastric cancer cases who received remedy radical gastrectomy after ESD between January 2012 to March 2015 in Nanjing Drum Tower Hospital were analyzed retrospectively.Results All cases were followed up and mid follow-up was 25 months.There was no death nor tumor reccurence cases during the follow-up.Three cases suffered from complications in radical surgery for gastric cancer including afferent jejunal loop obstruction,adhesive intestinal obstruction,stomach paralysis respectively,all were cured by conservative therapy.Postoperative pathology found lymph node metastasis in 3 cases.Conclusions En bloc resection and negative resection margin,as well as free lymphatic metastasis are two important factors determing the survival of early gastric cancer patients undergoing ESD treatment.

Objective To explore the clinical efficacy of navigation of sentinel lymph node (SLN) combined with endoscopic submucosal dissection (ESD) for non curative treatment of early gastric cancer.Methods Clinical data of 9 cases with early gastric cancer treated with ESD from August 2015 to December 2015 were enrolled.The SLNs were explored by laparoscopy after nano carbon or indocyanine green(ICG) was injected under endoscopy.Then all stained nodes were resected by laparoscopy.Results The mean number of SLN were 2.75±1.50 in ICG group,which was significantly smaller than the number in nano carbon group(8.40±4.93) according to the laparoscopic pathology,so the accuracy of ICG was higher than that of nano carbon.But ICG performed better in development.The postoperative complications such as postoperative intestinal obstruction,enteritis and gastric paralysis were found in 5 patients of nano carbon group.But no serious complications after operation were found in patients of ICG group.Conclusion Application of ICG can help avoid the excessive removal of tissue,and reduce the incidence of complications.ICG,as a new type of tracer for early gastric cancer,shows good application prospects.

Objective To understand the experiences and suggestions for clinical practice training of emergency nurses in suburb of Shanghai City,and to provide theoretical basis for further improving clinical practice training of nurses in emergency department.Methods Using the phenomenological methods and Colaizzi 7 step analysis method to refine the theme,11 interviews were conducted.Results Respondents believed emergency nurses in clinical practice training was important; Training content should follow the training outline and needed appropriate extension according with the demand of the regional students,and help to improve the students' practical ability to work.The students hoped to gain more knowledge.PBL teaching method and situational simulation assessment mode were used.The teachers' solid professional knowledge,skills,and teaching ability and professional dedication were strong.Conclusions We should listen to the voices of training students,adopt relevant suggestions,and gradually improve the clinical practice training of emergency nurses mode.

Postoperative patients who underwent digestive tract reconstruction have a high risk of malnutrition and absorbing bar-rier. Enteral nutrition support can effectively maintain and improve the nutritional status of the human body, shorten hospital stay, and reduce complications. Therefore, the enteral approach is the preferred postoperative means of nutrition support. This article retrospec-tively summarizes the appropriate time to start enteral nutrition support therapy after digestive tract reconstruction, the proper selection of the mode of enteral nutrition support, the different enteral nutrition preparations, and the treatment of postoperative complications.