Objective The patients with non-small cell lung cancer ( NSCLC) are still at risk of brain metastasis after surgi-cal treatment.The study was to investigate the clinical characteristics and the risk factors for postoperative brain metastasis in patients with NSCLC in order to provide references for prophylactic cranial irradiation ( PCI) . Methods The clinical and prognostic data of 213 patients with NSCLC in our department of oncology from February 2008 to February 2012 were retrospectively analyzed.The occur-rences of postoperative brain metastasis in NSCLC patients with different characteristics were observed.Cox model was used to investi-gate the risk factors for postoperative brain metastasis in patients with NSCLC. Results The overall cumulative rate of brain metasta-sis was 23.9%(51/213) and the rates of brain metastasis at 1-year, 2-year, 3-year after surgery were 6.1%, 14.1%, 22.5% re-spectively.Univariate analysis showed that the rates of postoperative brain metastasis in NSCLC patients with different ages, histological types, tumor stages and CEA levels were statistically significant (P<0.05).Cox regression showed that adenocarcinoma (HR=2.00, 95%CI:1.11~3.64), lung cancer stageⅢ(HR=3.70, 95%CI:1.67~8.25) and high CEA (≥5.0μg/L)(HR=3.16, 95%CI:1.60~6.25) were risk factors for postoperative brain metastasis in patients with NSCLC.The survival time in NSCLC patients with brain metastasis was remarkably lower than that in patients without brain metastasis (P<0.05). Conclusion The NSCLC pa-tients with adenocarcinoma, III stage disease, or high CEA are more likely to develop brain metastasis after surgery, which should be the focus of PCI.

Objective To study the cardiac electrophysiology changes of canine asynchrony ischemic heart failure under left ventricular endocardial pacing.Methods Left bundle branch radiofrequency catheter ablation and left anterior descending coronary artery ligation were used to establish the model of ischemic heart failure in 18 healthy dogs.Eighteen healthy dogs were randomly divided into two groups,9 cases in each group.The experimental group was treated with cardiac resynchronization therapy(CRT) in left ventricular endocardium,and the control group underwent the sham operation.ECG and echocardiography were done at 6 weeks after operation.Results The left ventricular ejection fraction in the experimental group was significantly higher than that in the control group(38.32 ± 6.08 vs.30.62 ±8.96).The asynchronization index in the experimental group was significantly lower than that in the control group(35.99 ±5.25 vs.78.21 ± 7.02),and the difference was statistically significant(P＜0.05).QRS(60.58 ± 7.43 vs.68.33 ± 8.01) and QTc(347.09 ± 17.33 vs.367.81 ± 22.02)in the experimental group were significantly shorter than those in the control group(P＜0.05);moreover Tp-e(37.03±9.07 vs.45.76±7.11) and ARI(162.33±22.06 vs.187.21±23.87) in the experimental group were significantly lower than those in the control group(P＜0.05).Conclusion Left ventricular endocardial pacing can produce preferably electrophysiological effects and achieve the goal of effective cardiac resynchronization therapy.

Aim To elucidate the biochemical mechanism of gossypol in inducing the decline of sperm quality.Methods Gossypol was administered orally at the dose of 50 mg?kg-1/2 d for two weeks.Then,the sperm was collected from the left caudal epididymis and was analysed by CASA.The morphological changeand the concentration of nitric oxide(NO)in testes as well as the level of hormone〔follicle-stimulating hormone(FSH)〕,luteotrophic hormone(LH),testosterone(T)in serum were assayed.Results Gossypol could induce the decrease of sperm number and sperm quality.The concentration of NO in testes increased significantly.Among the three kind of hormone,only the concentration of T showed decrease after the oral administration of gossypol.NA1108 could antagonize the decline of sperm quality damaged by gossypol and decrease the content of NO in testes.Conclusions The concentration of NO in testes beyond normal value was one of the toxic mechanism of gossypol that contributed to the inhibition of spermatogenesis.Some drugs with the ability to reduce NO content in testes could also increase sperm quality.

Objective: To explore the relationship between high sensitivity C-reactive protein (hs-CRP) and vascular access failure in hemodialysis patients. Methods: From July 2017 to June 2018, 105 patients with regular hemodialysis were selected from the blood purification center of Beijing Haidian hospital.According to the presence or absence of VAF, the patients were divided into two groups: VAF+ group and VAF - group.The difference of hs CRP level between the two groups was compared. Results: During the 12-month follow-up, 17 patients had more than one event of vascular failure.The total protein level of VAF+ group was significantly lower than that of VAF-Group((65.61±4.01) g/L and( 68.98±5.66) g/L, P=0.021). The male proportion of VAF+ group was lower than that of VAF-group (29.41% vs 53.41%, P=0.07), but the difference was not statistically significant.There was no significant difference in the annual change level of hs CRP between VAF + group and VAF Group((0.33±5.49) mg/L and(0.57±4.45) mg/L, P=0.840). The level of total protein was the independent protective factor of VAF(OR=0.889, 95%CI 0.797-0.991, P=0.034). The level of hs CRP was not significantly correlated with vascular access events(OR=1.018, 95%CI 0.926-1.119, P=0.713). Conclusion There is no correlation between hs CRP and VAF.The exact mechanism of inflammation in intimal hyperplasia needs further study.

