Objective To evaluate the efficacy and survival rate of neoadjuvant chemotherapy with docetaxe and pirarubicin in triple negative breast cancer (TNBC).Methods Total 51 breast cancer patients were divided into TNBC group (n =26,including 16 of stage Ⅱ and 10 of stage Ⅲ patients) and non-TNBC group (n =25,including 14 of stage Ⅱ and 11 of stage Ⅲ patients).All patients received a median of 4 treatment cycles with TAC regimen [docetaxe 75 mg/m2 on day 1,pirarubicin 40 mg/m2 on day 1 and cyclophosphamide (CTX) 500 mg/m2 on day 1 of each 21 day cycle].The efficacy of treatment and survival rate of two groups were evaluated.Results In TNBC group,9 out of 26 (34.62 ％) patients achieved clinical complete response (cCR),and 14 (53.85 ％) had partial response (cPR).Overall,88.46 ％ of TNBC patients had clinical response and 26.92 ％ (7/26) showed pathology complete response (pCR).In non-TNBC group,6 (24.00 ％) patients reached cCR and 8 (32.00 ％) showed cPR.The overall response rate was of 56.00 ％,and 4 (16.00 ％) patients achieved pCR.The overall 3-year survival rates in TNBC and non-TNBC groups were 73.08 ％ and 88.00 ％,respectively,indicating a poorer prognosis of TNBC.The 5-year survival rates of TNBC patients with and without pCR were 88.89 ％ and 47.06 ％,respectively.Conclusion TAC regimen improves the prognosis for locally advanced TNBC,indicating that the neoadjuvant chemotherapy is effective and safe for TNBC patients.

Polyethylene glycol (PEG) is extensively used to increasing the in vivo and in vitro stability of liposomes. However, PEGylated liposomes also produce some negative effects with further research, such as low cellular uptake, poor "endosomal escape" of pH sensitive liposome (PSL) and accelerated blood clearance (ABC) phenomenon, and this situation is referred as the "PEG dilemma". "PEG dilemma" posed severe challenges for the targeted delivery of PEGylated liposomes-loaded anticancer drugs, effective intracellular release of PEGylated PSL-encapsulated gene and protein drugs, and repeated administration of PEGylated liposomes. Therefore, it is urgent to solve the "PEG dilemma". This review focused on the definition, classification of "PEG dilemma", and discussed several possible approaches to overcome "PEG dilemma".

Objective To identify the common clinical symptoms and signs of pectoral qi insufficiency syndrome;To provide evidence for its clinical treatment.Methods By retrieving 129 medical cases related to pectoral qi insufficiency syndrome in CNKI from January 1954 to October 2013 and Wanfang Database from January 1985 to October 2013, the authors made a statistical analysis of the symptoms and signs in medical cases related to pectoral qi insufficiency syndrome and elementarily generalized the common clinical characterization on pectoral qi insufficiency syndrome under the guidance of the TCM specialists.Results The cardinal syndromes of common clinical manifestation on pectoral qi insufficiency syndrome were shortness of breath and panting on exertion. The concomitant syndromes were pale or dim complexion, lassitude of spirit, lack of strength, shortage of qi and disinclination to talk, inability to sleep, dizziness, dizzy vision, etc. And it commonly superimposed failing to circulation qi-blood of cardiopulmonary as oppression in the chest, chest pain, palpitations, cyanosis, cough, etc, dysfunction of the spleen in transportation and transformation as torpid intake, sloppy stool, abdominal distension, and impairment of qi transformation due to Yang deficiency as cold limbs, fear of cold, edema, inhibited urination, and dry mouth.Conclusion The authors summarized cardinal syndrome, concomitant syndromes and superimposed symptoms on pectoral qi insufficiency syndrome from reported medical cases, which can provide scientific basis for normalizing the clinical diagnosis and treatment and interpreting the scientific connotation of pectoral qi insufficiency syndrome.

