Clinical efficacy scale of traditional Chinese medicine (TCM) should be built according to the characteristics of TCM, scientific demand, and demonstrated by practice. This paper provides some considerations of the scale.

OBJECTIVE:To observe the clinical efficacy,safety,the maximal tolerated dose(MTD) and dose-limiting toxicity(DLT) of docetaxel(TXT) in the treatment advanced breast cancer.METHODS:Docetaxel was given by drip infusion in escalating doses from the initial dose of 65 mg?m-2 to 75 mg?m-2 and 85 mg?m-2 until the appearance of DLT.RESULTS:Among the 15 cases,1 case with CR,5 PR,4 SD,and 5 PD.The DLT of TXT was neutropenia,and its MTD was 85 mg?m-2.CONCLUSION:Docetaxel(at a dose of 75 mg?m-2) showed remarkable efficacy and good tolerance in patietns with advanced breast cancer.

Based on the shortcomings of graduate education in clinical medicine of our country and the characteristics of this specialty, the author point out that the cultivation of graduates in otolaryngology, head and neck surgery should be focused on the training of humanities, professional knowledge and skills. And they also make some suggestions and discussion about the reform of graduate education mode.

Brain injury of premature infant is a hot topic in the neonatal clinical study. Early diagnosis and intervention can improve the prognosis of premature infants. Although there are some interventions for brain injury of premature infants, most of them do not have evidence-based study to support the clinical application. Antenatal application of magnesium sulfate for pregnant women and application of erythropoietin for preterm infants may be the most promising interventions. Avoiding prematurity and brain damage is the key interventions for brain damage of premature infants.

Objective To evaluate the association between the expression of PTEN protein and the clinicopathological char‐acteristics of breast cancer patients .Methods All eligible studies regarding the association of PTEN protein expression with clini‐copathological features in patients with breast cancer were retrieved from PubMed ,Embase ,Cochrane Library ,CNKI and Wanfang databases .Odds ratio(OR) with corresponding 95% confidence interval(95% CI) form eligible studies were pooled .Heterogeneity and publication bias were also evaluated .All analyses were operated using RevMan 5 .2 software .Results A total of 28 articles con‐taining 3 172 patients were ultimately included for this Meta‐analysis .Our findings revealed that the expression level of PTEN was significantly correlated with estrogen receptor status(OR= 3 .16 ,95% CI:2 .01 -4 .97 ,P< 0 .01) ,progesterone receptor status (OR=2 .27 ,95% CI:1 .70 -3 .04 ,P<0 .01) ,lymph node metastasis(OR=0 .36 ,95% CI :0 .27 -0 .49 ,P<0 .01) ,clinical stage (OR=2 .59 ,95% CI:2 .04-3 .30 ,P<0 .01) and histological grade(OR=2 .19 ,95% CI:1 .74-2 .75 ,P<0 .01) .Conclusion Aber‐rant PTEN expression might have strong impacts on carcinogenesis ,tumor progression ,invasion and prognosis ,which makes it a potential biomarker for early cancer screening and endocrine therapy in breast cancer .

Falling in the elderly is a major health problem and may cause severe consequences. Fall risk assessment is important for preventing and intervening fall incidence. Inertial Measurement Unit (IMU) has been introduced to evaluate motion/balance function and fall risk among the older people. Some researches indicated that it might have advantages over the usual tools, and can be used in the hospitals, communities, nursing homes, etc. IMU is a good way to measure gait variability, which may be strongly related with the risk of falls.

