OBJECTIVE:To observe the clinical efficacy,safety,the maximal tolerated dose(MTD) and dose-limiting toxicity(DLT) of docetaxel(TXT) in the treatment advanced breast cancer.METHODS:Docetaxel was given by drip infusion in escalating doses from the initial dose of 65 mg?m-2 to 75 mg?m-2 and 85 mg?m-2 until the appearance of DLT.RESULTS:Among the 15 cases,1 case with CR,5 PR,4 SD,and 5 PD.The DLT of TXT was neutropenia,and its MTD was 85 mg?m-2.CONCLUSION:Docetaxel(at a dose of 75 mg?m-2) showed remarkable efficacy and good tolerance in patietns with advanced breast cancer.

The practice of daily case discussion in the morning using slice show has been cartied out since orthopedic trauma department of Nanfang Hospital was set up.Bilingual ( Chinese and Englisl) discussion was hold in the department before and after the operation on the cases requiring three-level or higher level operation and those of special diseases.The bilingual case discussions will greatly improve the clinical thinking and accumulate the clinical experiences for doctors.The professional English proficiency of all doctors in the department have been improved because of the bilingual case discussions and the most effective treatment for patients was provided at the same time.

Objective To evaluate the predictive accuracy of several risk-assessment strategies to predict the risk of significant neonatal hyperbilirubinemia, and to establish the best prediction model.Methods The transcutancous bilirubin (TcB) levels of 4907 term and near-team infants were measured.Trace blood bilirubin levels of the infants whose TcB levels ≥250 μmol/L were detected. Clinical data of newborns and their mothers were collected and were analyzed with Logistic regression model to investigate its correlation with signifrcant hyperbilirubinemia. Clinical high risk factors of significant neonatal hyperbilirubinemia were determined. Accuracy of three prediction methods for significant hyperbilirubinemia was compared by receiver operating characteristic (ROC) curve. The three methods included: whether predischarge bilirubin level (within 72 hours after birth) expressed in risk zone on an hour-specific bilirubin nomogram; clinical risk factors other than predischarge bilirubin level; and combination of the predischarge bilirubin risk zone and other clinical risk factors. Results Two hundred and eighty-six newborns (5.8%) were found with significant hyperbilirubinemia. The risk factors of significant neonatal hyperbilirubinemia were divided into three groups according to OR: (1) Major risk factors:predischarge (within 72 hours after birth) bilirubin level in the high risk-zone (OR=96. 39, 95% CI:53.32-174.27, P = 0. 000), large cephalohematoma (OR = 36.45, 95% CI: 10. 02-132.56,P=0. 0076), gestational age 35-36+6 weeks (OR= 30. 72, 95% CI 14.47-65.23, P=0. 0001) and exclusive breast feeding and weight loss was ＞9% of birth-weight (OR=22.44, 95% CI: 4.42-114. 03, P=0. 0016). (2) Minor risk factors: gestational age 37-37+6 weeks (OR=3.26, 95% CI:1.92-5. 55, P=0. 0232), predischarge bilirubin level in P76-P95(OR=13. 64, 95% CI: 8. 10-22.97,P=0. 0001) and bruising (OR = 2.32, 95% CI: 1.14-4.71, P = 0. 0497). (3)Protective factors (those factors associated with decreased risk of hyperbilirubinemia): predischarge bilirubin level in low-risk zone (≤P40) (OR=0. 00), gestational age ≥40 weeks (OR=0.21, 95% CI: 0.09-0.44,P=0. 0402) and mixed breeding (OR=0. 75, 95% CI: 0. 58-0.95, P=0.0059). The area under the ROC curve of predischarge bilirubin level was 0. 8687 and 0. 7375 for clinical risk factors other than predischarge bilirubin level. The area under the ROC curve of a combination of the predischarge bilirubin risk zone and additional clinical risk factors was 0. 9367. Conclusions The risk of significant neonatal hyperbilirubinemia could be simply and accurately predicted by infant's predischarge bilirubin level and the combination of predischarge bilirubin level, and clinical risk factors might improve the accuracy of prediction significantly.

Surgery,radiotherapy and chemotherapy are three traditional treatments for malignant tumors.With the development of medicine,immunotherapy has been gradually adopted as an emerging therapy of malignancies.Recent clinical studies have demonstrated that the combination of radiotherapy and immunotherapy can induce the abscopal effect and improve the prognosis of patients.Compared with the conventional radiotherapy,stereotactic radiotherapy has a larger single dose and higher accuracy,which is more likely to induce the bystander effect and anti-tumor response.The combination of stereotactic radiotherapy and immunotherapy has been proven to be a more promising therapy in certain clinical trials.However,not all types of tumors can benefit from such combined therapy in clinical practice.The optimal dose,fraction pattern and lesion of radiotherapy,immune enhancement and safety remain to be further clarified.In this article,the research progress,related controversies and future research direction of stereotactic radiotherapy combined with immunotherapy for malignancies were reviewed.

