Neoadjuvant chemotherapy is one of the common means in multidisciplinary treatment of locally advanced breast cancer,with anthracyclines and taxanes as main chemotherapeutic drugs.In recent years,molecular target agents have significantly improved the efficacy of chemotherapy,as well as have provided more choices and ideas for clinical treatment.Currently,the widely studied molecular targeted drugs include trastuzumab,lapatinib,pertuzumab,T-DM1 and bevacizumab.

The disposition of drug in vivo is subjected to a series of biotransformation and transport, depending on the involvement of drug-metabolizing enzymes and transporters.However, the individual capacity varies when metabolizing and transporting the same drug, and pharmacogenomics has trouble in completely explaining the differences.microRNA, a key aspect of epigenetic modifications, is a powerful complement to traditional genetics.Emerging evidences have confirmed that drug-metabolizing enzymes and transporters be controlled by different microRNAs, and the same microRNA also regulates several drug-metabolizing enzymes or/and transporters simultaneously.All of these researches infer that microRNAs are likely to realize the comprehensive macro-regulation of gene expression.The further study of microRNAs maybe a suitable point to research the interindividual variability in disposition of drugs, and it provides a theoretical basis for rational use of drug and individualized medicine.

Endophthalmitis ; complications ; drug therapy ; microbiology ; Humans ; Infant, Newborn ; Meningoencephalitis ; complications ; drug therapy ; microbiology ; Suppuration ; complications

OBJECTIVETo compare the differences in the efficacy on speech and swallowing dysfunction of medulla oblongata palsy (MOP) after brainstem infarction between electroacupuncture at eight-neck-occiput points and routine acupoints.

METHODSSeventy-two patients were randomized into a neck-occiput points group and a meridian points group, 36 cases in each one. In the neck-occiput points group, the eight-neck-occiput points (Neck 1-4 points, Occiput 1-4 points) were selected. In the meridian points group, Lianquan (CV 23), Futu (LI 18), Tongli (HT 5), Hegu (LI 4) and the others were selected. Electroacupuncture was used in the two groups, dense-dispersion wave, retaining for 30 min. The treatment was given once a day, 5 treatments a week. Totally, 4 weeks were required. The symptom scores of speech and swallowing dysfunction were observed before and after treatment in the two groups. The efficacy was compared between the two groups.

RESULTSThe scores of speech and swallowing dysfunction were improved significantly after treatment in the two groups (P < 0.05, P < 0.01). The results in the neck-occiput points group were better than those in the meridian points group (both P < 0.01). The curative rate of speech dysfunction was 30.6% (11/36) and that of swallowing dysfunction was 22.2% (8/ 36) in the neck-occiput points group, which were better than 11.1% (4/36) and 5.6% (2/36) in the meridian points group, respectively. The differences were significant in comparison of the two groups (P < 0.01, P < 0.05).

CONCLUSIONElectroacupuncture at eight-neck-occiput points achieves a better efficacy on speech and swallowing dysfunction of MOP after brainstem infarction as compared with the routine acupoints. This therapy is characterized as more accurate point localization and safer operation.

Acupuncture Points ; Adult ; Aged ; Brain Stem Infarctions ; complications ; Bulbar Palsy, Progressive ; etiology ; physiopathology ; therapy ; Deglutition ; Electroacupuncture ; Female ; Humans ; Male ; Medulla Oblongata ; physiopathology ; Middle Aged

BACKGROUND: Akt gene plays an important role in cell survival, proliferation, metabolism, and apoptosis. Although mechanism of Akt gene still remains unclear, it, a major element of survival signal, has aroused much attention in the domain of molecular biological research. OBJECTIVE: To construct eukaryotic expression vector pDC316-Akt1 for Aktl gene and to observe the expression in 293 cells. DESIGN, TIME AND SETTING: An observational study was performed at Molecular Biological Laboratory of Academy of Military Medical Sciences of Chinese PLA between September and December 2006. MATERIALS: pCD316 plasmid was provided by Benyuan Zhengyang Company; DH5α and 293 cells were reserved in our laboratory. METHODS: Aktl DNA segment was cloned from total RNA of hepatic tissue using RT-PCR and inserted into eukaryotic expressing vector pDC316 between EcoRI and Hind Ⅲ sites after sequencing. And then, 293 cells were transfected with the recombinant by liposome. MAIN OUTCOME MEASURES: Aktl gene content in transfected 293 cells using Westem blotting. RESULTS: Sequencing test indicated that Aktl amino acid sequence was in accordance with wild Aktl sequence. Akt-pDC316 was transcripted in 293 cells, and Akt1 protein with relative molecular weight of 55 000 was highly expressed in 293 cells when assayed using Western blotting. CONCLUSION: Eukaryotic expression vector for Aktl gene highly expresses in 293 cells.

