Objective:To explore the efficacy of different second-line treatment strategies in the real world after progression of first-line immunotherapy and its combination therapies in patients with driver gene-negative advanced non-small cell lung cancer (NSCLC) .Methods:A retrospective analysis was conducted on the clinical data of 93 driver gene-negative advanced NSCLC patients who received first-line immunotherapy and its combination therapies from January 1, 2018 to December 31, 2023 at the First Affiliated Hospital of Xinxiang Medical University and Xinxiang Central Hospital. Patients were categorized into immune checkpoint inhibitors (ICIs) -resistant ( n=43) and ICIs-responsive ( n=50) groups according to whether progression free survival (PFS) exceeded 6 months after first-line treatment. Patients were categorized into ICIs-treated ( n=55) and non-ICIs-treated ( n=38), anti-angiogenic-treated ( n=51) and non-anti-angiogenic-treated ( n=42) groups according to the different second-line treatment strategies after progression of first-line immunotherapy and its combination therapies. The median PFS2 (mPFS2) and median overall survival (mOS) 2 after second-line treatment of each group were compared. The Kaplan-Meier method was used for survival analysis. Results:The mPFS2 and mOS2 of 93 advanced NSCLC patients who progressed after first-line ICIs treatment were 4.9 months (95% CI: 4.1-5.7 months) and 14.7 months (95% CI: 11.2-18.2 months). The mPFS2 of patients in the first-line ICIs-responsive and ICIs-resistant groups were 6.0 and 3.8 months, respectively, with no statistically significant difference ( χ2=2.00, P=0.157), and the mOS2 were 25.3 and 11.3 months, respectively, with a statistically significant difference ( χ2=12.13, P<0.001). The mPFS2 of patients in the second-line ICIs-treated group and the non-ICIs-treated group were 5.2 and 4.6 months, respectively, with no statistically significant difference ( χ2=0.16, P=0.687). The mOS2 were 15.1 and 12.7 months, respectively, with no statistically significant difference ( χ2=0.01, P=0.930). The mPFS2 of patients in the second-line anti-angiogenic-treated and non-anti-angiogenic-treated groups were 4.5 and 6.0 months, respectively, with no statistically significant difference ( χ2=0.41, P=0.525), the mOS2 were 14.7 and 16.8 months, respectively, with no statistically significant difference ( χ2=0.01, P=0.943) . Conclusions:After progression of first-line ICIs therapy in patients with driver gene-negative advanced NSCLC, first-line ICIs-responsive patients have significantly longer OS after second-line treatment compared with ICIs-resistant patients. The efficacy of second-line therapy in patients after progression of first-line ICIs therapy does not show significant differences due to the type of treatment strategies.

Objective To cultivate competent rehabilitation assistive technology workers and systematically develop the undergradu-ate curriculum courses of assistive technology using World Health Organization Rehabilitation Competency Framework(RCF)and International Classification of Functioning,Disability and Health(ICF). Methods The competence of assistive technology workers was discussed based on the ICF,RCF and the service needs of modern assistive devices and technology,and the undergraduate curriculum courses of rehabilitation assistive technology were developed referring to the national vocational competence standards. Results Referring to the national vocational competence standards,the entry-level competence of assistive technology workers was developed based on ICF and RCF.The objectives of undergraduate education were set.Moreover,the undergraduate curriculum courses and core course of assistive technology were developed. Conclusion The undergraduate curriculum courses of assistive technology are developed using ICF and RCF.This will help improve the quantity and competency of rehabilitation assistive technology workers and increase the access for people with disabilities to obtain assistive technology.