Objective:To evaluate the clinical efficacy of modified Liqi-Hewei Decoction combined with conventional western medicine therapy in the treatment of Hp-positive chronic superficial gastritis (CSG). Methods:A total of 96 patients with Hp-positive CSG in the First People’s Hospital of Lianyungang and Changshu No.1 People’s Hospital who met the inclusion criteria between January 2017 and January 2019 were divided into two groups according to the random number table method, with 48 in each group. The control group was treated with conventional western medicine, and study group was additionally given modified Liqi-Hewei Decoction on the basis of control group. Both groups were treated for 8 weeks and followed up for 12 weeks. The TCM symptom score, gastric mucosa and pathological grading were scored before and after treatment. Levels of motilin, gastrin and somatostatin were detected by immunoturbidimetry, and levels of CD3 +, CD4 + and CD8 + were detected by automatic flow cytometry and the ratio of CD4 +/CD8 + was calculated. The Hp negative conversion rate was observed, the adverse reactions were recorded, the clinical efficacy was evaluated and the recurrence rate was statistically analyzed. Results:The Hp negative conversion rate was 89.6% (43/48) in study group and was 72.9% (35/48) in control group, where the difference was statistically significant ( χ2=4.376, P=0.036). The total effective rate was 95.8% (46/48) in study group and was 83.3% (40/48) in control group ( χ2=5.031, P=0.025). After treatment, the scores of epigastric pain, upper abdominal fullness, acid reflux, belching and poor appetite in the study group were significantly lower than those in control group ( t=8.919, 3.971, 7.949, 8.171, 9.865, all Ps<0.01). The scores of gastric mucosa and pathological grading were significantly lower than those in control group ( t=13.705, 15.495, all Ps<0.001). After treatment, the levels of gastrin [(126.15 ± 14.36) ng/L vs. (152.38 ± 17.51) ng/L, t=8.025], motilin [(93.59 ± 11.87) ng/L vs. (102.48 ± 14.68) ng/L, t=3.263] and somatostatin [(36.76 ± 8.97) ng/L vs. (40.84 ± 10.68) ng/L, t=2.027] in the study group were significantly lower than those in the control group ( P<0.01 or P<0.05). The levels of CD3 +, CD4 + and CD4 +/CD8 + were significantly higher than those in the control group ( t=6.883, 6.720, 4.306, all Ps<0.001). The recurrence rate was 4.3% (2/46) in the study group and was 17.5% (7/40) in the control group ( χ2=3.950, P=0.046). During treatment, the incidence rate of adverse reactions was 8.3% (4/48) in the study group and was 12.5% (6/48) in the control group ( χ2=0.446, P=0.504). Conclusion:Modified Liqi-Hewei Decoction combined with conventional western medicine therapy can effectively improve the levels of gastrointestinal hormones and clinical symptoms, enhance the immunity and Hp negative conversion rate, and reduce the recurrence rate of patients with Hp-positive CSG.

Objective: To observe the expression of microRNA-125b (miR-125), tumor necrosis factor alpha (TNF-α) and interleukin-6(IL-6) in premature rats exposed to hyperoxia. Methods: Eighty 1-day old Sprague Dawley (SD) rats were randomly divided into an air group and a hyperoxia group.The rats in the hyperoxia group were continuously exposed to oxygen chamber for 1-3 L/min, oxygen volume fraction was maintained at (800±50) mL/L, and the rats in air group were placed in the same room with the oxygen volume fraction at 210 mL/L.The feeding conditions were same in 2 groups.Lung tissues of premature rats were extracted at different time (1, 4, 7, 10, 14 days). The pathologic changes in the lung tissues were observed by hematoxylin-eosin (HE) staining.The levels of miR-125b and TNF-α, IL-6 in lung tissues were detected by reverse transcription polymerase chain reaction (qRT-PCT) and enzyme-linked immunosorbent assay (ELISA). Results: Compared with the air group, miR-125b in the hyperoxia group increased slowly after day 1, reached the highest in day 10 (2.554±0.323), and the relative expression in day 14 decreased slightly(2.329±0.263), and there were significant differences between 2 groups at di-fferent time (all P<0.05); in particular TNF-α level increased in day 7 [(78.55±39.53) ng/L], and reached the peak at day 10 [(80.16±11.24) ng/L], and there was a significant difference(P<0.05); IL-6 levels increased at day 7 [(45.44±31.94) ng/L], and reached the peak at day 10 [(90.38±8.24) ng/L], and there was a significant difference(P<0.05). There was a no significant correlation between miR-125b and TNF-α in the hyperoxia groups (r=0.132, P>0.05), but there was significant correlation between miR-125b and IL-6 in hyperoxia groups(r=0.439, P<0.05). Conclusions The levels of miR-125b, TNF-α and IL-6 are involved in the pathological process of bronchopulmonary dysplasia induced by hyperoxia, and IL-6 may be the key factor for miR-125b.

