Docetaxel and vinorelbine, which were plant alkaloids, had showed the good activities as chemotherapy of breast cancer. Combination chemotherapy with docetaxel and vinorelbine had drawn more and more attention. This papers reviewed the docetaxel/vinorelbine combination treatment of breast cancer.

[Objective]To investigate the clinical application of treating soft tissue defects of the feet、ankle and lower one third of the legs with reverse saphenous neurocutaneous concomitant vessel pedicled island flap.[Method]From March 1999 to June 2003,six cases of soft tissue defects of the feet,ankle and lower one third of the legs were treated with reverse saphenous neurocutaneous concomitant vessel pedicled island flap.The size of flaps were from 12 cm?7 cm to 5 cm?3 cm,aver aging 8 cm?5 cm.[Result]Flaps of 6 cases survived all showing good quality.After 10 months to 3 years follow-up,all of the six cases were thinked very good.[Conclusion]The reversed saphenous neurocutaneous concomitant vessel pedicled island flap treating soft tissue defects of the feet,the ankle and the lower one third of legs is easy to be performed.The flap has liable blood supply and does not sacrifice the major arteries.

Mechanical ventilation is regarded as an effective means of replacing artificial ventilation during cardiopulmonary resuscitation (CPR), and has been widely used in the treatment of cardiac arrest (CA) patients. However, there are still some controversial issues remaining to be settled, such as the assessmentof the effectiveness of mechanical ventilation, the selection of the optimal oxygen concentration (FiO2), tidal volume (VT), respiratory frequency, and mode of ventilation during the CPR process. The pros and cons of positive pressure ventilation are also inconclusive. We reviewed and summarized the related research in recent years, and recommended that the intermittent positive pressure ventilation (IPPV) of volume controlled with small VT (6-7 mL/kg), low ventilation rates (10 times/min), and pure oxygen could be applied during the mechanical ventilation of CPR. The best mechanical ventilation strategy still needs further experimental researches to discover and explore.

To promote the technical training and scientific popularization of cardiopulmonary resuscitation (CPR) in China, the Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association combined with the Science Popularization Branch of the Chinese Medical Association wrote "2018 National consensus on cardiopulmonary resuscitation training in China". The formation was based on the general outline about "2016 National consensus on cardiopulmonary resuscitation in China", and to implement the important strategies included the "three pre" policy, prevention, precognition, and pre-warning, before the cardiac arrest (CA); the "three modernization" methods, standardized, diversified and individualized, during the CA; and the "three life" strategies, the rebirth, the extra and the extended, after the CA; and also combined with the concrete National conditions and clinical practice of China area. The document summarized the evidence of published science about CPR training till now, and recommend the establishment of "the CPR Training Triangle" according to the Chinese National conditions. The bases of the triangle were system, training and person, the core of which was CPR science. The main contents were: (1) The "three training" policy for CPR training: the cultivation of a sound system, which included professional credibility, extensive mobilization and continuous driving force, and the participation of the whole people and continuous improvement; the cultivation of scientific guidelines, which included scientific content, methods and thinking; and the cultivation of a healthy culture, which included the enhancement of civic quality, education of rescue scientifically, and advocate of healthy life. (2) The "three training" program of CPR training: training professional skills, which included standard, multiple, and individual skills; training multidimensional, which included time, space, and human; and training flexible, including problem, time, and innovation oriented. (3) The "three party" direction of CPR training, the application for achievement translation, which included scientific translations, skill propagators, and cultural advocates; the precision disseminators, which included accurate communication sources, channels, and dissemination of the audience; and theoretical innovation guides, which included scientific, popular science and communication theory. That integrated the wisdom of scholars, melt the thought of genius, and created the act of envoy for Chinese and foreign CPR training. The training program should be suitable for different trainee, no matter who is trainer or trainee. The release of the expert consensus on the 2018 CPR training will make the National CPR education into the new training era with definite direction, clear target and fully standard of China.
Cardiopulmonary Resuscitation ; China ; Consensus ; Heart Arrest ; Humans

