Objective: To detect the correlation of the expression of c-erbB-2, p53, PCNA and bcl-2 with the biological behavior of breast cancer. Methods: We used immunohistochemistry to detect the expression of c-erbB-2, p53, PCNA and bcl-2 in 56 breast cancer patients. Results: The expression of c-erbB-2 was 41.1% and was negatively correlated with histological classification but was not correlated with age, clinical stage, ER, or PR. The expression of p53 was 48.2% and was positively related with ER and PR but was negatively correlated with clinical stage and pathological type. The expression of bcl-2 was 50.0% and was negatively correlated with histological classification, ER and PR and was positively correlated with clinical stage and pathological type. PCNA was highly expressed in the 56 cases. Conclusion: We should combine the detection of c-erbB-2, p53, PCNA and bcl-2 with the evaluation of clinical stage, histological degree and pathological type in order to improve the prognostic estimation of breast cancer.

As a high sensitive biomarker of lung cancer ,IGFBP2 plays an important role in the occur-rence,development and treatment of lung cancer .Studies have showed that it promotes tumor progression by acti-vating the IGF1R and integrin mediated signal transduction pathway .Recent researches have demonstrated that it participates in targeted therapy of lung cancer ,which may become a new target for the treatment of lung cancer . This paper makes a review on the relationship between IGFBP 2 and lung cancer .

Objective To observe the clinical effect of preoperative acupuncture on hypercoagulability of elderly patients with intertrochanteric fracture. Methods Sixty elderly patients with intertrochanteric fracture were evenly randomized into control group and acupuncture group. Both groups were treated with external application of Shangke Huangshui gauze on the affected region, and additionally the acupuncture group was treated with acupuncture on bilateral acupoints of Huantiao, Xuehai, Liangqiu, Zusanli, Sanyinjiao, and Taichong. The treatment for the two groups was performed from the hospitalized day to the day before operation. The parameters of thrombelastograph (TEG) before and after treatment and the occurrence of deep venous thrombosis (DVT) were observed . Results After treatment, the difference of TEG parameters of the control group was insignificant as compared with those before treatment (P>0.05). In the acupuncture group, the coagulation reaction time(R) and clot formation time(K) were significantly prolonged(P < 0.05) , and coagulation angle alpha (α), maximal amplitude (MA)of thrombus and clot strength (G) were significantly decreased (P <0.05), the effect being superior to that in the control group(P<0.05). Till the day before operation , 3 cases from the control group suffered from DVT, but none of acupuncture group suffered from DVT, the difference between the two groups being insignificant(P > 0.05). Conclusion Preoperative application of acupuncture can improve the hypercoagulability of elderly patients after hip fracture.

Acute respiratory distress syndrome (ARDS) is a common clinical critical condition of the respiratory system, with a high fatality rate and lack of effective drug treatment, hence it is a global medical problem to be solved urgently. Recently, with the in-depth research on extracellular vesicles (EVs) at home and abroad, more and more evidences suggest that EVs play a critical role in the initiation, development and progression of ARDS and have potential clinical application value. The role of different cells derived EVs in ARDS will be reviewed in this paper.

Objective To evaluate the possible factors that may influence the resting energy expenditure (REE) in patients with newly diagnosed esophageal cancer. Methods Totally, 40 patients with newly diagnosed esophageal cancer were prospectively collected from November 2008 to June 2009 in Xinhua Hospital. Nutritional risk screening 2002 (NRS 2002) was performed. REE and body composition were measured using indirect calorimetry and bioeletrical impedence method, respectively. Results Twenty-seven (67.5%) patients were found with nutrition risk, and NRS score was negatively correlated with prealbumin ( r = - 0.444, P = 0.004) and albumin levels (r = - 0.386, P = 0.014). Measured REE and predicted REE values were ( 6770 ± 1360) and (6021 ± 841 ) kJ/d, respectively (P ＜ 0.001 ). Among all 40 patients, 57.5% of them were hypermetabolic,30.0% were normal, and 12.5% were hypometabolic. Stepwise linear regression analysis showed that fat free mass was the only significant determinant variable for REE (P ＜ 0.001 ). Conclusion Fat free mass is a factor than can influence the energy metabolism in patients with newly diagnosed esophageal cancer.

Objective To observe the effects of electroacupuncture at Ganshu (BL18) and Zusanli (ST36) on depression state and gastrointestinal motility and relevant protein expressions in brain of rats with stress-induced depressive functional dyspepsia. Methods Totally 48 Wistar rats were randomly divided into normal, model, electroacupuncture (EA) and sham-operation group, with 12 rats in each group. Depressive functional dyspepsia model was established by chronic unpredictable mild stress protocols. From day 15 to day 28, the EA group was given electroacupuncture at BL18 and ST36, and the sham-operation group was stimulated by electroacupuncture at 1/3 and 2/3 of the tail. Body weight test, open field test and sucrose preference test were measured on day 0, day 14 and day 28. After 14-day administration, gastric residual volume and intestinal propulsion rate of semisolid paste were detected. The expression of βCaMK inⅡ lateral habenulas and BDNF in hippocampus were measured by Western blot. Results Compared with the normal group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus decreased significantly both in the model group and sham-operation group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas increased significantly (P<0.01). Compared with the model group, the weight, the sucrose preference rate, the behavior score, the small intestinal propulsion rate of semisolid paste and the expression of BDNF in hippocampus increased significantly in EA group (P<0.01), and the gastric residual volume of semisolid paste and the expression of βCaMK inⅡ lateral habenulas decreased significantly (P<0.01). Compared with the sham-operation group, the expression of βCaMKⅡ in lateral habenulas decreased significantly, the expression of BDNF in hippocampus increased significantly in EA group (P<0.01). Conclusion Electroacupuncture at Ganshu (BL18) and Zusanli (ST36) can improve depression and gastrointestinal motility of rats with depressive functional dyspepsia, which may be related to the inhibition of βCaMK inⅡ lateral habenulas and the activation of BDNF in hippocampus dyspepsia.

