The target therapy of trastuzumab (herceptin) opened up a new way to the treatment of breast cancer. Nowadays at least 6 prospective randomized controlled trials (RCT) have proved that trastuzumab could significantly prolong the disease free survival (DFS) and overall survival (OS) of Her-2 positive early breast cancer patients. This article summarized these data and gave the basic principles and strategies of adjuvant therapy with trastuzumab for our daily clinical practice.

The overexpression of human epidermal growth factor receptor 2 (HER-2) is generally considered as an signiifcant predictor of poor prognosis, but the outcome has been rewritten with the appearance and application of the HER-2 targeted monoclonal antibody trastuzumab and chemotherapy plus targeted therapy. For the superiority of acting as in vivo susceptibility” test, neoadjuvant chemotherapy has become a new comprehensive treatment mode for operable breast cancer. And it has also provided an important approach to investigate the effectiveness of newly appeared targeted therapy. We focused more on reviewing and analyzing the results of clinical trials related to preoperation chemotherapy and the latest studies in HER-2 positive breast cancer in this article.

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.

Breast precancerous disease is a group of benign proliferative disorders which is correlated to breast cancer, the latter being the most common female cancer. The relative risk of developing breast cancer within 10-20 years after diagnosis is quite different among histological types of premalignant disease, varying from 1.5 to 10. Most of these diseases increase the rate of cancer in both breasts. While further researches on the relationship between breast premalignant disorders and breast cancer are going on, the diagnosis and management of these precancerous conditions seem to be more and more important for the prevention of breast cancer.

Objective To explore the clinical effects of Jiawei Bazhen in treatment of fracture nonunion in children .Methods 60 cases of patients with fracture nonunion from December 2014 to June 2015 in Weinan Maternity and Child Health Care Hospital were divided into experimental group and control group according to random number table, 30 cases in each group.The control group were treated by Shangke Jiegu tablet combined with staphylococcal enterotoxin C injection, and the experimental group were treated by Jiawei Bazhen combined with staphylococcal enterotoxin C injection, with a consecutive treatment of 6 weeks.The efficacy, arthritis symptom score, serum bone morphogenetic protein-7(BMP-7) and vascular endothelial growth factor( VEGF) were compared between two groups.Results The total effective rate in experimental group were higher than that in control group (χ2 =6.667,P<0.05).The arthritis symptom score in experimental group was lower than that in control group(P<0.05).The serum levels of BMP-7 and VEGF in experimental group were higher than those in control group(P<0.05).There was no significant difference in adverse reactions between two groups(χ2 =1.086,P>0.05).Conclusion Jiawei Bazhen could improve the clinical symptoms, increase the levels of BMP-7 and VEGF, and promote the bone fracture's concresc in children with fracture nonunion, with fewer adverse reactions, which has distinct clinical curative effect.

Objective:To observe the clinical efficacy of rh-BNP combined with continuous renal replacement therapy on the re-fractory heart failure in cardiorenal syndrome. Methods:Totally 48 patients with refractory heart failure in cardiorenal syndrome in our hospital were selected and randomly divided into the observation group and the control group. The control group was received the con-ventional drug therapy combined with continuous renal replacement therapy, and the observation group was received rh-BNP therapy ad-ditionally. After 7 days, NT-ProBNP, heart rate, LVEF, SV, BUN, Scr and GFR of the two groups were compared, and the clinical efficacy of the two groups was evaluated. Results:After the treatment, all the observed indicators in the two groups were significantly improved than those before the treatment, and the improvement in the observation group was better than that in the control group ( P<0. 05). The total effective rate of the observation group was higher than that of the control group(91. 67% vs 79. 17%, P<0. 05). Conclusion:The combination of rh-BNP and continuous renal replacement therapy can improve heart and kidney function of the refrac-tory heart failure in cardiorenal syndrome with better efficacy.

Breast cancer is the most common cancer in women. Compared with older patients, young breast cancer has unique clinicopathological characteristics, with lower detective rate and worse prognosis. Multidisciplinary individual-based therapy is of great significance in maximizing therapeutic benefits, as well as minimizing their side effects. Today more and more young patients are eager to reserve reproductive functions at the same time. This article reviews the progress on screen?ing and diagnostic measures, comprehensive treatments, and reproductive endocrine problems brought by therapies in early young breast cancer.

