Objective: To investigate the utilization status of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in 11 hospitals of Zhejiang province from 2009 to 2015, and to analyze the use rationality.Methods: The doctor's advice in 40 days annually was collected in 11 hospitals of Zhejiang province from 2009 to 2015, and the drug consumption, frequency of utilization (DDDs), defined daily cost (DDC) and drug utilization index (DUI) were analyzed for the patients with lung cancer treated with EGFR-TKI.Results: Icotinib, erlotinib and gefitinib were the three prevalent EGFR-TKIs used in Zhejiang province, and icotinib started to be used in clinics in 2013.The overall cost of EGFR-TKIs increased year by year during 2009 and 2015, and the total amount of sales increased by 4.67 times in 2015 when compared with that in 2009.Generally, the DDDs value of erlotinib showed a decreasing trend, however, that of icotinib and gefitinib rose year by year during 2009 and 2015.Erlotinib had the highest DDC followed by gefitinib and icotinib.The mean value of DUI of the three targeted drugs was about 1.Conclusion: The utilization of EGFR-TKI is reasonable in 11 hospitals of Zhejiang province with increasing comsuption.

Objective To determine whether hemostatic agents directly injected into injury sites under the guidance of contrast-enhanced ultrasound(CEUS)can effectively control hemorrhage from hepatic or splenic trauma. Methods Healthy adult dogs were impacted by a impactor to create hepatic or splenic trauma. Among 32 dogs,28 had hepatic or splenic injury of grade Ⅲ～Ⅳ according to Injury Scale of the American Association for the Surgery of Trauma(AAST),which were divided into two groups,the treatment group and the control. In the treatment group,hemocoagulase and α-cyanoacrylate were injected respectively into the injury site and transected micro-vessel tinder the guidance of CEUS,while in the control group,normal saline was injected. Results All animals of the two groups survived after the injection. CEUS demonstrated that active hemorrhage disappeared in treatment group but still existed in the control group.In the treatment group,laparotomy showed that hepatic or splenic injury had been covered and adhered with clot and glue membrane of hemostatic agents and free intraperitoneal blood volume was significantly less than that in the control group(P=0.000),while in the control group injury bleeding did not stop after injection. Conclusions Hemostatic agents injected under the guidance of CEUS can effectively control hemorrhage from hepatic or splenic trauma of grade Ⅲ～Ⅳ. This therapy was simple,convenient and effective. It may be performed immediately after hepatic or splenic injury was diagnosed.

Objective To explore the value of percutaneous injection of hemostatic agents under the guidance of contrast-enhanced ultrasound(CEUS)for grade Ⅲ-Ⅳ hepatic trauma patients.Methods Eleven patients with severe hepatic trauma were treated using percutaneous focal injection of hemostatic agents.Five of these patients were hepatic injury of grade Ⅲ,and others were grade Ⅳ according to AAST.Results Out of all patients with severe hepatic trauma,9 patients were cured by once percutaneous injection of hemostatic agents under the guidance of CEUS,and 1 patient was cured by twice injection,and 1 patient was switched to surgery because of complicated pancreatic injury and the increase of free intraperitoneal fluid.Conclusions CEUS can display the site and severity of liver injury.Combining with interventional technology,injection of hemostatic agents under the guidance of CEUS can save life and avoid to resect organ,and it can win time for treating other compound injury.

Objective To investigate the efficacy and safety of contrast enhanced ultrasound (CEUS)-guided local injection therapy in treatment of abdominal trauma. Methods CEUS was per-formed in 12 patients with abdominal trauma to determine the location,iniury severity and possible active bleeding. Then,all 12 patients underwent CEUS-guided local injection therapy with haemostat. Conven-tional ultrasound and CEUS examinations were performed at days 0,1,3,7,14 and 30 after the treat-ment. Results The bleeding was instantly controlled by using CEUS-guided local injection therapy without delayed rehemorrhage. Conclusion Compared with conventional ultrasound,CEUS Call more significantly elevate diagnostic accuracy of abdominal trauma and accurately guide local injection therapy, with satisfactory curative effect and safety.

Objective To evaluate percutaneous injection of hemostatic agents under the guidance of contrast-enhanced sonography(CEUS) in controlling hemorrhage from severe splenic trauma. Methods Eight patients with splenic traumas of grade Ⅲ, Ⅳ were consecutively enrolled in this study. Percutaneous injection of hemocoagulase atrox and α-cyanoacrylate was performed by CEUS-guidance in all patients. Ultrasound examination was performed at 1,3,7 and 14 days after focal injection. Vital signs and hemoglobin (Hb) level were recorded. Results After the injection,immediate CEUS demonstrated that active bleeding from the injury sites disappeared. From 30 minutes after the injection arterial blood pressure began to ascend ( P <0. 05), and heart rate decreased to the normal level after the treatment ( P <0.05). Hb decreased at first and then gradually increased to the normal level. Conclusions Pereutaneous injection of hemoeoagulase atrox and α-cyanoacrylate under the guidance of CEUS can effectively control bleeding from a severe splenic trauma. CEUS can be helpful to the diagnosis of the suspected splenic trauma and to ensure hemostatic materials to be injected exactly into injury sites.

