[Objective] To explore the feasibility of exemption from radiotherapy after breast-conserving surgery for hormone receptor-negative elderly breast cancer. [Methods] A total of 139 estrogen receptor (ER) and progesterone receptor (PR)-negative older adults with breast cancer who underwent breast-conserving surgery admitted to the Second Affiliated Hospital of Nanchang University from December 1, 2013 to December 1, 2018 were recruited as the subjects of the study, and were divided into a case group of 67 patients who did not undergo postoperative radiotherapy and a control group of 72 ones who underwent postoperative radiotherapy, according to whether they received postoperative radiotherapy or not. Clinicopathological data including age, tumor T stage, tumor N stage, tumor Nottingham grade, pathology type, human epidermal growth factor receptor 2 (HER2) expression status, and chemotherapy regimen were collected and compared between the two groups. The study analyzed the 5-year disease-free survival (DFS) and 5-year overall survival (OS) of two groups of patients. The log-rank test was used to compare the survival rate, and a multifactorial COX proportional hazards regression model was used to analyze the effect of exempted radiotherapy after breast-conserving surgery on DFS and OS of hormone receptor-negative elderly breast cancer mammary carcinoma. [Results] The two groups did not significantly differ in age, tumor T-stage, tumor N-stage, pathological type, tumor Nottingham grade, HER2 status, or chemotherapeutic regimen (all P>0.05). The 5-year DFS rate of 139 hormone receptor-negative elderly breast cancer cases was 74.1% and the 5-year OS rate was 83.5%. The difference in the 5-year DSF rate between the case group and the control group was statistically significant (65.7 vs. 81.9%, P=0.023), but the difference in the 5-year OS rate was not statistically significant (79.1% vs. 87.5%, P=0.186). The results of multifactorial COX proportional risk regression model analysis showed that exemption from radiotherapy after breast-conserving surgery was an independent risk factor for DFS (HR=2.298, 95% CI: 1.113-4.746, P=0.024), but not for OS (HR=1.831, 95% CI: 0.740-4.532, P=0.191). [Conclusion] Hormone receptor-negative elderly breast cancer according to exemption of radiotherapy after breast-conserving surgery has a higher local recurrence rate, but OS has no significant effect. Therefore, whether hormone receptor-negative elderly breast cancer can be exempted from radiotherapy after breast-conserving surgery still needs to be verified by further clinical trials.

Objective To investigate the clinical value of combined detection of serum carcinoembryonic an-tigen(CEA) ,carbohydrate antigen-125 (CA125) ,cytokeratin 19 fragment antigen (CYFRA21-1) ,squamous cell carcinoma(SCC) antigen ,neuron-specific enolase(NSE) and plasma progastrin-releasing peptid(ProGRP) in the diagnosis ,pathological typing and clinical staging in lung cancer .Methods The serum CEA ,CA125 , CYFRA21-1 ,SCC ,NSE levels and plasma ProGRP level were detected by adopting the chemiluminescent mi-croparticle immunoassay method in 378 cases of lung cancer ,200 cases of benign lung diseases and 200 people undergoing healthy physical examination .Results The levels and positive rates of CEA ,CA125 ,CYFRA21-1 , SCC ,NSE and ProGRP in the patients with lung cancer were significantly higher than those in the patients with benign lung diseases and healthy control group ,the difference was statistically significant (P<0 .05);in the single index detection ,the biomarkers of highest positive rate in adenocarcinoma ,squamous cell carcinoma and small cell lung carcinoma were CEA ,CYFRA21-1 and SCC ,NSE and ProGRP respectively .The sensitivi-ty ,specificity ,accuracy ,negative predictive value and positive predictive value of combined detection of these 6 indexes were 92 .86％ ,85 .00％ ,88 .17％ ,92 .64％ and 85 .40％ respectively ,except the specificity and positive predictive value were slightly decreased ,the levels of other indexes were higher than those of single index de-tection .The aresa under the receiver operating characteristic (ROC) curves of CEA ,CA125 ,CYFRA21-1 ,SCC ,NSE and ProGRP were 0 .775 ,0 .778 ,0 .891 ,0 .585 ,0 .710 and 0 .620 respectively .The area under ROC curves of the combined detection was 0 .950 .The positive rates of CA125 ,CYFRA21-1 ,NSE and the combined detection in the patients with stage Ⅲ ,Ⅳof lung cancer were obviously higher those in the patients with stageⅠand Ⅱof lung cancer ,the difference was statistically significant (P<0 .05);the combined detection obviously improved the positive rates for the diagnosis in the patients with different stages of lung cancer .Conclusion The combined detection of CEA ,CA125 ,CYFRA21-1 ,SCC ,NSE and ProGRP is conducive to improve the di-agnosis performance and early detection rate for lung cancer ,differentially diagnosing different pathological types of lung cancer and judge the clinical stage of lung cancer .The combined detection of 6 tumor biomarkers is an ideal diagnosis index of lung cancer .

In China's new healthcare reform, the pilot local governments explore the practice of establishing a new model of hierarchical diagnosis and treatment system.Zhejiang Province has adopted a special policy of effectively allocating hospital resources and human resources, and efficiently improving primary healthcare institution capability and patient satisfaction(hereinafter referred to as double allocation, double improvement), focusing on the implementation of the 'Healthcare Talents Project', in order to fill a vacancy of human resources in primary healthcare institutions.This paper uses system dynamics modeling and the WISN method of WHO to estimate the gap in physician supply in primary healthcare institutions.After building the system dynamics model of 'Healthcare Talents Project', this paper simulates the influence of the policy on the vacancy of doctors in primary healthcare institutions and analyzes the sensitivity of regulatory factors.The simulation results show that, there are a big gap in physician supply of about 14,000 to build the hierarchical diagnosis and treatment system.The project can gradually increase the number of primary doctors, and the policy may fill the vacancy by 2021.However, if the efficiency of the hospital doctors who give assistance to primary institutions is increased by 10%, the targeted training and recruitment 100% achieve the policy plans and objectives, the project goal may be achieved by 2020.Therefore, this project can effectively adjust the human resources structure quickly and reasonably, and it can be used as reference for the reform of hierarchical diagnosis and treatment system.

