Nco-adjuvant endocrine therapy has provided opened new alternatives for locally advanced breast cancer, especially for patient groups such as the elderly, those who are not suited for chemotherapy, and those whose response may not be optimal. The latest generation of endocrine therapy for breast cancer,aromatase inhibitors, has proved superior to tamoxifen in terms of toxicity and efficacy in the adjuvant setting.Compared with neo-adjuvant chemotherapy, the appropriate patients to receive nco-adjuvant endocrine therapy can achieve similar short-term benefit. However, because of fewer long-term follow up results, the overall prognosis is not clear.

Objective: To analyze the efficiency and differences of China Community Health Service, to analyze the shares of eastern-middle-western regional differences and the difference within each region in the total efficiency difference. Methods: The super efficiency DEA model and decomposition of Gini coefficient by Subgroups are used to analyze the provincial data in China from 2008 to 2011. Results: The eastern-central-western regional difference is the major cause of the efficiency differences in China Community Health Service. In the meantime, the shares of the difference within each region in the total efficiency difference are also non-negligible. Conclusion: To narrow the efficiency differences among eastern, central and western areas; improve the inter-regional flow of community health service resources; improve the support and supervision on the backward regions; make regional policies to coordinate the internal resources of community health services and strengthen the assessment mechanism using efficiency as the indicator.

Transcatheter closure as an alternative to medical surgery has become a preferred therapeutic method to atrial septal defect (ASD).However,thrombopoiesis after occluder implantation has been reported comprehensively and causes a series of serious complications such as cerebral embolism、myocardial infarction,pulmonary embolism and so on.Reasons of device thrombopoiesis are closely associated with atrial fibrillation,persistent atrial septal aneurysm,occluder type,activated coagulation system and occluder endothelialization process.This paper summarizes correlation factors of occluder thrombopoiesis and current related prevention proposal after transcatheter closure of ASD,and provides theoretical and experimental foundation for prevenition of device thrombopoiesis after occluder implantation of ASD.

New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Objective To discuss the antitumor mechanism preliminarily by observing effects of Celastrus orbiculatus extracts (COE) on vascular endothelial growth factor (VEGF) mRNA and protein expression in hepatoma (Hepal-6) cells of mice.Methods Hepa1-6 cells were treated with COE at different nontoxic concentration (0, 10, 20, 40, 80, and 160 μg/mL) for 16 h. The mRNA and protein expressions of VEGF were detected by reverse transcription-PCR and Western Blotting,respectively. Results COE significantly inhibited VEGF expression at both mRNA and protein levels in a dose-dependent manner. Conclusion COE can inhibit VEGF expression in Hepa1-6 cells, therefore suggest that VEGF could be chosen as an therapeutic target for COE in the context of cancer chemoprevention and anticancer therapy.

Objective:To evaluate the present situation and trend of antifungal medicines used in 34 hospitals in Wuhan area. Methods:The sales volume,market share,DDDs and DDC of antifungal medicines in 34 hospitals in Wuhan area during 2012 and 2014 were statistically analyzed. Results:The consumption sum and growth rate of the medicines were increased year by year, and those of pyrrolic medicines were the highest. The sales volume of voriconazole ranked the first. The DDDs of clotrimazole vaginal tablets and nifuratel-nysfungin suppositories ranked the top two. Conclusion:The consumption of antifungal medicines in Wuhan area has been increased greatly and the consumption structure is relatively stable. The utilization evaluation of antifungal medicines should be enhanced. Antifungal medicines should be rationally used to prevent or slow down the spread of drug resistant bacteria.

Triple negative breast cancer (TNBC)is difficult to benefit from endocrine therapy or tras-tuzumab targeted drug therapy.Biological overexpression of breast cancer susceptibility gene 1,p53 gene,vas-cular endothelial growth factor and microRNA suggests that TNBC is easy to metastasis and recurrence and has a poor prognosis.Exploring the molecular subtypes of TNBC,setting out the treatment plan for subtypes and finding the corresponding monoclonal antibody targets are the research direction of TNBC in the future.

Objective·To discusses the high risk factors and therapy strategies for ovarian hyperstimulation syndrome (OHSS). Methods·Seventy-seven cases with moderate and severe OHSS were collected to be retrospectively analyzed in Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2010 to December 2016. Results·Compared with non-pregnant patients, pregnant patients were more likely to have severe OHSS (P<0.05). Embryo transfer patients who underwent ovulation induction and oocyte retrieval became severe OHSS much more easily and had a much longer hospital stay than oocyte retrieval patients (P<0.05). Pumping ascites and pleural effusion or not has no effect on the length of hospital stay and the usage of low molecular dextran for patients with severe OHSS. Conclusion·The risk of OHSS should be evaluated to determine whether or not to carry out a fresh embryo transfer in patients who underwent ovulation induction and oocyte retrieval. For OHSS patients who have undergone embryo transfer or pregnancy, more attention should be paid to the progress of the disease, and individualized treatment is required.

AIM: To investigate the adhesion between lymphocytes and extracellular matrix (ECM) in delayed-type hypersensitivity (DTH) in mice as well as the regulatory effect of several cytokines on it. METHODS: DTH was induced by the application of picryl chloride (PCl) to mice that had been sensitized twice by PCl, followed by isolating the spleen lymphocytes at different times. The adhesion of spleen lymphocytes to fibronectin or typeⅠcollagen were examined. In some cases, spleen lymphocytes obtained at 18 h were incubated with various concentrations of IL-2, IFN-?, and TNF-? for 4 h at 37℃ before the adhesion assay. T cells purified from the spleen lymphocytes were also used for the assay in the presence of TNF-?. RESULTS: The adhesion of spleen lymphocytes to ECM began to increase at 6 h after PCl challenge, reached a peak at 18 h, then decreased and returned to normal level at 36 h. IL-2 significantly increased the adhesion of lymphocytes to ECM at a dose of 1?10 5 U/L and TNF-? enhanced the adhesion in a concentration-dependent manner. The combined use of TNF-? and IFN-? showed a significantly enhanced adhesion. TNF-? was more effective to accelerate the adhesion of spleen T Cells than that of total spleen lymphocytes. CONCLUSION: In the process of DTH, the adhesion of lymphocytes to ECM was regulated by several cytokines and associated with the development of inflammation.

Preventive effect of pollen, (at 5～10g/kg/d orally for 1 month) on obe-sity and elevation of lipid in serum and liver was observed in obese mice induced by sub-cutaneous injection of L-monosodium glutamate (MSG)2 mg/g from 1st to 5th day afterbirth. The results showed that in MSG-treated mice the body weight and weight of fatin groin, around kidney, and in abdominal cavity and also the Lee's index were all redu-ced by pollen given orally before onset of obesity caused by MSG and during development.The total cholesterol and triglyceride levels in serum and liver were much higher in theMSG mice than normal mice. These results indicated that ora1 administration of pollencould prevent obesity of MSG treated mice.