Objective To analyze the clincopathological features and prognosis of 77 colorectal cancer patients with synchronous liver metastases after resection of the primary tumors.Methods Seventy seven colorec-tal cancer patients with synchronous liver metastases who underwent resection of the primary tumors and patholog-ical confirmed were enrolled in this retrospective study.The clincopathological features and prognosis were ana-lyzed.Kaplan-Meier method was used to analyze survival rate.The differences between survival curves were cal-culated by Log-rank test.Results The analysis showed that sex,tumor differentiation and TNM stage were as-sociated with prognosis(P<0.05).The analyses demonstrated no differences in age,primary tumor site,treat-ment,number of liver metastases and extrahepatic metastasis(P>0.05).There was a significant correlation be-tween CEA,CA19-9 level and gender,tumor differentiation and TNM stage(P<0.001)and the corresponding surgical procedure and TNM stage(P<0.05).Conclusion The analysis show that male,the low differentiation and stageⅢare poor prognosis factors.

OBJECTIVE:To systematically review the efficacy and safety of Shenxian shengmai oral liquid in the treatment of slow arrhythmia,and provide evidence-based reference for clinical treatment. METHODS:Cochrane library,EMbase,PubMed, CJFD,CBM and VIP database were retrieved to collect the randomized controlled trails(RCT)of Shenxian shengmai oral liquid(tri-al group)vs.other Chinese medicines(control group)in the treatment of slow arrhythmia. After quality evaluation,the Meta-analysis was performed using Rev Man 5.14 software. RESULTS:A total of 13 RCTs were included,involving 1 023 patients. The results of Meta-analysis showed that the effective rate [RR=1.26,95%CI(1.18,1.35),P<0.001] and average heart rate [MD=5.80,95%CI (4.01,7.58),P<0.001] in test group were significantly higher than control group;there were no significant difference in the inci-dence of adverse reactions between test group and control group[OR=0.46,95%CI(0.17,1.22),P=0.12]. CONCLUSIONS:Shenx-ian shengmai oral liquid is effective with good safety in the treatment of slow arrhythmia. However,due to low quality of included studies,it remains to be further verified by high-quality and large-sample long-term RCT.

Objective To evaluate the effect of neoadjuvant chemotherapy on lymph node micrometastasis and DC cell number in stage Ⅲ gastric cancer patients.Methods Lymph node micrometastases in pathologically negative lymph nodes from 76 stage Ⅲ gastric cancer patients [56 cases with neoadjavant chemotherapy (NCT) and 20 cases without],were assessed by cytokeratin-20 antibody.Dendritic cells (DC) in HE positive lymph nodes,HE negatives near tumor foci and HE negatives far foci were assessed by CD83 antibody respectively.Patients were divided into four groups:group 0 (20 cases without NCT),group 2 (two courses of NCT in 29 patients),group 3 (three courses of NCT in 16 patients),group 4 (four courses of NCT in 11 patients).Results In NCT group there were two patients with micrometastases (2/56).All the patients were with micrometastases in control group (20/20).Difference was statistically significant (P =0.000).In HE-positive lymph node group:the number of CD83-positive DC in 2 times group,3 times group,and 4 times group when compared with no chemotherapy group were statistically significant (P20 =0.001,P30 =0.000,P40 =0.000).In HE-negative lymph node near foci group:the number of CD83-positive DC in 3 times group,and 4 times group compared with 0 group were statistically significant increased (P30 =0.001,P40 =0.001).In HE-negative lymph node far foci group:the number of 4 times group was significantly higher than 0,2 and 3 group (P40 =0.000,P42 =0.000,P43 =0.001).Conclusions Neoadjuvant chemotherapy is effective in the prevention of lymph node micrometastases in stage Ⅲ gastric carcinoma and it increases the number of mature dendritic cells in lymph nodes.

Objective To observe the TCM syndromes of acute exacerbation of chronic obstructive pulmonary disease (COPD) with malnutrition. Methods TCM Syndromes Questionnaire of Acute Exacerbation of COPD was formulated with TCM clinical epidemiology methods. Totally 220 cases of hospitalized patients met the inclusion criteria were divided into two groups, 120 cases of malnutrition and 100 cases of non-malnutrition. The clinical data were observed and syndrome elements of malnutrition group and non-malnutrition group were analyzed to discuss the rule of syndromes in acute exacerbation period. Results In addition to respiratory system, the frenquency of symptoms such as weight loss, shortness of breath, easy cold, aversion to wind and cold, poor appetite, abdominal distension, constipation, belching, dizziness and tinnitus, tooth loose and hair loss, soreness and weakness of waist and knees significantly increased in COPD with malnutrition, mainly involving in syndromes of spleen deficiency and incoordination between spleen and stomach. In patients with acute exacerbation of malnutrition COPD, the single syndromes were 36 cases (30%), the composite syndromes were 84 cases (70%). The simple excess syndromes were 38 cases (31.67%), the simple deficiency syndromes were 23 cases (19.17%), and the intermingled deficiency and excess syndromes were 59 cases (49.17%). Conclusion Patients with acute exacerbation of COPD with malnutrition are mainly composite syndromes and the intermingled deficiency and excess syndromes. Spleen deficiency and incoordination between spleen and stomach may be the important pathogenesis of COPD with malnutrition.