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 .

Objective: To analyze the concordance rates of estrogen receptor (ER),progesterone receptor (PR),human epidermal growth factor receptor-2 (HER-2),and Ki67 statuses between the primary and loco-regional recurrence (LRR) lesions and its influence on the following treatment in breast cancer patients. Methods: The breast cancer patients undergoing surgery in Comprehensive Breast Health Center,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from January 2009 to September 2018,who were reported recurrence only in loco-regional site were retrospectively analyzed. ER,PR,HER-2,and Ki67 statuses were detected in primary and LRR lesions. Concordance rates and their influence on following treatment were further analyzed. Results: A total of 7 823 breast cancer patients received surgery,among whom 106 cases experienced LRR without distant metastasis. There were 56 patients having full information about ER,PR,HER-2,and Ki67 statuses of LRR lesions,with the positive rates of 48.2%,25.0%,35.2%,and 81.5%,respectively. Concordance rates of ER,PR,HER-2,and Ki67 between primary and LRR lesions were 76.8%,76.8%,89.1% and 77.8%,with κ values at 0.538,0.469,0.729,and 0.402,respectively. Hormone receptor (ER or PR) (14 cases) and/or HER-2 (6 cases) statuses were altered in 18 patients. The hormone receptor status changed from positive to negative in 9 cases,of which 4 cases did not receive following endocrine therapy. The HER-2 status changed from negative to positive in 4 patients,and 1 of them received following anti-HER-2 targeted therapy. Conclusion: The concordance rates between primary and LRR breast cancer lesions of ER,PR,and Ki67 are moderate,and the concordance rate of HER-2 is high. Changes in receptor status in LRR lesions may affect the choice of following treatment options.

Objective: To investigate the effect of aurora kinase A (AURKA) activity on pro-angiogenesis, migration and invasion of Hep2 cells. Methods: Down-regulation of AURKA phospholation in Hep2 cells with 100 nmol/L VX680. Western blotting was used to detect the expression of p-AURKA, vascular endothelial growth factor A (VEGFA) and its receptor VEGFR2 in blank control Hep2 cells and Hep2 cells treated with VX680 for 24 h and 48 h. Angiogenesis experiment was applied to observe the effect of Hep2 cells treated with VX680 on angiogenesis. CCK8 cell proliferation assay, Transwell migration and invasion experiment were used to observe the ability of cell proliferation, migration and invasion of Hep2 cells. Results: Compared with control cells, the expression of p-AURKA in Hep2 cells treated with VX680 for 48 h was decreased (P=0.000). After downregulation of p-AURKA, the expressions of VEGFA and VEGFR2 were decreased (P=0.000). Meanwhile, angiogenesis was inhibited (P=0.000), and migration and invasion of Hep2 cells were reduced (P=0.000). Conclusion: AURKA regulates pro-angiogenesis, migration and invasion of Hep2 cells, which is a new strategy for the treatment of laryngeal cancer by targeting AURKA.

Optical coherence tomography (OCT) has been developing continuously since its first application in clinical practice in the 1990's. Optical coherence tomography angiography (OCTA) is becoming progressively popular, as it can provide real-time blood flow parameter by detecting active red blood cells in capillaries without using a contrast agent. OCTA plays an important role in diagnosing eye diseases, such as diabetic retinopathy, retinal vessel occlusion, inflammatory eye disease, thyroid-associated ophthalmopathy, etc. This article reviewed the use of OCTA in auxiliary diagnosis of eye diseases.

The choroid is one of the most common ocular sites for metastatic disease. Lung cancer is the first cause of choroidal metastasis among primary cancers in China. The current management of choroidal metastasis of lung cancer is based on the combination of systemic treatments and local treatments. The latter mainly include radiotherapy, transpupillary thermotherapy, photodynamic therapy, intravitreous injection and enucleation. This review covers the research progress in local treatments on choroidal metastasis of lung cancer.

