In recent years,with the development of tumor molecular biology technology,molecular targeted therapy has become a study hotspot,which plays a significant role on breast cancer treatment strategy.Among them,the human epidermal growth factor receptor-2 (Her-2) has been proven as an effective molecular target.So molecular targeted therapy of breast cancer become another important treatment except chemotherapy and endocrine therapy.

The paper covered the background and development of medical institutions in groups,pointing out that such groups share medical resources,and optimize resources deployment structure for better utilization efficiency,thus conducive to regional health planning.In addition,the authors probed into key problems found in such groups,and discussed such problems as property ownership,third-part supervision,internal governance,and organizational culture building.

Objective To observe the toxicity, apoptosis and cell proliferation cycle of Mangiferin on the BEL 7404 human hepatocellular carcinoma cell line, and explore the possibility of Mangiferin as a new tumor chemopreventive drug. Methods MTT method was used to determine the effect of Mangiferin on cell proliferation, microscopy method was used to observe cytotoxicity of Mangiferin, and flow cytometry method was used to determine apoptosis induction and cell cycle proliferation blocking effects of Mangiferin. Results The cytotoxicity effects were observed in various concentrations of Mangiferin and at different exposure times. The effects were enhanced as the Mangiferin concentration increased and exposure time prolonged. The apoptosis effect was also enhanced, and cell cycle arrested at G 2/ M phase. All the above effects became significant when cells exposed to the concentration from 20 ?mol/L to 200 ?mol/L of Mangiferin at 24 h. Conclusions Mangiferin is cytotoxic, and may induce apoptosis. Mangiferin has cell cycle blocking effects on hepatocellular carcinoma cells. Its pharmaceutical potentials is worth for further investigating.

Objective To investigate the impact of nutritional risk of preoperative patients with different parts of colorectal cancer. Methods 385 cases of surgical patients diagnosed with colorectal cancer were selected in the retrospective study in April 2008 to March 2009, Gastrointestinal Surgery Center of West China Hospital in Sichuan University. Patients were divided into the right colon cancer group, the left colon cancer group, the rectal cancer group, using internationally recognized NRS- 2002 Scale and serum nutrition indicators to assess their preoperative nutrition. Results NRS-2002 score in the right colon cancer group showed higher than the left colon and rectal cancer group, but no statistical difference between the latter two rates; serum concentrations of HGB, TP, ALB, A/G were lower in the right colon cancer group than the other two groups, but the concentrations of ALT, AST, Ca2+, PO43-showed no statistical difference among three groups. Conclusions The proximal colon (right colon cancer) were more susceptible to the risk of preoperative malnutrition, the patients with different parts of colorectal cancer should be given to the corresponding preoperative nutritional assessment and nutritional support.

Objective To better understand the role of CREB signaling pathway in chronic mild stress (CMS), we investigated the alteration of CREB and p-CREB in CMS rats with and without fluoxetine hydrochloride. Methods Fifty adult male Sprague-Dawley rats were randomly divided into three groups:CMS group (26), fluoxtine group (12) and con-trol group (12). The rats in CMS group and fluoxtine group received 8 weeks of chronic mild stress. Rats in fluoxtine group were administered daily injections of fluoxetine 10mg/kg I.P. Sucrose preference tests and open-field test were car-ried out after the 8th week. Based on endpoint sucrose-intake, animals were further divided into 4 groups:CMS sensitive group, CMS resilient group, fluoxtine group and control group. Western blot was used to detect the expression levels of CREB and p-CREB in the hippocampus and prefrontal cortex. Results The sucrose consumption was significantly de-creased in CMS resilience group compared to sensitive group, control group and fluoxetine-intervention group (all P<0.05). Similarly, the numbers in total arm entries, percentage of entries into open arms and time spent in open arms was significantly lower in CMS resilience group compared to control group(all P<0.05), but not different compared to CMS sensitive group(all P<0.05). The p-CREB in the hippocampus was significantly lower in CMS sensitive rat compared to CMS resilience group, control group and fluoxetine-intervention group(all P<0.05), but CREB was not dfferent among the four groups(all P<0.05). Conclusions The elevated phosphorylation of CREB in the hippocampus and prefrontal cortex of resilience CMS rats may contribute to the mood alteration induced by stress.

Objective To evaluate the clinical efficacy of Clostridium butyricum tablets in treatment of diarrhea in patients with hepatitis B-related liver cirrhosis.Methods Eighty-seven patients with hepatitis B-related liver cirrhosis and diarrhea were collected from Pujiang People' s Hospital in Zhejiang province during January 2011 and May 2013.According to random number table,patients were divided into Clostridium butyricum treated group (n =44) and control group (n =43).Both groups were given antiviral,liver support,jaundice-relieving and fluid infusion treatments,while patients in Clostridium butyricum group were given Clostridium butyricum tablets (2 tables per time,3 tables per day for 4 weeks) additionally.Diarrhea remission time,improvements in liver function and the complications were observed.Differences in measurement data were compared with t test,and enumeration data were compared with x2 test or rank-sum test.Results The total effective rate in Clostridium butyricum group was 95.45％ (42/44),while that in control group was 74.4％ (32/43) (Z =2.82,P ＜ 0.05).After 4 weeks of treatment,the improvements of alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin (TBil),albumin (Alb) and Child-Pugh (CTP) score in Clostridium butyricum group were more marked than those in control group (t =2.13,2.57,4.83,5.93 and 3.30,P ＜ 0.01).Hepatic encephalopathy occurred in 2 patients in control group and none in Clostridium buayricum group.Conclusion Clostridium butyricum has significant curative effect on diarrhea in patients with hepatitis B-related liver cirrhosis,and it can also improve liver function and reduce the incidence of hepatic encephalopathy.

