The performance status(PS)≥2 patients with non-small cell lung cancer(NSCLC) are short of effective management.The phase Ⅱ/Ⅲ clinical trails of target therapy of anti EFGR of VEGFR have already got promise results.This article expatiates the actuality and development of the chemotherapy and novel target therapy for the PS≥2 patients with NSCLC.

Objective Estimating the therapeutic effect of music therapy and speech language therapy on post-stroke patients with non-fluent aphasia.Methods Eighty-four post-stroke patients diagnosed with non-fluent aphasia who came from the First Affiliated Hospital of Medical College of Shihezi University were collected between June 2012 and May 2014,then they were randomly divided into music therapy group (n =42) and speech language therapy group (n =42;including chronic (n =46) and acute groups (n =38)) based on table of random numbers.On the basis of conventionally using neurological drugs,music therapy and speech language therapy were given to the patients for one month,respectively.And language function was assessed by partial items of Chinese Version-Western Aphasia Battery before and after therapy.Results No significant changes were found in spontaneous speech,comprehension,repetition,naming and aphasia quotient in chronic and acute group patients through the music therapy and speech language therapy.Significant improvements were revealed in repetition (32.00 (15.00,53.75) vs 48.50(24.50,72.00),Z =2.147,P =0.032;33.00(14.50,49.25) vs 48.50(18.50,63.75),Z =2.018,P=0.038),naming (20.00 (8.50,34.75) vs 37.5(12.50,64.75),Z =2.298,P =0.022;19.50 (7.00,31.25) vs 34.50 (15.00,52.75),Z =2.039,P =0.041) and aphasia quotient (24.50 (10.50,37.50) vs 43.00 (18.00,64.75),Z =2.432,P =0.015;22.50 (10.00,34.50) vs 36.00 (14.00,54.00),Z =2.027,P =0.043) through music therapy and speech language therapy in chronic group patients.Comprehension was significantly improved through music therapy in chronic group patients.Repetition (24.50 (11.00,38.75) vs 46.50 (24.50,67.75),Z =2.038,P =0.043;26.50 (9.50,36.25) vs 42.50(19.00,64.25),Z =1.972,P =0.048) was significantly improved through music therapy and speech language therapy in acute group patients.And spontaneous speech (2.00 (1.00,3.75) vs 8.00 (4.00,12.75),Z =2.012,P =0.036),comprehension (51.00 (17.50,73.75) vs 85.00 (48.00,101.00),Z =2.298,P =0.022),naming (17.50(6.00,29.00) vs 37.50(16.00,58.75),Z =2.161,P =0.031) and aphasia quotient (18.00 (7.50,31.25) vs 42.50 (20.50,63.75),Z =2.256,P =0.024) were significantly improved through music therapy in acute group patients.However,no significant improvements were found in the speech language therapy group of acute patients.Conclusion The two therapies are effective in the chronic patients with non-fluent aphasia,and music therapy is also effective in acute patients with non-fluent aphasia.

Objective To investigate the influence of social support on the depression and anxiety of standardized training residents.Methods Three hundred and eighteen standardized training residents selected by random sampling method from 4 training bases in Shanghai participated in this survey.ResultsThe average score of PHQ-9 was(7.24±5.20), and 67.30%(n=214)of participants had different degrees of depression;the average score of GAD-7 was(5.57±4.55), and 55.03%(n=175)of participants had different degrees of anxiety.One-way analysis of variances showed that standardized training residents who had work experience, longer training years and less salary satisfaction got higher scores in PHQ-9 and GAD-7.Male physicians had higher scores in GAD-7 than female ones.The scores of PHQ-9 (r=-0.390, P<0.01) and GAD-7 (r=-0.376, P<0.01) were both negatively correlated with social support.Regression analysis showed that training years,salary satisfaction,objective social support and the availability of support were significant for predicting the scores of PHQ-9(adjusted R2=0.242,F=17.893), work experience, salary satisfaction,objective social support and the availability of support were significant for predicting the scores of GAD-7(adjusted R2=0.228,F=14.390).After controlled the demographic variables, social support explained the variation rate of 0.119 to the score of PHQ-9 and 0.126 to the score of GAD-7.Conclusion The depression and anxiety of standardized training residents in this study is in a serious situation.Providing the objective social support and the availability of support as well as improving the salary satisfaction of standardized training residents may relieve the depression and anxiety and enhance their mental health.

