Objective To evaluate the efficacy and security of metformin in the treatment of endocrine resistance and postmenopausal hormone receptor positive advanced breast cancer. Methods 60 cases of postmenopausal HR+advanced breast cancer whose first-line or second-line endocrine therapy failed were randomly divided into study group(n=30),treated with metformin combined with AI and control group(n=30),treated with placebo combined with AI. Standard RECIST guidelines were used to evaluate the clinical response. The objective response rate(ORR),clinical benefit rate(CBR),progression-free survival,and adverse reactions of two groups were compared. Results The ORR of two groups were 16.7%and 10%respectively and the difference was not statistically significant(P > 0.05). But CBR in study group was significantly higher than that in control group (63.3%vs 36.7%),and the difference was statistically significant(P<0.05). The median PFS in study group was slightly longer than that in control group (3.7 m vs 4.2 m),but there was no statistical difference. Multivariate regression analysis showed that PFS was only associated with the previous endocrine therapy. No serious adverse reactions occurred in two groups. Conclusion Metformin is expected to improve secondary endocrine resistance in breast cancer,but large prospective clinical studies are needed to confirm it.

Objective To discuss the efficiency and safety of thalidomide combined with mFOLFOX in trea-ting advanced colon cancer.In addition,to observe the influence of mFOLFOX combined with thalidomide on serum vascular endothelial growth factor(VEGF)leveles.Methods One hundred patients with advanced colon cancer were divided randomly into two groups by digital table method.In the combined group,fifty patients were treated by mFOL-FOX combined with thalidomide.In the control group,fifty patients were treated by mFOLFOX alone.All the patients were tested serum VEGF before and after four cycle of chemotherapy.Results The response rate was 42% in the combined group vs.38% in the control group.Higher clinical benefit rate was found in the combined group (78% vs. 68%).The median time to progression(TTP)was 110 days vs.107 days.The differents between the two groups were not statistically significant(all P >0.05).After treatment of 4 cycles,the serum VEGF concentration of combined group and control group were respectively(317.40 ±55.54)ng/L and (330.84 ±64.48)ng/L,which were signifi-cantly decreased compared with pretreafment.The combination group decreased more obviously,the difference between the two groups were statistical significance(t =11.634,P =0.000).Conclusion Combined thalidomide with mFOL-FOX can′t improved clinical curative effect on the advanced colon cancer significantly.However,thalidomide can re-duce the levels of serum VEGF,and improve the quality of life.

BACKGROUND:Low-temperature rapid prototyping technology is a new kind of rapid prototyping technology, and it is rapidly used in the preparation of bone tissue engineering scaffolds because it can make scaffold forming control able and can keep the biological activity of the materials, also can easily realize the scaffold with porous of three-dimensional structure and other advantages.
OBJECTIVE:To investigate the preparation process of polyethylene glycol-modified polylactic acid-glycolic acid/nano-hydroxyapatite (PLGA-PEG/n-HA) using the low-temperature rapid prototyping, and to test its performance.
METHODS:PLGA-PEG/n-HA and PLGA/n-HA were prepared by low-temperature rapid prototyping equipment. Under an electron microscopy, we observed ultra-structure of the scaffolds. Immersion (ethanol) method was used to test the porosity, and electronic testing machine was used to determine the material mechanical properties. Then these two kinds of scaffolds with rat osteoblasts were cultured in vitro, the cel adhesion rate was detected by precipitation method after 12 hours, and cel counting kit-8 method was used to determine the cel proliferation at culture days 1, 3, 5, 7, 9, 12.
RESULTS AND CONCLUSION:Both of the two scaffolds had ideal aperture range and high porosity. But the aperture range of PLGA-PEG/n-HA scaffolds had large fluctuations, and the average aperture was smal er than that of PLGA/n-HA. Some pores were closed up. The cel adhesion rate and the cel growth curve of PLGA-PEG/n-HA was better than that of PLGA/n-HA (P<0.05), but the mechanical properties were less than PLGA/n-HA (P<0.05). The results showed the PLGA-PEG/n-HA scaffolds had good cel compatibility.

Objective To discuss the efficacy of GP combined with cervus blood granule in treating advanced non -small cell lung cancer (NSCLC ) after chemotherapy.Methods Eighty patients with advanced NSCLC were randomly divided into two groups by digital table method.In the combined group,forty patients were trea-ted by GP combined with cervus blood granule.In the control group,forty patients were treated by GP alone.All the patients were tested routine blood in the seventh and tenth day.The value of platelet was recorded,the incidence of thrombocytopenia between two groups was compared.Results At the seventh day of chemotherapy,in the control group,thrombocytopenia Ⅰ found in 5 cases,2 cases of thrombocytopeniaⅡ,1 case of thrombocytopeniaⅢ,thrombo-cytopenia Ⅳ in 1 case.In the combined group,thrombocytopenia Ⅰ occurred in 3 cases,1 case of thrombocytopeniaⅡ,no grade 3 or 4 thrombocytopenia,there was no statistically significant difference between the two groups(Z=-1.259,P=0.208).At the tenth day of chemotherapy,in the control group,thrombocytopenia Ⅰ found in 6 cases, 3 cases of thrombocytopenia Ⅱ,1 case of thrombocytopenia Ⅲ,thrombocytopenia Ⅳ in 1 case.In the combined group,4 cases occurred thrombocytopenia Ⅰ,thrombocytopenia Ⅱ in 1 case,no grade 3 or 4 thrombocytopenia.The difference between the two groups was statistically significant(Z=-1.966,P=0.049).Conclusion Cervus blood granule combined with GP can effectively reduce the classification of thrombocytopenia caused by chemotherapy.To some extent,it can also prevent the happening of the thrombocytopenia.

