Objective To investigate androgen receptor (AR) expression in triple negative breast cancer(TNBC) patients and its predictive value for clinical outcomes.Methods Five hundred and sixty-eight primary breast cancer patients who received surgery treatment from January 2008 to January 2010 were included in this study.Tissue sections of surgical resection specimens were underwent estrogen receptor (ER),progesterone receptor (PR),and human epidermal growth factor receptor 2 (HER2) immunohisto chemical staining,according to the judgment for triple negative breast cancer and non triple negative breast cancer.Data on age,family history,menstruation,tumor size,tumor stage,tumor grade,pathological type and lymph node metastasis were collected for analysis.Immunohistochemical analysis of AR was done in tissue sections of triple negative breast cancer patients,Kaplan-Meier method was used to compare survival between AR(+) and AR(-) groups,and Log-rank method was used to determine the association between AR-positive expression and 5-year overall survival as well as disease free survival.Results Among 568 breast cancer patients,174 (30.6％)TNBC patients were identified,including 84 patiens with AR (-) expression and 90 patients with AR (+) expression.During 5 years' follow-up,reccurrence rate was 35.7％ (30/84) in AR (-) group and 20.0％ (18/90) in AR(+) group;5-year overall survival rate was 73.8％ in AR(-) group and 81.1％ in AR(+) group.There was no significant association between AR(+) expression and 5-year death or recurrence rate,while after adjusting for age,menstruation,tumor size and lymph node metastasis,AR (+) expression was significantly associated with decreased 5-year death and recurrence rate,adjusted hazard ratio (HR) was 0.794,95CI (0.430-1.021) and 0.722,95CI (0.451-0.965) respectively.Conclusion AR (-) expression is associated with increased risk of death and recurrence and is a promising predictive marker for poor clinical outcomes.

Her-2 targeting therapy is an important part of the treatment for breast cancer with Her -2 overexpression.However,the therapeutic effectiveness is largely influenced by Her -2 resistance.Previous studies have confirmed that PI3K/AKT/mTOR signaling pathway is activated during the process of drug resistance to Her-2-targeting therapy.Therefore,investigating the PI3K/AKT/mTOR signaling pathway and drugs -targeted pathway are important for the treatment of breast cancer .

By summarizing and analyzing recent 10 years’ relevant literature, this article reviews advances in clinical studies of acupuncture treatment for oculomotor paralysis from acupuncture point selection, needling methods and scalp acupuncture and shows that acupuncture therapy has the characteristics and advantages of being simple, convenient, efficacious and cheap.

[Summary] Chronic suppurative otitis media affects patients ’ quality of life, and is life-threatening in patients with cholesteatoma which causes intracranial or extracranial complications .The purpose of surgery is to clear up all the lesions and to reconstruct hearing function .Tympanoplasty is the main surgical method , which includes basically canal wall down ( CWD) and canal wall up (CWU) styles.CWD provides lager surgical field but impairs normal auditory canal structure ; CWU preserves the posterior wall of external auditory canal and provides better quality of life although it has higher possibility of recurrence of cholesteatoma .We reviewed the surgical methods , surgical effects , recurrence rates , and surgical indications of canal wall up mastoid-tympanoplasty , hoping to provide meaningful reference for clinical application .

SUMMARY Salivary gland tumors are a group of the most common tumors in the oral and maxillofacial region with obvious characteristics of clinical , histopathologic , and therapeutic aspects .During the past 50 years, our research group performed a systemic study on salivary gland tumors including imaging diag-nosis, fine needle aspiration cytology , FT-mid-IR fiber optics spectroscopy , histopathologic features and biological behaviour of the tumors , functional parotid surgery , and 125 I seed implant branchytherapy . More reasonable principles of management for various types of the tumors were put forward based on the histopathologic features of the tumors .The surgical techniques were modified and the postoperative com-plications were reduced obviously .Thus, the quality of life of the patients was improved greatly .