In this paper, through a systematic review of literatures on pectoral qi theory, we summarized the defini-tion of pectoral qi, physiological function, deficiency-excess changes, clinical manifestations of pectoral qi deficiency and modern research progress of pectoral qi theory, in order to deepen the understanding of pectoral qi connotation. The connotations of pectoral qi have four major kinds of views. The pectoral qi is a combination of the natural fresh air inhaled by the lungs and the foodstuff essence-qi transformed by the spleen-stomach accumulated in the thorax. The substance of pectoral qi is heart-lung yang qi. Pectoral qi is the special title of acquired essences in the thorax. Pectoral qi accumulated in the thorax is the beating-qi beneath the left breast. Its physiological function includes flowing through the respiratory tract to promote the respiration movement of the lungs, permeating the heart and ves-sels to promote circulation of qi and blood, comprehensively regulating of the heart and lungs, controlling all qi and zang-fu, accumulating body fluids, resisting external evils, controlling mental activities, maintaining mental state healthy and vigorousness, controlling vision, hearing, sound, color, smell and movement, converging primordial qi to maintain the vigor and vitality. Disorders of pectoral qi are mainly manifested as deficiency or excess. Deficiency is mainly manifested in pectoral qi insufficiency, or pectoral qi sinking. Excess is mainly manifested in pectoral qi ob-struction, or pectoral qi counterflow. The common clinical manifestations of pectoral qi insufficiency include short-ness of breath and panting on exertion. The concomitant symptoms are pale or dim complexion, lassitude, lack of strength, shortage of breath and disinclination to talk, insomnia, dizziness, spontaneous sweating, emaciation, darkish tongue with thin and white fur, sunken thin or weak pulse. And it commonly superimposed with failing to circulation qi-blood of heart and lungs as chest distress, chest pain, palpitations, cyanosis, cough, expectoration, and hard stool. Spleen transportation and transformation dysfunction were manifested as poor appetite, loose stool, and abdominal dis-tension. Impairment of qi transformation due to yang deficiency is manifested as cold limbs, aversion to cold, edema, urination difficulty, and dry mouth. In addition, diseases which are treated with pectoral qi are give priority to the heart-lung diseases, and then gradually extend to diseases of other systems. At the same time, there are many reports on using pectoral qi theory in disease treatment. The essence of pectoral qi is also discussed from the perspective of modern medicine. Generally speaking, pectoral qi theory has been put forward early; however, the systematic study is difficult to meet the needs of clinical diagnosis and treatment. There are many problems which remain to be further studied and solved.

With the research on tumor immunity and tumor immunosuppression development,immunotherapies for lung cancer has become a research hotspot.Tumor immune microenvironment plays an important role in tumor genesis,development and metastasis of lung cancer.Tumor-associated macrophages (TAMs) are the dominant leukocyte population found in immune microenvironment of lung cancer.The relationship between TAMs and lung cancer becomes clear with further research.TAMs may become the new target of lung cancer immunotherapy.

BACKGROUND: In post-menopausal women, the reduction of estrogen level is followed by gradual increase of bone absorption, accompanied by increased cytokine synthesis and bone metabolism disorder. Observation of serum interleukin-6(IL-6), osteocalcin(OC), estradiol(E2)and urinary pyridinoline (PYD) in women with osteoporosis may help understand role of these factors in the onset and development of osteoporosis.OBJECTIVE: To investigate the relationship of serum IL-6, OC, E2, and urinary PYD levels with bone metabolism in women with osteoporosis, so as to identify the factors responsible for the occurrence and development of osteoporosis.DESIGN: A case-controlled clinical observation.SETTING: Central Laboratory of Orthopedics, Nanshan People's Hospital of Shenzhen City.PARTICIPANTS: Between January 1999 and December 2001, 25 post-menopausal women with osteoporosis aged 42 -69 years were selected from the Department of Orthopedics, Nanshan People' s Hospital of Shenzhen to constitute the experimental group, with 10 healthy women from the same hospital serving as control group.METHODS: Two milliliters of fasting venous blood and 2 mL urine samples were collected from women in both groups in the morning to determine the contents of IL-6, OC, PYD and E2, respectively.MAIN OUTCOME MEASURES: Serum IL-6, OC, E2 and urinary PYD levels in the subjects.RESULTS: In the experimental group, the IL-6 level was(201.0±79. 9) ng/L, OC(25.5 ± 16.2) μg/L, and PYD(41.3 ±9.7) nmol/mmol (creatinine), all significantly higher than those in control group( t = 2. 159 -2. 953, P < 0.05-0.01) . Serum E2 level in the experimental group (79. 8 ± 73.2) ng/L, however, was significantly lower than that in control group ( t = 2.071, P < 0.05).CONCLUSION: IL-6, OC, PYD and E2 may play important roles in the occurrence and development of osteoporosis, and adjustment of the levels of these factors can be necessary in the treatment of women with osteoporosis.