Objective To reveal the effects of circadian gene Per2 on growth of human lung cancer cell A549 cell and its mechanism. Methods pcDNA3.1(+)-Per2 was transfected into A549 cells and controlled with the vector pcDNA3.1(+). The expression of Per2 was confirmed with RT-PCR and western blot. The Inhibitory effect of Per2 on cell growth and proliferation was demonstrated with MTT assay and colony-forming assay. Apoptosis was detected with flow cytometry. Results The circadian gene Per2 exhibited a growth-inhibitory and apoptosis-inductory effect on A549 cells. Conclusion The results indicate that Per2 may inhibit A549 cell proliferation,which mechanism might involve cellular apoptosis.

The rapid development of medical science and technology, which has greatly promoted the development of medicine and the improvement of diagnosis and treatment, has also brought about various negative impacts in clinical practice on the doctor-patient relationship. The paper attempts to analyze these impacts from such perspectives as medical treatment, society, ethics, and law and proposes some corresponding countermeasures in perspective of the present reality: (1)rationally controlling medical expenses; (2) effectively stepping up communication; (3)appropriately handling difficult ethical problems; (4) amplifying necessary health rules and regulations. The goal is to create a win-win situation for both progress in medical science and technology and improvement of the doctor-patient relationship.

Objective To investigate the advantages of susceptibility-weighted imaging (SWI) over conventional T2*-weighted spoiled phase gradient-echo imaging (T2* WI) in detecting brain hemorrhage in patients with mild traumatic brain injury (MTBI) and its relationship to outcome after MTBI.Methods Clinical information,T2* WI and SWI of 57 patients with MTBI were collected.Bleeding cases and number of cerebral micro-cerebral bleeds (MCBs) detected using T2* WI and SWI were compared statistically.Correlation analysis between SWI and clinical outcome was performed.Results Hemorrhage in 43 patients (75％) with MCBs amounting to 237 was detected using SWI,while hemorrhage in 32 patients (56％) with MCBs amounting to 123 was found using T2* WI (P＜0.01).Thirty-five patients experienced short-term unconsciousness,including 22 being detected with post cerebral traumatic syndrome (PCTS) at follow-up.Twenty-two patients experienced no coma,among which 10 developed PCTS at follow-up.Based on the SWI,patients who experienced coma showed higher incidence of hemorrhage compared with patients who did not (86％ vs 59％,P＜0.05),and patients with hemorrhagic focus was associated with higher probability of PCTS compared with patients without (65％ vs 29％,P＜0.05).Conclusions SWI is more sensitive than conventional T2* WI in detecting cerebral MCBs.MCBs are related to the late prognosis of MTBI patients,but SWI can supply certain valuable and objective information.

Objective: To establish an enzyme linked immunosorbent assay(ELISA)for erythropoietin(EPO) in serum, and observe its clinical application value thereof. Methods: Prepare the EPO polyclonal antibody, wash the plate with isopropyl alcohol, and then choose the suitable concentration of the antibody, enzyme labeled antibody, and antigen. After the reaction, check the sensitivity, recovery, specificity and stability of the method. The serum samples of anaemia and breast carcinoma individuals were detected. The results of radioimmunodetection were compared with that of normal control group. Results: The immo-assay plate showed strong adherence to proteins. The optimal concentrations of the antibody, enzyme labelled antibody and antigen were 1∶1 000, 1∶6 000 and 1∶800 separately. The sensitivity was 0.46 U/L. The cross-reaction with growth hormone and ferritin was low. The mean recoveries of samples with high and low concentrations were 96.3%, 97.3% respectively. The coefficients of variation of intra-assay and inter-assay were just 8.31% and 7.82%, and the stability was good. The EPO levels were higher in anaemia and breast carcinoma groups than that of normal group. There was no significant difference between the results of the radioimmunodetection and ELISA. Conclusion: The double-antibody sandwich ELISA method was established for EPO in serum, which had certain clinical application value.

Objective To investigate the correlation between the polymorphism of XRCC2 gene,a DNA double-strand break repair(DDSBR)gene,and the susceptibility to lung cancer in population of North China.Methods By PCR-based restriction fragment length polymorphism(RLFP)technique(PCR-RLFP),a case-control study was performed among 300 patients with lung carcinoma and 300 healthy controls to detect XRCC2(C41657T)polymorphism.Results There was no significant difference in XRCC2(C41657T)allele frequencies between lung cancer patients and healthy controls(P=0.16).The C/C,C/T and T/T genotype frequencies were 72.7%,24.0% and 3.3% in lung cancer patients,and 76.3%,22.0% and 1.7% in healthy controls,respectively.There was no significant difference in C/C and C/T genotype frequencies between cancer patients and healthy controls(?2=0.48,P=0.48).However,the C/T genotype frequency in non-smoke group was significantly higher in lung cancer patients than in healthy controls(?2=6.67,P=0.01).The risk for lung cancer in non-smokers was 2.11 times higher in C/T genotype carriers than that in C/C genotype carriers.There was no significant difference in C/C and C/T genotype frequency between lung cancer patients and healthy controls in the smoke group(P=0.16).Conclusion Overall,there was no significant correlation between genetic polymorphism of XRCC2(C41657T)and the susceptibility to lung cancer.But the C/T genotype might increase the risk of suffering from lung cancer in no-smoking populations of Northern China.