Currently targeted therapy of breast cancer therapy has become the hot research field and a kind of brand-new biological treatment mode after three traditional pattern of the surgery, radiotherapy and chemotherapy for breast cancer. Molecular targeted therapy is aimed at the target that may cause cancer cells, such as protocarcinogenic genes and tumor-suppressor genes, cell signaling pathways, cytokines and receptors, antiangiogenesis etc. It can reverse malignant biology behavior to inhibit tumor cell growth from the molecular level and has the advantages of high specific effects and low side effects. This paper focuses on the drug of the molecular targeted therapy for breast cancer and the latest progress of targeted therapy.

Medical institutes in the United States,the United Kingdom and Canada have systematically explored and published standard of physician competence,such as ACGME six-critical-components,GMC good medical practice and CanMEDS,which has led to changes in the content,item format and clinical skill test of foreign medical incensing exam.Foreign research inspires Chinese counterparts to study and develop the Chinese standard of physician competence so as to continuously enhance the medical licensing exam.

Objective:To prepare doxorubicin-tetrandrine complex liposomes for technology study and quality control.In order to provide a new idea to reverse the tumor multidrug resistance in clinic.Methods:The formulations of doxorubicin-tetrandrine complex liposomes were optimized by three different kinds of methods.And the optimum formula was selected according to the entrapment efficiency.Re- sults:The complex liposomes were prepared by(NH4)2SO4-gradient method combined with pH gradient method according to optimum recipe.The optimum recipe of DOX-TET liposome was founded as DOX-TET/EPC of 1∶10,EPC/Ch of 3∶1,pH value of 7.6,incubation temperature of 50℃,(NH4)2SO4 concentration of 250 mmol/L.Under the formulation,DOX and TET were encapsulated 90.77%and 80.12%,respectively.Conclusion:The doxorubicin-tetrandrine complex liposomes have high entrapment efficiency with fine looking, which provides basis for the further studies.

Objective To investigate the occurrence of hemolytic disease in neonates with maternal and neonatal blood group incompatibility,and to investigate the related factors affecting the occurrence of hemolytic disease.Methods A total of 52 newborns with maternal and neonatal blood group incompatibility in our hospital from May 2016 to May 2014 were selected as the research subjects.The clinical data of all neonates were analyzed by adopting the systematic review method,and the ocurrence situation of ABO hemolytic disease in all subjects was statistically analyzed.The differences in general data of age,gender and related clinical examination results were compared among the neonatal patients.The related factors possibly affecting neonatal ABO hemolytic disease were investigated.Results (1) Among 52 neonates,30 cases (57.69%) appeared neonatal hemolytic disease,and the incidence rate was high;(2) the non-conditional single factor Logistic regression model analysis showed that the weight,height,BMI,HGB,direct bilirubin,indirect bilirubin,total bilirubin and indirect bilirubin /total bilirubin and birth time could be the related factors affecting neonatal hemolytic disease occurrence;(3) non-conditional multiple factor Logistic regression model analysis showed that HGB,direct bilirubin,indirect bilirubin,total bilirubin and indirect bilirubin / total bilirubin and birth time were the independent influencing factors of neonatal hemolytic disease occurrence.Conclusion The incidence rate of hemolytic disease in neonates with maternal and neonatal blood group incompatibility is high,and the birth time,HGB concentration and related bilirubin expression level may be the possible influencing factors of hemolytic disease in neonates with maternal and neonatal blood group incompatibility.

Objective To investigate the indications and clinical values of percutaneous transthoracic biopsy guided by different locating means respectively on pulmonary lesions. Methods Patients were divided into different groups according the locating methods,which included X -ray, type -B ultrasonography, and CT. Pathologic diagnosis and complications were retrospectively analysed between groups. Conclusion Each locating method has its own advantages and disadvantages. Results we should choose the optimistic one according the patients′ condition.

