Therapies targeting endocrine receptors and human epidermal growth factor receptor 2 have become important treat-ment modes for patients with hormone receptor breast cancer. Despite the availability of these options, however, development of prima-ry or secondary drug resistance and subsequent disease progression in patients with advanced disease continue to occur. Mammalian tar-get of rapamycin (mTOR), a key regulator of cell growth and proliferation, has been implicated in the induction of cellular processes leading to the uncontrolled growth of cancer cells. Recent studies have suggested that overactivation of the mTOR pathway may be in-volved in the development of endocrine resistance. Interrupting this signaling cascade may alleviate such resistance and help restore drug sensitivity. A number of agents targeting the mTOR pathway have shown potent anti-tumorigenic effects in vitro, and several agents show great potential for treating breast cancer patients. Many clinical studies have shown that combining endocrine therapy with mTOR inhibitors could significantly increase the survival rate of breast cancer patients. In this study, we focus on recent research prog-ress on mTOR and its inhibitors in endocrine therapy resistance in breast cancer.

[Objective]To test and prove the mushroom shaped surface prosthesis of femoral head not only can be a weight-bearing device,but also could reduce stress-shelter and achieve long-term stability.[Method]A simplified three-dimensional model of femoral head was made.And the biomechanics of femoral head were compared by finite element analysis in two states:with and without the replacement.[Result]It showed that the maximum of strees in famoral head was less than 40Mpa,consequently the replacement had sufficient strength to meet its basic function.Furthermore,the prosthesis bear the force both at up part and down.Therefore it reduced stress-shelter.[Conclusion]This prosthesis can achieve immediate and long-term stability.And it provides new ideas for designing the femoral head resurfacing prosthesis.

Recommending postgraduate without tests is the path to improve the quality of postgraduate and choose talents with news ideas.In order to consummate the recommendation in local key medical college,the school of postgraduate in Hebei medical university formulated the selecting quota and standard scientifically and reasonably,selected the morally and academically excellent graduates,reasonably distributed quota of recommended exam-free postgraduates,reinforced cooperation between different colleges,explored the linkage among learning,studying and producing and attempted orderform talent-training model.

Objective To address the medical problems, in treatment of avascular necrosis of the femoral head, on loosening and subsidence of the prosthesis of femoral head. A set of Mushroom Shaped Surface Prosthesis of Femoral Head was designed. Methods Based on biomechanical of the femoral head and the principle of transferring the force through femoral head while reducing stress-sheltered, nickel-titanium alloy and other new medical alloy materials were used to develop a prosthesis, which not only can be a weight-bearing device, but also promotes bone-growth. Results The prosthesis is novel, compact and little-volume, and the manipulation of surgery is convenient and secure. Conclusion The design of this prosthesis can provide new ways or ideas for designing the femoral head replacement prosthesis to solve problems on loosening and subsidence.

Objective To express the capsid proteins of WU polyomavirus(WUPyV) for research and find antigen for diagnostic value. Methods Coding sequences of capsid proteins of WU polyomavirus by PCR were cloned in prokaryotic expression vector PGEX-20T. Recombinant plasmids were transformed into E. coli BL21(DE3) and induced by IPTG for proteins expression. Recombinant proteins were identified by Western blot. Results SDS-PAGE proved that recombinant proteins showed three bands with molecular relative mass of 69×103, 63×103 and 56×103. The recombinant proteins were recognized by anti-GST McAb. The antigenicity was tested by Western blot using 16 WU polyomavirus positive and 70 negative sera. Conclusion Recombinant VP1, VP2 and VP3 expressed in E. coli can combine with WUPyV-Ab and have good antigenicity. They can be used for further research.

