Objective To compare the advanced non -small cell lung cancer (NSCLC)patients before and after chemotherapy peripheral blood EGFR mutation status,we understand whether the chemotherapy drug impacts the EGFR mutation status of the advanced NSCLC patients,so as to improve the precision of EGFR TKIs -drug use. Methods To collect the peripheral blood of 30 cases of advanced NSCLC before chemotherapy and after chemotherapy for 6 cycles.DHPLC technique was used to detect the EGFR mutation states of EGFR exon 19 and in exon 21.Results In 30 patients,chemotherapy prior EGFR mutation positive rate was 53.3% (16 /30).After 6 cycles of chemotherapy, the EGFR mutation positive rate was 36.6% (11 /30),the consistent rate was 56.6 (17 /30)before and after chemo-therapy,inconsistent rate was 53.4% (13 /30).10 cases from positive to negative before chemotherapy,3 cases from negative into positive before chemotherapy with statistical significance (P =0.046).Six EGFR19 exons changed, change rate of 20%,8 EGFR21 exons shift changed at a rate of 26%.EGFR19,21 shift in 1 case,with no statistical significance(P =0.39,P >0.05).Conclusion (1)The late NSCLC patients before and after peripheral blood of EGFR mutation status change,so before starting the targeted therapy we must recive real -time detection of peripheral blood EGFR mutation status,so as to decide whether to choose EGFR TKIs targeted drug therapy.(2)EGFR21 exons transformation rate is higher than EGFR19 exons conversion rate,but with no statistical difference,this phenomenon may be related to EGFR19 exons patients who with EGFR mutations -TKIs treatment efficiency is higher.

Objective To investigate the effects of goal-oriented scheme for continuous mild sedation on patients with mechanical ventilation.Methods A total of 78 patients undergoing mechanical ventilation were enrolled via simple random number sampling method from January,2013 to December,2015,and divided into the experimental group(n=38)and the control group(n=40).The experimental group received goal-oriented scheme for continuous mild sedation designed by our department,and the control group received routine sedation protocol.Total sedative dosage,duration of mechanical ventilation,length of ICU stay,fatality rate in ICU,ventilator-associated pneumonia,pneumothorax,accidental extubation,tracheotomy were recorded.Results Duration of mechanical ventilation,length of ICU stay and total sedative dosage,incidence of ventilator-associated pneumonia and rate of tracheotomy in the experimental group were significantly lower than those in the control group and the differences were statistically significant(P＜0.05).There were no significant differences in accidental extubation,reintubation and barotrauma between two groups (P＞0.05).Conclusion Goal-oriented scheme for continuous mild sedation can reduce total sedative dosage,length of ICU stay,duration of mechanical ventilation,rates of ventilator-associated pneumonia and tracheotomy.It is safer and more effective which can improve the prognosis of mechanically ventilated patients.

BACKGROUND: Studies of umbilical cord blood stem cells transplantation for liver function failure have demonstrated that Astragalus membranaceus preparation can stimulate hemopoietic stem/progenitor cell proliferation.OBJECTIVE: To explore the effect of Astragalus membranaceus injection on the differentiation of umbilical cord blood stem cell into hepatocyte in vitro and in vivo for the treatment of liver failure. METHODS: The third and fourth passage of human umbilical cord blood stem cells (HUCBSCs) were collected. In drug screening test, there were 4 groups: cells were separately cultured with 0, 40, 200, and 400 mg/L Astragalus membranaceus injection to screen the appropriate for cell growth. In cell differentiation test, there were 2 groups: HUCBSCs were respectively cultured with hepatocyte growth factor (HGF, 10 μg/L), and HGF (10 μg/L) plus 200 mg/L Astragalus membranaceus injection. D-aminogalactose was intraperitoneally injected to establish a model of acute liver failure. Surviving model rats (48 hours) were randomly divided into six groups: model control, Astragalus membranaceus injection, rat peripheral blood mononuclear cells, combination, combination+Cytoxan, and combination+dexamethasone groups. The alpha fetoprotein mRNA and albumin mRNA expression was determined by RT-PCR, and liver function indexes were observed. RESULTS AND CONCLUSION: Different mass concentration of Astragalus membranaceus injection displayed varied influence on HUCBSC proliferation: 200 mg/L was the best for HUCBSC proliferation. Compared with HUCBSC cultured with HGF alone, the number of albumen-positive cells in HUCBSCs cultured with 200 mg/L Astragalus membranaceus injection and HGF was greater (P < 0.05). Moreover, the expression of albumen mRNA in combination, combination+Cytoxan, and combination+dexamethasone groups was greater than rat peripheral blood mononuclear cells group, while alpha fetoprotein mRNA expression was only greater than rat peripheral blood mononuclear cells group in early stage. At 7 days of treatment, the values of alanine aminotransferase, aspartate amino transferase and total bilirubin were significantly greater in combination, combination+Cytoxan, and combination+dexamethasone groups compared with model control, Astragalus membranaceus alone and rat peripheral blood mononuclear cells groups (P < 0.05), but no differences were observed among model control, Astragalus membranaceus alone and rat peripheral blood mononuclear cells groups (P > 0.05). Results indicate that Astragalus membranaceus injection at 200 mg/L can promote the proliferation and differentiation of HUCBSCs into hepatocyte in vitro and in vivo, ameliorate liver function and improve treatment effect of HUCBSC transplantation for liver failure.

