Epidermalgrowthfactorreceptor-tyrosinekinaseinhibitor(EGFR-TKI)resistanceinnon-small cell lung cancer(NSCLC)has become more and more common,which includes primary and secondary resistance.The primary resistance is mainly related with EGFR gene mutation,and the secondary resistant is mainly related with T790M,MET and other genes.

Objective To observe the influence of Qingwen Baidu decoction (QBD) on serum procalcitonin (PCT) and C-reactive protein (CRP) levels in septic rats and study the mechanism of heat-clearing and detoxifying method for treatment of sepsis. Methods Fifty male Sprague-Dawley (SD) rats were randomly divided into control group (n=5), model group (n=25), and heat-clearing and detoxifying experimental group (experimental group, n=20). The septic model was reproduced by intra-peritoneal injection of lipopolysaccharide (LPS, 5 mg/kg). In control group, an equal volume of normal saline was given. After modeling for 2 hours, the heat-clearing and detoxifying experimental group received QBD the first time (composition of the decoction: Gypsum Fibrosum Recens 30 g, Rehmanniae Radix 10 g, Bubali Cornu 15 g, Coptidis Rhizoma 4 g, Gardeniae Fructus 5 g, Platycodonis Radix 5 g, Scutellariae Radix 5 g, Anemarrhenae Rhizoma 5 g, Paeoniae Radix Rubra 5 g, Scrophulariae Radix 5 g, Forsythiae Fructus 5 g, Glycyrrhizae Radix 5 g, Moutan Cortex 5 g, Lophatheri Herba 5 g) by gavage (0.01 mL/g); the rest administration time was 08:00 to 09:00, once a day. The rats in model group were given an equal volume of warm water by gavage. At different time points after modeling, the blood of 5 rats in control group, model group, and experimental group was collected from the abdominal aorta. The serum PCT and CRP levels were tested by the enzyme linked immunosorbent assay (ELISA), and the pathological changes in lung and intestinal tissue were observed under a light microscope. Results Compared with the control group, the PCT level of the model group after modeling for 2 hours was significantly increased (ng/L:332.32±22.85 vs. 70.46±3.18, P<0.01), this situation continued until 72 hours after modeling. CRP level in the comparison between the control and model groups did not have statistical significant difference at 2, 8, and 48 hours after modeling (all P > 0.05). The level of CRP in model group was lower than that of control group at 24 hours and 72 hours after modeling (μg/L:281.34±32.81, 237.84±41.42 vs. 350.09±56.67, P<0.05 and P<0.01). There were no statistically significant differences in PCT levels between model group and experimental group after modeling for 8 hours and 24 hours (both P > 0.05). The PCT level of experimental group was significantly lower than that of model group beginning from 48 hours after modeling (ng/L: 321.57±28.00 vs. 358.12±10.14, P < 0.05), and this situation continued until 72 hours after modeling (ng/L: 269.50±49.10 vs. 347.69±26.90, P <0.05). The CRP level of experimental group was significantly lower than that of model group beginning from 8 hours after modeling (μg/L:232.73±13.29 vs. 335.35±53.78, P<0.05), this statistical significant difference between the two groups persisted until 72 hours after modeling (μg/L:177.31±6.70 vs. 237.84±41.42, P<0.05). Compared to those in the model group, the lung tissue inflammatory cell infiltration, the intestinal mucosal inflammation and interstitial edema were milder in the experimental group. Conclusion Heat-clearing and detoxifying therapy can effectively reduce the serum PCT and CRP levels of septic rats induced by LPS, and it can alleviate the infiltration of inflammatory cells in lung tissues so as to play a role in protection of tissue organ.

