Triple-negative breast cancer is defined by the absence of expression of oestrogen, progesterone, and Her-2 receptors. The clinicopathological characteristics include: higher histological grades, earlier relapse with worse prognosis, and a higher incidence of visceral metastases than bone metastases. Since it has no response to hormone treatment and targeted therapy for Her-2, chemotherapy became the main therapy. In addition, it may have a relationship with basal-like breast cancer and BRCA1-related breast cancer on the phenotype and molecular level. Inter-individual variations in DNA damage and repair have been associated with an increased risk of breast cancer. BRCA1 together with its associated genes such as BRCA2, ATM, RAD51 and CHEK2 play vital roles in different DNA repair pathways to preserve genome stability. Therefore variations of BRCA1 and its associated genes in multiple repair pathways may result in reduced DNA repair capacity and altered sensitivity to cytotoxic chemotherapeutic agents, which could promote incidence of distant metastases. Reduced DNA repair capacity and dysfunctional BRCA1 pathway in triple-negative breast cancer have been reported, however the detailed mechanisms are still unknown. Do the genetic variations of tumor cells or resistance of tumor cells to therapeutic drugs play the dominant role in high incidence of metastases in patients with triple-negative breast cancer? In this review, the association of dysfunctional BRCA1-related DNA repair pathways with high incidence of metastasis in triple-negative breast cancer would be introduced.

Triple-negative breast cancer is defined by the absence of expression of oestrogen, progesterone, and Her-2 receptors. The clinicopathological characteristics include: higher histological grades, earlier relapse with worse prognosis, and a higher incidence of visceral metastases than bone metastases. Since it has no response to hormone treatment and targeted therapy for Her-2, chemotherapy became the main therapy. In addition, it may have a relationship with basal-like breast cancer and BRCAl-related breast cancer on the phenotype and molecular level. Inter-individual variations in DNA damage and repair have been associated with an increased risk of breast cancer. BRCA1 together with its associated genes such as BRCA2, ATM, RAD51 and CHEK2 play vital roles in different DNA repair pathways to preserve genome stability. Therefore variations of BRCA1 and its associated genes in multiple repair pathways may result in reduced DNA repair capacity and altered sensitivity to cytotoxic chemotherapeutic agents,which could promote incidence of distant metastases. Reduced DNA repair capacity and dysfunctional BRCA1 pathway in triple-negative breast cancer have been reported, however the detailed mechanisms are still unknown. Do the genetic variations of tumor cells or resistance of tumor cells to therapeutic drugs play the dominant role in high incidence of metastases in patients with triple-negative breast cancer? In this review, the association of dysfunctional BRCA1-related DNA repair pathways with high incidence of metastasis in triple-negative breast cancer would be introduced.

CHEK2 is an important susceptibility gene of breast cancer. CHEK2 gene mutations are related to pathologic features and prognosis of breast cancer. So the test of CHEK2 gene mutations may be has certain indication role in the treatment of breast cancer. However, the role of CHEK2 gene mutations in Chinese population still needs further research.

Objective: To establish evidence and standards for syndrome differentiation of patients with chronic skin ulcer of lower limbs, which can be used to supervise and further improve the clinical treatment. The evidence and standards would also lay a foundation for the integrative evaluation system of clinical effects. Methods: This is a prospective study of clinical case collection and analysis. The syndrome factors of chronic skin ulcer of lower limbs were collected from clinical cases, and then the essential factors of syndromes were chosen to make cluster analysis and principal component analysis. After syndrome classification, specialist consultation was performed. Forecasting syndrome models were established on the basis of the statistical analysis and the specialist consultation. Results: The syndrome factors in 338 cases of chronic skin ulcer of lower limbs were clustered into four syndrome categories including deficiency of both qi and blood, spleen deficiency with dampness encumbrance, qi deficiency with blood stasis and blood stagnation with dampness-heat. The deficiency of both qi and blood, and qi deficiency with blood stasis were merged into qi deficiency with blood stasis by expert revision. The primary and secondary symptoms were identified by principal component analysis and average ranking determined by experts. The qi deficiency with blood stasis, spleen deficiency with dampness encumbrance, and blood stagnation with dampness-heat could reflect the clinical syndrome characteristics in patients with chronic skin ulcer of lower limbs. Conclusion: Chronic skin ulcer of lower limbs can be differentiated in three syndrome types, and differentiation of local symptoms of the ulcer is very important in syndrome differentiation of chronic skin ulcer of lower limbs.

