Cadherins that mediate the adhesion of the same type of cells by specific binding to calciumdependent adhesions of the same type with cadherins mainly consist of three subtypes including E-cadberin,P-cadherin and N-cadherin.In recent years,more and more studies have indicated that cadherins are closely related to triple-negative breast cancer(TNBC)and play an important role in prognosis and treatment of TNBC.

Objective To analyse the expressions and clinical significances of CXCR4,CXCL12 and PTEN in breast cancer.Methods The expressions of CXCR4,CXCL12 and PTEN in 60 cases of breast cancer were detected by immunohistochemistry technique SABC method.The correlations of levels of CXCR4,CXCL12 and PTEN expression and the age of patient,tumor diameter,histological grade,TNM stage,lymph node metastasis,ER status,Her-2 status,and vessel invasion were analysed.Twenty cases of breast fibroadenoma tissues and 20 cases of normal breast tissues were analysed as controls.Results The expressions of CXCR4 (x2 =48.754,P =0.000),CXCL12 (x2 =47.611,P =0.000) and PTEN (x2 =19.994,P =0.000) in breast cancer,normal breast tissues and breast fobroadenoma showed significant differences.The positive expressions of CXCR and CXCL12 were significantly correlated with histological grade (x2 =11.080,P =0.004;x2 =6.978,P =0.031),TNM stage (x2 =9.819,P =0.007;X2 =10.163,P =0.006),lymph node metastasis (x2 =6.213,P =0.013;x2 =8.031,P =0.005),ER (x2 =12.774,P =0.000;x2 =7.330,P=0.007),vessel invasion (x2 =5.860,P=0.013; x2 =5.185,P=0.020) and Her-2 (x2 =5.487,P =0.019;x2 =4.689,P =0.030).The expression of PTEN in breast cancer was significantly correlated with TNM stage (x2=7.366,P =0.025),lymph node metastasis (x2 =5.511,P =0.019) and ER state (x2 =4.077,P =0.043).There was a positive correlation between the expression of CXCR4 and the expression of CXCL12 in breast cancer (r =0.336,P =0.004).There was a negative correlation between the expression of CXCR4 and the expression of PTEN in breast cancer (r =-0.362,P =0.004).There was a negative correlation between the expression of CXCL12 and the expression of PTEN in breast cancer (r =-0.360,P =0.004).Conclusion The high expression of the chemokine CXCL12 and its receptor CXCR4 and the low expression of PTEN are closely related to the carcinogenesis and metastasis of breast cancer,which may play an important role in the development of breast cancer.

Cholangiocarcinoma (CCA) is a group of solid tumors with high malignant degree and poor prognosis. Surgical resection has still been the main therapy options. Targeting therapy and immunotherapy are the main anti-tumor methods that have been paid more and more attention in recent years, especially immunotherapy. The tumor microenvironment of CCA is complex, which encompasses not only interstitial and endothelial cells, but also a large number of immune cells. In addition, the innate and adaptive immune systems also play a role. This article summarizes the immune-related studies of cholangiocarcinoma and the latest clinical trials of immunotherapy.

Microwaves can be directly transformed into heat inside materials because of their ability of penetrating into any substance. The degree that materials are heated depends on their dielectric properties. Materials with high dielectric loss are more easily to reach a resonant state by microwaves field, then microwaves can be absorbed efficiently. Microwave irradiation technique with the unique heating mechanisms could induce drug-polymer interaction and change the properties of dissolution. Many benefits such as improving product quality, increasing energy efficiency and reducing times can be obtained by microwaves. This paper summarized characteristics of the microwave irradiation technique, new preparation techniques and formulation process in pharmaceutical industry by microwave irradiation technology. The microwave technology provides a new clue for heating and drying in the field of pharmaceutics.

Objective: To observe the efficacy and safety of analgesic drugs in the standardized treatment of cancer pain patients at the pain clinic. Methods: The data of 787 cancer pain patients and their corresponding prescriptions for cancer pain were collected from April, 2012 to April, 2013 at the pain clinic. The obtained information comprise of diseases that lead to cancer pain, cause of pain, pain intensity, and efficacy and side effects of medications. Diseases that caused cancer pain include 658 cases with primary malignant lung cancer. Results: Pain was mainly caused by primary lung cancer in 787 cancer-related patients. An analgesic drug, namely, oxycodone hydrochloride, was administered in 54.6% via single drug therapy. The daily dosage range of this drug was 20 to 90 mg/d in 280 cases. About 35.6% of the studied patients with a daily dosage of 90 mg/d or lower had their pain effectively managed. After the treatment, the number of cases with moderate to severe pain was reduced from 437 (55.5%) to 248 (31.5%). The oral administration of opioid oxycodone hydrochloride tablets ranked first among the prescribed drugs for cancer pain, and single-drug therapy was the choice of medication. The majority of patients had satisfactory pain-relief with a daily dosage of less than 90 mg/d upon the administration of oxycodone hydrochloride sustained-release tablets and morphine sulfate controlled-release tablets. Side effects included mild constipation, nausea, vomiting, dizziness, loss of appetite, urinary retention, somnolence, and so on. Intervention treatment was needed in most of the patients. Conclusion: Pain clinic is critical in the administration of standardized treatment for cancer pain in hospitals. The establishment of pain clinic ensures the standardized treatment of cancer pain.