Objective: To observe the analgesic effect and adverse effects of Controlled-Release Oxyco-done tablets(oxycontin) on moderate and severe chronic cancer pain, and the improvement of quality of life(QOL) in the cancer patients after the treatment. Methods: A total of 72 patients with moderate and se-vere chronic cancer pain were selected .The analgesic effects,adverse effects and quality of life (QOL) were observed and evaluated. Controlled-Release Oxycodone tablets were administered at an initial dose of 5 mg or 10 mg every 12 hours according to the degree of pain. The next analgesic dose should be adjust-ed if breakthrough pain occurs more than twice in 24 hours. If the initial dose is 5 mg, it may be increased to greater than or equal to 10 mg. If the initial dose is greater than or equal to 10 mg, the dosage may increased by 25%～50%. Short-acting morphine tablets are used to control the breakthrough pain. Results: The doses ranged between 10～100mg/d .Among the 72 patients with moderate and severe chronic cancer pain, 12 (16.7%)achieved complete remission ,52(72.2%)achieved partial remission,6(8.3%) achieved minor remis-sion.The overall rate of pain relief 88.9%. The mainly adverse reactions were including, nausea and vomiting, dizziness, drowsiness and dysuria. Followed the reduced of the pain intensity ,the QOL of most cancer pa-tients was improved. The KPS of 12 patients had been obviously improved, 20 patients had mildly improved, and 40 patients were stabilized. Conclusion: Oxycodone hydrochloride controlled-release tablets are effective and safe for the management of chronic cancer patients with moderate and severe pain, with less adverse reactions, and the QOL of cancer patients were significantly improved.

Objective To investigate the discussion of risk factors of severe head injury with multiple organ dysfunction syndrome.Methods The clinical data of 149 cases with severe traumatic brain injury patients were retro-spectively analyzed,and the risk factors in patients with severe traumatic brain injury were collected,which may affect MODS,such as gender,age,GCS score,associated injuries,chronic underlying diseases,infections and other details, statistically analyzed were combined with incidence of MODS.Results (1 )Univariate analysis results could be seen, age,chronic underlying diseases,admission GCS score,extensive brain parenchymal damage,merge large organ dam-age,brain herniation,concurrent infection,massive blood transfusion were risk factors of MODS severe traumatic brain injury(χ2 =12.962,11.725,11.021,13.894,11.486,12.031,12.967,13.078,P=0.023,0.025,0.027,0.017, 0.023,0.018,0.021,0.019).(2)MODS rate and the number of risk factors were positive correlation(r=0.528,P=0.021).(3)With the increase of the number of mortality in patients with MODS organ dysfunction occurred signifi-cantly increased,MODS patients in this group,the two organs mortality was 17.4%,the three organs were 46.7%, four or more mortality was 87.5%(χ2 =11.735,13.933,12.748,P=0.028,0.019,0.025).Conclusion Age, chronic underlying diseases,GCS low,extensive parenchymal injury,combined injury,the occurrence of hernia,com-plicated by infection,massive blood transfusion were independent risk factors for brain injury,which should be payed attention.

The medical engineering department is an important part in modern hospitals,but the status and functions of medical engineers are ignored,which result in the drain of the experts in this field.This paper analyses the reason and gives the countermeasure.

Cervical spondylotic amyotrophy is receiving increasing attention in recent years as a class of specificity of cervical spondylosis,this paper refers a large number of reference reported in the literature,and gives an accurate summary of the disease from the basic definition of disease,pathogenic factors,clinical manifestations,diagnostic criteria and prognostic point of view,and provides a theoretical foundation for clinical diagnosis and treatment of cervical spondylotic amyotrophy.

Objective To determine the free thiols in the chimeric protein PfCP-2. 9 of Plasmodium falciparum expressed by Pichia pastoris. Methods Two experiments of reverse phase HPLC and Ellman' s reaction were applied to the PfCP-2.9 for the determination of its free thiols. For RP-HPLC analysis, three kinds of samples were tested: PfCP-2. 9, dithiothreitol-reduced PfCP-2.9 and indoacetic acid-alkylated PfCP-2.9. Results Both experiments showed that there were no any free thiols present in the PfCP-2. 9. Conclution The disulfide bonds between cysteine residues of PfCP-2. 9 were formed completely.