Aim To study the influences of miR-203 on ursolic acid (UA ) sensitivity in leukemic K562 cell.Methods In the experimental system,eukaryot-ic expression vector of hsa-miR-203 (PmiR-203 )was transfected into K562 cells using LipofectamineTM 2000.K562 cells were incubated with different con-centration of UA alone or in combination with PmiR-203 .The cell proliferation was analyzed by MTT as-say.The cell apoptosis was measured by double stai-ning with Annexin V and Propidium Iodide.The ex-pression of Bcr/abl protein was detected by Western Blot.Results The miR-203 promoted the sensitivity of UA by up to 1 .55-fold and the IC50 was reduced from 44.3μmol · L-1 to 30.7 μmol · L-1 .The a-mount of apoptotic cells was increased in UA combined with PmiR-203 group (P<0.05).PmiR-203 downreg-ulated the expression of Bcr/abl protein in K562 cells. Conclusion Our results support a substantial role of miR-203 that enhances UA sensitivity in K562 cell and the mechanism appears to be related to the dounregula-tion of Bcr/abl by miR-203 .

Objective To investigate the diagnostic value of UL-16 binding protein 2 (ULBP-2,macrophage inhibitory cytokine-1 (MIC-1) for pancreatic cancer.Methods The serum samples of 152pancreatic cancer patients,20 precursors of pancreatic cancer,91 chronic pancreatitis patients and 96 age/sexmatched healthy persons were collected.The serum ULBP-2 and MIC-1 levels were determined by using the ELISA kit and were compared with level of CA19-9.A receiver operating characteristic (ROC) curve was constructed to evaluate their diagnostic values for pancreatic cancer.Results The serum levels of ULBP-2 in patients with pancreatic cancer,precursors of pancreatic cancer,chronic pancreatitis and healthy persons were (219.9 ± 182.5),(62.6 ± 11.4),(68.4 ± 36.8),(76.5 ± 40.9) μg/L,the corresponding values of MIC 1 were (3521.3±3903.4),(973.6±589.0),(959.6±879.0),(427.6±317.0) μg/L,while the corresponding values of CA19-9 were (1448.8 ± 3707.0),(12.0 ± 9.3),(38.2 ± 139.0),(7.7 ± 5.0)kU/L.The parameters in pancreatic cancer patients were significantly higher than those in control group (x2 =40.628,71.662,45.505,15.827,36.433,63.494,26.264,73.427,49.088,P ＜ 0.01).The area under ROC curves(AUC) of ULBP-2,MIC-1,CA19-9 were 0.909,0.864,0.818,and ULBP-2 was superior to CA19-9 and MIC-1,however the combined measurement of three markers produced the highest diagnostic yield(AUC =0.982).For early stage pancreatic diseases (precursors to pancreatic cancer and IA stage pancreatic cancer),AUC of ULBP-2,MIC-1,CA19-9 were 0.506,0.837,0.684,MIC-1 was superior to ULBP-2 and CA19-9,however the combined measurement of MIC-1 and CA19-9 produced the highest diagnostic yield(AUC =0.897).Conclusions Serum ULBP-2,MIC-1 levels are significantly elevated in pancreatic cancer patients.The combined measurement of ULBP-2,MIC-1 and CA 19-9 can increase the diagnostic yield for pancreatic cancer.

Objective To study the influence of preoperative nutritional status for postoperative recovery effect of patients with colorectal cancer. Methods Selected 395 patients with colorectal cancer from Feb 2008 to Jan 2009, evaluated their preoperative nutritional status by NRS-2002, and then divided them into three groups according to the NRS-2002 values. Compared the indexes which indicated postoperative recovery effect among the three groups. Results The nutritional risk level were related with the time of postoperative pulled out the catheter and plasma drainage, the time of consumption, exhaust and defecation and the length of hospital stay. There was no significant correlation between the nutrition risk score and the time of pulled out the stomach robe and getting out of bed. Conclusions There were some influence of preoperative nutritional status on postoperative recovery effect of patients with colorectal cancer, nurses should emphases the preoperative nutrition evaluation and then carry out related nutritional support and associated nursing cares.

One hundred and twenty nine patients with pelvic organ prolapse (stage Ⅲ to Ⅳ according to POP-Q staging) diagnosed in our hospital from January 2010 to December 2016 were enrolled,among whom 66 cases underwent vaginal hysterectomy plus vaginal anterior and posterior wall repair (TO group),63 cases underwent vaginal hysterectomy plus pelvic floor reconstruction with autologous tissue (AT group).Clinical parameters,perioperative and postoperative complications were analyzed.There was no statistically significant difference in intraoperative blood loss,indwelling urethral catheter time,length of hospital stay,and anal exhaust time between group AT and group TO (P＞O.05).The average operation time of group AT was significantly longer than that of group TO (P＜0.05).The postoperative rotation angle of urethra (UR),posterior vesicourethral angle (RVA),and bladder neck descent (BND) of group AT were significantly reduced (P＜0.05).The BND of group AT was significantly smaller than that of group TO 3 months and 12 months after the surgery (P＜0.05).There was no statistically significant difference in UR before and 12 months after surgery in group TO (P＞0.05),while the BND at 12 months after operation in group TO was increased compared to 3 months after operation (P＜0.05).There were significant differences in scores of PFIQ-7 and PISQ-12 before surgery and 12 month after surgery in both groups (P＜0.05).There was no statistically significant difference between the two groups in the incidence of postoperative recurrence and pressure incontinence (P＜0.05).It is suggested that the stability of pelvic floor anatomical structure after pelvic floor reconstruction with autologous tissue is better than that of the traditional surgery,especially for patients with severe pelvic organ prolapse.