Objective To explore the correlations of adult attachment with interpersonal conflict resolu-tions styles and differences between soldiers and employees. Methods Relationship questionnaire (RQ),experi-ence in close relationships (ECR),and Rahim handling interpersonal conflict inventory (ROCI-II) were adminis-tered to 543 employees from different enterprises in Beijing and Liaoning province and 701 soldiers. Results The results suggested the distribution of adult attachment style between soldiers and employees were significantly differ-ent. Compared with employees, there were higher dismissing hat lower secure rate in soldier sample. On handling interpersonal conflict strategy indices, such as integrating, avoiding, dominating and obliging but not compromising (t_((1120))=1.97, P<0.05), there were no significant differences between soldiers and employees. Only on in-tegrating, there were significant ditterenees among four adult attachment styles (F_((3,1009))=10.18, P<0.001).Attachment avoidance had a significantly negative correlation with integrating, obliging and compromising (r=-0.31,-0.11,-0.13 respectively), while attachment anxiety had moderate but significant correlations with a-voiding, dominating and obliging and compromising (r=0. 16,0.35, 0.35, 0.39, 0.30 respectively). Conclu-sion Adult attachment is closely related to handling interpersonal conflict strategies, and there was difference on compromising between soldiers and employees.

Objective To determine the efficacy and toxicity of docetaxel in patients with paclitaxel-resistant advanced non-small cell lung cancer (NSCLC). Methods The clinical data from 15 patients with NSCLC who were admitted in the Shanghai Chest Hospital from January 2005 to May 2008 were retrospectively analyzed. The effects and toxicities of the second-line treatment were assessed. The progression-free survival time(PFS) and overall survival time(OS) were analyzed. Results The disease control rate was 66.7 %, with a progression-free survival time of 6 months, and a overall survival time of 17.3 months. The 1-year survival rate was 63.3 %. The toxic effects were as expected. Conclusion The doeetaxel-based agent is active in patients with paelitaxel-resistant advanced NSCLC.

BACKGROUND:With the development of sports medicine and research of radiologic imaging techniques, Blumensaat line (the radio-opaque line at the roof of the intercondylar notch) has been paid increasing attention. Blumensaat line is considered as measurement indexes of knee diseases. Taking advantage of the Blumensaat line, many surgeons and radiography physicians are trying to diagnose some knee diseases. OBJECTIVE:According to the knowledge about Blumensaat line in auxiliary diagnosis of knee disease, we hoped that it wil have a wide application in clinic. METHODS:A computer-based online search of CBM, CNKI, Wangfang Database and PubMed between 2000 and 2015 was performed for articles addressing Blumensaat line. We summarized its application as different diagnostic indicators. The key words were patel a alta, Blumensaat line, anterior cruciate ligament (ACL) injuries and ACL reconstruction. Thirty-nine studies were accorded with the inclusion criteria. RESULTS AND CONCLUSION:Blumensaat line represents the tangential y hit part of the roof in the intercondylar fossa. The line can be used for diagnosing ACL injuries and directing ACL restruction. (1) Blumensaat line and patel a alta:Patel a heights can be measured with the use of Blumensaat method, modified Blumensaat method and modified Blumensaat ratio. Modified Blumensaat ratio was found by Japanese researchers in 2014 and it is efficient. (2) Blumensaat line and ACL injuries:Blumensaat angle is formed by Blumensaat line and ACL. If this angle is negative or it is greater than 15°, we can draw a conclusion that the ACL was hurt. (3) Harner’s method can be used for choosing an accurate isometric point and a perfect bone tunnel’s angel in ACL reconstruction.