Objective To explore the relationship between the subjective well-being and personality characteristics of nurses,and provide the basis for managers to implement humanized management and improve the nurse happiness from the perspective of positive psychology.Methods A total of 190 nurses were selected from a hospital of Zhongshan city by convenience sampling technique.And General Situation Questionnaire,Happiness Scale and the revised Eysenck Personality Questionnaire-Short Form (Chinese version) were used in the investigation.Results The average score of general happiness was (54.91± 9.18) points for male nurses,which was lower than that of the national norm.The sense of happiness between male and female nurses showed statistical difference.The emotional stability of nurses with different marital status showed significant difference.Nurses' subjective well-being and personality characteristics had a significant causal relationship by multiple stepwise regression analysis.Conclusions The general wellbeing about nursing staff is lower than the national norm,male nurses' happiness was lower than that of female and married nurses' emotional instability is higher than unmarried nurses.The nurses' personality is an important factor that affect their happiness.Managers should be under the guidance of the positive psychology,pay attention to the nurse' personality characteristics to improve the nurse' happiness,improve the level of nurse' mental health,to stabilize and optimize the nursing team,and improve the quality of nursing.

OBJECTIVE:To establish a dualwavelength TLC-scanning method for the determination of nucleosides in the preparation of Cordyceps sinensis.METHODS: The sample was analyzed on silica GF254 thin layer plate using 1% CMC-Na as adhesive and chloroform-ethylacetate-isopropanol-water-ammonia(8∶2∶6∶0.5∶0.12) as developing agent and detected by dualwavelength reflection sawtooth scanning(?s=254 nm and ?R=300 nm).RESULTS:Adenosine,Uracil and Uridnine had good linearity in the ranges of 11.16～58.03 ?g(r= 0.998 5),1.04～6.24 ?g(r=0.991 5) and 0.8～4.8 ?g(r=0.991 2) respectively,and their average recovery rates were 95.559%,96.366% and 95.270% and RSD were 0.74%,0.73% and 0.98% respectively(n=6).CONCLUSION: The method is simple,accurate,reproducible,and can be used as the quality control of Cordyceps sinensis preparation.

Objective To study the immunomodulation effects of different dosage of dexmedetomidine (Dex)in the septic shock model of rats after cecal ligation and puncture (CLP).Methods After CLP, 48 wistar rats were randomly (random number)allocated in four groups:(1)CLP group;(2)small-dose Dex group [2.5 μg/(kg·h)];(3)medium-dose Dex group [5.0 μg/(kg·h)];(4) large-dose Dex group [10.0 μg/(kg·h)].HLA-DR (human leukocyte antigen-DR)and plasma cytokine (IL-4, IL-6,IL-10 and TNF-α)were measured,meanwhile mean arterial blood pressure (MAP),heart rate (HR)and mortality were also documented at 1,3,and 5 h after the CLP procedure.Results There were no obvious differences in HLA -DR level,levels of inflammatory mediators,MAP and HR among there Dex treatment groups.Compared with CLP group,HLA-DR level decreased in three Dex treatment groups (P =0.020)and pro-inflammatory mediator (IL-6)increased at 3 h (P =0.011 )then declined at 5 h with decreased HR (P <0.01),and without obvious change in MAP (P =0.124),and all of them led to a significantly decrease in the mortality.The mortalities in CLP group,small dose group,medium dose group and large dose group were 91.7%, 66.7%, 25.0% and 18.0%, respectively. Conclusions Dexmedetomidine used in rats with septic shock rats partially induced immunomodulation initiated within 5 h after CLP evidenced by decreased HR,maintenance of MAP and reduction of mortality rate in dose-dependent fashion.

Sepsis refers to the infection caused by systemic inflammatory response syndrome.Sepsis is one of the leading causes of death in critically ill patients in the ICU and its morbidity and mortality are increasing year by year globally.According to statistics,in China,the incidence of sepsis in ICU is 8.68％ and the mortality rate can be as high as 44.7％,therefore,severe sepsis in the field of medicine to become one of the problems to be overcome.MicroRNAs (miRNAs) play an important role in the pathogenesis of sepsis through the TLRs / NF-κB signaling pathways,which play an important role in immune regulation.In this review,the progress of miRNAs involved in TLRs signaling pathway in sepsis is reviewed.

Macrophage activation syndrome (MAS)is a serious potentially life -threatening complication seen primarily in patients with systemic onset juvenile idiopathic arthritis (sJIA).Clinical symptoms include persis-tent fever,liver and spleen lymph node enlargement,cytopenia,hyperferritinemia,hypofibrinogenemia,hypertriglyceri-demia,coagulation disorders,and hemophagocytosis can be seen in the bone marrow.This article summarizes the characteristics of MAS occurring in the context of sJIA and discuss the recent advances in classification systems and management.