Objective To explore the effect of gene mutations of epidermal growth factor receptor ( EGFR) on targeting therapy of advanced non-small cell lung cancer (NSCLC). Methods The 139 hospitalized patients who had been treated at least once with platinum-based chemotherapy and had tumor progression or recurrence after the last chemotherapy between December 2005 and December 2009, underwent EGFR gene test extracted from the pathological tissues. Based on the results of the test, the patients were divided into three groups: EGFR mutation per os (p.o.)Gefitinib (MPG) group, wild-type EGFR per os (p. o. ) Gefitinib (WpG) group and wild-type EGFR post-docetaxel chemotherapy (WpD) group. Clinical characteristics, pathology, treatment efficacy,survival time, performance status (PS) score, adverse reaction and quality of life of patients in the three groups were assessed. Results The EGFR mutation rate were higher in female, patients with adenocarcinoma and non-smokers than in male, smokers and those without adenocarcinoma. There were significant differences in median progression-free survival and median survival time among the three groups, which were 2.8 and 8. 9 months in MpG group, 2.0 and 7.1 months in WpG group,2.5 and 7. 8 months in WpD group(H=11. 198, 16. 991 ,all P＜0.01). The changes of PS score were significantly different between MpG group and WpG group (96. 8% vs. 62. 0%, x2 = 12. 583 ,P＜0. 01 ). However, there was no difference in changes of PS score between WpG group and WpD group (62. 0% vs. 66. 0%, x2 =0. 878,P＞0. 05). Conclusions The gene mutation of epidermal growth factor receptor may be served as an important indicator of advanced non-small cell cancer therapy.

Objective To observe the effects of electro-acupuncture (EA) on body weight, insulin resistance, hypothalamic agouti gene-related protein (AGRP) and neuropeptide Y (NPY) in diet induced obesity (DIO) rats; To discuss its mechanism for DIO.Methods Fifty SD male rats were randomly divided into low fat diet groups (LFD) and high fat diet group. After the DIO models were established, the successful model rats were randomly divided into model group, EA group and Orlistat (OLST) group. EA was applied to “Zusanli” (ST36) and “Quchi” (LI11) for 20 minutes. The treatment was done once a day for 28 days. OLST was treated with orlistat by gavage. LFD and model did not receive treatment. Body weight was recorded every day. FPG and FINS were detected. The expressions of AGRP and NPY were detected by RT-QPCR. Morphological changes of adipocyte and liver were examined by HE staining.Results The body weight, HOMA-IR, AGRP, NPY and diameter of adipocyte of EA group and OLST group were significantly lower than model group (P<0.05), difference between EA group and OLST group. The states of hepatic steatosis were improved in EA group and OLST group.Conclusion EA has the effects on weight loss by inhibiting the expressions of AGRP and NPY by improving IR.