Objective:To investigate the effects of Chinese herbal decoction on traditional Chinese medicine syndrome, menstrual cycle and sex hormone levels in amenorrhea patients with polycystic ovary syndrome.Methods:A total of 124 amenorrhea patients with polycystic ovary syndrome who received treatment in The First People's Hospital of Lianyungang, China between December 2016 and December 2018 were included in this study. They were randomly assigned to receive either oral metformin hydrochloride and clomiphene citrate (control group, n = 62) or oral metformin hydrochloride and clomiphene citrate combined with Chinese herbal decoction (observation group, n = 62). Clinical effective rate and remission of traditional Chinese medicine syndrome were compared between control and observation groups. After treatment, recovery of menstrual cycle, ovulation rate, change of sex hormone level relative to before treatment, and the incidence of adverse reactions were determined in each group. Results:Total clinical effective rate in the observation group was significantly higher than that in the control group [96.77% (60/62) vs. 77.42% (48/62), χ2 = 12.817, P < 0.001]. Total effective rate in term of TCM syndrome in the control group was significantly higher than that in the observation group [83.87% (52/62) vs. 43.55% (27/62), χ2 = 21.800, P < 0.001]. After treatment, serum luteinizing hormone, free testosterone, luteinizing hormone / follicle stimulating hormone, estradiol, follicle stimulating hormone levels in the observation group were (4.28 ± 2.04) U/L, (1.93 ± 0.07) nmol/L, (3.17 ± 1.07), (240.32 ± 30.26) pmol/L, (3.17 ± 1.07) U/L, respectively, which were significantly lower than those in the control group [(6.45 ± 2.11) U/L, (3.27 ± 0.07) nmol/L, (5.73 ± 2.46), (300.32 ± 31.26) pmol/L, (5.12 ± 1.07) U/L), t = 5.822, 106.583, 7.514, 10.859, 10.147, all P < 0.001]. Ovulation rate in the observation group was significantly higher than that in the control group [80.65% (50/62) vs. 51.61% (32/62), χ2 = 11.666, P = 0.001]. Periodic ovulation rate in the observation group was significantly higher than that in the control group [91.94% (57/62) vs. 35.48% (22/62), χ2 = 14.528, P < 0.001]. In the observation group, the proportion of patients having edema, gastrointestinal reaction, vomiting, and diarrhea was 4.84% (3/62), 6.45% (4/62), 11.29% (7/62) and 11.29% (7/62), respectively, and they were 9.68% (6/62), 12.90% (8/62), 19.35% (12/62) and 25.80% (16/62)], respectively in the control group (all P < 0.05). Conclusion:Chinese herbal decoction can help regulate the hormone balance in amenorrhea patients with polycystic ovary syndrome, promote ovulation, eliminate amenorrhea, increase the curative effects on traditional Chinese medicine syndrome, and increase the rate of menstrual cycle recovery.

Objective To investigate whether Andrographolide(AG)can alleviate intestinal injury in sepsis by ac-tivating the SLC7A11/GPX4 axis in ferroptosis.Methods Forty rats were randomly divided into sham group(sham group),sepsis group(CLP group),AG low,medium and high dose groups(5,10 and 20 mg/kg).HE staining was used to observe the pathological changes of Intestinal tract.ELISA method was used to determine Inter-leukin 6(IL-6),tumour necrosis factor α(TNF-α),intestinal fatty acid binding protein(I-FABP),D-lactate content.The mechanism of ferroptosis was explored with AG high dose group(AG20 group),forty rats were ran-domly divided into sham group,CLP group,ferroptosis inhibitor(Fer-1)group,AG20+Fer-1 group.HE staining and transmission electron microscopy were used to observe the pathological changes of Intestinal tract.The kits were used to determine oxidative stress MDA,GSH levels and Fe3+content.Western blot was used to detect the protein levels of solute carrier family 7 member 11(SLC7A11),glutathione peroxidase 4(GPX4),and ferritin heavy poly-peptide 1(FTH-1).Results Compared with the sham group,the CLP group showed severe morphological damage to the small intestine,with significantly higher levels of inflammation,I-FABP and D-lactate(all P＜0.05),the AG group reversed these changes in a concentration-dependent manner(all P＜0.05).Compared with the CLP group,the AG20 and Fer-1 groups showed improved pathological damage to the small intestine,with lower levels of MDA and Fe3+and higher levels of GSH,SLC7A11,GPX4 and FTH-1 protein expression increased(all P＜0.05),and pathological injury and oxidative stress were reduced in the AG20+Fer-1 group,and SLC7A11,GPX4 and FTH-1 protein expression increased more significantly(all P＜0.05).Conclusion The mechanism by which AG attenuates intestinal injury in sepsis may be related to SLC7A11/GPX4 axis activation in ferroptosis.

