Objective To study the effect and toxicity of COX-2 selective inhibitor, celecoxib, plus doxetaxel + epirubicin regimen for LABC as neoadjuvant chemotherapy. Methods 59 women with LABC staged ⅡB～ⅢB were allotted and randomly divided into 2 groups: the control group consisted of 29 patients and with the dosage: doxetaxel (75 mg/m2, d1), epirubicin(75 mg/m2, d1) every 3 weeks; the experiment group consisted of 30 patients and with the dosage: doxetaxel (75 mg/m2, d1), epirubicin(75 mg/m2, d1) and celeeoxib (40Omg, twice daily, d1～21) every 3 weeks. After 2 cycles, the efficacy and toxicity of each group were evaluated. Results The control group achieved an overall response rate (RR) of 72.41%(21/29), and consisted of clinical complete remission (cCR) 2 cases, partial remission (PR) 19 cases, stable disease (SD) 8 cases; the experiment group achieved a RR of 80.00 %(24/30), and consisted of eCR 3 cases, PR 21 cases, SD 6 cases. Both of the group had no pathological complete remission (pCR) and progressive disease (PD) case, and the difference of RR between 2 groups showed no statistical signifieance(χ2=0.469, P=0.493). There was no difference of the diameter of tumor between 2 groups before neoadjuvant ehemotherapy(t=0.569, P= 0.570), but showed statistieal significance after neoadjuvant chemotherapy (t=7.300, P=0.000). Incidence of myalgia and arthralgia of the experiment group was lower than that of control group and had statistical significance (P=0.013). Conclusion Doxetaxel plus epirubiein regimen is effective for LABC with tolerable toxicity. Celeeoxib can enhance the effect and reduce the incidence of myalgia and arthralgia.

Objective: To investigate the influence of maternal age on the health status of pregnant women and the pregnant outcomes. Methods: Data obtained from "Beijing perinatal health management registration system" was analyzed, 263 157 pregnant women with age information were included from October 1st, 2015 to September 30th, 2016, in which 43 594 women delivered at the age of 35 or above (advanced age) . According to the age of maternal age, there were 5 groups. (1) Proper age: 219 563 (83.43%, 219 563/263 157) cases of the age of 18-34 years, including 122 735 cases (46.64%, 122 735/263 157) in the ≤29 years old group and 96 828 cases (36.79%, 96 828/263 157) in 30-34 years old group. (2) Advanced age: there were 43 594 cases (16.57%, 43 594/263 157) ≥35 years old, including 37 395 cases (14.21%, 37 395/263 157) in the 35-39 years old group, 5 790 cases (2.20%, 5 790/263 157) in the 40-44 years old group and 409 cases (0.16%, 409/263 157) in the ≥45 years old group. The trend-based chi-square test and logistic regression were used to analyze the effects of different age groups on maternal complications and pregnant outcomes. Results: (1) The total incidence of high risk pregnancy (HRP) : in advanced age women, the incidence of HRP was 67.83% (29 571/43 594) which was 56.73% (124 550/219 563) in proper age women, the difference was statistically significant (χ²=1 848.91, P<0.000) . In advanced age women, the incidence of severe HRP was 7.64% (3 329/43 594) which was 6.18% (13 571/219 563) in proper age women, the difference was statistically significant (χ²=128.211, P<0.000) . In advanced age women, the incidence of very severe HRP was 1.76% (769/43 594) which was 0.84% (1 838/219 563) in proper age women, the difference was statistically significant (χ²=318.58, P<0.000) . (2) Comparison of the incidence of HRP in 5 groups:the total incidence of HRP increased through the following age group ≤29 years, 30-34 years, 35-39 years, 40-44 years, ≥45 years (53.28%, 61.09%, 67.41%、70.09%, 74.57% respectively) , the difference was statistically significant (linear by linear χ²=3 165.72, P<0.000) . The incidence of very severe HPR increased (0.66%, 1.06%, 1.66%, 2.35%, 2.93% respectively) , the difference was statistically significant (linear by linear χ²=218.31, P<0.000) . The incidence of severe HPR increased (5.77%, 6.70%, 7.48%, 8.34%, 11.49% respectively) , the difference was statistically significant (linear by linear χ²=422.20, P<0.000) . The incidence of general HPR increased (46.84%, 53.34%, 58.26%, 59.40%, 60.15% respectively) , the difference was statistically significant (linear by linear χ²=1 947.51, P<0.000) . (3) As the maternal age group increased, the incidence of adverse pregnancy outcomes increased (5.54%, 6.85%, 8.77%, 9.90%, 18.09%, linear by linear χ²=674.57, P<0.000) . The incidence of perinatal death, premature birth and low birth weight also presented the above trends (perinatal death: linear by linear χ²=34.79, P<0.000; premature birth: linear by linear χ²=692.87, P<0.000; low birth weight: linear by linear χ²=379.20, P<0.000) . (4) Logistic regression analysis with the assisted reproductive technology and multiple pregnancy considered showed the same trend (P<0.000) . Conclusion The maternal age has an impact on the maternal health status and pregnancy outcomes, and the risk of various types of pregnancy complications and adverse pregnancy outcomes increase with the maternal age group, antenatal care and management should be emphasized in women with advanced maternal age, especially for women ≥40 years old.