Objective To construct a lentiviral vector-based short hairpin RNA (shRNA) targeting the gene encoding tryptophan-aspartate containing coat protein ( TACO) and to evaluate its inhibitory effect on the expression of TACO , and to further elucidate its effects on the phagocytosing and intracellular killing of My-cobacterium tuberculosis (M.tb) by macrophages and the possible mechanisms.Methods Three shRNA frag-ments targeting TACO gene and a scrambling control shRNA fragments were designed and cloned into the lentivi -ral vector pSicoR .The recombinant lentiviral vectors were identified by sequencing analysis and then packed in 293T cells.Real-time RT-PCR and Western blot assay were performed to evaluate the gene-silencing efficiency of the recombinant lentiviral vectors among RAW 264.7 cells transfected with the concentrated lentivirus .The most effective lentivirus was screened out to transfect the RAW 264.7 cells for 48 hours, followed by infection those cells with M.tb strains.The entry and intracellular survival of M .tb strains in RAW264.7 cells were de-termined by bacterial culture at indicated time points .The colocalization of M .tb and lysosomes was detected by immunofluorescence staining .The cyto-ID autophagy kit was used to detect the cellular autophagy and the auto-phagy-associated protein LC 3 was determined by Western blot assay .Results The recombinant lentiviral vec-tors were successfully constructed and confirmed by sequencing analysis .Decreased expression of TACO in RAW264 .7 cells was detected after transfecting the cells with the lentiviral vector-based shRNA vectors targeting TACO gene for 48 hours.The most effective lentivirus , LV-pSRT1, decreased the expression of TACO by 85.24%and 69.00%at the mRNA and protein levels, respectively.The bacterial loads in LV-pSRT1 trans-fected RAW264.7 cells were significantly decreased at the time point of 0 h after M.tb infection as compared with those in the control lentivirus treated cells (5.50×104 vs 8.1 ×104, P<0.05).Compared with the RAW264 .7 cells transfected with control lentivirus , the survival rate of intracellular M .tb strains in LV-pSRT1 transfected cells was significantly decreased at the time point of 48 h (134.54% vs 213.58%, P<0.05) and 72 h (148.18%vs 262.96%, P<0.05) considering the bacterial load at the time point of 0 h as the standard. The immunofluorescence staining demonstrated that the colocalization of M .tb strains with lysosomes was signifi-cantly enhanced in LV-pSRT1 transfected cells as compared with that in control lentivirus treated cells (75.67%vs 10.66%, P<0.05).Moreover, significantly enhanced autophagy and relative expression of LC 3Ⅱ protein were observed in RAW264.7 cells with TACO gene knockdown (16.20%vs 8.50%, P<0.05;0.51 vs 0.34, P<0.05).Conclusion The lentiviral vector-based shRNA targeting TACO gene could effectively knockdown the expression of TACO protein , decrease the entry and increase the intracellular killing of M .tb strains in mac-rophages.The enhanced intracellular killing of M .tb strains by macrophages was associated with the increased fusion of M.tb-containing phagosome and lysosome .

Objective: To evaluate the surgView-RFT electromagnetic navigation system in radiofrequency thermocoagulation(RFT). Methods: 6 foramen ovales of 3 cadavers were punctured by 3 beginners. Every one tried 5 times by free-hand and 5 times by SurgView-RFT electromagnetic navigation-guidance. After each puncture, CT scans were used as golden standard to measure the distance between the tip of needle and the anterior margin of the foramen ovale. T test and variance of SAS 6.12 statistical software was used to do the statistic analysis. Results: The punctures by free-hand failed, and the distances between the tip of needle and the anterior margin of the foramen ovale were 8-10.6 mm. The punctures by navigation guidance were successful, and the distances between the tip of needle and the anterior margin of the foramen ovale were 2.68-3.54 mm. The error of navigation system was 0.59 mm which was verified by CT scan. There was significant difference between free-hand puncture and navigation-guided puncture. Conclusion: The surgView-RFT electromagnetic navigation system is characteristic with high performance, high accuracy and minimal invasion, while it is applied in training or clinical using.