Objective To investigate the relationship between plasma triglycerides ( TG ) , cholesterol (TC)levels and breast cancer.Methods 105 cases of breast cancer(age from 22 to 69 years)and 261 cases of healthy control(age from 16 to 52 years)admitted from May.2014 to Oct.2014 were studied.TG and TC were tested.Subgroup analysis was performed by age (<35, 35-45, ≥45 years) and BMI( <18.5, 18.5-24, ≥24).Results TG level in breast cancer group was significantly higher than that of the healthy control group (t=-3.97,P=0.00), and TC level was lower than that in the healthy control group (t=2.49, P=0.01).TG lev-el of breast cancer patients≥45 years old was higher than that in the healthy control group ( t=-4.31, P=0.00).TC level of breast cancer patients <35 years and from 35 to 45 years was lower than that of the healthy control group(t=3.12, P=0.00及t=2.41, P=0.02); TG levels in breast cancer group were significantly lower than those of the healthy control group for all BMI subgroup ( t=-3.67, P=0.01 for BMI<18.5; t=-3.87, P=0.00 for BMI from 18.5 to 24.0;t=-2.01, P=0.04 for BMI≥24).TC level of breast cancer patients was higher than that of the healthy control group for patients whose BMI <18.5(t=-3.41, P=0.01) and it was lower than that of the healthy control group for patients whose BMI≥24.Conclusions The relation-ship between TG , TC and breast cancer is associated with age .Compared with healthy group , breast cancer pa-tients≥45 years have a higher TG level and breast cancer patients <45 years have a lower TC level .

Objective To investigate the effects of lipoxygenase inhibitor NDGA on expression of 5-LOX and its apoptosis related genes in HepG2 cell line.Methods The expression of 5-LOX and apoptosis related genes hTERT,bcl-2 and bax mRNA was determined by reverse transcriptasepolymerase chain reaction (RT-PCR).Results After 25,50,100,200 μmol/L NDGA treatment for24,48 h,the expression of 5-LOX of HepG2 cell decreased,but the expression of bax was up-regulated and the expressions of bcl-2 and hTERT mRNA were down-regulated,(P＜0.05 compared with the control group).The decrease in the expression of 5-LOX,hTERT and bcl-2 in HepG2 cell was negtively correlated with the dose duration of action of NDGA.Conclusion In vitro,5-LOX is expressed highly in HepG2 cell.Overexpression of 5-LOX may be related to the progression of hepatocellular carcinoma,NDGA can significantly decrease the expression of 5-LOX,up-regulate of bax and downregulation of bcl-2 and telomerse.Lipoxygenase might be a novel therapeutic target for the hepatocellular carinoma.

