Herpes simplex virus-I type thymidine kinase gene is a drug sensitivity gene. It is still not very clear about how it kills tumor cells, the article reviewed in short in a few aspects such as molecular structure of TK gene, TK enzyme,bystander effect,gap junction intercellular communication,cell apoptosis and phagocytosis,inflammation and immunity reaction, and the developing direction of TK gene.

The high morbidity and mortality of pulmonary carcinoma,especially in male patient,are still the unsolved problems. Recently,more and more reports showed that gene therapy could have potential application in the treatment of the disease. In this article,some progresses in the gene therapy of pulmonary carcinoma, such as tumor suppressor gene,drug sensitive gene,antisense gene,multi-drug resistance gene,immune gene as well as anti-angiogenesis gene, were discussed.

Objective To study the characteristics of heart rate variabili ty (HRV) in states of calm supine position, supine position and counting, and ca lm upstanding position, and the relationship with TCM syndromes of cold-h eat and deficiency-excess. Methods Totally 233 patient s diagnosed by TCM & western medicine with different syndromes were divided into five groups. B y comparing the general changes of frequency domain of HRV under three kinds of condition s, the variation of HRV indexes was measured in the excess heat syndrome group ( 64 cases), deficiency cold syndrome group (16 cases), cold-heat complex syndrom e group (38 cases), yin deficiency with fire syndrome group (67 cases), and defic iency of both yin and yang syndrome group (48 cases). Results The low frequenc y (LF) and low frequency normalized unit (LFNU) manifested sympathetic nervous a ctivity were augmented and were related with the yang syndrome and heat syndrome obvi ously. The high frequency (HF) and high frequency normalized unit (HFNU) manifes ted parasympathetic nervous activity were augmented and were related with the yi n syn drome and cold syndrome. The increased LF/HF reflected the yang syndrome and hea t syndrome. The decreased LF/HF reflected yin syndrome and cold syndrome. The co ndition of counting had a weighing influence on the diagnosis of yang syndrome a nd heat syndrome. And the condition of upstanding played a weighing role in defi ciency syndrome and cold syndrome. Conclusion The law o f changes of HRV under three kinds of condition is helpful in syndrome differentiation of cold-heat an d deficiency-excess.

A Review Resistin, a new hormone found in the year 2001 and secreted by adipocytes, is related to type 2 diabetes and obesity. It brings some hope to solve the medical hamper of insulin resistance. The resistin discovery, molecule structure, function and expression, secretion regulation as well as gene polymorphism are reviewed in the article. [

Objective To research the jugular foramen,internal auditory pore (IAP)and the turning point between its components by imageological methods and to provide theoretical basis for retrosigmoid approach in the operation of acoustic neurinoma.Methods The skulls of 100 volunteers were scanned to get the final result with thin-section computed tomographic image. High-resolution spiral CT multiplane reformation was used to reform images that were parallel to the Frankfort horizontal plane to measure the distance between the turning point of retrosigmoid (A),the edge of jugular foramen(B)and the lower edge of the internal auditory canal(C)(denoted AC,AB,BC) and the shortest distance from the jugular foramen to AC.The angles between AC,AB and sagittal axis(α,β) were measured.Results The distance of AC was (44.94 ± 3.84)mm,the distance of AB was (43.68 ± 4.56)mm.The distance of BC was (6.15 ±2.04)mm,and the shortest distance between jugular foramen and AC was (5.21±0.23)mm.The angleαwas measured as (39.50±4.74)°,and the angleβwas measured as (46.35± 5.51)°.Conclusion The research measure the distance and angle between entry points and landmarks of retrosigmoid approach and the safe distance.