Objective To evaluate the effects of sevoflurane postconditioning on the oncosis and apoptosis in cardiomyocytes during ischemia-reperfusion (I/R) in isolated rat hearts and the role of extracellular signalregulated protein kinase 1/2 (ERK1/2) signal transduction pathway in it.Methods Seventy-two isolated rat hearts perfused in a Langendorff apparatus were randomly divided into 6 groups (n =12 each) using a random number table:sham operation group (group S),myocardial I/R group (group I/R),sevoflurane postconditioning group (group SP),PD98059 vehicle dimethyl sulfoxide (DMSO) group (group DMSO),selective ERK1/2 inhibitor PD98059 group (group PD),and sevoflurane postconditioning + PD98059 group (group SP + PD).The hearts were subjected to ischemia for 30 min followed by 2 h reperfusion in the other groups except group S.In SP,DMSO and PD groups,the hearts were perfused with K-H solution saturated with 3.0％ sevoflurane,DMSO (＜0.2％) and PD98059 (20 μmol/L),respectively,for 15 min starting from the end of ischemia until 15 min of reperfusion,and then with plain K-H solution for 105 min.In group SP+ PD,the hearts were perfused with K-H solution saturated with 3.0％ sevoflurane and PD98059 for 15 min starting from the end of ischemia until 15 min of reperfusion.Myocardial infarct size and expression of porimin and caspase-8 proteins (by Western blot) were measured at the end of reperfusion.Results Compared with S group,the myocardial infarct size was significantly increased,and the expression of porimin and caspase-8 proteins was up-regulated in the other groups (P ＜ 0.05).Compared with I/R group,the myocardial infarct size was significantly decreased,and the expression of porimin and caspase-8 proteins was down-regulated in group SP (P ＜ 0.05),and no significant changes were found in the other groups (P ＞ 0.05).Conclusion Sevoflurane postconditioning can activate ERK1/2 signal transduction pathway and inhibit the oncosis and apoptosis in cardiomyocytes,thus attenuating I/R injury in isolated rat hearts.

The research on clinical efficacy evaluation of traditional Chinese medicine (TCM) is a hot and difficult issue in the field of TCM. However, the overall level of current related research also needs to be improved. There are still a lot of academic controversies in the field of TCM clinical efficacy evaluation. The author believed that before conducting research, it is necessary to sort out core issues of TCM clinical efficacy evaluation, which in-clude the concept of TCM clinical efficacy and its evaluation. In recent years, Chinese scholars have conducted a series of studies on these issues and have some achievements. To think and answer these questions will play an important role for the ultimate resolution of problem of TCM clinical efficacy evaluation.

Through analyzing the current situation and coverage controversy of Chinese clinical trial insurance,this paper stated that the attending insurance rate in domestic clinical trials was entirely low.The sponsors,clinical trial institutions,investigators and insurance companies paid attention of different levels to clinical trial insurance.Therefore,the risk awareness of drug/medical device clinical trials should be enhanced.It is necessary to give impetus to clinical trial insurance system,during which all parties need to make a joint effort including government departments,ethics committees,sponsors,clinical trial institutions,investigators and insurance companies.

Objective:To analyze the features and clinical significance of damages to non pulmonary organs like the heart,kidney and peripheral blood in SARS patients.Methods:SPSS 11.0 and SDAS software packages were used to retrospectively analyze the damages to the heart,kidney and peripheral blood in 330 clinically confirmed SARS cases.Results:(1)The heart damage occurred within 1 week after SARS onset in mild cases; the rates of LDH,HBDH,CK and CK MB returning to normal were 74.2%,80.6%,100% and 100%,respectively.In severe cases,the heart damage usually occurred 1 week after SARS onset; the rates of LDH,HBDH,CK and CK MB returning to normal were 32.2%,29.5%,55.2% and 44.4%,respectively.Ten patients whose CK MB didnot return to normal died.(2) The changes of RBC count appeared after an average of 1 week (1 10 d) in 54.2% of the patients.It returned to normal in all the mild SARS cases after an average of 12.5(4 21) d but didnot in 18.4% of the severe cases ( P