Objective To observe the effects of insulin-like growth factor-Ⅰ (IGF-Ⅰ) and transforming growth factor-β1 (TGF-β1) on the expressions of sodium iodide symporter(NIS) and pendrin mRNA in a placental villous trophoblast cell line(HPT-8) exposed to different levels of iodine.Methods HPT-8 cells were cultured in vitro in the culture flask and divided into low iodine group-Ⅰ (LI-Ⅰ),low iodine group-Ⅱ (LI-Ⅱ),control group,high iodine group-Ⅰ (HI-Ⅰ) and high iodine group-Ⅱ (HI-Ⅱ) that exposed to different concentrations of iodine (0,5,50,500,5000 μg/L).After cell cultured for 24 h,the followings were added to the culture medium:iodine plus IGF-Ⅰ(0.050 mg/L),iodine plus TGF-β1 (0.001 mg/L).After cultured for another 24 h,total RNA was extracted,the expressions of NIS and pendrin mRNA of HPT-8 cells were determined by real-time quantitative PCR.Results The expression of NIS mRNA in HPT-8 cells:at different levels of iodine,the differences of NIS mRNA expression between groups were statistically significant in group with iodine alone(F =3.612,P ＜ 0.01).The expression of NIS mRNA in LI-Ⅰ group(0.44 ± 0.21) was significantly lower than that of control group(1.25 ± 0.77,P＜ 0.01).At the same level of iodine,in LI-Ⅰ group and HI-Ⅰ group,the differences of NIS mRNA expression within groups were statistically significant (F =13.632,6.900,all P ＜ 0.01).In LI-Ⅰ group,the expressions of NIS mRNA were higher in iodine plus IGF-Ⅰ(1.13 ± 0.38) and iodine plus TGF-β1 (0.81 ± 0.34) than that of pure iodine(0.44 ± 0.21,P ＜ 0.01 or ＜ 0.05);in HI-Ⅰ group,the expression of NIS mRNA was lower in iodine plus TGF-β1 (0.62 ± 0.30) than that of pure iodine(1.23 ± 0.91,P ＜ 0.01).The expression of pendrin mRNA in HPT-8 cells:at different levels of iodine,the differences of pendrin mRNA expression between groups were statistically significant in group with iodine alone(F =12.717,P ＜ 0.01).The expression of pendrin mRNA in LI-Ⅰ group(0.59 ± 0.15) was significantly lower than that of control group(1.03 ± 0.14,P ＜ 0.01) ; HI-Ⅰ group(1.29 ± 0.31) was higher than control group(P ＜ 0.05).At the same level of iodine,the differences of pendrin mRNA expression within groups were statistically significant in LI-Ⅰ,LI-Ⅱ,control and HI-Ⅰ groups (F=12.588,4.588,8.679,8.445,all P ＜ 0.01).In LI-Ⅰ,LI-Ⅱ and control groups,the expressions of pendrin mRNA were significantly higher in iodine plus IGF-Ⅰ(1.68 ± 0.82,1.51 ± 0.79,1.50 ± 0.51) than that of pure iodine(0.59 ± 0.15,0.89 ± 0.22,1.03 ± 0.14,all P ＜ 0.01); in HI-Ⅰ group,the expression of pendrin mRNA was significantly lower in iodine plus TGF-β1 (0.78 ± 0.20) than that of pure iodine(1.29 ± 0.31,P ＜ 0.01).Conclusions In the case of iodine deficiency,the mRNA expressions of NIS and pendrin in HPT-8 cells are decreased and the iodine uptake ability is decreased; the expression of pendrin mRNA in HPT-8 cells is increased and placental iodine uptake is increased under the conditions of mild iodine excessive.IGF-Ⅰ and TGF-β1 play a role in the placental iodine uptake through increasing iodine uptake under the conditions of iodine deficiency and decreasing iodine uptake under the conditions of iodine excessive.

Objective To observe the changes of behavior,blood cortisol level,glucocorticoid receptors (Grs) and mineralocorticoid receptors (MRs) in hippocampus area after four weeks of unpredictable chronic mild stress,and to investigate the probable role of hypothalamus-pituitary-adrenal (HPA) axis in the pathogenesis of depression in aged people.Methods Aged male Wister rats were randomly assigned to control group and model group.The model group received unpredictable mild stress,including food and water deprivation,restrain,tail clipping,forced swimming,white noise,cage titling and cage rotating for 4 weeks,while the control group was undisturbed unless routine feeding and cage changing.After 4 weeks of procedure,the behavior changes were assessed by sucrose intake test,open-field test and state evaluation,serum cortisol level was measured by chemiluminescent assay,the qualitation and quantitation of GRs and MRs in hippocampus area were evaluated by immunohistochemistry and Western blotting respectively.All data were analyzed by using t-test.Results Body weight,the grooming score,activities in openfield test,food intake and sucrose intake were decreased in model group as compared with control group after 2 weeks of chronic mild stress (all P＜0.01),suggesting the stress induced depressive-like behavior effects on aged rats.Serum cortisol level was elevated in model group as compared with control group after 4 weeks of chronic mild stress (P＜0.01).A decrease of the neurons was found in CA3 of hippocampus,but not in DG area.In CA3 area,GR positive neurons were decreased,but no significant decrease was found in MR positive neurons.Conclusions The chronic mild stress leading to depressive-like behavior effects in aged rats induces overall HPA axis dysfunction,elevation of serum cortisol level,impairment of hippocampus neurons and decrease of GR positive neurons.The HPA axis dysfunction induced by chronic mild stress may play an important role in the pathogenesis of depression.