Objective To explore the correlation between chromosome fragile site in peripheral blood lymphocytes and proto-oncogene expression rate in patients with hepatocellular carcinoma.Methods The peripheral blood lymphocyte chromosome preparation was made routinely.The cells were cultivated with low concentrations of calf serum and folic acid,higher pH medium and G-banding method.The fragile sites in 20 patients with hepatocellular carcinoma(experimental group) and 18 healthy subjects(control group) were exactly located and analyzed.(Results The) fragile sites in experimental group were determined as 44 species mainly distributed on the chromosomes of A,B,C group.The expression rate of the fragite site in experimental group(9.90%) was significantly higher than that in control group(0.67%)(P

Nowdays, Chinese medicine training has two modes, apprentice education and college education. The two modes showed the differences in the source of students, teaching content, methods and effect of the education. The two models should be combined to cultivate excellent talents of Chinese Medicine. Additionally, different training should be conducted according to different goals. This article focused on the traning mode of Chinesae medicine talents at Beijing University of Chinese Medicine in recent years, put forward some issues in future education and provided some promoting strategies to combine traditional apprentice education and college education.

ObjectiveTo explore the risk factors for the prognosis of respiratory failure in neonates with gestational age≥34 weeks. MethodsA total of 143 hospitalized neonates with respiratory failure who had gestational age≥34 weeks were enrolled from Jan. 2011 to Jun. 2013. According to the outcome, the neonates were divided into good prognosis group and poor prognosis group. The risk factors for the prognosis of respiratory failure were screened by univariate analysis and mul-tivariate binary logistic regression model.ResultsAmong the 143 neonates, 105 neonates had good prognosis and 38 neonates had poor prognosis. Univariate analysis showed that the mode of delivery, small for gestational age, 5 minutes Apgar score <7, and with primary disease being pneumonia/sepsis were associated with a poor prognosis. The differences were statistically signif-icant (P<0.05). Furthermore, the multivariate binary logistic regression model showed that, small for gestation age (OR=23.87, 95%CI:3.149-180.9) and pneumonia/sepsis (OR=2.996, 95%CI:1.514-5.928) were the independent factors of poor prognosis. ConclusionsSmall for gestation age and primary diseases being pneumonia/sepsis are the independent factors inlfuencing prog-nosis of respiratory failure in neonates born at a gestational age≥34 weeks.

Human resources are the key to TCM development. This article explored the effective channels to construct the system by deeply studying and identifying problem of the quantity, quality, configuration, development and training of TCM human resources under the characteristic medical reform of Gansu Province to provide references for better research and plan of TCM human resources for relevant department, further to realize the sustabile development of TCM characteristic medical reform in Gansu Province.

Objective To studyeffect of different processes for preparation ofβ- cyclodextrin inclusion pericarpium citri reticulatae - Radix Aucklandiae essential oil.Methods Extract pericarpium citri reticulatae-radix aucklandiae essential oil with steam distillation method, conductβ- cyclodextrin inclusion of pericarpium citri reticulatae-radix Aucklandiae essential oil with ultrasonic method, grinding method andsaturated aqueous solution method, and detect inclusion effect respectively by polarized light microscopy observation method and TG-DTA analysis method.Results Polarized lightphenomenon disappears under a microscope for the three inclusion preparation products, and TG-DTA curve of ultrasound method is superior to that of saturated aqueous solution method and grinding method.Conclusion Polarized light microscope observation method and TG-DTA method enjoysa good effect in determination of cyclodextrin inclusion, which provides a new method for determination of cyclodextrin inclusion results.