ObjectiveTo study the way of famous TCM doctors to success in modern times. MethodsTotally 96 famous TCM doctors and 30 TCM masters (122 in total, and 4 overlapping) recorded in the book ofThe Way of Distinguished Veteran Doctors of TCM were set as samples in the study. Their learning life was employed as evidence, and the following information was analyzed and concluded:the provinces they come from, their approaches to success, the ages when they became useful, learning time before they became useful, the most influential books, whether they started with classical prescription.ResultsDistinguished veteran doctors of TCM mainly come from Jiangsu Province (21.31%) and Zhejiang Province (11.48%). Learning from other TCM maters (40.98%) and inheriting the family’s TCM knowledge (22.95%) were their main approaches to becoming useful. The learning years before they became useful were 10-15 years (32.81%) and 6-10 years (26.56%). They became useful mainly at the ages of 21-30 (57.58%). 65.98% (64/122) of them treatedTreatise on Febrile Diseases as the most influential book. ConclusionThe study will provide beneficial reference for talent cultivation of TCM colleges and universities.

Primary mediastinal large B-cell lymphoma represents a distinct entity with unique clinicopathologic features and a molecular gene-expression signature. There is no standard regimens. Retrospective analysis suggests that dose-dense and dose-intensive regimens are more effective than CHOP. The addition of rituximab may mitigate such difference. The role of mediastinal radiotherapy upon completion of chemotherapy remains unclear. The role of PET scanning requires prospective examination, which may allow the de-escalation of treatment if it can be shown to yield reliable prognostic information.

[A Review] The irritable bowel syndrome (IBS) is a chronic functional bowel disorder,and its pathogenesis remains unclear. Serotonin is thought to be an important brain-gut axis neurotransmitter,which plays an important role in the gastrointestinal motility,sensation and secretion. Serotonin is closely associatied with IBS and regarded as one of the therapeutic targets. This article reviews the related investigations in the recent years.

Objective:To evaluate the value of CK19 mRNA detection in diagnosis of breast cancer. Methods: Patients were categorized into 3 groups:Group 1 consisting of 77 stageⅠ/Ⅱbreast cancer patients, group 2 consisting of 77 stage Ⅲ/Ⅳ breast cancer patients, and control group consisting of 40 non-cancer volunteers. Total RNA was extracted from peripheral blood cells with the RNA Kit as described by the manufacturer, which was followed by one step RT-PCR of RNA. Agarose gel electrophoresis and sequencing were carried out to confirm the amplification of expected sequence (314 bp). ?~2 test was used to compare CK19 mRNA positive rates in different stages of breast cancer. Results: 15/77 (19.48%) of stage Ⅰ/Ⅱ breast cancers patients, 31/77 (40.26%) of stage Ⅲ/Ⅳ breast cancers patients and 2/40 (5.00%) of non-cancer volunteers demonstrated positive RT-PCR results. The positive rate of CK19 mRNA in peripheral blood of stage Ⅰ/Ⅱ or stage Ⅲ/Ⅳ breast cancer patients was significantly higher than that of non-cancer volunteers(P=0.037, P=0.001). The positive rate of CK19 mRNA in peripheral blood of stage Ⅲ/Ⅳbreast cancer patients was significantly higher than that of stageⅠ/Ⅱbreast cancer patients(P=0.005). Conclusion: CK19 RT-PCR is a promising method for detecting circulating tumor cells in patients with breast cancer, which may provide valuable information for tumor staging and treatment.

Objective To develop a novel targeted delivery system for the treatment of brain metastases from breast cancer.Methods Micelles were prepared by membrane hydration method,and the micelles were connected to Angiopep-2.Results The micelles were confirmed to be well targeted in vitro.Conclusion Nano-particles with the targeting molecule Angiopep-2 has good brain-targeting function.

Objective:To study the role of adenoviral-mediated PTEN gene transfection in reversing drug resistance of trastuzumab-resistant human breast cancer.Methods:Recombinant adenoviruses carrying PTEN gene(AdPTEN) were constructed and transfected into trastuzumab-resistant human breast cancer cell line BT474.Proliferation and apoptosis of BT474 cells treated with AdPTEN and trastuzumab were measured by MTT assay and FCM.Time course of BT474 cells apoptosis induced by AdPTEN was analyzed by detection of DNA fragmentation.Western blotting was employed to measure phosphorylated-Akt expression levels in AdPTEN treated BT474 cells.The nude mice model of BT474 cells was employed to observe the effects of AdPTEN and trastuzumab on trastuzumab-resistant human breast cancer in vivo.The expression of PTEN gene,cancer cells apoptosis and ultrastructural changes were evaluated after the mice were sacrificed.Results:We successfully constructed recombinant AdPTEN;and the titer of the recombinant adenovirus was about 4.2?1011TCID50/ml.PTEN gene expression was identified by PCR,RT-PCR and Western blotting assay.Combinatorial AdPTEN and trastuzumab significantly suppressed the proliferation of BT474 cells and induced the apoptosis.The percentage of apopotosis cells treated with AdPTEN was(20.7?5.82)%,companied by cells cycle arrest in G1 phrase(P