To investigate the expression of miR-133a and miR-424 in the serum of patients with connective tissue disease(CTD)and interstitial lung disease(ILD)and their relationship with T lymphocyte subpopulations,total of 96 CTD-ILD patients treated in our hospital from December 2019 to December 2022 were selected as CTD-ILD group,while 96 CTD patients without ILD were as the control group.The real-time fluorescence quantitative PCR(qRT-PCR)method was applied to detect serum levels of miR-133a and miR-424;flow cytometry was applied to detect the levels of T lymphocyte subpopulations.Pearson method was applied to analyze the relationship of miR-133a and miR-424 with T lymphocyte subpopulations.Compared with the control group,the level of serum miR-133a in the CTD-ILD group was obviously reduced,while the expression level of miR-424 was obviously increased(P＜0.05).Under different degrees of pulmonary ventilation disorders,the expression level of miR-133a in the serum of mild,moderate,and severe patients decreased obviously,while the expression level of miR-424 increased obviously(P＜0.05).Under different grades of pulmonary diffusion dysfunction,the expression level of miR-133a in the serum of mild,moderate,and severe patients reduced obviously,while the expression level of miR-424 increased obviously(P＜0.05).Furthermore,the levels of CD4+and CD4+/CD8+in the CTD-ILD group were obviously increased,as compared to the control group,while the levels of CD8+and CD3+were obviously reduced(P＜0.05).In addition,miR-133a was negatively correlated with CD4+,and positively correlated with CD8+and CD3+;miR-424 was positively correlated with CD4+,and negatively correlated with CD8+and CD3+(P＜0.05).In conclusion,the expression level of miR-133a in serum of CTD-ILD patients is decreased,while the expression level of miR-424 is increased,and both of them are related to the T lymphocyte subpopulations.

Objective:To learn about the thyroid volume and goiter status of adults in Wuhan, analyze related influencing factors, and provide a basis for revising the diagnostic criteria for adult goiter.Methods:From December 2019 to November 2021, a multi-stage cluster random sampling method was used in 13 districts of Wuhan. Two communities or townships were selected from each district, 100 permanent residents over 16 years old were selected from each community or township according to the inclusion and exclusion criteria for general information collection, thyroid ultrasound examination, urinary iodine detection and physical examination were performed, and the influencing factors of thyroid volume were analyzed.Results:A total of 2 578 adults aged 16 and older in Wuhan were selected, including 1 168 males and 1 410 females, with an average age of (41.79 ± 13.01) years old. The median thyroid volume (interquartile range) in adults was 6.36 (4.88, 8.11) ml, the rate of goiter was 0.70% (18/2 578), and the detection rate of thyroid nodules was 35.49% (915/2 578). The median urinary iodine (interquartile range) was 185.32 (107.93, 277.08) μg/L. According to Spearman correlation analysis, the thyroid volume of adults in Wuhan was positively correlated with their height, weight, body mass index (BMI), and body surface area (BSA, r = 0.12, 0.22, 0.21, 0.20, P < 0.001). Through multiple linear regression analysis, the regression equation was obtained: thyroid volume = 7.72 + 1.19 × thyroid nodules - 1.04 × gender + 0.15 × age group. Patients with thyroid nodules had a thyroid volume greater than those without, males greater than females, and the elderly group greater than the younger group. Conclusion:The goiter rate in Wuhan is relatively low, and factors such as gender, age, presence of thyroid nodules, height, weight, BMI, BSA and other body measurement are the influencing factors of thyroid volume.

BackgroundStress is closely related to migraine attacks， however， previous studies on stressors， stress responses and their impact on the daily life of college students with migraine remain unclear. ObjectiveTo explore the impact of stressors and stress responses on the daily life of college students with migraine， in order to provide references for improving daily life of this population. MethodsFrom August 2018 to August 2019， 458 students from North Sichuan Medical College who met the International Classification of Headache Diseases third edition （ICHD-3）， were selected using random sampling method. General data and headache characteristics were collected. The 6-item Headache Impact Test Questionnaire （HIT-6） was used to assess the impact of migraine on daily life. Student-Life Stress Inventory （SLSI） was used to assess the stressors and stress responses. Hamilton Anxiety Scale （HAMA） and Hamilton Depression Scale-24 item （HAMD-24） were used to assess anxiety and depressive symptoms. Pearson correlation analysis were used to examine the relationship between HIT-6 score and scores on various scales. Multiple linear regression was used to analyze the influencing factors on daily life in college students with migraine. ResultsIn the SLSI， stressors in the dimensions of frustration （r=0.138， P<0.01）， conflict （r=0.168， P<0.01）， pressure （r=0.157， P<0.01）， change （r=0.148， P<0.01）， self-imposed （r=0.158， P<0.01） ， as well as physiological response （r=0.256， P<0.01）， emotional response （r=0.241， P<0.01）， behavioral response （r=0.164， P<0.01）， HAMA total score （r=0.192， P<0.01）， dHAMD-24 total score （r=0.250， P<0.01）， and SLSI total score （r=0.250， P<0.01）， were positively correlated with HIT-6 score. Cognitive response （r=-0.104， P<0.05） was negatively correlated with HIT-6 score. Stepwise multiple linear regression revealed that physiological response （β=0.140， P<0.05）， anxiety （β=0.159， P<0.05）， and cognitive response （β=-0.091， P<0.05） could predict the impact on daily life of college students with migraine. ConclusionPhysiological response， cognitive response and anxiety may be the independent influencing factors on the daily life of college students with migraine. ［Funded by Nanchong City University Science and Technology Strategic Cooperation Project （number， NSMC20170420）］