BACKGROUND:Human hypoxia-inducible factor-1 alpha can regulate the expression of osteogenic and angiogenic genes, and promote osteogenic activity. OBJECTIVE:To observe the expression of osteogenic genes in rat bone marrow mesenchymal stem cells carrying human hypoxia-inducible factor-1 alpha slow virus infection. METHODS:Hypoxia-inducible factor-1 alpha was obtained from Hela cells using RT-PCR. Lentivirus expression vector plasmid carrying hypoxia-inducible factor-1 alpha (Lenti-HIF-1α-eGFP) was constructed. 293Ta cells with LentiPac HIV mixed packaging plasmid was packaged, and then lentivirus was obtained. Rat bone marrow mesenchymal stem cells were isolated and cultured using direct whole bone marrow adherent method. Bone marrow mesenchymal stem cells were identified using flow cytometry. Bone marrow mesenchymal stem cells were infected with slow virus for 1, 4, 7 and 14 days. Bone morphogenetic protein-2, osteocalcin, osteopontin and alkaline phosphatase expression levels were detected in bone marrow mesenchymal stem cells using real-time fluorescent quantitative PCR. RESULTS AND CONCLUSION:Bone marrow mesenchymal stem cells were effectively infected with Lenti-HIF-1α-eGFP. Real-time fluorescent quantitative PCR results revealed that bone morphogenetic protein-2, osteocalcin, osteopontin and alkaline phosphatase began to obviously overexpress from 4 days after infection with Lenti-HIF-1α-eGFP until 14 days. Results suggested that hypoxia-inducible factor-1 alpha could elevate the osteogenic activity of bone marrow mesenchymal stem cells.

To sum up the reform of internal performance appraisal system and income allocation system of Shanghai municipal hospitals.The internal performance appraisal index system,evaluation methods and corresponding income allocation system,featuring two breaks,one change and eight elements.The reforms highlight public welfare nature of public hospitals,which is expected to create profound impacts on hospital operation and medical staff behavior.

BACKGROUNDInsulin resistance (IR) plays an important pathophysiological role in the development of diabetes, dyslipidemia, hypertension, and cardiovascular disease. Moreover, IR can occur even in non-obese people without diabetes. However, direct detection of IR is complicated. In order to find a simple surrogate marker of IR early in non-obese people, we investigate the association of commonly-used biochemical markers (liver enzymes and lipid profiles) with IR in urban middle-aged and older non-obese Chinese without diabetes.

METHODSThis cross-sectional study included 1 987 subjects (1 473 women). Fasting blood samples were collected for measurement of glucose, insulin, liver enzymes, lipid profiles and creatinine. Subjects whose homeostasis model of assessment-IR (HOMA-IR) index values exceeded the 75th percentile (2.67 for women and 2.48 for men) of the population were considered to have IR. The area under the receiver operating characteristic curve (ROC) was used to compare the power of potential markers in identifying IR.

RESULTSTriglycerides (TG) and ratio of TG to high-density lipoprotein cholesterol (TG/HDL-C) discriminated IR better than other indexes for both sexes; areas under the receiver operating characteristic (ROC) curves (AUC) values were 0.770 (95% confidence interval 0.733-0.807) and 0.772 (0.736-0.809), respectively, for women and 0.754 (0.664-0.844) and 0.756 (0.672-0.840), respectively, for men. To identify IR, the optimal cut-offs for TG and TG/HDL-C ratio were 1.315 mmol/L (sensitivity 74.3%, specificity 71.0%) and 0.873 (sensitivity 70.1%, specificity 73.4%), respectively, for women, and 1.275 mmol/L (sensitivity 66.7%, specificity 74.4%) and 0.812 (sensitivity 75.8%, specificity 69.2%), respectively, for men.

CONCLUSIONTG and TG/HDL-C ratio could be used to identify IR in urban middle-aged and older non-obese Chinese without diabetes.

Aged ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Cholesterol, HDL ; blood ; Cross-Sectional Studies ; Diabetes Mellitus ; blood ; Female ; Humans ; Insulin Resistance ; physiology ; Liver ; enzymology ; Male ; Middle Aged ; Triglycerides ; blood