OBJECTIVE To elucidate the toxicological properties of CdTe quantum dots (CdTe QD) by investigating their effect on mitophagy in human umbilical vein endothelial cells (HUVECs).METHODS The purity of primarily cultured HUVECs was detected by immunofluorescence.Then,HUVECs were incubated with CdTe QD 0.1-100 mg· L-1 for 24 h.After treatment,the cell viability of HUVECs was detected with MT-T assay.The mitochondrial morphology was observed under a laser scanning confocal microscope after labeling with Mitotracker.The treated HUVECs were also labeled with JC-1 probe,and the mitochondrial membrane potential (MMP) was then examined by flow cytometry.The expression of mitophagy-related proteins including microtubule-associated protein 1 light chain 3 Ⅰ /Ⅱ (LC3 Ⅰ /Ⅱ),moesin-like BCL2-induced protein1(Beclin1),phosphatase and tensin (PTEN) homologinduced putative kinase 1(PINK1) and dynamin-related protein Ⅰ (DRP1) was determined by Westem blotting.RESULTS More than 95％ of the cultured cells expressed vascular endothelial cadherin and herein were vascular endothelial cells.The MTT result showed that the cell survival of HUVECs was significantly decreased after incubation with CdTe QD (0.1-100 mg,L-1) for 24 h (P＜0.05,P＜0.01).CdTe QD also induced extensive fragmentation of the mitochondrial network.The results of JC-1 assay showed that CdTe QD (0.1-100 mg· L-1) caused the disruption of MMP.The percentage of HUVECs with higher MMP was reduced from (91.8±0.6)％ in cell control group to (90.2±1.1)％,(84.4±0.9)％ (P＜0.05) and (78.1 ±1.3)％ (P＜0.01),respectively.The Western blotting data suggested that CdTe QD 10 mg·L-1 significantly increased the expression of autophagy-related protein beclin 1 and the ratio of LC3 Ⅱ/LC3 Ⅰ (P＜0.05,P＜0.01),CdTe QD 1 mg· L-1 also raised the level of mitophagy-related proteins like PINK1 and DRP1.CONCULSION CdTe QD can induce mitochondrial dysfunction as well as mitophagy in HUVECs.

Objective To distinguish BRO ?-lactamase by use of restriction endonuclease analysis and investigate antibacterial agents resistance of Moraxella catarrhalis(M. Catarrhalis) with different BRO ?-lactamases .Methods Nasopharyngeal swabs of children with respiratory tract infections from the outpatient department of Beijing Children's Hospital were cultured for isolating M.Catarrhalis. BSAC(british society for antimicrobial chemotherapy) agar diffusion test was used to determine antibacterial agents resistance of M.Catarrhalis.Nitrocefin disk was used to detect ?-lactamase. Restriction endonuclease analysis was used to distinguish BRO ?-lactamases . Antibacterial agents resistance of M. Catarrhalis with different bro genes was compared.Results (1)95.0% of the 80 strains were beta-lactamase positive. MIC 90 of ampicillin was 32 ?g/ml and MIC 90 of cefuroxime,cefaclor and cefotaxime were 4 ?g/ml,8?g/ml and 1?g/ml respectively,MIC 90 of tetracycline was 16?g/ml. Among the antibacterial agents,ciprofloxacin was the most sensintive agent.(2)Among 80 strains,6(7.5%) Strains were bro negative,55(68.8%) were bro-1 positive,19(23.8%)were bro-2 positive。Except 2 strains,the results of ?-lactamases were same as the results of nitrocefin disk and restriction endonuclease analysis.(3)Compared with bro-2 positive strains,the MIC value of ampicillin and cefaclor for bro-1 positive strains were higher.Conclusions Antibacterial agents resistance of M. Catarrhalis to ampicillin was sierous in China. It should be strengthened to monitor antibacterial agents resistance of M.Catarrhalis. Restriction endonuclease analysis can play an important role on characterizing bro genes,evaluating antibacterial agents resistance of Moraxella Catarrhalis to ?-lactam and investigating molecular epideminology