Effects of six kinds of Chinese herb extracts, including Folium Crataegi extract, Herba Epimedii extract, Folium Acanthopanacis Senticosi extract, Trifolium pratense L. extract, Folium Ginkgo extract and Radix Puerariae extract, on the activities of CYP450 isozymes (CYP1A2, CYP2C, CYP2E1, CYP2D, CYP3A) in rat hepatic microsomals were studied by using a UPLC-MS/MS (MRM) and cocktail probe substrates method. The results showed that effects of six kinds of Chinese herb extracts on each CYP450 isozyme activity were inhibitory. The IC50 of Folium Crataegi extract for the inhibition of rat microsomal CYP2D activity was only for 4.04 microg x mL(-1), which showed the highest inhibition; Trifolium pratense L. extract had strong inhibitory action to CYP2D, the IC50 value was 5.73 microg x mL(-1); Folium Crataegi extract also had strong inhibitory action on CYP2E1, the IC50 value was 10.91 microg x mL(-1). Furthermore, the IC50 of Folium Ginkgo extract for the inhibition of rat microsomal CYP3A, 2D, 2E1 activities were 45.12, 35.45 and 22.41 microg x mL(-1), respectively, and the IC50 of Folium Acanthopanacis Senticosi extract on the inhibition of rat microsomal CYP2E1 activity was 32.89 microg x mL(-1). In addition, mechanism of inhibition experimental results showed that the inhibiting abilities of Folium Crataegi extract and Radix Puerariae extract on each CYP450 isozyme increased with the increasing of the preincubation time, therefore, the inhibitory effects were a mechanism-based inhibition.

Objective To prepare the immunoconjugate composed of Adriamycin nanoparticles and VEGFR 2 monoclonal antibody(conjugate of ADM-NP and VEGFR 2-MAb) and study its pharmacokinetics property. Methods Adriamycin nanoparticles were prepared by using double emulsion method, with PLA and O-CMC as materials. Conjugate of ADM-NP and VEGFR 2-MAb was prepared by using molecule conjugate technology. Immunoreactivity of the conjugate with type IV collagenase and H 22 cell were analyzed by using ELISA. Pharmacokinetics parameters of the immunoconjugate were obtained by using SD rats as study objects. Results The prepared ADM-NP was sphere particles under SEM, which diameters were (160±34) nm. The drug loading rate and entrapment rate were (30.15±3.5)% and (80.56±4.24)% respectively. Conjugate of ADM-NP and VEGFR 2-MAb was successfully prepared, which had immunoreactivity with type IV collagenase and H 22 cell. The immunoconjugate showed good ADM control-release ability and could prolong the retention time of ADM in vivo. Conclusion Conjugate of ADM-NP and VEGFR 2-MAb keeps the immunoreactivity of VEGFR 2-MAb and shows good ADM control-release ability.

Objective To evaluate the diagnostic value of cardiac magnetic resonance (CMR) in suspected coronary heart disease patients with electrocardiogram abnormalities but normal coronary angiography. Methods The data of 25 suspected coronary heart disease patients with electrocardiogram abnormalities but normal coronary angiography were collected from Taiyuan central hospital between October 2010 and April 2012. Comparison was done in terms of anterior interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end diastolic dimension, left ventricular end systolic dimension, left atrial diameterand ejection fraction measured by CMR and by UCG. Correlation of the aboved paremeters between the 2 imaging exams. Results 40%of patients had their diagnosis changed after CMR exam, 32%of the patients with adjusted assessment. The differences in anterior interventricular septal thickness, left ventricular posterior wall thickness, left ventricular enddiastolic dimension, left ventricular end systolic dimension, left atrial diameter, ejection fraction by CMR and by UCG were similar (P>0.05) with positive correlation (P<0.01). Conclusions CMR can provide diagnosis and evaluation information to chest pain patients with ECG abnormalities but normal CAG, and it is a good supplement for routine examination.

Theultraperformanceliquidchromatographycoupledwithmassspectrometry(UPLC-MS)was used to investigate the metabolic difference of the decoction of Radix Aconiti Preparata ( RAP ) and its co-decoctions with Radix Paeoniae Alba ( RAP-RPA ) or Radix Stephaniae Tetrandrae ( RAP-RST ) in rat intestinal bacteria. The principal component analysis ( PCA) of the relative contents of Aconitum alkaloids after metabolism was performed by SIMCA-P software. The score plots of PCA could successfully distinguish the three groups of RAP, RAP-RPA and RAP-RST. The result indicated that the differences of biotransformation among the groups of PAP, RAP-RPA and RAP-RST were significant. With the loading plot and independent-samples T test, seven relevant markers with the significant differences were found in the group of RAP-RPA, six relevant markers were obtained in the group of RAP-RST. The relative content of four markers in RAP-RPA was higher than that in RAP, and one marker in RAP-RST was higher than that in RAP. The relative contents of other markers were all lower than that in RAP. These markers may be the effective substance for explaining the different effects of Radix Aconiti Preparata before and after combination with Radix Paeoniae Alba and Radix Stephaniae Tetrandrae.

