This study aimed to review the research progress on the contribution of microRNA (miRNA) to the chemotherapy re-sistance of breast cancer. With“miRNA,”“breast cancer,”and“chemotherapy resistance”as key words, the literature was searched in Pubmed and CNKI databases between 01-2000 and 10-10-2012. We described the characteristics and mechanisms of breast cancer che-motherapy resistance and focused on the contribution of miRNAs in the chemotherapy resistance of breast cancer. MiRNA participate in chemotherapy resistance of breast cancer through different ways. This article summarizes different miRNAs that participate in che-motherapy resistance and identifies their specific pathways in drug resistance. The potential clinical utilization of the serum miRNA as a tumor marker is also discussed. Further research on the effect and mechanism of serum microRNA in chemotherapy resistance will bring a new chapter in the targeted therapy of breast cancer.

The decade practical training experiences in vascular department of Xuanwu Hospital were reviewed.Quality training and medical education measures for further study physicians in department of vascular surgery were introduced and summarized from medical ethics education,professional training,theoretical knowledge training and quantitative assessment.All these measures were intended to improve the overall quality of vascular surgical further study physicians and to guarantee the most gain for trainees.

Focal nodular hyperplasia (FNH) is one of the most common benign liver tumors.It has no potential for malignant transformation and an extremely low rate of rupture or hemorrhage.However,its nature and pathogenesis are still controversial.Accurately diagnosing atypical lesions of FNH based on clinical presentation and radiographic studies are still difficult.This review aims to analyze current literature of FNH and to discuss the new progress of pathologically and clinically relevant advice regarding diagnosis and management.

Objective To summarize the clinical features of patients suffering from pulmonary embolism (PE) with D-dimer ＜ 0. 5 μg/mL in order to raise the diagnostic accuracy and reduce the mortality rate of PE. MethodsD-dimer-negative patients with suspected PE were admitted from January 2006 through December 2009. A comparison of clinical features including clinical manifestations, vital signs, laboratory and ancillary findings between 16 patients finally diagnosed PE and 41 patients without PE. ResultsCompared with patients without PE, the D-dimer-negative patients with PE usually had past history of venous thromembolism (VTE) or recent surgery. The symptoms of chest tightness, acute dyspnea, tachypnea, lower extremity edema and typical S I QⅢTⅢ changes of ECG were more often occurred in patients with PE than those in patients without PE of control group. ConclusionsD-dimer test is a good screening test for acute PE because its negative predictive value is high, but when the patients have acute dyspnea, lower extremity edema, previous history of VTE or/and recent surgery and ECG SI QⅢ TⅢ changes, even if D -dimer ＜ 0. 5 μg/mL, clinicians also should pay attention to and if necessary, further tests should be considered to confirm the diagnosis of PE.

Interleukin-15 is a multffunctional cytokine,which are the activating and induction factors of the T-cell,B-cell,NK-cell and lymphokine-activated killer cell (LAK).It can stimulate hematopoietic stem cell proliferation and differentiation,enhance immunity and has anti-tumor effects.IL-15 and IL-2 have similar structures and functions,but many activating effects of IL-15 are stronger than the other's.IL-15 is closely related to tumor development,and has broad application prospects in biological therapy of cancer.

Limitation of donor source for allograft makes the xenotrans plantation be focus again.But xenotransplantation rejection is far more complicated than allotransplantation.This article reviewd the progress of xenotransplantation rejection and its strategy.

h specific measures of humanistic management from three aspects of the hospital service processes,making it clear the importance and significance of humanistic management in hospital service processes.

