Epithelial-mesenchymal transition cause primary carcinoma cells to acquire mesenchymal features and re-epithelialize to form a secondary mass at a metastatic site. Such plasticity has implications in the progression of breast carcinoma to metastasis, and will likely influence cancer's response to therapy. The transcriptional and epigenetic regulation that underlie the development of breast cancer and result in characteristic changes in cell behavior can be monitored using an array of marker proteins, providing the potential for emergent prognostic and therapeutic targeting.

Objective:To explore an improved osteotomy of mandible ascending ramus for the surgical approach to large tumors in parapharyngeal space.Methods:According to the operation of parotid gland, masseter muscle was cut near the border of mandibular angle till subperiosteum dissection to mandibular notch, vertical osteotomy outside mandibular foramen to 1.0 cm under mandibular notch, vertical to posterior border of ascending ramus, tumor was exposed and removed, bone plate was repositioned and fixed with titanium. Results:Tumors were completely removed in this way in 3 patients without complications. Conclusion:This surgical approach is suitable for the surgical removal of parapharyngeal interstitial giantism tumor.

Objective To study the role Erk/Slug signal pathway in the radiosensitivity of MDAMB-231 cells.Methods MDA-MB-231 cells were transfected with NF-κBp65 siRNA,PUMA siRNA and Slug siRNA respectively or treated with U0126 for 24h,then the cells were irradiated with 4 Gy γ-ray.At different time points post-irradiation,the expressions of Erk1/2,NF-κBp65,Slug and PUMA protein were detected.The cell survival rate and apoptotic index were detected by MTT and TUNEL methods.Resluts Compared with 4 Gy irradiated group,the expression of PUMA was reduced in NF-κB p65 siRNA/4 Gy group,the expressions of Slug and Erk1/2 were obviously decreased but PUMA increased in U0126/4 Gy group,the expression of Erk1/2 had no change but the expression of PUMA increased significantly in Slug siRNA/4 Gyγ group.Meanwhile,at 48h post-irradiation,for U0126/4 Gy group and Slug siRNA/4 Gy group,cells survival rates were decreased to 19.78 ±2.71 (F=11.39,P＜0.05) and 17.41 ±4.58(F=15.31,P＜0.05),cell apoptosis rates were 28.61 ±4.70 (F=9.84,P＜0.05) and 27.55±6.41(F =10.31,P ＜ 0.05),respectively.At 24 h post-irradiation,for NF-κB p65 siRNA/4 Gy group and PUMA siRNA/4 Gy group,cell survival rates approached to 85.65 ± 9.60 (F =12.31,P ＜ 0.05) and 87.53±11.50 (F=13.68,P＜0.05),and cell apoptosis rates declined to 3.28 ±0.78 (F=10.83,P ＜ 0.05) and 3.46 ± 0.84 (F =9.92,P ＜ 0.05).Conclusions The radiosensitivity of MDA-MB-231cells was relative to the induction of NF-κB up-regulated PUMA,and the radioresistance was caused by the up-regulation of Slug induced by Erk1/2,which inhibited the expression of PUMA.

Objective To analyze the clinical effect of anterior cervical decompression with double-way connection intervertebral fusion device (ROI-C) implantation for type Ⅱ or type Ⅱ a Hangman fracture.Methods A retrospective study was made on 14 patients with type Ⅱ or type Ⅱ a Hangman fracture treated with anterior cervical ROI-C implantation between February 2011 and March 2014.The patients (11 males and 3 females) were aged between 22 and 46 years (mean,26.4 years).Nine patients sustained traffic injury,4 fall injury and 1 crash injury.Nine patients were classified as type Ⅱ and 5 type Ⅱ a according to the Levine-Edwards classification.All were completed cervical anteroposterior and lateral X-ray,CT scan,three-dimensional CT reconstruction and MRI examination after adnission.American Spinal Injury Association (ASIA) grade E was noted in all before operation.Clinical posttraumatic neck score,visual analogue scale (VAS) as well as angle deformity and displacement of the axis were recorded before operation and at the latest follow-up.Results All patients were operated successfully.Mean operation time was 61 min(range,45-116 min).There were no injuries of superior laryngeal nerve,hypoglossal nerve,throat wall and vessel during operation.Laryngeal edema,dysphagia,paralysis of tongue,hematoma and wound infection were not observed after operation.Mean period of follow-up was 24.2 months (range,4-32 months).All segments and fracture sites showed solid fusion after 3 months.No cages became subsided or displaced,no discs collapsed,and no malunion occurred at the latest follow-up.Data of preoperation and latest follow-up differed significantly with respect to clinical posttraumatic neck score[(53.1 ±7.2) points vs.(91.1 ±5.0)points],VAS[3.38(2.43,4.33)points vs.0.58(0,1.29) points],axis displacement[(4.0 ± 1.5) mm vs.(1.3 ± 1.2) mm],and angle deformityoftheaxis[(9.2±4.7)° vs.(2.1 ±1.9)°] (P＜O.05 or O.01).Conclusion Anterior cervical surgery with ROI-C implantation for type Ⅱ or type Ⅱa Hangman fracture provides good fusion rate and satisfactory clinical effect.

