The third generation of aromatase inhibitors (AI) play an important role in the adjuvant treatment of hormonal positive postmenopausal breast cancer. Compared with tamoxifen, either upfront or sequential using of Al can both significantly improve the outcome of breast cancer patients. However, there is a continuous debate of sequence or upfront usage of Al in clinical applications. With the publication result of BIG 1-98 clinical trial and interpretation of the data, we can further recognize and optimize the usage of Al in breast cancer treatment.

BACKGROUND:The biopsy material induced by foreign body is autologous tissue, which, in theory, avoids the role of immune rejection and destruction faced by non-autologous implants. This biology advantage has no way to comparison by synthetic and de-cel ular materials.
OBJECTIVE:To explore a biotube consisting of autologous cel s and extracel ular matrix and to evaluate its structure and mechanical features.
METHODS:The biotubes were prepared by embedding silicon rods as a mold intraperitoneal y. Specimens were analyzed by mechanical tests, histological observation and superficial study.
RESULTS AND CONCLUSION:It was easy to excite the biotubes prepared by embedding silicon tube
intraperitoneal y. The biotube mainly included col agen-rich extracel ular matrices and myofibroblasts appearing as elongated cel s with circumferential or longitudinal orientations. At 1 month of embedding, the wal was 70-250μm in thickness and had burst strength of (1 100±187) mm Hg (1 mm Hg=0.133 kPa), with perfect sewability. The biotubes, which possess the ability for wide adjustments in their shapes, are composed of autologous cel s and extracel ular matrices, and are an ideal graft for tissue engineering because they avoid immunological rejection and have sufficient mechanical strength.

Objective To observe expression of neuronal nitric oxide synthase (nNOS) and inducible NOS (iNOS) in nerve and dominated muscle of rat after injury of sciatic nerve.Methods 12 female SD rats were divided into 4 groups, right sciatic nerve was squeezed by using forceps for 0.5hr, 1hr, 2hr and 5hr respectively. Then right sciatic nerve and gastrocnemius was isolated and RNA was extracted by using Trizol reagent and meanwhile, the left sciatic nerve and gastrocnemius was used as a normal control. NOS expression was detected by using RT PCR and RNAase protection assay (RPA), and GAPDH was used as an internal standard. The density of PCR and RPA bands was determined by using NIH image software.Results 2 NOSs did not vary in nerve tissue in 4 groups, but in muscle, nNOS increased in 1h group, decreased in 2h group and increased in 5h group; iNOS decreased in 1h and 2h groups but increased in 5h group when compared to normal control.Conclusion Injuring of nerve does not effect NOS expression itself within short period, but effects the dominated muscle via the transmission of non NOS nerve signal.

Objective The clinical features of elderly patients with severe acute pancreatitis (SAP) were atypical and these patients were often misdiagnosed as having paralytic ileus. The clinical presentations of elderly patients with SAP whose first diagnosis as paralytic ileus were analyzed. Methods 18 patients of elderly SAP who were misdiagnosed as having paralytic ileus were included and the clinical data were compared with 58 elderly patients with SAP. Results Among the misdiagnosis group, the first symptom onset were fleus, abdominal distension, vomiting, constipation, abdominal pain, diarrhea for 5, 4, 3, 3, 2, 1 case, respectively. Among SAP group, the first symptoms onset were 2, 31, 9, 3, 11, 2 cases, respectively. For misdiagnosis group, 13 cases were correctly diagnosed by CT scan, 3 cases by ultrasound and 2 cases by serum amylase test. For SAP group, 32, 15, 11 cases were diagnosed by CT scan, ultrasound and serum amylase, respectively (P < 0.05). 4 and 13 patients died in misdiagnosis and SAP group, respectively; among these 13 patients, 10 were female and 3 were male. Conclusions The elderly patients with paralytic ileus should consider the possibility of SAP, and CT scan was valuable for correct diagnosis.

ObjectiveTo explore the clinical manifestations of infant cytomegalovirus infection in different age. MethodThe clinical data of 237 infants who suffered from cytomegalovirus infection was analyzed retrospectively and divided into three groups: 0-3 months old (77 cases,group A) ,4-6 months old ( 65 cases , group B ) , 7-12 months old ( 95 cases , group C ). ResultsThe incidence of respiratory infection was the highest among all infectious organs in three groups, the numbers of patients who had wheeze in group A was less than that in the other two groups[24.7％(19/77) vs. 61.5％ (40/65), 61.1％( 58/95 )](P ＜ 0.01 ).The incidence of jaundice decreased gradually as the babies grew up[23.4％( 18/77 )→7.7％(5/65 )→1.1％( 1/95 )](P ＜ 0.05). There was no significant difference in diarrhoea and bleeding among three groups (P＞0.05 ). The proportion of alanine aminotransferase], aspartate amino transferase increasing was similar among three groups, but gamma-glutamyl transferase (GGT) was different, the proportion of GGT increasing was 77.9％ (60/77) in group A which was higher than that in the other two groups[10.8％ ( 7/65 ), 2.1％ ( 2/95 )].Granulocytopenia in group B was obviously decreased compared with the other two groups (P ＜ 0.05 ), anemia was easily occurred in group C (P ＜ 0.05 ). ConclusionThe injury of cytomegalovirus infection may be related to month old.