Objective To investigate the expression of Specific protein1(SP1)in esophageal squamous cell carci-noma(ESCC)and adjacent normal tissues and its effect on the proliferation and apoptosis of ESCC cells.Methods The expression of SP1 protein in 121 ESCC tissues and 74 adjacent normal tissues was detected by immunohisto-chemistry.Chi-square test and Cox regression analysis were used to analyze the relationship between SP1 and clini-copathological parameters and survival prognosis of ESCC patients.SP1 siRNA(small interfering RNA)was con-structed and transfected into esophageal squamous cell carcinoma Eca1 09 and EC9706 cell lines.Western blot was used to detect the expression of SP1 after transfection.The effects of SP1 on the proliferation and apoptosis of e-sophageal squamous cell carcinoma cells were detected by cloning assay,CCK-8 cell proliferation assay and flow cytometry.Results SP1 protein was expressed in the nucleus of esophageal squamous cell carcinoma tissues,and the expression rate of SP1 protein in esophageal squamous cell carcinoma tissues was significantly higher than that in adjacent normal tissues(x2=20.568,P＜0.01).Comparison between groups showed that the high expression rate of SP1 was higher in female(P=0.041),moderately or poorly differentiated(P=0.038)and T3-T4 inva-sion depth(P=0.041)ESCC(esophageal squamous cell carcinoma)patients.Log-rank test showed that the sur-vival time of patients with high expression of SP1 was shorter than that of patients with low expression of SP1(P=0.048).Multivariate Cox regression analysis showed that TNM(tumor node metastasis classification)stage(Ⅲ+Ⅳ)was a potential risk factor for shorter survival time in patients with esophageal squamous cell carcinoma(P＜0.001).Cell biological experiments showed that compared with the control group,the proliferation ability of esoph-ageal squamous cell carcinoma cell lines decreased(P＜0.05)and the apoptosis index increased(P＜0.05)after silencing SP1.Conclusion SP1 protein is highly expressed in human esophageal squamous cell carcinoma tissues and is associated with poor prognosis in patients.Silencing SP1 can inhibit the proliferation of esophageal squamous cell carcinoma cells and promote their apoptosis.

Objective:To explore the influencing factors of hemodialysis (HD) initiation in non-diabetic kidney disease (NDKD) patients with predialysis arteriovenous fistula (AVF) creation.Methods:This was a single-center prospective cohort study. The NDKD patients undergoing predialysis AVF creation were enrolled at the First Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2018. According to the estimated glomerular filtration rate (eGFR, the Chronic Kidney Disease Epidemiology Collaboration equation) and age, patients were divided into different subgroups, eGFR: group 1 [eGFR<10 ml·min -1·(1.73 m 2) -1], group 2 [ eGFR between 10 to 15 ml·min -1·(1.73 m 2) -1], and group 3 [eGFR > 15 ml·min -1·(1.73 m 2) -1]; age: age ≥65 years group and age <65 years group. The primary outcome was defined as the initiation of HD within 1 year after AVF surgery. The second outcome was the use of AVF access at the time of HD initiation. Cox proportional hazard regression was performed to identify which demographic and clinical factors were associated with the initiation of HD after AVF surgery. Logistic regression analysis was performed to investigate factors associated with AVF use at the initiation of HD. Results:A total of 220 patients were enrolled, with age of (48.1±16.2) years, of which 143(65.0%) were males. Overall, the clinical parameters of eGFR, cystatin C, serum albumin, 24h-Urine protein, serum phosphorus were as follows respectively, 7.7 (6.6,9.2) ml·min -1·(1.73 m 2) -1, (3.93±1.12) mg/L, (36.0±4.0) g/L, (2.22±1.36) g, (1.71±0.53) mmol/L. The proportion of patients initiating HD within 6 months ( Fisher=6.832, P=0.020) and the level of hemoglobin ( F=3.112, P=0.047) were higher in group 3 compared to the other two eGFR groups. While the median time interval between AVF creation and HD initiation ( H=6.295, P=0.043) was shorter in group 1. In age <65 years group, the level of serum albumin ( t=2.076, P=0.039), triglyceride ( t=1.995, P=0.048) were higher compared with age ≥65 years group; interestingly, the proportion of patients initiated HD within 3 months ( χ2=4.033, P=0.045) and 6 months ( χ2=5.012, P=0.025) were lower in age <65 years group. The median time interval between AVF creation and HD initiation among these patients was 84 (49,174) days. The patients initiating HD within 3 months, 6 months, and 1 year after AVF creation were 112 (50.9%), 152 (69.1%), and 202 (91.8%), respectively. Multivariate Cox regression analysis indicated that higher cystatin C level ( HR=1.283, 95% CI 1.121-1.469, P<0.001) was associated with earlier HD initiation within 1 year of AVF surgery in NDKD patients. AVF usage was accomplished in 64.3% of patients who initiated HD within 90 days, the ratio was 100.0% in those initiated HD between 91 to 180 days, and 88.0% in those ≥181 days after AVF surgery. No factor was independently associated with AVF use at HD initiation identified by multivariate logistic regression analyses in patients with NDKD. Conclusion:Serum cystatin C level is associated with HD initiation within 1 year of the predialysis AVF creation in NDKD patients.