Objective To explore the auricular application pressure added dietary intervention of perimeno-pausal syndrome (PS)the influence of women's sex hormone levels.Methods Research subjects were randomly divided into two groups.The observation group was given auricular application pressure to add dietary intervention, control group was given dietary intervention alone.Before and after six months of follow -up,sex hormone levels in the blood were monitored.Results After the intervention,the estrogen level of the observation group was (272.93 ± 15.71)pmol/L,progesterone was (3.14 ±0.47)nmol/L,which of the control group was (186.32 ±12.80)pmol/L, (2.86 ±0.34)nmol/L;After the intervention,the follicular thorn hormone content of the two groups were decreased, which of the observation group was (12.88 ±1.50)U /L,which of the control group was (21.35 ±4.70)U /L;The perimenopausal symptoms were reduced,Kuppermun score in the observation group were (9.36 ±1.41 )points, (10.43 ±1.63)points,the difference between the two groups were statistically significant (t =40.15,4.52,3.82, 4.65,all P <0.01)for the control group.Conclusion Auricular application press fit dietary intervention for patients with perimenopausal syndrome sex hormone regulation of metabolic disorders has obvious effect,can significantly improve the patients'symptoms of the menopausal transition,it is worthy of further research on intervention measures.

Effects of Cu2+,Zn2+and Mn2+ on responses to ACh were studied with toad rec-tus abdominis. Cu2+, Zn2+and Mn2+concentra-tion- dependently shifted the concentration-response curves for ACh to the right unparallelly and reduced the maximal response considerably. The pAh values of Cu2+ , Zn2+ and Mn2+ were 3.69, 2.95 and 2. 62, respectively. The inhibitory potent of Cu2+ and Zn2+ seemed to be 11.7 times and 2. 1 times respectively more thanthat of Mn2+. It was suggested that Cu2+, Zn2+ and Mn2+postsynaptically interfere with the action of ACh. However, Zn2+in lower concentration shifted the bottom section of the curve for ACh to the left and top, and shifted the top section of the curve to the right, suggesting that Mn2+in lower concentration be possessed of partial agonistic property.

Objective To assess the prognostic value of progesterone receptor (PR) in Luminal B HER2(-) lymph-node-negative breast cancer.Methods The clinical data of 196 Luminal B HER2 (-) lymph-node-negative breast cancer patients were collected in this study.The correlation between PR and clinicopathological factors and its influence on prognosis was analyzed.Results Among 196 patients with Luminal B HER2 (-) lymph-node-negative breast cancer,14.8％(29/196)were PR-negative and 85.2％(167/196)were PR-positive (HR=3.25,95.0％ CI:0.73-1.45,P=0.123).PR negativity indicated postmenopausal status (P=0.029) and high tumor grade (P=0.001).Mter a median follow-up of 60 months,9.7％(19/196) of the patients had relapses and 4.1％(8/196) died of breast cancer.The 5-year disease-free survival(DFS) was 75.9％ in PR-negative group and 92.8％ in PR-positive group (Log-rank P=0.001).The 5-year overall survival (OS) was 89.7％ in PR-negative group and 97.0％ in PR-positive group (Log-rank P=0.023).In multivariate analysis,PR negativity was significantly associated with a poor 5-year DFS (HR=2.85,95.0％ CI:1.05-7.72,P=0.039)but not with 5-year OS (HR=1.78,95.0％ CI:0.34-9.35,P=0.495).Conclusion In this study,PR is a prognostic factor for relapse in Luminal B HER (-) lymph-node-negative breast cancer.

