Currently targeted therapy of breast cancer therapy has become the hot research field and a kind of brand-new biological treatment mode after three traditional pattern of the surgery, radiotherapy and chemotherapy for breast cancer. Molecular targeted therapy is aimed at the target that may cause cancer cells, such as protocarcinogenic genes and tumor-suppressor genes, cell signaling pathways, cytokines and receptors, antiangiogenesis etc. It can reverse malignant biology behavior to inhibit tumor cell growth from the molecular level and has the advantages of high specific effects and low side effects. This paper focuses on the drug of the molecular targeted therapy for breast cancer and the latest progress of targeted therapy.

Medical institutes in the United States,the United Kingdom and Canada have systematically explored and published standard of physician competence,such as ACGME six-critical-components,GMC good medical practice and CanMEDS,which has led to changes in the content,item format and clinical skill test of foreign medical incensing exam.Foreign research inspires Chinese counterparts to study and develop the Chinese standard of physician competence so as to continuously enhance the medical licensing exam.

Objective To investigate the occurrence of hemolytic disease in neonates with maternal and neonatal blood group incompatibility,and to investigate the related factors affecting the occurrence of hemolytic disease.Methods A total of 52 newborns with maternal and neonatal blood group incompatibility in our hospital from May 2016 to May 2014 were selected as the research subjects.The clinical data of all neonates were analyzed by adopting the systematic review method,and the ocurrence situation of ABO hemolytic disease in all subjects was statistically analyzed.The differences in general data of age,gender and related clinical examination results were compared among the neonatal patients.The related factors possibly affecting neonatal ABO hemolytic disease were investigated.Results (1) Among 52 neonates,30 cases (57.69%) appeared neonatal hemolytic disease,and the incidence rate was high;(2) the non-conditional single factor Logistic regression model analysis showed that the weight,height,BMI,HGB,direct bilirubin,indirect bilirubin,total bilirubin and indirect bilirubin /total bilirubin and birth time could be the related factors affecting neonatal hemolytic disease occurrence;(3) non-conditional multiple factor Logistic regression model analysis showed that HGB,direct bilirubin,indirect bilirubin,total bilirubin and indirect bilirubin / total bilirubin and birth time were the independent influencing factors of neonatal hemolytic disease occurrence.Conclusion The incidence rate of hemolytic disease in neonates with maternal and neonatal blood group incompatibility is high,and the birth time,HGB concentration and related bilirubin expression level may be the possible influencing factors of hemolytic disease in neonates with maternal and neonatal blood group incompatibility.

Objective:To prepare doxorubicin-tetrandrine complex liposomes for technology study and quality control.In order to provide a new idea to reverse the tumor multidrug resistance in clinic.Methods:The formulations of doxorubicin-tetrandrine complex liposomes were optimized by three different kinds of methods.And the optimum formula was selected according to the entrapment efficiency.Re- sults:The complex liposomes were prepared by(NH4)2SO4-gradient method combined with pH gradient method according to optimum recipe.The optimum recipe of DOX-TET liposome was founded as DOX-TET/EPC of 1∶10,EPC/Ch of 3∶1,pH value of 7.6,incubation temperature of 50℃,(NH4)2SO4 concentration of 250 mmol/L.Under the formulation,DOX and TET were encapsulated 90.77%and 80.12%,respectively.Conclusion:The doxorubicin-tetrandrine complex liposomes have high entrapment efficiency with fine looking, which provides basis for the further studies.

Objective To investigate the indications and clinical values of percutaneous transthoracic biopsy guided by different locating means respectively on pulmonary lesions. Methods Patients were divided into different groups according the locating methods,which included X -ray, type -B ultrasonography, and CT. Pathologic diagnosis and complications were retrospectively analysed between groups. Conclusion Each locating method has its own advantages and disadvantages. Results we should choose the optimistic one according the patients′ condition.