Objective To explore the protective effect of long non-coding RNA(lncRNA) metasta-sis associated in lung denocarcinoma transcript 1 (MALAT1) involved in hyperoxia-induced lung injury in preterm infants.Methods This study had downloaded chip data set GSE25286 (Mouse GEO Genome 430 2.0 Array) from gene expression database gene expression omnibus (GEO),according to the state of hyperoxia exposure,the MALAT1 mRNA expression in rats normal lung tissues and hyperoxic lung tissues was compared at day 14th and 29th.In chip data set GSE43830(Human Exon 1.0 ST Arrays) from GEO,the expression of multi-ple genes[cell division cycle 6(CDC6),death effector domain containing 2(DEDD2),and Cyclin B1 (CCNB1)] in WI38 cells(lung fibroblasts) was compared before and after MALAT1 was knockout.At the same time,the peripheral blood samples of premature infants were collected to verify.Totally 40 premature infants were hospitalized in the department of neonatology in our hospital from Jan 2015 to Dec 2016,the pe-ripheral blood samples of 40 premature infants were collected.RNA was extracted and Real time-PCR was performed after reverse transcription,clinical data of these 40 cases were retrospectively analyzed. Results (1) By using Affymetrix Expression console and Affymetrix Transcriptome analysis console software source files of the chip of pretreatment and difference expression gene screening,the expression of lncRNA MALAT1 gene in lung tissues of hyperoxia lung injury mice significantly upregulated[fold change(FC) =2.33,P=0.001].(2) After MALAT1 in WI38 cell was knockout,MALAT1 expression was significantly reduced(FC= -15.6,P=0.000),the expression of CDC6(FC= -2.37,P=0.001) and CCNB1(FC=-2.16,P=0.002) were down regulated,DEDD2 expression was up regulated(FC =2.46,P =0.000). (3) The results of peripheral blood samples from preterm infants showed that the expression of MALAT1 was significantly increased in preterm infants with hyperoxia-induced lung injury(0.375 5 ± 0.081 9,t =4.634, P=0.015),compared with normal preterm infants(0.273 4 ± 0.067 3).Conclusion Through inhibiting cell apoptosis,lncRNA MALAT1 can protect preterm infants with hyperoxia-induced lung injury,it may provide a new strategy for prevention and treatment of hyperoxia-induced lung injury in premature infants.

The UL49.5 gene of most herpesviruses is conserved and encodes glycoprotein N. However, the UL49.5 protein of duck enteritis virus (DEV) (pUL49.5) has not been reported. In the current study, the DEV pUL49.5 gene was first subjected to molecular characterization. To verify the predicted intracellular localization of gene expression, the recombinant plasmid pEGFP-C1/pUL49.5 was constructed and used to transfect duck embryo fibroblasts. Next, the recombinant plasmid pDsRed1-N1/glycoprotein M (gM) was produced and used for co-transfection with the pEGFP-C1/pUL49.5 plasmid to determine whether DEV pUL49.5 and gM (a conserved protein in herpesviruses) colocalize. DEV pUL49.5 was thought to be an envelope glycoprotein with a signal peptide and two transmembrane domains. This protein was also predicted to localize in the cytoplasm and endoplasmic reticulum with a probability of 66.7%. Images taken by a fluorescence microscope at different time points revealed that the DEV pUL49.5 and gM proteins were both expressed in the cytoplasm. Overlap of the two different fluorescence signals appeared 12 h after transfection and continued to persist until the end of the experiment. These data indicate a possible interaction between DEV pUL49.5 and gM.
Animals ; Ducks/virology ; Genes, Viral/genetics ; Mardivirus/*genetics ; Membrane Glycoproteins/*genetics ; Microscopy, Fluorescence ; Phylogeny ; Polymerase Chain Reaction/veterinary ; Viral Envelope Proteins/*genetics