Objective:To measure the safe range from the foramen rotundum to the siphon of internal carotid artery using three-dimensional reconstruction technique, and to provide guidance for operation through pterygopalatine fossa.Methods:The skulls of 121 volunteers were scanned to get the final results with thin-section computed tomographic images.The position of the siphon of internal carotid artery (point A)and foramen rotundum (pointB)were ascertained.Three-dimensional reconstruction technique was used to build a coordinate system paralleled to the frankfort horizontal plane and the nasal septum plane.The coordinate system took point A as the coordinate origin.Point C and point D were the projections of point A in two planes parallel with frankfort horizontal plane and nasal septum plane which included point B.The distances of AC,AB,and BC were measured. The angles of the line went through A and B to the three planes were also measured.Results:The distance of AC was measured as 13.22 (3.79)mm (range,8.33 - 105.67 mm;95%CI:8.55 - 21.39 mm).The angle to the sagittal plane was measured as 33.54 (9.23)° (range,5.38- 66.58°;95%CI:30.88 - 34.20°). The angle to the coronal plane was measured as 53.17 (10.48)°(range,5.60-75.02°;95%CI:51.29-55.06°).The angle to the horizontal plane was measured as 9.43 (12.91 ) mm (range,- 28.44 - 82.22;95% CI:7.11 - 11.76 ). Conclusion:The safety distance from foramen rotundum to the siphon of internal carotid artery in the operation through pterygopalatine fossa (PPF) under nasoendoscope is obtained by thin-section computed tomographic images.

Objective To investigate the methods and effectiveness of heterotopic reconstruetion of hepatic artery in orthotopic liver transplantation. Methods The methods of heterotopic hepatic artery reconstruction and postoperative management of 36 cases of recipient vascular anomalies among 440 cases of liver transplantation performed in our hospital over a ten year period,were retospectively analysed. Results In 10 of 36 recipients the donor hepatic artery was anastomosed to recipient infrarenal aorta ,10 to the suprarenal aorta ,4 to the left gastric artery and 2 to the splenic artery. Five patients died perioperatively with patency of hepatic artery, and 31 recipients have survived for 3 to 48 months without hepatic artery complications; 1 patient had to receive liver retransplantation because of ischemic necrosis of bile duct. Conclusions In cases of disease or anomaly of recipient hepatic artery during liver transplantation,the heterotopic reconstruction of donor hepatic artery to the infarenal or suprarenal aorta,splenic artery or left gastric artery of the reeipient is indicated,and the results are satisfactory.

Objective　To observe killing effect of HSV1-TK／GCV system on human pulmonary adenocarcinoma cell A549 in vitro and in vivo. Methods　A retroviral vector containing TK gene was constructed and transduced into pulmonary adenocarcinoma cell A549 by electroporation. The sensitivity of transfected cell to GCV in vitro and bystander effect and cellular apoptosis were observed. The recombination and expression of TK gene were examined by DNA PCR and in situ hybridization individually. In addition, the therapeutic effect of GCV on subcutaneous tumors inoculated with transfected and parental cells respectively was observed. Results　The transfected cells were irregular in shape, polyangular and easy of vacuolization. The double time of A549,A549-PLXSN and A549-TK was 36.15±3.27、40.82±3.75 and 42.06±4.12 hours respectively (P＞0.05). The sensitivity of transfected cells to GCV was 46 times higher than that of parental cells and bystander effect was more apparent in high density inoculation cells than in low density. Apoptotic bodies and semimoon feature in nuclear were observed in transfected cells, but not in parental cell. Apoptotic cells were found significantly more in transfected cells than in parental cells by FCM and TUNEL (P＜0.001). The recombination and expression of TK gene were positive in the transfected cells. In vivo, growth of tumors which formed by transfected cells was significantly inhibited by GCV, however, there was no similar inhibitive effect found in control group. Conclusion　The transfected cells have obtained sensitivity to GCV. The killing effect of TK／GCV system on tumor cells is probably related to apoptosis. GCV could inhibit growth of tumors inoculated by transfected cells.

