Bone metastasis is the most freguently in breast cancer. To diagnose and treat bone metastasis in time, is very important to improve quality of life and prolong the survival time of patients. Recently the effect of tumor marker on bone metastasis in breast cancer was regarded increasingly. The article reviewed the development of tumor marker research on diagnosis, treatment of bone metastasis in breast cancer.

Based on special biological characteristics and prognosis, the incidence of gastroesophageal junction adenocarcinoma (GEJA) has rapidly increased over recent years, and its diagnosis and treatment remain controversial. Compared with simple surgery, neo-adjuvant and adjuvant therapies can improve the survival of patients with locally advanced GEJA. Under neo-adjuvant therapy, neo-adjuvant chemoradiation is superior to neo-adjuvant chemotherapy alone for improving the resectability, maintaining loco-regional control, and improving the quality of life of the patient. The combination of this therapy with targeted drugs may further increase the ef-ficacy of GEJA. Most data on GEJA-treated patients were obtained from randomized clinical studies on esophageal cancer or gastric cancer. Thus, prospective randomized controlled studies with a large sample size should be performed to optimize the strategy of neo-adjuvant and adjuvant therapies, and further improve the treatment outcome. In this article, studies on the comprehensive treatment of GEJA were reviewed.

Objective To detected the motor cortex reorganization and compared the influence on reorganization process as regard to different transfer modes of contralateral seventh cervical nerve root (C7)in young rats model of total brachial plexus root avulsion. Methods The young Sprague-Dawley rats model of total brachial plexus root avulsion was established. The left radix dorsalis and radix ventralis from the fifth cervical nerve root (C5) to the first thoracic nerve root (T1)were exposed and the roots from C5 to T1 were avulsed from the spinal cord. Then, the contralateral C7 transfer operation was performed. Three different operative modes were applied randomly which included contralateral C7 transference to anterior division of the upper trunk (group A, n=30), to both musculocutaneous and median nerves (group B, n=30), or to median nerve (group C, n=30). The movement evocation of motor cortex was measured by intracortical microstimula-tion in both hemispheres, and functional reorganization was assessed dynamically in 1.5, 3, 6, 9 and 12 months after operation. Results After contralateral C7 transference, the ipsilateral motor cortex initially acti- vated the injured limb at 1.5 month, and subsequently the motor cortex of both hemispheres activated the in-jured limb at the 3rd and 6th month. The injured limb was activated mainly by the contralateral motor cortex in group A at the 9th month. The contralateral motor cortex exclusively controlled the injured limb in all three groups at the 12th month after the operation. Meanwhile, the extent of functional reorganization was better in group B than that of group C. Conclusion After contralateral C7 transfer operation, motor cortex in charging injured limb developed a transhemispheric functional reorganization in young rats with total brachial plexus root avulsion. Different operative modes contributed to the functional reorganization of motor cortex. Transferring contralateral C7 to anterior division of the upper trunk or to both musculocutaneous and median nerves provided better functional reorganization than to median nerve.

Objective To investigate the protective effect of Fas ligand (FasL) gene transfer to renal allografts in rats. Methods FasL recombinant adenovirus vector was contruccted and transduced into rat renal allografts by renal artery perfusion. RT-PCR and immunohistochemistry were use d to detect the expression of exogenous FasL gene. Electronic microscopy was use d to observe the changes in the ultra-structure. At the same time, mean surviva l of animals and the level of serum creatinine were observed. Results FasL mRNA and protein were positively expressed in FasL gene transduced renal al lografts. FasL protein mainly distributed in renal small artery, glomerular and proximal tubues. FasL transduced allografts had less renal graft rejection and c hange in the ultra-structure, and prolonged allograft survival and lower serum creatinine as compared to control animals (P

Cancer-related fatigue (CRF) is associated with tumor and (or) anti-tumor treatment,which has a high incidence and seriously affects the life quality of patients.The etiology of CRF involves psychology,physiology and social factors.There are various hypothesis of pathogenesis and the inflammatory system may play an important role in the generation and development of CRF.A variety of inflammatory cytokines such as IL-1β,IL-6,TNF-α,CRP are significantly correlated with CRF.

Objective To investigate the role of Wnt/β-catenin pathway in the glucocorticoids (GC)-mediated Alzheimer' s disease-like pathological changes in vitro.Methods Human embryonic kidney 293 (HEK293/wt) cells stably transfected with the longest human tau (tau441,HEK293/tau) and wild-type HEK293 cells were employed to study the role of GC.Cell viabilities of the two cell lines were examined by cell counting kit-8 ( CCK-8 ).Levels of phosphorylated tau ( p-T205 ) and dephosphorylated tau (Tau-1),β-catenin,phosphorylated β-catenin (p-β-catenin),glycogen synthase kinase-3β (GSK-3β),phosphorylated GSK-3β at Ser9 (ps9-GSK-3β) and Bcl-2 were determined by Western blotting.Results Treatment with 1 μmol/L GC for 48 h decreased the viability of HEK293/wt and HEK293/tau cells to 95.5％ ±3.2％ and 77.8％ ± 4.4％ (t =6.60,P ＜ 0.05 ).Moreover,GC treatment decreased the levels of ps9-GSK-3β,Tau-1,β-catenin and Bcl-2 to 47.8％ ± 10.4％,53.9％ ± 11.7％,50.9％ ±7.6％,48.4％ ±6.5％ of control groups ( t =7.01,3.86,7.09,7.30,all P ＜ 0.05 ),and increased the relative levels of pT205,p-β-catenin to 180.5％ ± 22.2％,201.3 ％ ± 27.6％ of control groups (t =5.51,5.27,both P ＜0.05) only in HEK293/tau cells.Finally,LiCI efficiently prevented the above effects of GC in HEK293/tau cells.Conclusion GC may trigger Alzheimer' s disease-like pathological changes by inhibiting the Wnt/β-catenin pathway and these pathological processes seem to specifically depend on the presence of human tau.

