Breast cancer is by far the most common cancer for females.The recent researches focus on early diagnosis,optimal adjuvant therapy and curative effect surveillance.The paper summarizes the application of tissue and fluid tumor markers in the diagnosis,treatment,curative effect surveillance and prognostic prediction of breast cancer,which include widely-accepted estrogen receptors,HER2-neu and CA15-3,and novel ones such as Cyclin E,TIMP-1,RAR-?,hK10 and BRCA-1.

OBJECTIVE:To investigate the condition and characteristics of drug-induced liver injury (DILI) of anti-infective agents and provide reference for the prevention and treatment of anti-infective agents related DILI. METHODS:Based on retrospective analysis,a total of 572 DILI reports of anti-infective agents were collected from PLA ADR monitoring center during 2009 to 2013, and then analyzed statistically in terms of patient’s age and gender,main diagonosis,categories of DILI-inducing drugs,type,route of administration,occurrence time,lab indicator,DILI types and clinical manifestations,the application of liver protective drugs,out-comes,etc. RESULTS:Among 572 DILI cases,there were 412 cases(72.03%)of male patients and 160 cases(27.97%)of female patients,and average age of the patients was(44.54±23.75)years old. ADRs were related to 57 kinds of anti-infective agents in 6 cat-egories. Rifampin was the most frequent in suspected drugs,followed by isoniazid,moxifloxacin,fluconazole,azithromycin,cefurox-ime, cefoperazone/sulbactam, levofloxacin, cefoxitin and voriconazole. Intravenous infusion was the main administration route (74.48%). The occurrence time of ADRs was mainly within two weeks (86.19%). Hepatocellular damage (93.33%) was the main type in 360 cases of ADR for evaluation of liver injury types. The majority of cases(82.17%)were cured or improved after drug with-drawal and symptomatic treatment. CONCLUSIONS:Cephalosporin,fluoroquinolones,antituberculosis and antifungal drugs might be the common agents which caused liver injury. Hepatocellular damage is the most frequent type. Most of patients have a favourable prognosis. Clinical medical staffs should strengthen the awareness of DILI caused by anti-infective agents and ehance the prevetion of it.

Objective To evaluate the outcome of the laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy. Then define the characteristics of the learning curve of this procedure. Methods A prospectively collected database comprising all medical records of the first 79 consecutive patients underwent laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy performed by one surgeon was studied. The patients were divided into seven groups (13 cases in last group) by operative sequence. Data on patients' demographics, clinical and outcome variables including operative duration, conversion to open surgery, complications, and length of hospital stay were analyzed. The learning curve for the laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was established through the moving average and ANOVA methods. Results Comparing the early with the late experiences (33 v. 46 cases), the surgeon-specific outcomes significantly improved in terms of operating times [(292.7 ± 29.8) vs (215.3 ± 10.2) min, P < 0.05], There was four patients converted to open surgery in the early of experiences.the late experiences was five case, it was no statistical significance. significant differences were not shown in the hospitalization period and infectivity complications. Conclusion Operative duration can be reduced with increasing experience of laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy, In this study, the learning curve for a laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was about thirty-three cases.