Objective To study the anatomy basis and biomechanical stability of euthyphoria reduction and percutaneous cannulated screw fixation for sacroiliac dislocation,and to evaluate the primary clinical efficacy of this method.Methods The distances from the anterior branches of the nerve roots at L4,and L5 and obturator nerve on the superior border of sacral ala to the sacroiliac joint were measured on 12 adult cadavers (24 sides) fixed and preserved by formalin.Models of sacroiliac dislocation were made on six pelvic specimens of fresh cadavers.A comparison of stability was made on the six models between the fixation studied here and the traditional fixations by posterior percutaneous sacroiliac screws and by anterior sacroiliac joint plates.At the same time,17 patients with type C Tile fracture were treated with our method.The clinical efficacy was analyzed for the 17 patients.Results The distances from the anterior branches of the nerve roots at L4,and L5 and obturator nerve on the superior border of sacral ala to the sacroiliac joint were 20.24?1.20mm,23.80?1.43mm,and 16.26?2.07 mm respectively. There was no statistically significant difference in stability between our method and the traditional fixation by posterior percutaneous sacroiliac screws,though ours seemed better.Follow-ups for the 17 cases averaged 2.2 years,re- vealing fine functional recovery in all according to Matta scoring.Conclusions Euthyphoria reduction and per- cutaneous cannulated screw fixation can lead to sufficient biomechanical stability for the sacroiliac joint and effec- tively avoid nervous injuries.In addition,our method is simple and clinically effective,It is recommendable for small and middle-sized hospitals.

Objective:To investigate the correlation between the expression of angiogenic factors (MVD, IGF-1, and STAT3) in colorectal carcinoma and adenoma and the microvascular characteristics under narrow band imaging (NBI), in order to evaluate the fea-sibility of NBI in real-time observation of angiogenesis. Methods:Patients with pathologically confirmed colorectal polyps were re-cruited and examined by NBI. Vascular patterns were classified into typeⅠ(invisible or faintly visible), typeⅡ(clearly visible and regularly arranged in a round, oval honeycomb-like pattern), and typeⅢ(clearly visible and irregularly arranged in terms of size and caliber or irregularly winded). Immunohistochemical staining was performed to determine the expression of CD34, IGF-1, and STAT3. Histological results were compared with the vascular patterns under NBI. Results:The NBI endoscopy results of 64 sites (15 adenocar-cinomas, 29 adenomas, and 20 normal tissues) from 58 patients were introduced and examined in this study. Adenomas ranked the first (82.1%, 23/28) among the vascular patternⅡcases, whereas early adenocarcinomas dominated the vascular patternⅢcases (66.7%, 10/15). The expression levels of MVD-CD34 and IGF-1 in normal mucosa, adenomas, and adenocarcinomas were significantly differ-ent (P<0.0001 and P=0.0062, respectively). All the expression levels of MVD-CD34, IGF-1, and STAT3 in sites displaying vascular pat-ternsⅠ,Ⅱ, andⅢwere significantly different (P<0.0001, P=0.0010, and P=0.0055, respectively). Spearman correlation coefficients between the NBI vascular patterns and the MVD-CD34, IGF-1, and STAT3 expression levels were 0.67, 0.41, and 0.40, respectively. Conclusion:Vascular pattern analysis through an NBI system can be a promising tool to evaluate angiogenesis of colorectal lesions in real-time endoscopic observation.

