Background and purpose:Chemotherapy including anthracyclin and taxanes is one of the effective regimens for patients with advanced breast cancer, but 20%-30% patients do not achieve a satisfactory curative effect .At present, there is no unified standard second-line chemotherapy regimen for these patients. We studied the efficacy and toxicity of gemcitabin plus capecitabine in the treatment of the patients with advanced breast cancer who had failed in response to the treatment of anthracyclin and taxanes chemotherapy. Methods:Gemcitabin 1 000 mg/m2 iv infusion at d1,8 and capecitabine 950 mg/m2 po tid at d1-14.The interval between the two cycles was 3 weeks. The assessment for clinical effect and side effect was conducted for the patients with completion of 2 cycles of chemotherapy at least.Results:30 female patients were enrolled in this trial ,overall response rate was 46.7%,with 6.7% complete response (2/30)and 40% partial response (12/30). Stable disease was seen in 42.3%(13/30),and disease progression in 10% (3/30).Median time to progression was 9 months, and median overall survival was 12.5 months. The main toxicities were myelosuppression and hand-foot syndrome.Conclusions:Gemcitabin plus capecitabine is effective for the patients with advanced breast cancer who failed in the treatment of anthracyclin and taxanes chemotherapy, and its side effect is tolerable.

In order to implement the 'excellent doctor education training plan' for clinical medicine majors,a series of principles and measures were adopted to train medical students.On the basis of clearing ideas and goals of ‘excellent doctor education training plan',constructing cmriculum system based on basic clinical skills,innovatively constructing the practical teaching platform,optimizing practical teaching system,improving teaching methods,revising assessment and evaluation methods and employing an outstanding teaching team with reasonable structure,we constructed the talent training mode with ‘one goal,two processes,three combinations'.In conclusion,the talent training mode played an important role in the cultivation of medical talents in clinical medicine.

Objective To investigate the effects of general anesthesia and hard epidural anesthesia on the incidence of postoperative cognitive dysfunction (POCD),serum S-100β and Aβ1-42 protein in elderly patients with transurethral resection of the prostate (TURP).Methods 120 cases of elderly male patients who wanted to implement TURP were enrolled in this study.From March 2014 to August 2016,60 patients underwent general anesthesia (general anesthesia group) and 60 patients underwent epidural anesthesia (hard epidural Group).The effects of two anesthesia methods on the cognitive function,serum S-100 β and Aβ1-42 protein were compared.Results There was no significant difference in mini-mental state examination (MMSE) score in preoperative,postoperative 12 h,postoperative 24 h,postoperative 72 h,and postoperative 1 week between hard epidural group and general anesthesia group (P ＞ 0.05).The MMSE scores at 12 h,24 h and 72 h after operation in both groups were significantly lower than those before operation in both groups (P ＜0.05).There was no significant difference in clock drawing task (CDT) score in preoperative,24 h after operation,72 h after operation and one week after operation (P ＞ 0.05).The CDT scores of both groups at 12 h,24 h,72 h after operation were significantly lower than those before operation (P ＜0.05).There was no significant difference in serum S-100β levels between the two groups at preoperative and 12 h,72 h after operation (P ＞0.05).Serum S-100β levels at 12 h and 72 h after surgery in both groups were significantly higher than those before surgery (P ＜ 0.05).There was no significant difference in preoperative and postoperative 12 h,postoperative between hard epidural group and general anesthesia group (P ＞ 0.05).Serum Aβ1-42 levels at preoperative,12 h and 72 h after operation in both groups were significantly lower than those before operation (P ＜ 0.05).There was not statistically significant in the incidence of POCD between hard epidural group [28.33 ％ (17/60)] and general anesthesia group [35％ (21/ 60)] (P ＞ 0.05).Conclusions There was no significant difference in the incidence of POCD between general anesthesia and hard epidural anesthesia group in elderly patients with TURP.The incidence of POCD in elderly patients was related to the decrease of serum S-100β and the decrease of Aβ1-42.