Endocrine therapy is one of the important treatments of adjuvant therapy among patients with positive hormone receptor breast cancer.In the endocrine therapy setting,5 years of tamoxifen therapy has been the standard treatment regimen for premenopausal patients.In recent years,this standard has been challenged.The results of many large randomized clinical trials have made a new choice for adjuvant endocrine therapy in premenopausal patients.In this paper,we review the present situation of endocrine therapy in premenopausal patients with positive hormone receptor breast cancer.

Objective:To clone and sequence of 16S~23S r RNA intergenic spacer region of Proteus mirabilis and Acinetobacter lowffii for further identification of these two bacteria by means of molecular probe.Methods: The PCR universal clinical common pathogenic bacteria primers for 16S and 23S rRNA's conserved sequences were designed.Then the genomes of these two bacteria were amplified,T Vector clones were constructed with PMD-18 T Vector ad PCR products.The vectors were sequenced and the sequence was submitted to Genbank.Results: T Vector clones were constructed with products amplified by using universal primers;according to Blast analyses,the results of sequencing were determined as ISR sequences of the two kinds of bacteria.And the reports to Genbank were accepted.Conclusion: Genbank accepted the cloning and sequencing results of Proteus mirabilis and Acinetobacter lwoffii as new sequences.And these sequences can be used to identify the two bacteria by universal primers.

Innovations of English class teaching methods are considered crucial in the improvement of English class effectiveness.Many approaches have been practiced towards that goal.The essay mainly discusses the issue from the new RICH perspective, intending to spark new thinking about innovations of English teaching methods.

OBJECTIVE:To observe clinical efficacy and safety of pidotimod combined with montelukast sodium in the treat-ment of children with bronchial asthma. METHODS:120 children with bronchial asthma were randomly divided into control group and observation group,with 60 cases in each group. Both group were given routine treatment as aerosol inhalation of glucocorticoid and anti-infective treatment. Control group was additionally given Montelukast sodium chewable tablet 5 mg orally,qd,at bed-time;observation group was additionally given Pidotimod capsule 0.4 g,qd,on the basis of control group. Both group received treatment for consecutive 3 months. Clinical efficacies of 2 groups were observed as well as IL-4,IFN-γ,IgE,T lymphocyte sub-set and lung function indexes of 2 groups before and after treatment. The occurrence of ADR were compared between 2 groups. RE-SULTS:The effective rate of observation group was 88.3%,which was significantly higher than that of control group (61.7%). There was no statistical significance in IL-4,IFN-γ,IgE,T lymphocyte subset and lung function indexes between 2 groups before treatment(P>0.05). After treatment,IL-4,IFN-γ,IgE,CD4+,CD4+/CD8+ and lung function of 2 groups were improved signifi-cantly,and the observation group was significantly better than the control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Pidotimod combined with monte-lukast sodium is effective for children with bronchial asthma,and can significantly relieve airway inflammation,enhance immunity and improve lung function with good safety.

With the emergence of new endocrine drugs and the development of research in resistance mechanisms,significant progress has been achieved in the endocrine treatment of breast cancer in recent years. Fulvestrant,the combination of endocrine drugs and the combination of targeted therapy with endocrine therapy will be effective treatments for postmenopausal women with hormone receptor positive in advanced breast cancer.

Aim To establish a gefitinib-resistant NSCLC cell line, and observe its pharmacological properties. Methods HCC827 cells were treated with hepatocyte growth factor( HGF) and increasing concen-tration of gefitinib to induce cell resistance. MTT assay was used to test cell viability and chemosensitivity. Clone formation and Edu staining were used to verify the inhibitory effect of gefitinib on cell growth. qRT-PCR and Western blot were used to assay the expres-sion of c-Met. Results The use of HGF greatly short-ened the induction time of HCC827GR resistant cells. gefitinib could significantly suppress cell viability, col-ony formation and cell proliferation of HCC827 , but had a weaker inhibitory effect on HCC827GR cells. HCC827GR overexpressed c-Met protein, and was highly sensitive to c-Met inhibitors. Conclusion The gefitinib-resistant HCC827 GR cells were induced suc-cessfully and efficiently. The growth of HCC827GR is dependent on the activity of c-Met protein, and it can be used as a phenotypic screening model of c-Met in-hibitors.