Objective To analyze the doctors' working enthusiasm and its influencing factors on county level hospitals.Methods 17 seminars were held in 8 counties of 3 provinces to investigate 1055 doctors with questionnaires, analyzing the three scales of working enthusiasm, working enthusiasm influencing factors, and changes since the 2009 new healthcare reform.Results Working enthusiasm comprises inner drive, working pleasure, work recognition and external recognition, and inner drive of which is found to play the most important part, with 20.55％ variance contribution.Among the six dimensions of the influencing factors, working conditions rank the highest with 19.46％ variance contribution.Conclusion Optimized measures in the healthcare reform, better working conditions and social environment can improve working enthusiasm of these doctors.

Objective:To silence ERCC2 (excision repair cross-complementing rodent repair deficiency,complementatin group 2,ERCC2) expression in esophageal cancer KYSE150 cells by small interfering RNA (siRNA) and observe the altered sensitivity of KYSE150 cells to paclitaxel (PTX) and elucidate the mechanism underlying the reversion of the PTX resistance of KYSE150 cells. Methods:ERCC2-targeted siRNA was synthesized in vitro and transiently transfected into ERCC2 overexpressing KYSE150 cells via Lipofectamine mediation. The mRNA and protein expression levels of ERCC2 were determined by using RT-PCR and FCM method, respectively. The sensitivity of KYSE150 cells to PTX was measured by MTT assay before and after siRNA transfection. Results:RT-PCR results suggested that the specific bands of ERCC2 mRNA were not detected in si-ERCC2 group at 24, 48 and 72 h post transfection. FCM results indicated that the expression levels of ERCC2 protein gradually decreased by 31.2%, 51.6% and 60.0% at 24, 48 and 72 h respectively(P<0.01). The IC_(50) value of PTX for ERCC2-silencing KYSE150 cells was (6.32±0.87) μg/mL, lower than that for control cells (P<0.01). Conclusion:siRNA successfully silenced the expressions of target gene ERCC2 at both the transcription and translation levels. Silencing ERCC2 expression partly reversed the resistance of KYSE150 cells to PTX.

Objective To assess the safety and efficacy of percutaneous nephrolithotripsy withpneumatic and ultrasonic power in pediatric renal calculi. Methods The clinical data of 44 patientstreated with combination of pneumatic and ultrasonic power during pereutaneous nephrolithotripsywere retrospectively analyzed. The 44 patients had 49 renal calculi. The patients were all under 14years old. The average age was 11 years (range 7-14 years). There were 39 unilateral and 5 bilateralcalculi. Among the 44 patients,metabolic disturbance occurred in 19 cases (43.2%),anatomical dys function occurred in 15 cases (34.1%),urinary tract infection occurred in 14 cases (31.8%). Ante grade percutaneous access was established under ultrasound guidance,a combination of pneumatic andultrasonic lithotripsy were used. The effect was evaluated by postoperative KUB and ultrasonic. Re suits The access was successfully established in all patients. Complete stone clearance was achievedin 36 kidneys in phase Ⅰ,stones from 9 kidneys were completely removed with second lithotripsy.Leftover stone in 2 kidneys were treated by ESWL. Open surgery was performed in 2 kidneys due toexcessive bleeding. The operative time ranged from 52 132 min,average time was 79 min. Two pa tients needed blood transfusion. No severe complications occurred in all patients. Thirty seven pa tients were followed up for 3 18 months. The renal function was not worsened and hydronephrosiswas not aggravated in these patients. Conclusion The percutaneous nephrolithotripsy with pneumatic and ultrasonic power is a safe,effective treatment for pediatric renal calculi.

Background and purpose: ERCC2 gene silence by siRNA interference was observed in esophageal cancer cell line and it could change cell sensitivity to taxol. This study was to investigate the biological mechanism of paclitaxel-resistance in esophageal cancer cells. Methods: ERCC2 targeting siRNA (si-ERCC2) has been synthesized. The constructor were transfected into ERCC2 cell lines high-KYSE150(bigh expression of ERCC2) through lipofectamine. RT-PCR and flow cytometry (FCM) were used to detect the ERCC2 mRNA and protein expression levels. MTr assay was used to estimate the paclitaxel sensitivity of the cells. Results: In si-ERCC2 group, ERCC2 could not be detected and ERCC2 protein expression were reduced by 31.2%, 51.6% and 60.0%, respectively, 24,48,72 b after transfection. Paclitaxel IC_(50) value for si-ERCC2 group was 6.32±0.87 μg/mL, lower than the control group(49%). Conclusion: siRNA could successfully silence the target gene ERCC2 at the level of transcription and translation of the gene, the reduction of ERCC2 expression may reverse taxol resistance of the cells.