Objective To explore the causes of secondary breast deformity after breast conservative therapy and its preventive methods.Methods 30 cases were selected from the patients with secondary breast deformity of more than 1 year after breast conservative therapy,and more than half a year after radiotherapy and chemotherapy,and no local recurrence and distant metastasis occurred.After cicatrectomy and contracture loose solution,different methods were used according to varying degrees of the secondary breast deformity to reconstruct and repair the deformity.Results Three reconstructive methods were conducted.Local mammary flaps were used in 7 patients,latissimus dorsi myocutaneous flap in 21 patients,and transverse rectus abdominal musculocutaneous flaps in 2 patients.The shape and feeling were satisfactory in 30 patients with reconstructive breasts,in which 23were excellent (76.7 ％),and 7 were good (23.3 ％).All the patients were followed-up for average 2.5 years,and they were survived without tumor recurrence.Conclusions The secondary breast deformity after breast conservative therapy could be effectively prevented,and successfully reconstructed and repaired with different procedure according to varying degrees of the secondary breast deformity.As a result,the shape and feeling of reconstructive breasts are satisfactory.

Objective:To study the expression of P53, Bax, Bcl-2 proteins and the role of cell apoptosis in the formation and development of acute radiation-induced skin ulcers.Methods:A rat model which was locally irradiated with 60 Co γ-rays was used, and the pathological changes were observed for 40 days. Immunohistochemistry and TUNEL assay were performed which enabled the detection of P53, Bax, Bcl-2 and cell apoptosis during the formation and development of radiation skin ulcers.Results: Skin ulcers were found on day 14 after irradiation, and enlarged and deepened gradually during the observation period. P53 was over expressed during days 11 to 40 after irradiation and was localized in vascular endotheliocytes and smooth muscle cells. Bax was moderately positive during days 14 to 21 and weakly positive during days 28 to 35, and was localized in vascular endotheliocytes, some fibroblasts and proliferating keratinocytes. Bcl-2 was weakly positive during days 1 to 11 after irradiation, and was located in keratinocytes, hair follicular cells and some vascular endotheliocytes. Bcl-2 was negative during days 11 to 40.The rate of cell apoptosis, especially of vascular endotheliocytes,wash igher than that in the early process of normal wound healing. Conclusions:After irradiation,the increased expression of the apoptosis-inducing protein P53, Bax and the decreased expression of the apoptosis-inhibiting protein Bcl-2 might be associated with the high rate of apoptotic events, and play important roles in the formation and development of radiation skin ulcers.

Objective To investigate the preliminary clinical result of thoracolumbar fracture combined with posterior ligamentous complex injuries repaired by posterior transpedicular screw fixation.Methods A retrospective review was performed on 22 patients with thoracolumbar flexion-distraction fracture combined with posterior ligamentous complex injuries treated with transpedicular screw fixation from July 2008 to March 2013.There were 16 males and 6 females with mean age of 39 years (range,23-62 years).After medically stable,posterior pedicle screw fixation was performed under intravenousinhalational anesthesia.According to the degree of fracture displacement and types of ligament injury,posterolateral bone grafting or intervertebral fusion at the level of injury was conducted.Vertebral height restoration,Cobb' s angle and American Spinal Injury Association (ASIA) score were reviewed preoperatively,at postoperative 3 days and at the last follow-up.Results All the patients were operated on smoothly.There were no complications during operation.All the patients were followed up for 5-51 months (mean,26.5 months).Fracture reductions were satisfied with the closure of vertebral posterior element.Mean anterior vertebral height and Cobb' s angle improved by 20.6％ and 10.60°respectively after operation (P ＜0.01).Eight patients with neurological dysfunction showed some recovery after operation with the mean sensory score improved by 20.7％ (P ＜ 0.05) and mean motor function score improved by 30.9％ (P ＜ 0.0l).All bone grafts were healed,without pain,loosening or breakage in the fixation system.Conclusions Posterior pedicular screw fixation attains good short-term outcome for thoracolumbar flexion-distraction fracture combined with posterior ligamentous complex injuries.The surgery provides satisfactory reduction and instant spinal three-column stability for the unstable spine fracture.Sufficient bone graft is the guarantee to permanent stability.