Objective To survey and analyze the factors that may affect the results of human-ities education about master degree postgraduates, and provide the basis and reference for traditional medical humanities education reform. Methods By using the self-made questionnalre, a survey was conducted among 100 medical postgraduates of a university. Questionnalre items included basic infor-mation of the postgraduates, humanities-related extracurricular experiences, whether there had been personal experiences corresponding to these options or these experiences affected the attitude of hu-manistic education options. The survey data were analyzed using SPSS 19.0 software and the results were expressed by the relative number. The differences between different gender, marriage and differ-ent specialty student satisfaction were analyzed by using chi-square test or Fisher's exact test, showing no statistical significance (P>0.05). Results Respondents believed that the highest rate of the top four which supported the experiences that promoted humanistic education were clinic volunteer activi-ties, interpersonal harmony, rescuing the patient experiences and illness experiences, accounting for 95.8%(91/95), 92.6%(88/95), 89.5%(85/95) and 88.4%(84/95), respectively. On the other hand, the highest rate of the top four that impeded humanities education-related experiences were academic stress, workload, limited communication and lack of humane care, accounting for 100.0% (95/95), 95.8%(91/95), 91.6% (87/95) and 84.2% (80/95) respectively. In addition, different types of students' attitude towards experiences that may have impact on the humanistic education were not statistically significant (P>0.05). Conclusion Humanities education in medical colleges should not be limited to classroom instruction form. We should broaden humanistic education approach, flexible assessment methods of humanities, to enhance the effect of humanities education.

OBJECTIVE: To study the characteristics of adverse drug reactions( ADR) in our hospital. METHODS: 240 ADR cases collected between 2003 and 2006 in our hospital were analyzed retrospectively. RESULTS: Of the total ADR cases, 211( 87. 92% ) were induced by intravenous drugs, 153( 63. 75% ) were induced by antibacterials, and 118( 49. 17% ) were manifested as lesions of skin and its appendages. CONCLUSIONS: Importance should be attached to the monitor and reporting of ADR so as to lessen or avoid the occurrence of ADR.

Objective To investigate the protective effect of local mild hypothermia on the ischemic cerebral tissues. Methods A model of middle cerebral artery occlusion was prepared in Wistar rats to compare the difference of the cerebral infarction volume and neurologic function and the serum concentration of neuron-specific enolase (NSE) between the local mild hypothermia group and the normal temperature group. Results It was found that the cerebral infarction volume was 84.90?11.36 and 128.95?13.42 mm 3 in the local mild hypothermia group and the normal temperature group, the neurologic function score 0.95?0.17 and 1.60?0.24, and the serum concentration of NSE 9.19?3.42 and 13.55?4.07ng/ml,respectively. The differences between the two groups were statistically significant. Conclusion The findings of this study suggest that the local mild hypothermia treatment exerted protective effect on the ischemic neurons.

Objective To study the effect of pereutaneous electrical stimulation of acupuncture points on blood oxygen free radical induce by ischemia-reperfusiou injury in limbs. Methods 30 patients who received the unilateral lower limb surgery were randomly allocated to A and B groups equality. All the patients were received spinal-epidural anesthesia. Before the anesthesia,B groups patients were stimulated bilateral at NeiGuan and WaiGuan acupuncture points by HAN stimulate instruction until the end of the operation. The concentration of malondialdehyde(MDA), glutathione(GSH) and superoxide dismutase(SOD) were measured by venous blood draw from their elbow in four different periods-before the anesthesia(T0), 10 minutes after the tourniquet released(T1), 30 minutes after the tourniquet released(T2) and 60 minutes after the tourniquet released(T3) respectively. Results Gender, age, weight and the time of using tourniquet shows no different between-group differents. There is also no significant different between two groups before theanesthesia in MDA, GSH and SOD. The two groups all shows obviously increase of MDA(P<0.01) and significant decrease of GSHand SOD (P<0.01) in T1, T2 and T3 in contrast to in T0 compare with the A group, B group shows a significant decrease of MDA (P<0.01) and a significant increase in GSH and SOD (P<0.01) in T1,T2,T3. Conclusion The percutaneous electrical stimulation of acupuncture points can protect the limb by ischemia-reperfusion injury.