The therapy to different type of breast cancer has resulted in chemoresistance which is induced by auto-phagy.Autophagy, to tumor’s generation, is a double edged sword, and it can result to chemoresistance and auto-phagic cell death through interaction with apoptosis in breast cancer chemotherapy.However, autophagy may be unrelated to chemoresistance.It will be a key research point to further explore the relationship and mechanism be-tween autophagy and chemoresistance.

Objective To investigate drug metabolism distribution of flurbiprofen axetil(FA) in uterine fibroids and its effect on prostaglandin E2 (PGE2).Methods A total of 86 patients with uterine fibroids from January 2014 to February 2016 in The NO.2 Hospital of Ningbo were randomly divided into control group of 44 cases and observation group of 42 cases.The control group and the observation group were given 0.9% sodium chloride solution and 1 mg/kg FA at 15 min before operation,detection of the active metabolite of FA flurbiprofen (FP),and the concentration of PGE2 in tissue homogenate was detected by ELISA.Results The observation group FP concentration of normal and tumor tissue were (0.70 ±0.13)μg/mL and (1.72 ± 0.13)μg/mL,significantly higher than the control group(0.00 ±0.00)μg/mL and (0.00 ±0.00)μg/mL, the difference was statistically significant(P<0.05), the FP concentration of tumor tissue in the observation group was significantly higher than that in the normal group, the difference was statistically significant(P<0.05), the normal tissue and tumor tissue PGE2 concentration in the observation group were (189.29 ±26.38) pg/mL and (260.01 ±46.63) pg/mL,which were significantly lower than those in the control group(210.03 ±35.22)pg/mLand(390.20 ±92.10)pg/mL, the difference was statistically significant(P<0.05), the observation group plasma FP was (5.50 ±0.72)μg/mL,significantly higher than the control group (0.00 ±0.00)μg/mL, the difference was statistically significant(P <0.05),and PGE2 was (602.38 ±84.09) pg/mL,significantly lower than the control group(920.13 ±89.05)pg/mL, the difference was statistically significant(P <0.05).Conclusion FA in the uterine fibroids have a certain distribution of targeted,can reduce the concentration of PGE2 ,so as to alleviate the pain of patients.

Objective To compare the clinical pathological characteristics in young and old patients with colorectal cancer (CRC) and investigate their relationship with prognosis. Methods A retrospective review was made in 68 CRC patients less than 35 years old and 322 CRC patients older than 65 treated in our hospital from July 1993 to July 2003. Their clinical manifestation, pathological feature, Dukes staging, misdiagnosis rate and results of following-up were compared. Results The main manifestation in young group was abdominal pain (69.1%), but in old group was hemafecia or mucous bloody stools (53.7%). The ratio of poorly differentiated neoplasm was obviously higher in young group (48.5%) than in old group (20.5%) (P

Procalcionin ( PCT) is a soluble protein liberated into the circulation of patients in response to severe systemic in-fection, in particular by bacterial infection.It is used as the most accurate biomarker for the diagnosis of sepsis.This review briefly de-scribes the induction of PCT, the comparison of PCT and other markers of sepsis, the application of PCT measurement in confirmation or exclusion of diagnosis of sepsis, the assessment of severity and treatment effectiveness of systemic infection, the application of PCT in guiding individual and specific treatment of antibiotics, and the anormaly situation of elevated levels of PCT in patients who do not have sepsis.

Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.

Objective To determine the effects of cyclooxygenase-2 (COX-2) on risk stratification and prognosis of patients with gastrointestinal stromal tumor (GIST).Methods Literatures in the Cochrane libraries of clinical comparative trials,PubMed,EMBASE,Cancer Lit and Chinese BioMedical Literature from 1966 to 2012 were retrieved using the Cochrane systematic evaluation method.The original data were extracted and crosschecked by 2 reviewers.The indicator for assessment including positive rates of COX-2 in GIST patients with different tumor diameters (＜5 cm versus ≥5 cm),mitosis of cancer cells (＜5/50 HPF versus ≥5/50 HPF) and National Institute of Health (NIH) risk stratifications (very low + low versus intermediate + high).The relationship between COX-2 expression and recurrence and metastasis of GIST was evaluated.All the data were analyzed using the RevMan 5.1 software with Meta analysis.The heterogeneity between studies was analyzed using the I2.The binary data were presented by odds ration (OR) and 95％ confidence interval (95 ％ CI).Results Seven articles with a total of 415 patients were included in the analysis.The COX-2 expression did not correlate with the tumor diameters,NIH risk stratifications and tumor metastasis and recurrence (OR =0.60,0.72,2.46,P ＞ 0.05),but with the mitosis of cancer cells (OR =0.46,P ＜ 0.05).Conclusion COX-2 expression is partly correlated with risk stratification of GIST,but has no effect on the prognosis.