Objective To discuss a new effective method for treatment of chronic subdural hematoma in elderly patients. Methods Flush operation for elderly patients with chronic subdural hematoma(CSDH) by neuroendoscopy through burrhole approach were performed in 37 elderly patients. The mean age of the group was 68.5 years (60-86 years). 5 cases were recurrent after simple drainage. Thoroughly flushs the hematoma cavity under television monitor, removes the clot, coagulates the bleeding focus, break the septum of hematoma cavity to make it communicate with the normal subdural space. Results On following up 2-18 months, all the hematoma disappeared, 34 cases improved in clinic manifestation, no serious complications and death occurred. Conclusions Flush operation for elderly patients with chronic subdural hematoma by flexible neuroendoscopy through burrhole approach can improve the therapeutic effect and avoid the recurrence and the complilcations of the traditional drainage therapy.

Objective To observe the effects of Dengzhan Shengmai capsule on β-amyloid protein (Aβ) deposition in the brain and learning and memory function in renovascular hypertensive rats (RHRSP).Methods Male Sprague-Dawley rats were randomly divided into four groups (5 rats per group):normal group,shamoperated group,hypertension with Dengzhan Shengmai capsule treatment group and hypertension with normal saline (NS) treatment group.Renovascular hypertensive models were created by clipping two-kidney.Dengzhan Shengmai capsules were dissolved in sterile 0.9％ NS and were administered (20 mg · kg-1 per day) by daily gavage for 4 weeks.In the NS group,hypertensive rats were given saline in the same volume.Immunofluorescent labeling and western blot were used to detect the expression of Aβ,NF-κB,IL-1β,TNF-α in the brain,respectively.Learning and memory function were detected by Morris water maze.Results RHRSP significantly increased Aβ deposition in the cerebral cortex and impaired memory function in rats.Dengzhan Shengmai capsule treatment significantly lowered the blood pressure compared with NS treatment((157.45±11.58) mmHgvs (197.76±10.12) mmHg).In addition,the levels of Aβ,NF-κB p65,IL-1β,TNF-α protein were significantly reduced,by Dengzhan Shengmai caspule treatment.The escape latency was shortened((24.64±4.57) s vs (37.17±3.87)s),while the frequency of passing through the platform quadrant(5.39±0.12 vs 3.05±0.28) and the dwell time((27.34±3.67) s vs (16.83±5.76)s) (all P＜0.01) in the platform quadrant were significantly increased by Dengzhan Shengmai capsule treatment.Conclusions Dengzhan Shengmai capsule may reduce Aβ deposition in brain and improve learning and memory function by anti-inflammatory effects in RHRSP.

Objective To observe the protective effects of salidroside on glutamate-induced injury in cultured hippocampal neurons.Methods Primarily cultured hippocampal neurons from fetal Wistar rat were incubated with salidroside(10,20 and 40mg/L) for 24 hours,then glutamate(125?mol/L) was added for 15 minutes to induce injury.Cell viability was detected by MTT assay,the vigor of LDH was determined by biochemistry method,the apoptosis rates were anallyzed using Annexin V-FITC and PI labelling and Hoechst 33342 staining and flow cylometric assay.Fluorescent intensity of intracellular free calcium was observed with laser scanning confocal microscopy(LSCM).Results After the pretreatment with salidroside for 24 hours,the increases of LDH vigor and apoptosis rates and the decrease of cell viability caused by glutamate were resisted obviously.Salidroside inhibited the increase of Ca~2+ in cytoplasm significantly.Conclusion Salidroside can significantly resist the injury induced by glutamate.The neuroprotective activities of salidroside can be related to its ability to reduce Ca~2+ overload in cytoplasm.

Patients were divided into normal control, liver fibrosis and liver cirrhosis groups. The patients with cirrhosis were categorized according to the Child Pugh classification into Child A,Child B and Child C groups. The waveforms of the right hepatic vein were examined with ultrasonography. HV(hepatic vein)0 waveforms were found in all the control subjects, 70.8% in those with fibrosis and 40.7% in those with cirrhosis. HV1 were found in 16.7% of those with fibrosis and 17.8% of those with cirrhosis. HV2 were found in 12.5% of those with fibrosis and 41.5% of those with cirrhosis. Statistical analysis showed that HV2 waveforms were significantly more often in patients with cirrhosis than in those with fibrosis. HV2 waveforms in the right hepatic vein are suggestive of liver cirrhosis.

OBJECTIVE:To observe the efficacy of small dose of uremic clearance granule combined with colon enema on aged patients with chronic renal failure(CRF) . METHODS:60 aged CRF patients were randomly divided into treatment group(n=30) and control group(n=30) . Two groups were given essential treatment. Control group were treated with medicinal carbon additionally. Treatment group were additionally treated with uremic clearance granule(p.o.) combined with colon enema. The course of treatment was 15 days and curative effects were compared between two groups after 30 days of treatment. RESULTS:30 days later clinical symptom of patients in treatment group was obviously improved and the levels of blood urea nitrogen,serum creatinine,blood uric acid and serum potassium were lower than before treatment with significant difference. CONCLUSION:Small dose of uremic clearance granule combined with colon enema show satisfactory effect on CRF in aged patients as well as simple,practical and good compliance. This therapy is worth of spreading and putting into application.