Objective: To observe the analgesic effect and adverse effects of Controlled-Release Oxyco-done tablets(oxycontin) on moderate and severe chronic cancer pain, and the improvement of quality of life(QOL) in the cancer patients after the treatment. Methods: A total of 72 patients with moderate and se-vere chronic cancer pain were selected .The analgesic effects,adverse effects and quality of life (QOL) were observed and evaluated. Controlled-Release Oxycodone tablets were administered at an initial dose of 5 mg or 10 mg every 12 hours according to the degree of pain. The next analgesic dose should be adjust-ed if breakthrough pain occurs more than twice in 24 hours. If the initial dose is 5 mg, it may be increased to greater than or equal to 10 mg. If the initial dose is greater than or equal to 10 mg, the dosage may increased by 25%～50%. Short-acting morphine tablets are used to control the breakthrough pain. Results: The doses ranged between 10～100mg/d .Among the 72 patients with moderate and severe chronic cancer pain, 12 (16.7%)achieved complete remission ,52(72.2%)achieved partial remission,6(8.3%) achieved minor remis-sion.The overall rate of pain relief 88.9%. The mainly adverse reactions were including, nausea and vomiting, dizziness, drowsiness and dysuria. Followed the reduced of the pain intensity ,the QOL of most cancer pa-tients was improved. The KPS of 12 patients had been obviously improved, 20 patients had mildly improved, and 40 patients were stabilized. Conclusion: Oxycodone hydrochloride controlled-release tablets are effective and safe for the management of chronic cancer patients with moderate and severe pain, with less adverse reactions, and the QOL of cancer patients were significantly improved.

Objective To analyze the clinical effect of small incision operation and traditional operation in treatment of pediatric hernia,and to provide a theoretical basis for the clinical treatment of pediatric hernia.Methods 68 children with pediatric hernia were treated as the research subjects,they were randomly divided into control group and observation group,34 children in each group.The control group adopted the traditional operation treatment,while the observation group was taken small incision.The clinical efficacy and complications of both two groups were compared. Results The operation time,bleeding volume,hospitalization time and incision length of the observation group were (10.45 ±1.35)min,(5.21 ±0.78)mL,(1.98 ±0.76)d,and (1.04 ±0.23)cm,which were better than those of the control group [(15.67 ±3.24)min,(8.56 ±1.87)mL,(3.78 ±1.12)d,and (2.54 ±0.65)cm,respectively],the differences were significant (t =5.760 0,5.747 7,4.171 7,7.986 8,all P <0.05).The incidence rate of complica-tions of the observation group was 2.94%,which was significantly lower than that of the control group (11.76%),the difference was significant (χ2 =5.7118,P <0.05).Conclusion The clinical curative effect of using small incision in the treatment of pediatric hernia is significant,this method has the advantages of small operation wound,less pain, faster postoperative recovery,less complications and other advantages,it is worthy of clinical application.

Objective:To express MSP1-31 gene of Plasmodium falciparum in Salmonella typhi CVD908 vaccine strain using a tetracycline-controlled P LtetO promoter. Methods:The MSP1-31 gene was cloned into the plasmid of pZE11 and transformed into the CVD908/tetR strain by electroporation. Expression of MSP1-31 in CVD908/tetR strain was detected using the method of Western blot. Results: The recombinant plasmid of pZE11/MSP1-31 was constructed, there was effective expression of MSP1-31 protein in CVD908/tetR strain in presence of tetracycline, and no expression of gene in absence of tetracycline. Conclusion: The recombinant Salmonella typhi strain in which the expression of Plasmodium falciparum MSP1-31 fragment induced by tetracycline is established successfully.

The medical engineering department is an important part in modern hospitals,but the status and functions of medical engineers are ignored,which result in the drain of the experts in this field.This paper analyses the reason and gives the countermeasure.

Objective:To evaluate clinical application of American College of Prosthodontics classification system for complete edentulism;and to analyze the relationship between clinician's rating of general degree of difficulty of each case and patients' rating of denture satisfaction.Methods:One hundred and seven edentulous patients were examined clinically using American College of Prosthodontics(ACP) classification for complete edentulism.The least heights of patients' mandible were measured on panoramic radiographs.Clinician rated general degree of difficulty of each case on visual analogue scale.Six month following denture delivery,patients rated their denture using Mcgill satisfaction Visual Analog Scale(VAS).Multivariate linear regression analysis were conducted to analyze the relationship between clinican's rating of general degree of difficulty and mandibular bone height adjusting for confounding factors such as mandibular ridge form,soft tissue quality etc.Pearson correlation analysis was conducted to analyze the correlation between clinician's rating of case difficulty and patients' rating of denture satisfaction.Results: Advanced residual ridge resorption were found in around 80%(83/105) of all the cases.When the least mandibular bone height were measured on panoramic radiographs,intra-examiner reliability was 0.96,inter-examiner reliability was 0.90.Cases were rated as more difficult when patients showed lower mandibular bone height,unfavoriate ridge form(knife ridge and irregular ridge),mobile soft tissue and longer period of wearing time of their previous dentures.No significant correlation(r