Objective To analysis the occurrence status of breast disease in married women in Tangshan area,and to provide basis for early prevention of breast cancer in this region.Methods 773 married women in Tangshan area were given mammography examination.The tissue biopsy or surgical treatment was recommended for patients with above grade 3 of breast imaging reporting and data system (BI-RADS) classification to obtain pathological diagnosis.Results In 773 women,482 cases (62.35 ％) were diagnosed as BI-RADS grade 2 or below,256 cases (33.12 ％) were BI-RADS grade 3,33 cases (4.27 ％) were BI-RADS grade 4,2 cases (0.26 ％) were BI-RADS grade 5.The distribution of each BI-RADS grade among different age group was statistically significant (x2 =17.90,P ＜ 0.001),35 cases got pathological diagnosis by biopsy or surgical treatment,including 30 cases of mammary gland hyperplasia,3 cases of breast fibroadenoma,and 2 cases of breast cancer.Conclusion Women's mammography screening is important for the prevention and early detection of mammary gland diseases.

Objective To evaluate the feasibilty of modified osteogenic culturing of goat adipose derived stromal cells(ADSCs).Methods From March,2013 to September,2014,platelet-rich plasma(PRP) was made from goat autogenous vein blood,and abodimoneal fat was aspirated,following aspetic procedure,primary and series passage of ADSCs was established.Osteoinduced ADSCs was carried out according to following group:combinative osteoinduction group(PRP+rhBMP-2 +ADSCs),growth factor group(rhBMP-2+ADSCs),conventional inductive group(dexamathasone+ascorbic acid + ADSCs) and noninductive group(blank group).Converted microscope was used to observe cellular pattern,cell activity,osteocalcin and collagen type Ⅰ level were detected at 1,3,5,7,9,13,17,21 days.Red Alazarin and Von Kossa staining were also assayed at different interval.Results Under observation of converted microscopy,remarkable cell proliferation with abundant ECM was noticed in combinative osteoinduction group,compared with other groups,level of cell activity,osteocalcin,collagen type Ⅰ [(0.82 ± 2.19)AU,(79.82 ± 1.36)U/L at,(78.51 ± 4.32)μ g/ml at]were significantly higher than other groups (P ＜0.05),and remarkable ALP expression and calcifed nodules were also seen.Conclusion PRP can enhance the inductive effect of rhBMP-2,and combinative osteoinduction procedure acts as a satisfactory culturing method.

Objective To explore the clinical application value for calculating the volume of splenic embolization by splenic artery branch diameter ratio method.Methods Data of 20 patients with cirrhosis and hypersplenism who underwent partial operation of splenic artery embolization were retrospectively analyzed.Based on the angiography of splenic artery during operation,the diameter of branch vessels of splenic artery was measured and the percentage of embolism volume in spleen was calculated.CT scans were performed on all patients after one month of the operations.Based on VR reconstruction image,the percentage of embolism volume in the spleen was calculated.Postoperative complications and adverse responses were observed.Peripheral blood red cells,white blood cells and platelets were tested repetitively three days before the operation,and a week,a month,three months after the operation.Moreover,the statistical analysis was performed.Results The difference between the percentage of embolism volume in the spleen calculated by splenic artery branch diameter ratio method ([52.15±3.29]％) and calculated by CT ([49.99±6.02]％) was not statistical (t=-1.630,P=0.120).All the patients had moderate or below moderate pain on left upper quadrant,and had symptoms of nausea,vomiting and fever after the operation.They all got better after symptomatic treatment.Peripheral blood red cells,white blood cells and platelets all had significant differences among three days before the operation,a week,a month and three months after the operation (all P＜0.001).Conclusion During the partial splenic embolization,the application of ratio method on branch vessels of splenic artery to measure the volume of embolism in the spleen is convenient,prompt and relatively accurate.It is worthy to be expanded in clinic.

Tumor metastasis is one of the most important biologi-cal characteristics of malignant tumor, and it is also the main factors that cause treatment failure and poor prognosis. Clinical studies have shown that the number of platelets in patients with malignant tumor increased more significantly than that in benign tumor patients and healthy people, which indicate that platelet might be involved in the development process of tumor. Further study found that in the process of cancer spreading to blood, platelet could interact with tumor cells to form tumor emboli, helped tumor cells escape from immune surveillance, thus pro-moted the tumor metastasis. In recent years, related mechanisms on platelets in promoting tumor metastasis were revealed gradual-ly, and several targeted therapies based on platelets were also carried out. This paper reviews the role of platelet in mediating tumor metastasis by hematogenous spread and its mechanisms and discusses the therapy strategies that target platelet, which may provide references for follow-up research and clinical treat-ment.

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.

Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.