Major obstetric hemorrhage (MOH) may endanger the life of maternal during the perioperative period. Its highly efficient management involves multidisciplinary co-operation and is a complex clinical emergency situation which needs teamwork to complete. Anesthesiologist, as the key member of the obstetric MOH management team, should actively cooperate with the obstetricians once they decide to perform an emergency procedure for the parturient. They should possess perfect skill in resuscitation and rich experiences for assessment of MOH. They also should be professional in monitoring and caring for the critically ill patient. Constantly simulation training also should be actively carried out for MOH. In this review, the definition and etiology of MOH, drug and surgical treatment, anesthesia management (including preparation before anesthesia, hemorrhagic shock assessment, choice of anesthesia methods, blood transfusion, blood cell salvage, coagulation function and hemodynamic monitoring) were reviewed, and the conclusions were just for references.

Gallbladder cancer is a high malignancy which is predisposed to invade adjacent organs and have lymph node metastasis. Gallbladder cancer is not sensitive to radiotherapy or chemotherapy with the worst prognosis among biliary tract cancers. At present, radical resection is the only possible method to cure gallbladder cancer. However, there are still many controversies about the surgical strategies, the extent of liver resection and lymph node dissection, and the treatment of incidental gallbladder cancer. In addition, under the background of the great success of immunotherapy and targeted therapy in a variety of solid tumors, it is also a question worthy of further considerations that whether the status of surgery in the treatment of advanced gallbladder cancer will be changed in the near future.

Benign gallbladder diseases are common in general surgery practice, and laparoscopic cholecystectomy (LC) has become the standard treatment for these conditions. With the widespread adoption of LC and the improved understanding of gallbladder disease, it is necessary to re-evaluate the diagnosis and treatment of benign gallbladder disease. Based on the latest expert consensus on the diagnosis and treatment of benign gallbladder disease, this review aims to provide an overview of the diagnostic and treatment strategies for benign gallbladder diseases. Specifically, it focuses on enhancing our understanding of the role of benign gallbladder diseases in the development of gallbladder cancer, the impact of congenital biliary anomalies on the diagnostic and treatment processes of benign gallbladder diseases, and the significance of the preoperative examinations.

Objective:The epidemiological and clinical characteristics of 18 cases of Japanese spotted fever (JSF) in Zigui County were analyzed in order to improve the prevention and treatment of JSF.Methods:This is a case series analysis. The epidemiological and clinical data, laboratory tests and imaging characteristics of 18 JSF cases with median age of 60 years (54, 68) identified by The People′s Hospital of Zigui from April 2021 to August 2022 were collected and analyzed retrospectively.Results:Most (17/18) of the patients were farmers and all had a field exposure history. The patient′s onset was from April to October. Spring and autumn were the seasons with the highest incidence of JSF. The first symptoms of patients were high fever, headache, and fatigue. Of the 18 cases, 15 had a rash and 12 presented an eschar and 3 had neither rash nor eschar. In addition, 10 of 18 cases experienced edema of both lower extremities, and 3 got disturbance of consciousness. Laboratory tests found that 15 patients had abnormal white blood cells and 11 patients had decreased platelets. C-reactive protein, procalcitonin, D-dimer, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were elevated in all patients; 13 patients with elevated alanine aminotransferase, 14 patients with elevated aspartate transamination. Kidney damage caused by Rickettsia japonica infection showed by abnormal proteinuria in 11 of the patients. Conclusions:The most common clinical manifestations of JSF are non-specific indications such as high fever, chills, fatigue, headache. The eschar and rash, which are the main features of Rickettsia infection, are not present in all patients, resulting delay of diagnosis or misdiagnosis. Medical workers should be more alert to rickettsial infections in patients with fever of unknown origin, especially in seasons of high incidence of spotted fever. Early diagnosis and correct antibiotic treatment shall be given according to the patient′s clinical manifestations, laboratory results and imaging test to control disease progression.

Objective:To study the risk factors of lymph node metastases in patients with intrahepatic cholangiocarcinoma (ICC) and to establish a risk prediction model of lymph node metastases in ICC.Methods:The clinicopathological data of 587 ICC patients who underwent radical hepatectomy and lymph node dissection at Third Affiliated Hospital of Naval Medical University (Shanghai Eastern Hepatobiliary Surgery Hospital) from January 2007 to December 2011 were retrospectively analyzed. There were 395 males and 192 females with ages which ranged from 20 to 82 (54.7±10.8) years. Independent risk factors of lymph node metastases were studied using univariate and multivariate logistic regression analysis, and a risk prediction model was established. Receiver operating characteristic (ROC) curve was used to evaluate the accuracy of this model.Results:Of 587 patients, 158 (26.9%) had lymph node metastases. Multivariate logistic regression analysis showed that platelet count >300×10 9/L ( OR=1.985, 95% CI: 1.030-3.824, P=0.041), carbohydrate antigen 19-9 >37 U/ml ( OR=2.978, 95% CI: 1.994-4.448, P<0.001), tumor situated in left hemiliver ( OR=1.579, 95% CI: 1.065-2.341, P=0.023), multiple tumors ( OR=1.846, 95% CI: 1.225-2.783, P=0.003), and absence of cirrhosis ( OR=2.125, 95% CI: 1.192-3.783, P=0.011) were independent risk factors for lymph node metastases in ICC. The area under the ROC curve was 0.714, with a cutoff value of 0.215, and the sensitivity and specificity being 75.9% and 58.3%, respectively. Conclusions:The risk prediction model of ICC lymph node metastases was established using readily available clinical data obtained before operation. This model has good predictive values and can provide a reference for treatment decision on patients with ICC.