The results of chemotherapy in the treatment of soft tissue sarcoma seem to have reached a plateau.Targeted therapy is the key to improve curative efficacy.Although there are many kinds of targeted therapy drugs of the first generation,only several targeted drugs that target angiogenesis and the epidermal growth factor receptor have showed survival benefits in prospective,randomized,phase Ⅲ clinical trials.Recent data suggest that multitargeted inhibitors might have greater activity owing to their ability to simultaneously block several key signaling pathways.Preliminary results of such agents in clinical trials show that they have a well tolerated toxicity profile,and might have a promising vahle in the treatment of soft tissue sarcoma.

Congenital heart disease (CHD) is the most common heart disease in children, which does great harm to children's health. Tetralogy of Fallot(TOF) is the primary form of cyanosis CHD, with the incidence rate of 10% ～ 15% in CHD. Tissue Doppler lmaging(TDI) ,a new type of Doppler echocardiography, is a noninvasive and a promising method in determination of right and left ventricle constriction and dilatation function quantificationally, which will improve the development of acquainting with heart disease and guid the clinical treatment of CHD. This review is to summarize the status quo of TDI in congenital heart disease especially in TOF.

Objective To evaluate the effects of restraint stress on behaviors of mice with focal cerebral ischemia. Methods Male mice were first subjected to left middle cerebral artery occlusion/reperfusion. Repeated restraint stress (2 hours/day for 2 weeks) was given from 1 week after surgery. At the end of stress scheme, sucrose solution consumption test, open-field test and forced swimming test were performed. Results Spontaneous locomotor activity and coordination test were decreased to the lowest level on the 1st day after MCAO compared with the baseline values before surgery (P

China ; Combined Modality Therapy ; Esophageal Neoplasms ; pathology ; surgery ; therapy ; Esophagectomy ; methods ; Humans ; Lymphatic Metastasis ; Neoplasm Staging ; Survival Rate

Based on the theory of cancer stem cells (CSCs),people have been searching for the treatments of malignant cancers.Gastric cancer side population cells (SP) have the characteristics of CSCs.Searching for the molecular targeted therapy strategy of gastric cancer which embarks from the gastric cancer SP and is based on the theory of CSCs provides a new direction for the treatment,early diagnosis,therapeutic effect and prognosis of gastric cancer.

Objective To review the status and controversy on skin-sparing mastectomy (SSM) for breast cancer. Methods The pertinent literatures about SSM published recently to comprehend its relevant techniques and improvements in comparison with non-skin-sparing mastectomy (NSSM) were analyzed and also the safety of SSM by analyzing the relationships between SSM and ductal carcinoma in situ, restrict nipple-areola complex reservation, and postmastectomy radiotherapy were discussed. Results Skin-sparing mastectomy combined with immediate breast reconstruction is a safe operative modality for T1/T2 tumor without skin adhesion, multicentric tumors, and ductal carcinoma in situ. What is more, it does not defer adjuvant therapy. However, it may be prudent to reserve the nipple-areola complex only for peripherally located T1/T2 tumors and some other less serious invasion degree. Since the effect of SSM and immediate breast reconstruction on postmastectomy radiotherapy is confusing, there are still controversies on whether the patients who have already been operated should take radiotherapy. Conclusion SSM is a safe operative modality for selected patients with breast cancer, and delayed reconstruction may be a good choice for patients who would take postmastectomy radiotherapy.

Objective:To observe characteristics of TCM syndrome types in the patient of cerebral infarction,and cerebral infarction with respiratory disorder at sleep.Methods:90 in-patients of cerebral infarction were monitored by polychannel sommocinematogram (PSG)within 72 hours of admission,which were used as diagnosis of respiratory disturbance at sleep,and all of the patients with apoplexy involving the channels and collaterals were divided into 3 types,collaterals hollow and pathogenic wind attacking the interior;Yin-deficiency of the liver and kidney,and wind-Yang stirring upper,hot phlegm and excess of Fu-organs,and wind- phlegm stirring the upper.Results:The patient had sleep structure disorder,with large change of blood pressure and lower heart variety,and decrease of degree of blood oxygen saturation.The apnea indexes were the highest for the patient with phlegm-heat hollow-organ excess,wind-phlegm stirring the upper,and baic normal for collateral hollow and pathogenic wind attacking the interior.Conclusion:There is close relation of cerebral infarction,especially in the patient of hot phlegm and excess of Fu-organ, with respiratory disorder at sleep.