Objective To investigate the role of p38 mitogen-activated protein kinase (MAPK) signal transduction pathway in lipopolysaccharide (LPS)-induced acute lung injury (ALI).Methods Sixty male SD rats weighing 180-230 g were randomly divided into 4 groups: control group (group C, n = 6), ALI group ( n = 24),p38MAPK specific inhibitor SB203580 + ALI group (group SB + ALI, n = 24), SB203580 group (group SB,n =6). LPS 5 mg/kg was injected intravenously via tail vein in group ALI and SB + ALI, while the equal volume of normal saline was given instead in group C. Group SB + ALI received iv injection of SB203580 10 mg/kg via tail vein 30 min before LPS administration. Group SB received injection of SB203580. The rats were sacrificed at 1, 3 and6 h agter LPS administration (T1-3) in group ALI and SB + ALI (8 rats at each time point) andat 1 h after administration in C and SB groups. The lungs were immediately removed for microscopic examination and determination of phosphorylated p38MAPK (p-p38MAPK) expression, the concentration of protein in bronchoalveolar lavage fluid (BALF) and apoptotic index (AI). Another 32 rats were selected and randomly divided into 2 groups for survival study: ALI group and SB + ALI group ( n = 16 each), and then they were treated as mentioned above and observed for 48 h. Results The concentration of protein in BALF, AI and p-p38MAPK expression were significantly increased in group ALI and SB + ALI compared with group C, while decreased in group SB + ALI compared with group ALI ( P ＜ 0. 05 ). LPS-induced pulmonary histological changes were significantly attenuated in group SB + ALI compared with group ALI. The survival rate was significantly decreased in group ALI compgred with group SB + ALI ( P ＜ 0.01 ). Conclusion p38 MAPK signal transduction pathway is involved in LPS-induced ALI, which may be related to the apoptosis in the cells in the lung.

Objective In order to provide scientific evidence for revealing the pathophysiological changes, levels of the humoral and cellular immunity and cytokines in elderly patients with bacterial pneumonia were determined. Methods The changes of immunological markers including IgA, IgG, IgM,C3, C4,T cell subpopulation (CD3 +, CD4 +, CD8 +) and CD4 +/CD8 +, IL 2, IL 6, IL 8, TNF ? were examined for the elderly bacterial pneumonia group(BPG), the aged control group(ACG) and the young control group(YCG). Results The level of CD3 +〔(53 90?7 10)% vs (62 67?6 08)%〕, CD4 +〔(33 85?4 69)% vs (3 57?3 40)%〕, IL 2〔(4 09?0 69) ?g/L vs (6 72?0 52) ?g/L〕 and IL 8〔(0 28?0 07) ?g/L vs (0 39?0 09) ?g/L〕 in ACG were significantly lower than those in YCG. The levels of IgA, IgG, IgM, C3, CD8 +, IL 8〔(0 33?0 08) ?g/L vs (0 28?0 07) ?g/L〕, and TNF ?〔(1 25?0 23) ?g/L vs (1 10?0 20) ?g/L〕in BPG were significantly higher than those in ACG; and in BPG the levels of IgG, IgM, C3, IL 8 and TNF ? were significantly higher than those in YCG. However, the levels of CD3 +, CD4 + and the ratio CD4 +/CD8 +in BPG were markedly lower than those in YCG;the IL 2(2 730?0 612 ?g/L) was much lower than that of ACG〔(6 72?0 52) ?g/L〕 and YCG〔(4 09?0 69) ?g/L〕, respectively. Conclusions The occurrence and the progress of bacterial pneumonia in the elderly are related to the immunological functioning including the excessive humoral immunity, the super activation of complement system, the dysequilibrium of T cellular immunoloregulation network and the super excretion of inflammatory cytokines.

Clinical Clerkship is the necessary stage from theory to clinical practice,As teaching hospital of Nanjing Medical University.we explore various kinds of methods of clinical practice quality improvement by emphasizing practice training,developing multiform teaching activities,highhghting autonomic learning and strengthening intemship management.

Aim To study the dopaminergic neuroprotection of quercetin-3-O-sophoroside and total flavonoids derived from Poacynum hendersonni in MPTP-induced mice model of Parkinson's disease.Methods To inject MPTP intraperitoneal to C57/bl6 mouse at 30 mg·kg~(-1)·d~(-1) 5 days for PD model preparation, qercetin-3-O-sophoroside(25 mg·kg~(-1))and total flavonoids(250 mg·kg~(-1))were treated through intragastric administration 7 days before.Watching the mice behavior change through autonomic activities and pole test after final treatment, dopamine content in striatum was determined with fluorescence photometer.The neurons pathological change in substantia nigra(SN)was observed by pafaffin slice and immunohistochemistry staining to analyze the dopaminergic neuroprotective effects of Poacynum hendersonni.Results Treatment of quercetin-3-O-sophoroside for 7 days in advance, can improve PD mice motivation and dopamine concentration in striatum, tyrosine hydroxylase immune-reactive neurons in SN increased as well.Conclusion Quercetin-3-O-sophoroside can attenuate the impairment of MPTP in mice model of PD.