Objective To investigate the molecular mechanism of translocation of heterogeneous nuclear ribonucleoprotein A2B1 (hnRNPA2B1 )to the cytoplasm after glucose starvation and the effects of increased cytoplasmic translocation of hnRNPA2B1 on the survival of prostate cancer PC3 cells. Methods Human prostate cancer PC3 cells were divided into normal control group (cultured conventionally with glucose-containing medium,RPMI 1640 Medium)and glucose starvation group (cultured with glucose-free medium,RPMI 1640 Medium).The 2 types of cells were treated with deacetylase inhibitor,trichostatin A (TSA ) combined with nicotinamide (NAM),AKT inhibitor BEZ235,si-NC transfection,and si-hnRNPA2B1 transfection,respectively.Cytoplasmic and nuclear protein separation,immunoprecipitation and Western blotting were used to detect changes in hnRNPA2B1 acetylation,total AKT protein and its phosphorylation level,and expression levels of hnRNPA2B1 in the cytoplasm and nucleus.CCK-8 assay was employed to observe cell survival in each group.Results After 3～5 h of glucose starvation treatment,the acetylation of hnRNPA2B1 protein was reduced (P<0.01 ),and its cytoplasmic translocation was increased in PC3 cells (P<0.01 ),which was accompanied by enhanced AKT phosphorylation and activation of the AKT signaling pathway.TSA/NAM treatment,BEZ235 treatment,and si-hnRNPA2B1 transfection all resulted in obvious increase in acetylation of hnRNPA2B1 protein when compared with glucose starvation treated cells (P<0.01 ),which could inhibit the glucose starvation-mediated cytoplasmic translocation of hnRNPA2B1,suppress AKT phosphorylation,and consequently decrease the cell survival rate after glucose starvation (P<0.01).Conclusion Glucose starvation can maintain the survival of PC3 cells by inducing the activation of the Ac-hnRNPA2B1-AKT signaling pathway.

ObjectiveTo systematically develop the courses of rehabilitation based on World Health Organization rehabilitation competency framework (RCF). MethodsThe theories and methods of RCF were used to analyze competency characteristics of rehabilitation workers and educational objectives to construct the curriculum contents in rehabilitation. ResultsThe competency of the rehabilitation workers included practice, professionalism, learning and development, management and leadership, research, values and beliefs in the specific rehabilitation situations. The objectives of rehabilitation medicine education needed to correspond to the competencies of the rehabilitation workers and set up knowledge units that could develop competency in terms of behaviour, activity tasks and proficiency. The curriculum systems of rehabilitation with RCF included the fields of rehabilitation physiotherapy, rehabilitation occupational therapy, hearing and speech rehabilitation, and prosthetic and orthopaedic engineering, etc. ConclusionThe teaching objectives corresponding to the competency characteristics of rehabilitation workers need to be translated into competency-based education. The curriculum contents in rehabilitation needs to be systematically constructed based on RCF from the areas of rehabilitation physiotherapy, rehabilitation occupational therapy, hearing and speech rehabilitation, and prosthetic and orthopaedic engineering.

Organ transplantation is the most effective method to treat end-stage organ failure. As the increase of transmission risk of donor-derived diseases, the quality, safety and selection criteria of transplanted organs become more and more important. Chapter 7 of the European Union's Guide to the Quality and Safety of Organs for Transplantation (6th Edition) proposed basic requirements in terms of donor and organ quality assessment, selection criteria and procedures, which were worthy of study and practice in clinical practice.

Background and purpose:MicroRNA(miRNA) is a class of small non-coding RNA playing an important regulatory role in many tumors. This study investigated which miRNA might negatively regulate the expression of Aurora-B in osteosarcoma cells, and to lay the foundation for the further investigation of the effort and regulation of Aurora-B in osteosarcoma malignant phenotype.Methods:Bioinformatics prediction software (http://www.targetscan.org) and luciferase assays were used to investigate which miRNA might target to modulate the Aurora-B. Real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot assay were used to further verify which miRNA could negative regulate the expression ofAurora-B gene.Results:Bioinformatics prediction showed let-7 family have the possibility to modulate the expression of Aurora-B; Luciferase assays showed thatAurora-B might be the target gene of let-7a/b/c/d/e/f/g/i; RTFQ-PCR and Western blot analysis testiifed that both the expression levels of Aurora-B mRNA and Aurora-B protein were signiifcantly decreased in Let-7a/g/i up-regulated U2-OS and HOS cells, compared to the cells in the negative control group; but in Let-7b/c/d/e/f up-regulated U2-OS and HOS cells, the expression levels of Aurora-B mRNA and Aurora-B protein have no signiifcant difference, compared to the cells in the negative control group.Conclusion:Let-7a/g/i may downregulate the expression of Aurora-B in human osteosarcoma cells.