Objective To explore the effects and mechanisms of hepatitis B virus-X protein (HBx) on invasion and migration of hepatocellular carcinoma (HCC) cells.Methods The retrospective cohort study was conducted.The clinicopathological data of 30 patients with liver tumor (20 with HCC and 10 with benign tumor of liver) who were admitted to the Affiliated Hospital of Xuzhou Medical College between July 2014 and July 2015 were collected.HCC tissues of 20 patients with HCC (with history of HBV infection) were collected by surgical resection and peritumoral normal tissues (outside of tumor capsule) of 10 patients with benign tumor of liver (without history of HBV infection) were collected.The expressions of epidermal growth factor receptor 3 (ErbB3)in HCC tissues and peritumoral normal tissues were detected by immunohistochemistry (IHC).The relative expressions of ErbB3 and HBx in HCC tissues and peritumoral normal tissues were detected by Western blot,and relative expressions of ErbB3 in HepG2 of which green fluorescent protein (GFP) and GFP-HBx were respectively transfected were detected.The relative expressions of ErbB3 mRNA in HepG2 transfected by GFP and GFP-HBx were detected by real-time polymerase chain reaction (RT-PCR).The migration and invasion of HepG2 were respectively detected by Transwell assay with and without matrix.The measurement data with normal distribution were represented as $± s.The comparisons between groups were evaluated with the independent-sample t test.Correlation analysis was done by the Pearson test.Results (1) The expressions of ErbB3 were detected by IHC:relative value of mean optical density (MOD) of ErbB3 in HCC tissues of 20 patients with HCC and peritumoral normal tissues of 10 patients with benign tumor of liver were 2.54± 1.33 and O.99±0.29,respectively,with a statistically significant difference (t =6.542,P ＜ 0.05).(2) The relative expressions of ErbB3 and HBx were detected by Western blot:relative expressions of ErbB3 and HBx were respectively 0.79±0.13,1.10±0.28 in HCC tissues of 10 patients with HCC and 1.07±0.17,0 in peritumoral normal tissues of 10 patients with benign tumor of liver,with statistically significant differences (t =3.229,19.486,P＜0.05).The results of Pearson test showed that there was a positive correlation of expression between ErbB3 and HBx in HCC tissues (r=O.637,P＜ 0.05).(3) The relative expressions and transcriptional levels of ErbB3 were detected by Western blot and RT-PCR:relative expressions of ErbB3 in HepG2 of which GFP and GFP-HBx were respectively transfected were O.75±0.11 and 1.10±0.10,respectively,with a statistically significant difference (t=4.291,P＜0.05).The relative expressions of ErbB3 mRNA in HepG2 of which GFP and GFP-HBx were respectively transfected were O.38±0.03 and O.94±0.07,respectively,with a statistically significant difference (t=11.703,P＜O.05).(4) The effects of ErbB3 on migration and invasion of HepG2:numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay with matrix were respectively 271± 18 and 463± 31,respectively,with a statistically significant difference (t =8.202,P＜0.05).Numbers of transmenbrane cell in HepG2 of which His and His-ErbB3 were respectively transfected by Transwell assay without matrix were respectively 315±38 and 549±34,respectively,with a statistically significant difference (t =8.310,P＜0.05).Conclusion HBx protein can promote the invasion and migration of hepatocellular carcinoma cells through up-regulating expressions of ErbB3 protein.

Background and purpose:Tumor suppressor gene P53 has long been studied in tumors, including breast cancer. More studies focused on the relationship between P53 and prognosis of breast cancer and found that P53 overexpression suggested a bad prognosis. However, the effect of P53 on early stage postmenopausal patients with ER-positive breast cancer has not been clariifed yet. This study was to investigate the role of P53 plays in aromatase inhibitor (AI) resistance among early stage postmenopausal patients with ER-positive breast cancer patients. Methods:A total number of 293 operable breast cancer patients who received surgical treatment during Jul. 2000 to Jul. 2006 in Fudan University Shanghai Cancer Center were enrolled into this study. All patients received AI treatment. The SPSS 12.0 software was used to estimate the survival rate. Univariate and multivariate analysis were also performed via above software. Results:The median follow-up time is 72 months (6-140 months). The 5 year disease free survival (DFS) of P53 positive and negative were 78%and 89%. The results showed that P53 overexpression (HR=1.729, 95%CI:1.038-2.880, P=0.035), pathological stage (HR=2.270, 95%CI:1.399-3.681, P=0.001);histological grade (HR=2.328, 95%CI:1.312-4.133, P=0.004); age (HR=1.988, 95%CI:1.511-2.617, P<0.005) were still the independent risk factors of recurrence and metastasis in breast cancer patients treated with AI. Conclusion:P53 overexpression correlated strongly with AI resistance in early stage postmenopausal patients with ER-positive breast cancer patients who were treated with AI and conifrmed the relevance of previously described prognostic factors. It is reasonable to take P53 expression into account when we evaluate the risk of breast cancer patients and decide the anti-cancer treatment strategy.

