Currently targeted therapy of breast cancer therapy has become the hot research field and a kind of brand-new biological treatment mode after three traditional pattern of the surgery, radiotherapy and chemotherapy for breast cancer. Molecular targeted therapy is aimed at the target that may cause cancer cells, such as protocarcinogenic genes and tumor-suppressor genes, cell signaling pathways, cytokines and receptors, antiangiogenesis etc. It can reverse malignant biology behavior to inhibit tumor cell growth from the molecular level and has the advantages of high specific effects and low side effects. This paper focuses on the drug of the molecular targeted therapy for breast cancer and the latest progress of targeted therapy.

Medical institutes in the United States,the United Kingdom and Canada have systematically explored and published standard of physician competence,such as ACGME six-critical-components,GMC good medical practice and CanMEDS,which has led to changes in the content,item format and clinical skill test of foreign medical incensing exam.Foreign research inspires Chinese counterparts to study and develop the Chinese standard of physician competence so as to continuously enhance the medical licensing exam.

Objective:To prepare doxorubicin-tetrandrine complex liposomes for technology study and quality control.In order to provide a new idea to reverse the tumor multidrug resistance in clinic.Methods:The formulations of doxorubicin-tetrandrine complex liposomes were optimized by three different kinds of methods.And the optimum formula was selected according to the entrapment efficiency.Re- sults:The complex liposomes were prepared by(NH4)2SO4-gradient method combined with pH gradient method according to optimum recipe.The optimum recipe of DOX-TET liposome was founded as DOX-TET/EPC of 1∶10,EPC/Ch of 3∶1,pH value of 7.6,incubation temperature of 50℃,(NH4)2SO4 concentration of 250 mmol/L.Under the formulation,DOX and TET were encapsulated 90.77%and 80.12%,respectively.Conclusion:The doxorubicin-tetrandrine complex liposomes have high entrapment efficiency with fine looking, which provides basis for the further studies.

Objective To investigate the occurrence of hemolytic disease in neonates with maternal and neonatal blood group incompatibility,and to investigate the related factors affecting the occurrence of hemolytic disease.Methods A total of 52 newborns with maternal and neonatal blood group incompatibility in our hospital from May 2016 to May 2014 were selected as the research subjects.The clinical data of all neonates were analyzed by adopting the systematic review method,and the ocurrence situation of ABO hemolytic disease in all subjects was statistically analyzed.The differences in general data of age,gender and related clinical examination results were compared among the neonatal patients.The related factors possibly affecting neonatal ABO hemolytic disease were investigated.Results (1) Among 52 neonates,30 cases (57.69%) appeared neonatal hemolytic disease,and the incidence rate was high;(2) the non-conditional single factor Logistic regression model analysis showed that the weight,height,BMI,HGB,direct bilirubin,indirect bilirubin,total bilirubin and indirect bilirubin /total bilirubin and birth time could be the related factors affecting neonatal hemolytic disease occurrence;(3) non-conditional multiple factor Logistic regression model analysis showed that HGB,direct bilirubin,indirect bilirubin,total bilirubin and indirect bilirubin / total bilirubin and birth time were the independent influencing factors of neonatal hemolytic disease occurrence.Conclusion The incidence rate of hemolytic disease in neonates with maternal and neonatal blood group incompatibility is high,and the birth time,HGB concentration and related bilirubin expression level may be the possible influencing factors of hemolytic disease in neonates with maternal and neonatal blood group incompatibility.

Objective To investigate the indications and clinical values of percutaneous transthoracic biopsy guided by different locating means respectively on pulmonary lesions. Methods Patients were divided into different groups according the locating methods,which included X -ray, type -B ultrasonography, and CT. Pathologic diagnosis and complications were retrospectively analysed between groups. Conclusion Each locating method has its own advantages and disadvantages. Results we should choose the optimistic one according the patients′ condition.

This paper discussed the detection of tumor micrometastasis, and analysed the influence of chemotherapy and blood transfusion on the immunity of tumor patients. Chemotherapy and blood transfusion can increase the opportunity of tumor metastasis. By analysing the mechanism of the treatment of tumor with traditional Chinese medicine, the author put forward the new method about eliminating tumor micrometastasis with traditional Chinese medicine.