Total paeony glycoside (TPG) is extracted and purified from a traditional Chinese herbal medicine. It has many biological and pharmacological activities. However, there are few dosage forms of TPG in the market because of its low bioavailability. Self-microemulsifying drug delivery system (SMEDDS) is a vital tool in solving low bioavailability of poor absorption drugs. So the objective of this study is to develop a new TPG-SMEDDS for the oral delivery of poorly soluble TPG. Through the construction of pseudo-ternary phase diagrams, the optimum prescription was obtained, which consisted of 18.70% TPG, 16.27% ethyl oleate as oil, 43.34% Cremophor RH40 as surfactant and 21.73% Transcutol P as cosurfactant. The characterizations of TPG-SMEDDS including morphological characterization, droplet size, zeta-potential, emulsification time, and dissolution study of TPG-SMEDDS were evaluated. The results showed that TPG-SMEDDS is stable and its release rate is high in four different media (0.1 mol x L(-1) HCl, pH 6.8 PBS, pH 7.4 PBS, and water). The relative bioavailability of SMEDDS was dramatically enhanced in an average of 1.52-fold that of TPG-suspension. It is concluded that the bioavailability of TPG is enhanced greatly by SMEDDS.

Objective This research puts the academic leader under the competency background to investigate the current status of academic leaders in tertiary hospitals in Shanghai,combines the theories a-nalysis with practice on the Correlative Research,takes evaluation of academic leaders as the target to deep into the discussion,studies the application value and special significance of the competency model on culti-vation,introduction and evaluation of academic leaders in tertiary hospitals in Shanghai area.Methods Core elements of competency of the academic leaders were investigated by literature reviews,expert inter-views,behavioral event interview,and questionnaires.The questionnaire of the competency of academic leaders was prepared and the numbers and induction relevant to characteristic items of the competency were obtained.Results The notion of six feature families is proposed by study of the competency model which composed 18 relative characteristic items.Six feature families are leadership,organization team with coordi-nation,innovation and implement of project,strategic thinking and overall outlook,self-control and self-management,pursuit excellence and development.Conclusions The academic leader not being lack of professional quality,it is the deep characteristics under the Iceberg Model that influenced the development degree,efficiency,effects of subjects.The study on the competency of the academic leader is helpful for e-valuation of academic leaders'comprehensive abilities and put forward some proposal about stuff rundle con-struction for reference in hospital.

BACKGROUND:Although bone marrow mesenchymal stem cels from multiple myeloma patients present a variety of abnormalities, it is unclear how these abnormal mesenchymal stem cels influence the chemotactic function of myeloma cel lines.
OBJECTIVE:To investigate thein vitro effects of bone marrow mesenchymal stem cels from normal donors versus multiple myeloma patients on the chemotactic capacity of myeloma cel lines.
METHODS:In vitro cultured bone marrow mesenchymal stem cels derived from either normal donors (N-MSCs group) or newly-diagnosed multiple myeloma patients (MN-MSCs group) were directly co-cultured with U266 cels, in the presence or absence of bortezomib; and then harvested U266 cels were assayed for Transwel migration and mRAN expression of chemotaxis-related genes. U266 Transwel migration to conditioned medium derived from either N-MSCs or MN-MSCs was also tested.
RESULTS AND CONCLUSION:After co-cultured with N-MSCs or MN-MSCs, U266 cels harvested from MN-MSCs group showed increased spontaneous Transwel migration and up-regulated CCR1 mRNA level than those from N-MSCs group (P < 0.05), whatever bortezomib was present or not. However, there was no evident difference between U266 cel Transwel migration to conditioned medium derived from either MM-MSCs group or N-MSCs group. Our study implies that there may be some intrinsic aberrance in bone marrow mesenchymal stem cels derived from multiple myeloma patients, which can modulate the chemotactic migration of myeloma cel lines when they directly interact with each other.

Objective To observe the effects of Huazhuo Granule on expression of phosphatidylinositol-3-kinase (PI-3K) and glucose transporter 4 (GLUT4) in skeletal muscle type 2 diabetes (T2DM) rats;To discuss its effects on activating signal path of PI-3K and GLUT4. Methods High-fat diet combined with low-dose streptozotocin intraperitoneal injection was used to establish T2DM rat models. The rats were randomly divided into blank group, Huazhuo Granule group, rosiglitazone group, and model group. Each treatment group was given relevant medicine for gavage. Model group and blank control group were given normal saline for gavage. The general state, weight, and food ration of rats were observed. After ten-week medicine intervention, 10%chloral hydrate was used for anesthesia to detect the levels of FBG, OGTT (2 h PG), and FINS. RT-PCR was used to detect the expressions of PI-3K and GLUT4 mRNA of rat skeletal muscle in all groups. Results Compared with model group, the levels of FBG, 2 h PG, and FINS decreased (P<0.05);the expressions of PI-3K and GLUT4 mRNA of rat skeletal muscle increased significantly (P<0.05). Conclusion Huazhuo Granule has the effects on increasing insulin sensitivity, which is related to activating insulin signal path of PI-3K and GLUT4 of skeletal muscle tissues.