Objective To explore the effects of application of standard evaluation process of spinal cord motor function in patients with thoracic or lumbar diseases. Methods Selected 60 patients with thoracic and lumbar disease treated in the orthopedic ward of Henan Provincial People's Hospital from April 2016 to June 2016 as the experimental group. We retrospectively analyzed 60 cases of patients with thoracic or lumbar diseases treated with routine nursing evaluation process admitted between January to March 2016. We compared before and after the standardization evaluation process of spinal cord motor function, the theory and operation achievements of nurses, satisfaction of doctors with nurse specialist ability, mean hospitalization days and average cost of two groups. Results The development and implementation of the standardized evaluation process of spinal motor neurotically function, after the training, the theoretical assessment score of the nurse was (94.70±1.18) points, and the operation assessment score was (93.50±2.34) points; the average length of stay was (6.10±1.98) days. The average cost of hospitalization was (29 088±341) yuan; the overall satisfaction of doctors to nurses increased to 14/15; compared with 42.30±12.95, 46.80±15.31, 7.80±2.37, 37 566±592 of the control group, the difference was statistically significant (t=4.76-8.31, P=0.00). Conclusion Application of the standard evaluation process for Spinal cord motor function in patients with thoracic or lumbar diseases can standardize nurses' working procedure, making nursing work more comprehensive, timely and professional, and can better guide clinical practice.

Objective To explore the effects of application of self-made assessment card for spinal nerve motor function in clinical nursing.Methods An assessment card for spinal nerve motor function was designed and produced according to "spinal cord injury grading standards" by American Spinal Injury Association(ASIA).A total of 40 nurses working in orthopedic ward of our hospital were selected as study subjects,and divided into the experimental group and the control group with 20 nurses in each group.Theoretical and practical training regarding spinal nerve motor function was provided to nurses in both groups.Then totally 398 patieuts with spine or spinal cord diseases hospitalized in our orthopedic ward were recruited from June to September 2016 as subjects for assessment.The experimental group used self-made assessment card for spinal nerve motor function as guidance;the control group performed routine assessment for spinal nerve motor function.Results There were no significant differences between the experimental group and the control group in scores of theoretical and practical examinations (P＞0.05);compared with the control group,the error of assessment in the experimental group was reduced by 9.5％,missed assessment rate decreased by 16.2％;and the time for assessnent in the experimental group was significantly shorter than that in the control group(P＜0.05).Conclusion The assessment card for spinal nerve motor function can reduce the error of assessment,save the time for assessment,enhance the capacity of specialist nurses and improve work efficiency.

Objective? To optimize the emergency process with the healthcare failure mode and effect analysis (HFMEA) tool among lumbar surgery patients with muscle weakness so as to shorten the first-aid time, standardize doctor-nurse behavior and improve the timely cure rate. Methods? The emergency process from muscle weakness to hematoma evacuation in operating room was optimized based on the HFMEA. From June 2016 to May 2017, a total of 6 lumbar surgery patients with muscle weakness were in control group before optimization. From June 2017 to May 2018, a total of 7 lumbar surgery patients with muscle weakness were in experimental group after optimization. We compared the time from muscle weakness to effective cure of patients between two groups, and the detection rate for lumbar surgery patients with muscle weakness within 6 hours by nurses as well as the misjudgment probability for muscular strength assessment after lumbar surgery by nurses. Results? After implementing optimal process, the time from muscle weakness to effective cure of patients decreased from (23.78±1.95) h to (5.37±0.78) h. The detection rate for lumbar surgery patients with muscle weakness within 6 hours by nurses increased from 33.3% to 100.0%. The misjudgment probability for muscular strength assessment after lumbar surgery by nurses decreased from 12.2% to 4.6%. Conclusions? The application of HFMEA tool can optimize the muscular strength assessment management process for patients after lumbar surgery, standardize doctor-nurse behavior, shorten the first-aid time of muscle weakness and improve the detection rate for muscle weakness within 6 hours so as to guarantee the safety of patients.