Neoadjuvant chemotherapy or neoadjuvant chemotherapy in combination with targeted therapy has been widely accepted as the standard treatment for locally advanced breast cancer (Ⅱb-Ⅲ). Nearly forty percent of the patients who accepted neoadjuvant chemotherapy achieved pathological complete response of axillary lymph nodes in addition to downstage the primary lesions. However, for patients with clinical complete response of lymph nodes after pre-operative systemic therapy, there are constant controversies regarding the prediction of axillary lymph nodes response and sentinel lymph nodes biopsy after the treatment. Here we design to review the latest studies about how to evaluate the axillary lymph nodes response after neoadjuvant chemotherapy and try to enlighten the treatment choices in clinical practice.

Histone methyltransferase modulates heterochromatin formation,genomic imprinting and genetic transcription by regulating the combination of histones and DNA.As encoding genes of histone methyltransferase,mixed-lineage leukemia (MLL) genes are found to have close relationship with tumors.Recently,MLL2,a member of this family,has been found highly expressed anomalously in breast cancer,colorectal cancer and lymphoma.Whether MLL2 participates in the progression of cancer,the time phase of its participation and its specific role are still remained to further study.

Objective To analyze the correlation between the metal components and MRI signal intensities of gallstones, to investigate the causes of gallstone signal features on MRI. Methods The MRI data and the metal components of the gallstones in vivo and in vitro of 30 patients were retrospectively analyzed. The MR sequences, namely 3D fast spoiled gradient-echo with fat saturation T1-weighted imaging (3D-FSPGR-FS T1WI), fast spoiled gradient-echo with fat saturation T1-weighted imaging(FSPGR-FS T1WI), fast imaging employing steady-state acquisition(FIESTA)and fast spin-echo T2-weighted imaging with fat saturation(FSE-FS T2WI), were performed on the gallstones in vivo and in vitro. According to the characteristics of the surface and cross section, gallstones were divided into pigment gallstones( n=16) and cholesterol gallstones(n=14). The MR signal characteristics of the gallstones were observed and the signal intensity rates of the gallstones were calculated. Preoperatively, the signal intensity rates of cholesterol and pigment stones of each MR sequence were compared by using t test and Mann-Whiteney U test. Postoperatively,the signal intensity rates of the fresh,dried and re-soaked gallstones were compared by using paired t test and Wilcoxon test. The correlation between the signal intensity rates of gallstones on the 3D-FSPGR-FS sequence and their metal components was analyzed by using Linear Regression analysis. Results The pigment gallstones showed high signal intensity on the 3D-FSPGR-FS T1WI. The signal intensity rates of the pigment gallstones were higher than the rates of the cholesterol gallstones on the 3D-FSPGR-FS T1WI, which were 2.02 ± 0.53 and 0.51 ± 0.24 (t=10.26,P< 0.01), respectively. On the 3D-FSPGR-FS T1WI, the signal intensity rates of the drying pigment stones were significantly lower than the rates of the fresh ones, the rates of the two states of the pigment gallstones were 0.21±0.06 and 1.42±0.35(t=13.49,P<0.01),respectively. The signal intensity rates of pigment gallstones showed significant rebound after re-soaking, the rates of the two states of the pigment gallstones were 0.21±0.06 and 1.68±0.86(t=-6.63,P<0.01),respectively. The metal components of pigment gallstones were significantly higher than the cholesterol stones. In the pigment gallstones and cholesterol gallstones, the medians of the Calcium were 28.186 and 2.347 mg/g(Z =-4.66,P< 0.01),respectively.For pigment gallstones, there was a significant correlation between the calcium and the signal intensity rate on 3D-FSPGR-FS T1WI. The regression equation of linear regression analysis was SI=65.40 logCa-166.67. Conclusions The pigment gallstones containing much more water and metal showed high signal intensity on 3D-FSPGR-FS T1WI. The Calcium in the pigment gallstones may be the main cause for this MR appearance.