Objective To investigate the correlation between the expression of CD10,Bcl-6,VEGF with clinical characteristics and the prognosis in the primary gastrointestinal diffuse large B-cell lymphoma. Methods The clini-cal characteristics data of 66 patients with PGI-DLBCL were determined the levels of CD10,Bcl-6 and VEGF by immunohisto-chemical staining. Analyzed their correlation via Kaplan-Meier method and Log-rand test. Results Among those 66 patients,there were 36 cases(54. 5% )of primary stomach,while other 30 cases(45. 5% )were primary intestinal. 39 cases were GCB and 27 cases were non-GCB. The tumor stage and IPI were inverse propor-tion with the prognosis. The median progression-free-survival of GCB was 21. 50 months while non-GCB was 12. 00 months. The positive expression rate of Bcl-6 was 43. 9%(29 / 66)while that of CD10 was 34. 8%(23 / 66)and there were 29 cases(43. 9% )with positive expression of VEGF. Log-rank test revealed there was a positive correc-tion between the positive impression of CD10,Bcl-6 and PFS. On the contrary,the relationship between the ex-pressions of VEGF and PFS was negative. The expressions of CD10,Bcl-6 and VEGF were not correlated with clini-cal features. Cox multivariable analysis showed that the curative effect,the expressions of Bcl-6 and VEGF were in-dependent prognostic factors. Conclusion PGI-DLBCL is a highly invasive and heterogeneous malignancy. The stage of disease,the Hans classification,the level of IPI,the expression of CD10,Bcl-6 and VEGF may play im-portant roles in predicting the curative effect and the prognosis of the disease.

Background:Some functional dyspepsia(FD)patients are accompanied by sleep disorder,which severely affects the quality of life. Aims:To explore psychological factors and quality of life of FD patients with sleep disorder. Methods:A total of 240 FD patients from Jan. 2013 to Jan. 2014 at the Second Affiliated Hospital of Xi’an Jiaotong University and the Affiliated Hospital of Yan’an University were enrolled,and were divided into sleep disorder group and non-sleep disorder group according to Pittsburgh sleep quality index. Zung’s self rating anxiety scale,Zung’s self rating depression scale and SF-36 quality of life questionnaire were performed in all the patients. Results:Compared with non-sleep disorder group, the incidence of anxiety(72. 5% vs. 40. 8% )and incidence of depression(65. 0% vs. 37. 5% )were significantly higher in sleep disorder group(P < 0. 05). Score of physical function(86. 65 ± 3. 84 vs. 88. 88 ± 4. 56),vitality(44. 79 ± 18. 13 vs. 54. 63 ± 9. 63),mental health(46. 90 ± 11. 47 vs. 63. 42 ± 17. 60),general health(42. 79 ± 11. 07 vs. 58. 29 ± 14. 99)in sleep disorder group were significantly lower than those in non-sleep disorder group,and no significant differences in physical role function,emotional role function,social role function,and body pain were found between the two groups(P > 0. 05). In patients with sleep disorder,the incidence of mental disorder was significantly different among young age group,middle age group and old age group(50. 0% ,55. 0% ,80. 0% ,respectively)(χ2 = 8. 10,P < 0. 05), and the incidence of mental disorder in male patients was significantly lower than that in female patients(32. 6% vs. 79. 2% ;χ2 = 25. 62,P < 0. 05). Conclusions:FD patients with sleep disorder has its own clinical characteristics. Study on the clinical characteristics of FD patients with sleep disorder could facilitate the effectiveness therapy,and has important significance in improving the quality of life.

Objective To improve understanding of the varied, especially atypical mammographic appearances of breast infiltrating lobular carcinoma(ILC). Methods We retrospectively studied 28 ILC (27 patients) mammographic appearances and correlated with the clinical examination, ultrasonographic(US) findings.Results ①The most frequent mammographic finding was an uncalcified mass (13), followed by a mass with calcifications (5), architecture distortion was seen in 4 lesions, two lesions appeared indistinct calcifications. Pleomorphic microcalcifications, focal asymmetric density were 1 respectively, negative mammogram was in two cases. ②Eighteen lesions appeared a mass with or without calcifications on mammogram. Of them, 5 lesions appeared irregular shape. The mass with indistinct margins and spiculated borders were 9 and 6 lesions respectively. ③Seven lesions appeared subtle features, such as architecture distortion (4), indistinct calcifications (2) and focal asymmertric density (1). ④The sensitivity of mammographic detection was 86%(24/28), clinical examination was 64%(18/28), US was 85% (17/20). The sensitivity could be improved to 96%(27/28) by the use of integrated mammography, US, and clinical examination.Conclusion The irregular mass with indistinct or spiculated margins is the predominant mammographic sign in ILC. Atypical features, such as architectural distortion etc are frequently findings. The combination of mammography, ultrasonography and clinical examination is effective to detect ILC.