OBJECTIVE: To determine the clinical characteristics, causes of pre-operative misdiagnosis and therapy of pulmonary cryptococcosis. METHODS: We retrospectively analyzed the clinical data of 28 patients suffering from pulmonary cryptococcosis from 2008 to 2013 in the Second Xiangya Hospital of Central South University. All patients were diagnosed pathologically. RESULTS: Of the 28 patients, 19 had no clear host factors. No patient was exposed to pigeons recently. The imaging findings showed that most patients had solitary, multiple nodules, masses, and patches. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) showed abnormal accumulation of fluorodeoxyglucose. Seven patients demonstrated malignancy and 1 demonstrated tuberculosis. None was considered as pulmonary fungus diseases. Microscopically, cryptococcosis granuloma formation was found in all patients and cryptococcosis neoformans were detected by Periodic acid-schiff and Grocott methenamine silver staining methods in the histopathological examination, respectively. Twenty-seven patients underwent lobectomy, and 1 had the medical antifungal drugs treatment. During the follow-up, symptoms in only 1 patient were not controlled. CONCLUSION Most pulmonary cryptococcosis patients have no evident immunocompromise. Clinical presentation of pulmonary cryptococcosis varies and is often related to the immune status of patients. Radiological manifestation of pulmonary cryptococcosis is indistinguishable from malignant tumor, and even 18F-FDG-PET imaging does not help to get a clear diagnosis. After surgical resection of the lung, systemic antifungal treatment is still necessary for special population. Systemic therapy of both fluconazole and itraconazole is classic choice for pulmonary cryptococcosis.
Cryptococcosis ; diagnosis ; pathology ; Fluorodeoxyglucose F18 ; Humans ; Lung ; microbiology ; pathology ; Lung Diseases, Fungal ; diagnosis ; pathology ; Positron-Emission Tomography ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To study the inhibitory effect of Huidu Yinhua powder from the Orthodox Manual of External Medicine on methicillin-resistant Staphylococcus aureus(MRSA),virulence factor α-hemolysin(Hla)activity,and biofilm formation,and to explore the optimal ratios of Huidu Yinhua powder and provide experimental support for its use.Methods The inhibitory effects of Huidu Yinhua powder and the herbs in the formula on USA300 were analyzed by the minimum inhibitory concentration(MIC),minimum bactericidal concentration(MBC),and disk diffusion assay(K-B method).Hemolysis,neutralization,oligomerization,and Western blot assays were used to verify in which form the drug inhibits the activity of virulence factor α-hemolysin(Hla).A biofilm assay was performed to evaluate the inhibitory effect of Huidu Yinhua powder on biofilm.Orthogonal experiments were performed to explore the optimal ratio of Huidu Yinhua powder.Results Huidu Yinhua powder inhibited the MRSA strain with a MIC90 of 64 mg/mL and an MBC of 256 mg/mL with antibacterial circle diameter of(7.50±0.50)mm.Huidu Yinhua powder inhibited Hla activity by inhibiting Hla secretion.The minimum effective concentration(MEC)was 16 mg/mL,and the MEC of biofilm was 8 mg/mL.In Huidu Yinhua powder,honeysuckle and astragalus only affected the hemolytic activity of MRSA and biofilm formation without inhibiting bacterial growth.The hemolytic activity and biofilm of MEC were both 32 mg/mL.Glycyrrhiza had a strong bacterial inhibitory capacity with a MIC90 of 8 mg/mL and biofilm MEC of 1 mg/mL without showing inhibitory hemolytic activity at subinhibitory concentrations.The orthogonal experiment showed that,at a ratio of honeysuckle,astragalus,and glycyrrhiza in Huidu Yinhua powder of 1∶2∶4,the MIC90 was 16 mg/mL,MEC of hemolytic activity was 8 mg/mL and that of biofilm was 4 mg/mL,both of which were the lowest among the nine groups.Conclusions Huidu Yinhua powder affects the hemolytic activity and biofilm formation of MRSA at subinhibitory concentrations with the optimal ratio of honeysuckle,astragalus,and glycyrrhiza being 1∶2∶4.

Objective:To study the relationships between neutralizing antibody response against autologous virus and disease progression of HIV-1 B'/C infected individuals in China.Methods:Twenty-four primary HIV-1 isolates were incubated with autologous plasma collected either freshly or at approximately six months intervals thereafter.Normal human peripheral blood mononuclear cells were incubated with the virus-serum mixtures for 7 days and then the production of p24 antigen was measured.The neutralizing titer of a particular plasma and virus was defined as the reciprocal of the highest dilution giving a 50% reduction in p24 Ag compared with NHP control wells.More than 1∶8 were considered significant and were scored as positive.Results:In neutralizing antibody(Nabs) response against contemporaneous virus,Nabs were produced in all slow progressors(SP) individuals,while only four in 21 of HIV group had.There was statistically significance of the neutralizing antibody titers between SP and HIV.When plasma samples of six months later were tested for their ability to neutralize autologous virus,all of SPs had higher neutralizing antibody titers and the titers of neutralizing antibody in HIV group had increased in different rate.Among the twenty-one individuals of HIV group,12 of these individuals had neutralizing antibody response against autologous virus and other 9 of these individuals had not.NAb titers of SP in six months later plasma were higher than those of HIV.There was a negative correlation between the generation of the neutralizing titer against autologous virus and the plasma HIV RNA level in HIV-1 B'/C infected individuals(including SP,HIV).Conclusion:Neutralizing antibody against autologous viruses in HIV-1 B'/C infected SP is higher than those of HIV group,suggesting that neutralizing antibodies play a vital role in delaying disease progression in these individuals.