Objective:To investigate cognitive function changes and their influential factors in patients with ischemic stroke and leukoaraiosis.Methods:A total of 500 patients with ischemic stroke who received treatment in Yiwu Central Hospital from January 2018 to October 2019 were included in this study. They were divided into simple ischemic stroke group ( n = 200) and ischemic stroke complicated by leukoaraiosis group (combination group, n = 300). The infarct location and the degree of leukoaraiosis in the combination group were analyzed. An additional 150 volunteers who concurrently underwent the Cognitive Function Test in the same hospital were selected as controls. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Patients in the combination group were divided into cognitive impairment group (MoCA score ≥ 26 points) and non-cognitive impairment group (MoCA score < 26 points) according to MoCA score. The risk factors of cognitive impairment in patients with ischemic stroke and leukoaraiosis were analyzed. Results:The scores of the MMSE, MoCA, Clock Drawing Test (CDT), Verbal Fluency Test (VFT), and Digit Span Test (DST) in the control group were (28.93 ± 2.70) points, (28.35 ± 2.74) points, (4.69 ± 1.14) points, (4.94 ± 0.42) points, and (14.33 ± 1.66) points respectively. They were (26.92 ± 2.18) points, (25.02 ± 3.52) points, (3.61 ± 1.60) points, (4.77 ± 0.46) points, and (11.73 ± 1.16) points, respectively in the simple ischemic stroke group and (24.91 ± 2.79) points, (20.70 ± 3.06) points, (2.87 ± 1.23) points, (4.07 ± 0.85) points, and (10.82 ± 0.93) points respectively in the combination group. There were significant differences in the scores of the MMSE, MoCA, CDT, VFT, and DST among the three groups ( F = 124.50, 318.50, 93.43, 112.60, 428.60, all P < 0.001). Significant differences in the scores of the MMSE, MoCA, CDT, VFT, and DST were observed between patients with different degrees of leukoaraiosis ( F = 69.09, 102.40, 20.98, 60.90, 57.00, all P < 0.001). Spearman correlation analysis results showed that the scores of the MMSE, MoCA, CDT, VFT, and DST were negatively correlated with the degree of leukoaraiosis ( r = -0.61, -0.69, -0.43, -0.56, -0.44, all P < 0.05). Logistic regression analysis results showed that age, history of smoking and drinking, history of diabetes, history of stroke, and infarct location were the independent risk factors for cognitive impairment in patients with ischemic stroke and leukoaraiosis. Education level was a protective factor against ischemic stroke and leukoaraiosis. Conclusion:The degree of cognitive impairment in patients with ischemic stroke and leukoaraiosis is related to the degree of leukoaraiosis. Age, history of smoking and drinking, history of diabetes, history of stroke, infarction location, and education level are the influential factors of cognitive impairment.

Gefitinib is the well-tolerated first-line treatment of non-small cell lung cancer. As it needs analgesics during oncology treatment, particularly in the context of the coronavirus disease, where patients are more susceptible to contract high fever and sore throat.This has increased the likelihood of taking both gefitinib and antipyretic analgesic acetaminophen (APAP). Given that gefitinib and APAP overdose can predispose patients to liver injury or even acute liver failure, there is a risk of severe hepatotoxicity when these two drugs are used concomitantly. However, little is known regarding their safety at therapeutic doses. This study simulated the administration of gefitinib and APAP at clinically relevant doses in an animal model and confirmed that gefitinib in combination with APAP exhibited additional hepatotoxicity. We found that gefitinib plus APAP significantly exacerbated cell death, whereas each drug by itself had little or minor effect on hepatocyte survival. Mechanistically, combination of gefitinib and APAP induces hepatocyte death via the apoptotic pathway obviously. Reactive oxygen species (ROS) generation and DNA damage accumulation are involved in hepatocyte apoptosis. Gefitinib plus APAP also promotes the expression of Kelch-like ECH-associated protein 1 (Keap1) and downregulated the antioxidant factor, Nuclear factor erythroid 2-related factor 2 (Nrf2), by inhibiting p62 expression.Taken together, this study revealed the potential ROS-mediated apoptosis-dependent hepatotoxicity effect of the combination of gefitinib and APAP, in which the p62/Keap1/Nrf2 signaling pathway participates and plays an important regulatory role.