Potential target proteins binding to VirB4 of type Ⅳ secretion system were screened during Brucella infected bovine embryonic trophoblast cells .Brucella VirB4 genes were amplified by PCR with species-specific primers .Expression vector pGBKT7-virB4 was constructed and analysed by sequencing and restriction enzymes ,transforming to the yeast strain Y187 and testing self-activation and toxicity .The cells model and cDNA library of bovine embryonic trophoblast cells infected with Brucella abortus strain were constructed respectively .Utilizing yeast two-hybrid system was employed to screen the target proteins of bovine embryo trophoblastic cells which was conjunctive with virB4 .These proteins were detected by real-time fluo-rescence quantitative PCR .The results suggested that bait plasmid pGBKT7-virB4 was successfully transformed into the Y187 and there was no toxicity and self-activation;the cDNA library of bovine embryonic trophoblast cells infected with Brucella abortus strain was constructed .There screened 13 positive plasmids in which Q10 and SLC3A2 were up-regulated at the mRNA level .In this paper ,we reported the interactions between the VirB4 protein of Brucella and the bovine embryo trophoblastic cells ,which provide an upstream work for further elucidating the pathogenesis of Brucella infection of the host cell .

Objective To investigate the effects of down-regulating phosphorylated human epidermal growth factor receptor 2 (HER2) on the proliferation and metastasis in human osteosarcoma cells (U2-OS) in vitro. Methods Various concentrations of HER2 phosphorylation inhibitor lapatinib ditosylate (5, 10, 20, 30 and 40 μmol/L) were adopted to deal with U2-OS. MTT assay was performed to evaluate the cell proliferation during various times (24, 48 and 72 h), and the IC50 value in 24 h was calculated. The value of 10μmol/L (IC50=22.15μmol/L) was chosen to deal with U2-OS cells. The expres-sion level of phosphorylated HER2 (p-HER2) was measured by Western blot assay. The cell migration and invasion abilities were detected by Wound healing and Transwell invasion assays. Results The cell proliferation of U2-OS was significantly inhibited by HER2 phosphorylation inhibitor lapatinib ditosylate in a concentration- and time-dependent manner. During 24 hours, the p-HER2 level was significantly lower in lapatinib ditosylate group than that of negative control group (0.093± 0.033 vs 0.306±0.033), the cell migration rate was significantly lower in lapatinib ditosylate group than that of negative con-trol group (32.70%±3.00%and 94.52%±4.76%), and the trans-membrane cells were significantly lower than those of nega-tive control group (37/HP±5/HP and 85/HP±10/HP), respectively. Conclusion The down-regulating p-HER2 in U2-OS could efficiently inhibit the cell proliferation, migration and invasion in vitro. HER2 has the potential to become a molecular target for anti-osteosarcoma metastasis.

Objective To explore the therapic effect of the combination of endovascular embolization and clinical hormone in treatment of Kasabach-Merritt phenomenon (KMP),and analyze the advantages.Methods Six cases with KMP from May 2010 to June 2012 were retrospectively analyzed.All the patients underwent large dose hormone shock therapy after admission for 7-10 d.Subsequently,selective endovascular embolization was performed using Seldinger technique under general anesthesia Then,the hormone therapy was continued for 2 weeks after embolization.The platelet count and the effect were recorded.If the area of the tumor reduction is less than 50％,3-4 courses of local hardening treatment was conducted for the residual tumor.The local treatment used multipoint puncturing of the tumor and injection drugs under X-ray fluoroscopic monitoring until the tension of local vascular increased.Results On DSA,the lesions of all the 6 cases showed rich blood supply with a large number of hybrid distribution of tumor blood vessels.The lesions disappeared in 4 cases after 1-2 weeks combination therapy and no recurrence for 0.5-1.0 year follow-up.Two cases whose tumor reduced less than 50％ after combination therapy received local hardening treatment,and faded after 3-4 courses.The number of platelet for all patients kept normal and the spirit of the patients showed great improvement,the bleeding tendency and local soft tissue swelling was in remission.Subcutaneous blood stasis and petechiae disappeared.There were no serious adverse reaction and complications.Conclusion Combination therapy with endovascular embolization and clinical hormone for Kasabach-Merritt phenomenon has a good curative effect.

OBJECTIVE: The purpose is to report a calcification of the cartilaginous of the tracheobronchial case in child, and to recognize the clinical and imaging features on Keutel syndrome. METHOD: A comprehensive analysis of the clinical data and X-ray,CT. Some literatures involving some symptoms of this child were reviewed. RESULT: This patient diagnosed with Keutel syndrome finally. CONCLUSION When we meet calcification of the cartilaginous of the tracheobronchial patient in clinic, it may be Keutel syndrome.
Abnormalities, Multiple ; diagnosis ; pathology ; Calcinosis ; diagnosis ; pathology ; Cartilage Diseases ; diagnosis ; pathology ; Hand Deformities, Congenital ; diagnosis ; pathology ; Humans ; Infant ; Male ; Pulmonary Valve Stenosis ; diagnosis ; pathology