Objective:To evaluate the potential effects of serum lipid levels, appendicular skeletal muscle mass index (ASMI) and body mass index (BMI), together with its dynamic changes, on tumor progression in renal clear cell carcinoma patients, so as to inform body weight management.Methods:This prospective cohort study included a total of 100 patients with high-risk clear cell renal cell carcinoma. Serum lipid levels were detected, ASMI and BMI were measured using bioelectrical impedance analysis and the dynamic changes of BMI were tracked. The effects of BMI, ASMI and serum lipid levels on tumor progression within 2 years were explored.Results:Patients with normal BMI and low ASMI had 5.248 (95% CI: 1.946 to 14.153, P = 0.001) times higher risk of tumor progression than those who were overweight or obese. For every 0.1-unit increase in pre-operative HDL-C, the risk of tumor progression decreased by 0.771 (95% CI: 0.631 to 0.942, P = 0.011) times. Patients who experienced more than 5% decrease in BMI compared with baseline had 5.165 (95% CI: 1.735 to 15.370, P = 0.003) times the progression risk of patients whose BMI changed within ±5% from baseline. Conclusions:The advantage of obese clear cell carcinoma patients over normal-weight patients in tumor progression-free survival may be influenced by ASMI, pre-onset involuntary weight loss and lipid levels. Therefore, patient weight management should not merely focus on absolute BMI but tailor to individual characteristics, including cancer stage, body composition and metabolic status.

Objective To detect the changes of serum microRNA-126(miR-126)before interventional thrombectomy for acute cerebral infarction,and to explore its correlation with the prognosis of patients.Methods A retrospective analysis was performed on 101 patients with cerebral infarction who underwent interventional thrombectomy in he First People's Hospital of Huzhou from January 2019 to December 2021.The patients were followed up for 2 month.According to modified Rankin scale(mRS),they were divided into good prognosis group(mRS≤2 points,56 cases)and poor prognosis group(mRS>2 points,45 cases).The clinical data of two groups and the difference of miR-126 before thrombectomy were compared,and the effect of serum miR-126 change on the prognosis of patients with cerebral infarction was analyzed.Results The serum miR-126 level before thromrectomy in good prognosis group was significantly higher than that in poor prognosis group[(9.31±2.14)vs.(1.36±0.28),P<0.01].There was a negative correlation between miR-126 and National Institute of Health stroke scale(NIHSS)score(r=-0.737,P<0.01),and a positive correlation between miR-126 and good collateral circulation(r=0.645,P<0.01).The area under the receiver operating characteristic curve for establishing miR-126 to predict prognosis after thrombolectomy for cerebral infarction was 0.818.The sensitivity and specificity were 78.9%and 86.0%at the optimal cut-off value.Conclusion The change of serum miR-126 level before thrombectomy may be related to the prognosis of patients with cerebral infarction,which can be used as a marker to predict the prognosis of cerebral infarction after interventional therapy.