Objective To investigate the discussion of risk factors of severe head injury with multiple organ dysfunction syndrome.Methods The clinical data of 149 cases with severe traumatic brain injury patients were retro-spectively analyzed,and the risk factors in patients with severe traumatic brain injury were collected,which may affect MODS,such as gender,age,GCS score,associated injuries,chronic underlying diseases,infections and other details, statistically analyzed were combined with incidence of MODS.Results (1 )Univariate analysis results could be seen, age,chronic underlying diseases,admission GCS score,extensive brain parenchymal damage,merge large organ dam-age,brain herniation,concurrent infection,massive blood transfusion were risk factors of MODS severe traumatic brain injury(χ2 =12.962,11.725,11.021,13.894,11.486,12.031,12.967,13.078,P=0.023,0.025,0.027,0.017, 0.023,0.018,0.021,0.019).(2)MODS rate and the number of risk factors were positive correlation(r=0.528,P=0.021).(3)With the increase of the number of mortality in patients with MODS organ dysfunction occurred signifi-cantly increased,MODS patients in this group,the two organs mortality was 17.4%,the three organs were 46.7%, four or more mortality was 87.5%(χ2 =11.735,13.933,12.748,P=0.028,0.019,0.025).Conclusion Age, chronic underlying diseases,GCS low,extensive parenchymal injury,combined injury,the occurrence of hernia,com-plicated by infection,massive blood transfusion were independent risk factors for brain injury,which should be payed attention.

OBJECTIVE: To prepare indomethacin amorphous preparation with Co-PVP as carrier, characterize it for exploring the interaction between indomethacin and Co-PVP, and investigate the difference of dissolution between indomethacin crystalline and amorphous preparations. METHODS: The inhibitory effect of Co-PVP on the crystallization of indomethacin supersaturated solution was studied. The indomethacin amorphous preparation was prepared by solvent evaporation method and characterized by differential scanning calorimetry (DSC), powder X-ray diffraction (PXRD), and Fourier transform infrared spectroscopy (FT-IR). In addition, the dissolution behavior in vitro was investigated. RESULTS: Co-PVP had an inhibitory effect on the crystallization of indomethacin supersaturated solution evidently. Indomethacin existed in amorphous state in Co-PVP as hydrogen bonds formed between them. The amorphous preparation of indomethacin-Co-PVP improved the dissolution rate and extent obviously. CONCLUSION: The indomethacin amorphous preparation with Co-PVP as carrier can improve the dissolution in vitro significantly, which providing a reference for obtaining stable amorphous preparation.

Objective: To observe the analgesic effect and adverse effects of Controlled-Release Oxyco-done tablets(oxycontin) on moderate and severe chronic cancer pain, and the improvement of quality of life(QOL) in the cancer patients after the treatment. Methods: A total of 72 patients with moderate and se-vere chronic cancer pain were selected .The analgesic effects,adverse effects and quality of life (QOL) were observed and evaluated. Controlled-Release Oxycodone tablets were administered at an initial dose of 5 mg or 10 mg every 12 hours according to the degree of pain. The next analgesic dose should be adjust-ed if breakthrough pain occurs more than twice in 24 hours. If the initial dose is 5 mg, it may be increased to greater than or equal to 10 mg. If the initial dose is greater than or equal to 10 mg, the dosage may increased by 25%～50%. Short-acting morphine tablets are used to control the breakthrough pain. Results: The doses ranged between 10～100mg/d .Among the 72 patients with moderate and severe chronic cancer pain, 12 (16.7%)achieved complete remission ,52(72.2%)achieved partial remission,6(8.3%) achieved minor remis-sion.The overall rate of pain relief 88.9%. The mainly adverse reactions were including, nausea and vomiting, dizziness, drowsiness and dysuria. Followed the reduced of the pain intensity ,the QOL of most cancer pa-tients was improved. The KPS of 12 patients had been obviously improved, 20 patients had mildly improved, and 40 patients were stabilized. Conclusion: Oxycodone hydrochloride controlled-release tablets are effective and safe for the management of chronic cancer patients with moderate and severe pain, with less adverse reactions, and the QOL of cancer patients were significantly improved.

BACKGROUND:The treatments of plantar fasci tis as an important cause of calcaneodynia are different in medical institutions, as wel as the therapeutic results.
OBJECTIVE:To summarize various treatments of plantar fascia, and based on the pathogenesis and pathological mechanics of plantar fasci tis, to investigate the effect of various treatment methods and indications.
METHODS:A computer-based online search of PubMed database and Wanfang database was performed for articled related to plantar fasci tis published between January 1993 and January 2014. The keywords were
“plantar fasci tis, mechanism, treatment”in English and Chinese, respectively, by screening the titles and abstracts. Final y, 34 articles were included in result analysis.
RESULTS AND CONCLUSION:The treatment of plantar fasci tis needs to fol ow the principle from noninvasive to invasive treatment. Stretching the plantar fascia and heel cord, using prefab-ricated orthotics, and wearing night splints are crucial for the treatment of plantar fasci tis. Local hormone injection can be used as first-line therapy for patients with acute plantar fasci tis if they can tolerate the adverse reactions due to hormone therapy. Platelet-rich plasma therapy has a promising prospect, but there is lack of experimental evidences. Extracorporeal shock wave therapy can be a choice for recurrent chronic intractable plantar fasci tis. Surgical intervention remains the last line of therapy, for which, rigorous screening is important, but it is not always effective at reducing pain.