Proteomic technology has been widely used in the research of differently-expressed proteins under different physiology and pathologic conditions.In the aspect of the human spermatozoa proteomics,many reports have demonstrated the differently expressed proteins and the roles of sperm under different physiology and pathologic state from proteome level,and these results provided reliable theoretic base for well understanding of sperm molecule mechanism in physiology and pathologic conditions.

Aim To establish a model of focal cerebral ischemic tissue of rat brain and explore the injury mechanism of focal cerebral ischemia reperfusion in whole level of proteins.Method The model was established with suture method by reperfusion 24 h after ischemic 2 h according to Koizumi′s method,total brain tissue proteins were extracted with Lysis buffer,proteins were separated by two-dimensional electrophoresis(2-DE),stained by Coomassie brilliant blue,the patterns were gotten,differential proteins were found out,PMS was obtained by MALDI-TOF-MS,and related information of proteins was gained by MS-Fit database.Results A comparative proteomic study of model and normal group was performed.Compared with model group,the normal group gained 23 differential protein spots,13 spots expressed lowly,and 10 spots high,6 protein spots were identified,the relative cerebral ischemic proteins such as Leukotriene A-4 hydrolase,Thyrotropin-releasing hormone-degrading ectoenzyme etc were found out.Conclusions Establishing a 2-DE technology is applied to protein analysis of brain tissue,and the relative proteins of cerebral ischemia are found from proteome aspect.This will contribute to the research on the injury mechanism of cerebral ischemic tissues.

Objective To explore the difference of male and female rats in establishing diabetic model by feeding lardy diet and intraperitoneally injecting a low dose streptozotocin(STZ).Methods Totally 184 male and female Wistar rats(each 92 rats) were induced to diabetes mellitus by feeding lardy diet and intraperitoneally injecting 25 mg/kg STZ for 5 weeks.For the 114 left living rats(70 females and 44 males),they were randomized into female high rosiglitazone group(n=23),male high rosiglitazone group(n=15),female low rosiglitazone group(n=23),male low rosiglitazone group(n=15),female model group(n=24),and male model group(n=14).Rosiglitazone at 2 or 0.5 mg/kg were intragastrically administered to corresponding rats once a day for 4 weeks.Another 8 health female and 8 health male rats receiving same volume solvent served as normal control.The body weight,taken food amount,fasting blood glucose,plasma insulin content and the morphology of the spleen were measured and examined to validate the animal models.Results Blood glucose,total plasma lipids and cholesterol of model rats were markedly increased after STZ injection.And there were some other symptoms of model rats,such as polyuria,polydipsia and polyphagia,which indicated that diabetes had been induced in the models.The male model rats had higher mortality,body weight,triglyceride level and lower plasma insulin than in female(P

Objective To investigate some points in evaluating the effects of insulin sensitizer on obesityassociated non-insulin-dependent diabetes mellitus Zucker fa/fa rat model. Methods Total 20 male Zucker fa/fa rats were divided into model group and rosiglitazone groups. Another 10 male Zucker fa/? rats served as normal control. Rosiglitazone at 6 mg/kg was given intragastrically once per day for 4 weeks,and the rats of the other 2 groups were fed with same solvent at same volume. Results Rosiglitazone reduced the levels of fasting insulin,triglyceride ( TG) and free fatty acid ( FFA) of Zucker fa/fa rats ( P

Aim To investigate whether ecdysterone is able to exert glucose-lowering effect on hepatocytes or stimulate the secretion of insulin.Methods For glucose consumption studies,the amounts of glucose disappeared from the culture medium of HepG2 cells within 24 h were determined.?TC3 cells were also used to monitor insulin secretion.Results The glucose concentrations decreased significantly by ecdysterone 1?10~(-6)～10~(-4) mol?L~(-1),while glucose consumption increased by 44%～77% with ecdysterone.Glucose consumption declined as its concentrations increased.Insulin had no effect on glucose-lowering of ecdysterone.?TC3 cells were not stimulated by ecdysterone.Conclusion Ecdysterone is able to exert glucose-lowering effect on hepatocytes which is insulin independent,but has no effect on insulin secretion.

This article reviewed the appli ca tion of molecular biology technology, such as genomics, DNA labeling technology, and DNA microarray. The aim is to provide the reference for the modernization o f Chinese material medica.

OBJECTIVE:To study the content change regularities and the dynamic characteristics of paeonol,the major active ingredients in Cortex moutan from Chongqing Dianjang county under different influencing variables.METHODS:The determination of paeonol in moutan cortex samples was conducted by HPLC,and dynamic analysis on content change regularities was conducted.RESULTS:The content of paeonol took a para-curve pattern at an altitude from 400m to 800m,with that from 600m in altitude has the highest content;The content increased year by year from growing life of 3 to 5 years;The content took a para-curve pattern when harvested from 8mo to 11mo,with that harvested in 10mo was the highest.CONCLUSION:The optimal altitude for the growing of Cortex moutan was from 400m to 800m,in particular at an altitude of 600m,and it is preferable to harvest Cortex moutan with 4 or 5 years growing life in the first 20 days of 10mo.