ion:Objective To study the effect of enteral nutrition on cardio-pulmonary function in elderly patients with chronic obstructive pulmonary disease (COPD) .Methods Fifty-eight elderly COPD patients were randomly divided into treatment group (enteral nutrition group ,n=29) and control group (free diet group ,n=29) .Their nutrition parameters (BMI ,serum total protein ,al-bumin and prealbumin) ,LVEF and pulmonary function (FEV1 ,FVC ,FEV1/FVC) were assayed before and after treatment .Results The BMI ,serum levels of total protein ,albumin and prealbu-min were significantly higher in treatment group after treatment than before treatment ( P<0.05) .However ,no significant difference was observed in these parameters in control group after treatment .The LVEF ,FVC ,FEV1 and FEV1/FVC were significantly higher in treatment group than in control group after treatment (P< 0 .05) .Conclusion Enteral nutrition in combination with conventional treatment can improve the nutrition and cardio-pulmonary function in elderly COPD patients ,thus shortening their hospital stay time .

Objective To explore different doses of recombinant tissue-type plasminogen activator (rt-PA) intravenous thrombolytic therapy for acute cerebral infarction.Methods 130 patients with acute cerebral infarction were as the research subjects selected from May 2014 to May 2015 for rt-PA thrombolytic therapy, who were divided into two groups according to rt-PA thrombolytic agent dose, 65 cases in each group.Evaluated the clinical efficacy of thrombolytic therapy after treatment in accordance within 24 h intracerebral hemorrhage (ICH) , symptomatic intracerebral hemorrhage (SICH) , other bleeding symptoms and for 3 months after treatment the prognosis was good rate, total mortality.For pre-treatment, the degree of defect nerve function after two groups of patients were scored by NIHSS score, correlation analysis between the two groups of clinical efficacy and function of the degree of nerve defect before treatment.Results 3 months after thrombolysis total mortality in the standard dose group was significantly higher than that in the low-dose group (P<0.05) .After treatment, both groups NIHSS scores were significantly lower than before treatment (P<0.05); After treatment, NIHSS score 4-8 points in the proportion of low-dose group was significantly more than that in the standard dose group (P<0.05); NIHSS score 9-16 points, 17-24 points in the proportion of low-dose group were significantly less than that in the standard dose group (P<0.05).NIHSS9-16 points of patients after total mortality three months in the standard-dose group was significantly higher than that in the low-dose group (P<0.05) . Conclusion Different doses of rt-PA thrombolytic therapy in acute cerebral infarction are basically the same, and the degree of neurological deficit does not affect the efficacy, but reduce mortality in patients 3 months after low-dose rt-PA treatment, it is worth widely used in clinical practice.

Despite solitary pulmonary nodule (SPN) is a common medical problem in the clinic,the managements can be quite complex.The aetiological agent is largely unknown.Making a definitive diagnosis for SPNs before the operation has been a clinical challenge.A major problem for clinicians and radiologists were to identify the nature of benign and malignant SPNs at an early stage,and let the patients receive therapies timely and effectively.At present,many clinical features and detect methods of SPNs have been applied for differentiating the nodules,but these are not fully to distinguish it.Recently,some progressions had brought qualitative improvements to the diagnosis and treatment of SPNs.Therefore,in this paper,the research status and progresses of SPNs were reviewed.

Objective : To revise the general self-efficacy scale. Methods : 3094 subjects from 7 different cities in China finished the general self-efficacy scale. Results : The result of Item Analysis showed that 19 of the scale met psychometric criteria. The scale's internal consistency was 0.81, split reliability 0.81. It had acceptable discriminant validity: subjects with higher scale scores also had significantly higher scores in every items than those with lower scale scores, and this scale could effectively differentiate the high and low level managers, it also could effectively differentiate the managers groug and workers group. Exploratory factor analyses indicated that the scale had one dominant factor. Conclusion : The general self-efficacy scale has sound psychometric properties for further research.