Objective:To discuss the characteristics of auditory brainstem response in preterm very low birth weight (VLBW) babies and to investigate the correlations between the ABR and clinical characteristics. Method: Fifty-nine VLBW babies (118 ears) were enrolled in the study and 30 term normal babies as the control group. Tympanometry, acoustic reflex, DPOAE, ABR were obtained in all the babies. Result:The prevalence of hearing loss in VLBW babies was higher than normal term babies and babies with perinatal complications higher than those without perinatal complications. There was no correlations between ABR threshold and gestational age, birth weight, postconceptional age, negative correlations between wave Ⅰ,Ⅲ and Ⅴ latencies Ⅰ-Ⅲ ,Ⅲ-Ⅴ and Ⅰ-Ⅴ intervals and postconceptional age. Wave Ⅰ and Ⅴ latencies, Ⅰ-Ⅲ and Ⅲ-Ⅴ intervals differed significantly between the two groups. Conclusion:The perinatal complications were the most important causes of the hearing loss in preterm VLBW babies than the gestational age and birth weight. There was a high prevalence of peripheral hearing loss in the preterm VLBW babies. Combining OAE and automated ABR should be applied for hearing screening. Regular follow-up was very important in all the preterm VLBW neonatal.

OBJECTIVETo investigate the clinical and hematological features and prognostic factors of primary myelofibrosis (PMF) patients in Shanghai and surrounding area of Shanghai, China.

METHODSThe clinical manifestations, laboratory parameters and survival were retrospectively analyzed in 75 PMF patients diagnosed from Jan, 1996 to Dec, 2013 in our hospital and were compared with those of Chinese subjects from Tianjin and foreign Caucasian patients, respectively. Comparison of categorical variables was performed by χ² test. Survival was estimated using the Kaplan- Meier method. Log- rank test was used to compare survival date. A Cox model was used for multivariate analyses.

RESULTSThe median age of the 75 patients was 56(19-81) years old. There were 51(68%) patients with HGB less than 100 g/L. The median value of HGB was 83 g/L. Similar with those from Tianjin, the patients in our study were significantly younger with higher proportion of severe anemia and lower platelet counts when compared with foreign Caucasian patients. Using IPSS and dynamic international prognostic scoring system (DIPSS) model, the survival curves of intermediate- 1, intermediate- 2 and high risk groups were significantly different. In univariate analyses, variables significantly correlated with poor prognosis were systemic symptoms, HGB<100 g/L, HGB<80 g/L, PLT ≤ 100 × 10⁹/L, WBC<10 × 10⁹/L and blood blasts ≥ 0.01. Multivariate analysis identified IPSS and HGB < 80 g/L as independent risk factors for survival.

CONCLUSIONChinese PMF patients may have characteristics of younger age at onset with more severe anemia. However, IPSS and DIPSS model are still suitable for Chinese patients to predict survival. To increase the weight of anemia severity may provide a better prognostic stratification for Chinese patients with PMF.

Adult ; Aged ; Aged, 80 and over ; China ; Humans ; Middle Aged ; Primary Myelofibrosis ; diagnosis ; Prognosis ; Retrospective Studies ; Risk Factors ; Young Adult

AIM:To investigate the effects of celecoxib,a selective cyclooxygenase-2 inhibitor,on antioxidative capability and apoptosis of cardiac myocytes after myocardial infarction.METHODS:24 New Zealand rabbits were divided into three groups randomly(8 in each group):sham-operated group(sham group),myocardial infarction group(MI group),celecoxib group(Cele group,10 mg kg-1?d-1,qd,with the drugs gastric gavage for six weeks).The NO concentration,total antioxidative capability(T-AOC),the activity of constitutive nitric oxide synthase(cNOS)and inducible NOS(iNOS)in cardiac tissue homogenate,adjacent to the infracted area,were detected.The pathological changes were observed by light microscope and electron microscopy.The expressions of Bcl-2 and Bax protein in myocytes were observed using immunohistochemistry,and the degree of apoptosis were examined by TUNEL.RESULTS:Cardiac tissue in MI group presented interstitial edema,fibroplastic proliferation,inflammatory cellular infiltration,and vacuolar degeneration in cardiac myocytes.The results of electron microscopy showed that myocytes presented more changes caused by ischemic injury:widened interspace of myofibril,disordered myofibrillae,focal lysis of myofilament,ectasia of sarcoplasmic reticulum.In Cele group,the pathological changes were light,the NO-_2/NO-_3 concentration,the activity of iNOS were lower(P