China ; Esophageal Neoplasms ; surgery ; Esophagectomy ; history ; History, 20th Century ; History, 21st Century ; Humans ; Lung Neoplasms ; surgery ; Thoracic Surgical Procedures ; education ; history

Objective To investigate the relationship between the levels of serum procalcitonin (PCT) and cardiac troponin I (cTnI) in patients with sepsis.Methods According to the severity of the disease, 126 patients with sepsis in the Department of Critical Care Medicine of Hubei Provincial Hospital of Integrated Chinese and Western Medicine from June 2013 to February 2015 were divided into three groups: sepsis, severe sepsis and septic shock groups, 42 cases in each group. The changes of lactate (Lac) and central venous oxygen saturation (ScvO2) were monitored in the three groups within 72 hours after admission, the mortality and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours after admission, the levels of serum PCT and cTnI were compared among the three groups, and the correlations between serum PCT, cTnI levels and APACHE Ⅱ score were analyzed.Results Along with the increase of patients' severity in the three groups, the levels of Lac (mmol/L) were gradually increased (prior treatment: 5.82±2.42, 7.97±3.76, 10.30±2.82; 6 hours after treatment: 3.63±1.54, 5.08±1.98, 7.50±1.35; 12 hours after treatment: 2.70±1.55, 4.13±1.96, 6.23±1.16; 24 hours after treatment: 2.58±1.35, 3.95±2.44, 5.25±1.13; 48 hours after treatment: 2.15±1.82, 3.86±2.36, 4.12±1.72; 72 hours after treatment: 1.83±1.04, 3.78±1.84, 3.74±0.87), while the levels of ScvO2 were gradually reduced (prior treatment: 0.556±0.102, 0.502±0.095, 0.402±0.092; 6 hours after treatment: 0.627±0.062, 0.557±0.083, 0.504±0.075; 12 hours after treatment: 0.658±0.076, 0.601±0.083, 0.595±0.072; 24 hours after treatment: 0.676±0.059, 0.625±0.084, 0.603±0.050; 48 hours after treatment: 0.704±0.049, 0.656±0.066, 0.615±0.035; 72 hours after treatment: 0.755±0.053, 0.707±0.066, 0.629±0.048). The higher the Lac, the lower the ScvO2, and the differences among the three groups were of statistical significance (allP < 0.01). The mortalities of patients in the septic, severe septic and septic shock groups were as follows: 11.9% (5/42), 21.4% (9/42), 38.1% (16/42); serum PCT (μg/L): prior treatment: 5.21±2.92, 17.20±4.81, 40.71±5.22; 4 days after treatment: 2.51±1.52, 10.72±3.83, 46.45±4.25; the levels of cTnI (μg/L): prior treatment: 5.31±0.82, 9.50±0.31, 15.12±3.15; 4 days after treatment: 1.16±0.62, 5.35±0.53, 9.24±1.25; APACHE Ⅱ score: prior treatment: 10.41±3.72, 20.15±5.14, 35.17±4.58; 4 days after treatment: 7.25±2.22, 14.15±4.16, 28.12±3.13. Their levels were also increased along with the increase of the septic severity. The correlation analyses showed that the serum levels of PCT was significantly positively correlated with cTnI and APACHE Ⅱ score (r value was respectively 0.922, 0.921, bothP < 0.01).Conclusion Myocardial damage often easily occurs in patients with sepsis, and the more serious the illness, the more prominent the injury.

Objective To evaluate the effect of group reminiscence therapy on improving the depressive symptoms of the institutionalized elderly. Methods Collecting clinical randomized controlled trials and quasi-randomized controlled trials of group reminiscence therapy for improving depressive symptoms in institutionalized elderly which published from 2000 to November 2016, by searching the Cochrane Library, PubMed, CINAHL, PsycINFO, EMbase, China Biology Medicine, China National Knowledge Infrastructure, VIP, Wanfang Database, Taiwan Academic Online Database and Airiti Library. And reviewing the quality of the studies by using the tools for assessing risk of bias. RevMan 5.3 software was used for data analysis. Results Ten studies(2 randomized controlled trials and 8 quasi-experiments), including a total of 511 cases, were included. The results showed that group reminiscence therapy significantly improved the depression, life satisfaction, and self-esteem of institutionalized elderly (95%CI-1.11--0.56, 0.41-2.05, 1.99-3.82, all P<0.01). There was no statistically significant difference between group reminiscence therapy and usual nursing in relieving loneliness (P = 0.21). Conclusions Group reminiscence therapy can improve the depression in institutionalized elderly, decrease the degree of depression, improve the level of life satisfaction and self-esteem. But in the ease of loneliness has not been confirmed. The randomized controlled trials included in this study were rare and the quality of the literature was low, and large-scale randomized controlled trials of higher quality are needed to confirm this.