ObjectiveTo assess the anxiety and depression symptoms and sleep quality in patients with menstrual migraine， so as to provide references for the prevention and treatment of menstrual migraine and its comorbidity. MethodsAccording to the diagnostic criteria of the International Classification of Headache Disorder， third edition （ICHD-3）， 501 female migraine patients， including 112 patients with menstrual migraine and 389 patients with non-menstrual migraine， who attended the outpatient clinic of the Affiliated Hospital of North Sichuan Medical College from February 2019 to February 2020， were selected for the study. The general and clinical data of the patients were collected， meantime， patients were assessed using Hamilton Anxiety Scale （HAMA）， Hamilton Depression Scale-24 item （HAMD-24）， 6-item Headache Impact Test （HIT-6） and Pittsburgh Sleep Quality Index （PSQI）. ResultsThe detection rates of pure anxiety， pure depression， comorbid anxiety-depression and sleep disorders in patients with menstrual migraine were higher than those in patients with non-menstrual migraine （χ²=4.198， 4.355， 5.236， 8.624， P<0.05 or 0.01）. Patients with menstrual migraine had higher scores of HAMA、HAMD-17、PSQI and HIT-6 than those of non-menstrual migraine patients （Z=-3.550、-2.723、-2.482、-4.717，P<0.05 or 0.01）. Correlation analysis showed that PSQI score of menstrual migraine patients was positively correlated with HAMA score （r=0.338， P<0.01）， HAMD-24 score （r=0.372， P<0.01） and HIT-6 score （r=0.192， P<0.05）. ConclusionCompared with non-menstrual migraine patients， patients with menstrual migraine experience more severe anxiety and depression symptoms and sleep problems and suffer greater negative life impacts. In addition， the influence of anxiety and depression symptoms and headache on daily life is associated with sleep quality.

Background and purpose:In 2016 the National Cancer Institute(NCI)decided stopping to use NCI-60 cell lines for drug screening,suggesting that tumor cell lines were losing their value as a tool for drug discovery and basic research.The reason for NCI-60 cells'retirement'was that the preclinical studies based on traditional cellular and animal models did not obtain the corresponding expected efficacy in clinical trials.Since the major cancer behaviors,such as proliferation and metastasis,are fundamentally altered with long-term culture,the tumor cell lines are not representative of the characteristics of cancer in patients.Currently,scientists hope to create a new cancer model that are derived from fresh patient samples and tagged with details about their clinical past.Our purpose was to create patient-derived breast cancer primary cell lines as new cancer model for drug screening and basic research.Methods:Breast cancer tissues were collected in the Department of Breast Surgery,Affiliated Hospital of Guizhou Medical University.The collection of tumor tissue samples was approved by the Ethics Committee of the Affiliated Hospital of Guizhou Medical University(approval number:2022 ethics No.313),and the collection and use of tumor tissues complied with the Declaration of Helsinki.The primary breast cancer cell lines were isolated from the patient's breast cancer tissues and cultured in BCMI medium.After the cells proliferated,the media were replaced with DEME medium.Cell line STR genotyping was done to determine cell-specific genetic markers and identification.Clone formation assay and transplantation assay were done to analyze the ability of breast cancer primary cell lines to form tumors.Results:We created 6 primary breast cancer cell lines.The 6 primary breast cancer cell lines from the patients were tagged with the definitively clinicopathological features,clinical diagnosis,therapeutic regimens,clinical effectiveness and prognostic outcomes.The STR genotyping assays identified the genetic markers and determined the identities of the 6 primary breast cancer cell lines.Clone formation assays and transplantation assay showed that the proliferative capacities of the patient-derived primary breast cancer cell lines were significantly greater compared with the conventional breast cancer cell lines.Conclusion:We created a panel of 6 patient-derived primary breast cancer cell lines as new cancer model for drug screening and basic research in breast cancer.