Objective This study was to investigate the characteristics of posterior corneal astigmatism (PCA) and aberration in cataract patients with high myopia.Methods A retrospective study was designed.Two hundred and eighty-two eligible eyes of 190 cataract patients were enrolled in Eye and ENT Hospital of Fudan University from September to December,2014.The eyes were classified into two groups according to axial length (AL):high myopia group with 139 eyes (AL≥26 mm) and control group with 143 eyes (AL was 20 to 25 mm).The mean keratometric mid-radius of curvature (Km),corneal central thickness (CCT),astigmatism and aberrations were measured by the rotating Scheimpflug System (Pentacam),and the AL were measured by the partial coherence interferometry (IOL Master).This study followed the Helsinki declaration,and was approved by the Ethic Committee of Eye and ENT Hospital,Fudan University.Informed consent was signed from each patient.Results In high myopia group,the mean PCA was 0.3 D (range 0 ～ 0.9 D) and 92.8％ eyes had PCA values ＜0.5 D.The steep corneal meridian was aligned vertically (60°～ 120°) in 87.1％ eyes for the posterior corneal surface.There was no significant difference in PCA between the high myopia group and the control group (P =0.797).Significant positive linear correlations was found between PCA and anterior corneal astigmatism (ACA),PCA and anterior corneal root mean square (RMS),PCA and anterior lower-order RMS,PCA and posterior corneal RMS,PCA and posterior high-order RMS,PCA and posterior lower-order RMS (r =0.235,P =0.005;r =0.217,P =0.010;r =0.229,P =0.007;r =0.395,P =0.000;r =0.243,P =0.004;r =0.384,P =0.000).Compared with total corneal astigmatism (TCA),anterior corneal measurements overestimated with-the-rule astigmatism (WTR) by a mean of (0.27 ± 0.18) D in 65.67％ eyes,underestimated against-the-rule astigmatism (ATR) by (0.27 ± 0.18) D in 88.10％ eyes and underestimated oblique astigmatism (Obl) by (0.22 ± 0.10) D in 63.33％ eyes.Compared with total corneal aberrations,anterior corneal aberrations measurements overestimated by (0.275 ±0.176) μm in 87.05 ％ eyes,and the anterior corneal astigmatism types had no effect on the result.Conclusions In high myopia group,92.8％ eyes had PCA values ＜0.5 D and the main astigmatism type in posterior corneal surface was ATR.The posterior corneal astigmatism and aberration were needed to consider in choosing intraocular lens (IOL) before cataract surgery.

The discharge preparation service is a complete process, which is of great significance for ensuring the patients′ discharge safety and the home sustainability of rehabilitation nursing. It has become a hot issue among international nursing scholars. This paper reviews the concept, implementation content, assessment tools, nursing practice of patient discharge preparation services, so as to provide theoretical basis for forming patient discharge preparation services system with medical environment in China.

Objective To analyze the focuses and advances of professionalism studies in the field of nursing,and to provide reference for China′s nursing research. Methods Papers published from 1997 to 2016 on professionalism in nursing were retrieved from "Web of Science TMcore collection" citation database using the strategy of"Mesh=(professionalism AND Nurs*)".The knowledge atlas of the relevant literature of nursing professionalism were displayed by citespace visual analysis software. Results From 1997 to 2016, papers on professionalism in nursing amounted to 265, with the USA having the largest amount of publication of 32.94%,followed by the UK(8.67%)and Australia(8.30%),China was at No.7 on the list, accounting for only 3.77%. It was found that there was a wide range of research on professionalism studies in the field of nursing in foreign countries, including nursing education, nursing student, nursing profession, professional development, etc. Conclusions Nursing professionalism research mainly concentrated in nursing education in foreign,the present research on nursing professional spirit is still in its preliminary exploration phase in China. It should optimize the structure of nursing education and promote the development of nursing students professional.