Objective To discuss bilateral percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) using inside and outside intravertebral vacuum cleft (IVC) respectively with bone cement injection for the treatment of Kümmell disease.Methods From January 2008 to October 2015,16 cases of Kümmell disease patients were treated with bilateral PVP or PKP with inside and outside IVC perfusion of bone cement respectively.Of 16 cases,6 were male and 10 were female,aged from 63 to 94 years,with a disease duration from 2 to 15 months.The bone mineral density of every patient was measured by dual-energy X-rayabsorptiometry.The T value ranged from-4.3 to-2.6.Fractures located from T10 to L4,including 2 cases of multiple fractures.Postoperative X-ray was used to observe the vertebral bone cement leakage and anterior height changes of affected vertebrae.Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate pain status and functional activity.Results All cases were followed up for 12-96 months.Cement leakage occurred in 4 patients without nerve complications.The anterior height of affected vertebrae before operation,2 d after operation and at the last follow-up was (50.3 ± 8.3)％,(67.1 ± 8.1)％ and (65.2 ± 6.4)％.The anterior height of affected vertebrae 2 d after operation and at the last follow-up were significantly improved compared with those before operation (P ＜ 0.05),but there were no significant differences between 2 d after operation and at the last follow-up (P ＞ 0.05).The scores of VAS before operation,2 d after operation and at the last followup was (8.63-± 1.23),(2.56 ± 3.48) and (1.38 ± 0.92) scores,and the scores of ODI was (82.1 ± 6.7)％,(28.5 ± 7.3)％ and (22.1 ± 8.2)％.The scores of VAS and ODI 2 d after operation and at the last follow-up were significantly decreased compared with those before operation (P ＜ 0.05),but there were no significant difference between 2 d after operation and at the last follow-up (P ＞ 0.05).There was no postoperative in situ or adjacent vertebral fracture.Conclusions Using internal and external IVC bone cement injection for treatment of Kümmell disease has a good clinical curative effect.It can effectively relieve back pain symptoms,reduce intraoperative and postoperative bone cement leakage and recurrent adjacent or in situ vertebral fracture.

Objective To investigate the correlation of M-type phospholipase A2 receptor (PLA2R) genetic polymorphism in two single nucleotide polymorphisms (SNPs) with idiopathic membranous nephropathy (IMN) of Chinese Han population in Northeast China.Methods A total of 327 individuals were enrolled in the study including 95 adult patients with biopsy-proved IMN (IMN group) followed up for (25.4±11.6) months and 232 healthy people identified by healthy examination in China-Japan Union Hospital of Jilin University (HC group).Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the genotype and allele frequency of rs35771982 and rs3828323 site in PLA2R gene.The x2 test was performed to compare the distribution difference of allelic frequency and genotype frequency of the two sites in PLA2R gene between two groups.Unconditional Logistic regression analysis was used to determine the risk factor of IMN.Results IMN and HC group were matched in male predominance and body mass index (BMI).Patients with IMN were older than the healthy controls and had higher Scr,serum total cholesterol (TC),24-hour urine protein level and lower serum albumin (Alb) level,lower estimated glomerular filtration rate (eGFR) than the healthy controls (all P ＜ 0.01).The CC genotype frequency and the C allele frequency at SNP rs35771982 site of PLA2R gene in IMN group were significantly higher than those in HC group (x2=13.658,P=0.001;x2=15.315,P=9.10× 10-5),whereas there was no distribution difference of genotype and allele frequency at rs3828323 site between two groups (x2=2.844,P =0.241; x2 =2.959,P=0.085).The CC genotype at rs35771982 site in patients with IMN was not related to,age,gender,BMI,blood pressure and several laboratory indexes such as Alb,TC,Scr,eGFR and 24-hour urine protein level (all P ＞ 0.05).Unconditional Logistic regression analysis revealed that the genotype at rs35771982,age,TC,Scr and eGFR were correlated with IMN occurrence.The CC genotype at rs35771982 was the risk factor of IMN (OR =4.408,95％CI 1.488-13.058).Conclusions The CC genotype and C allele at rs35771982 site in PLA2R may be associated with the susceptibility to IMN,whereas the correlation between gene polymorphism at rs3828323 site and IMN is not demonstrated.The CC genotype at rs35771982 is the independent risk factor of IMN in Chinese Han population in Northeast China.