Ultrafine powder and cell wall-broken powder of herbal medicine lack of the morphological characters and microscopic identification features. This makes it hard to identify herb's authenticity with traditional methods. We tested ITS2 sequence as DNA barcode in identification of herbal medicine in ultrafine powder and cell wall-broken powder in this study. We extracted genomic DNAs of 93 samples of 31 representative herbal medicines (28 species), which include whole plant, roots and bulbs, stems, leaves, flowers, fruits and seeds. The ITS2 sequences were amplified and sequenced bidirectionally. The ITS2 sequences were identified using Basic Local Alignment Search Tool (BLAST) method in the GenBank database and DNA barcoding system to identify the herbal medicine. The genetic distance was analyzed using the Kimura 2-parameter (K2P) model and the Neighbor-joining (NJ) phylogenetic tree was constructed using MEGA 6.0. The results showed that DNA can be extracted successfully from 93 samples and high quality ITS2 sequences can be amplified. All 31 herbal medicines can get correct identification via BLAST method. The ITS2 sequences of raw material medicines, ultrafine powder and cell wall-broken powder have same sequence in 26 herbal medicines, while the ITS2 sequences in other 5 herbal medicines exhibited variation. The maximum intraspecific genetic-distances of each species were all less than the minimum interspecific genetic distances. ITS2 sequences of each species are all converged to their standard DNA barcodes using NJ method. Therefore, using ITS2 barcode can accurately and effectively distinguish ultrafine powder and cell wall-broken powder of herbal medicine. It provides a new molecular method to identify ultrafine powder and cell wall-broken powder of herbal medicine in the quality control and market supervision.
Cell Wall ; DNA Barcoding, Taxonomic ; DNA, Plant ; genetics ; DNA, Ribosomal Spacer ; genetics ; Drugs, Chinese Herbal ; analysis ; Phylogeny ; Plants, Medicinal ; classification ; genetics ; Powders ; Quality Control

Objective To evaluate the therapeutic effect of Gamma knife radiosurgery (GKRS) on patients aged ≥65 years who presented with brain metastasis. Methods The clinical treatment and follow-up data of 134 patients,admitted to and treated with GKRS in our hospital from March 2004 to March 2010,were analyzed.These 134 patients totally underwent 212 GKRS for 403 metastases.The median maximal and marginal doses were (29.3±8.4) Gy and (15.9±4.8) Gy,respectively.Kaplan-Meier survivor analysis was utilized to calculate the median survive time and multivariate analysis was employed to determine the clinical factors influencing the treatment outcome. Results Of the 372 metastasis followed by imaging,complete response was achieved in 66 lesions (17.7％),partial response in 174 lesions (46.8％),no change in 94 lesions (25.3％),and partial progression in 38 lesions (10.2％).Median survival was 10.9 months.Grade of recursive partitioning analysis (RPA),number of tumors,scores of Karnofsky performance scale (KPS) and status of primary malignancies were found to be factors influencing the efficacy (P＜0.05). Conclusion GKRS for patients aged over 65 years with brain metastases is an effective and safe treatment method that appears to improve survival and is helpful in maintaining relative good life quality in selected population

Rheumatoid arthritis (RA) is a most common inflammatory joint disease with direct invasion of joint synovial membrane, cartilage and bone. Currently, although the RA mitigation drugs are being improved continously, but these drugs only can delay the development of joint dysfunction. Total hip arthroplasty or total knee arthroplasty(THA or TKA) has become the only choices for patients with advanced RA, and the joint function and deformity of the patients after surgical treatment can be improved to some extent. However, the progression of RA has a direct effect on the long-term clinical effect of the surgery, and how to improve perioperative management, and combine the joint replacement surgery and drug therapy effectively, have become the focus of attention in clinical doctors. This article intends to summarize the current situation of domestic and foreign management of usage of pre-operative drugs, operation skills, prosthesis selection, postoperative treatment, rehabilitation and complications, so as to improve the long-term efficacy of joint replacement.

OBJECTIVETo analyze the distribution of the musculoskeletal disorders, work load and working postures in different factories, gender, education levels, age and working years among manufacturing workers.

METHODSIn a cross-sectional study of 5134 manufacturing workers in 12 factories, the morbidities for musculoskeletal disorders in one year period were measured with questionnaires.

RESULTSThe morbidities for musculoskeletal disorders in body sites: waist, neck, shoulder, wrist, ankle/feet, knee, hip/buttocks and elbows were 59.7%, 47.9%, 38.1%, 33.7%, 26.9%, 25.4%, 15.2%, and 14.9%, respectively in one year period. There were significant differences of morbidities for musculoskeletal symptoms in body sites of workers among different factories (P < 0.05 or P < 0.01). The morbidities of musculoskeletal symptoms in elbows, waist, wrists and ankle/feet of the workers in refractory material and chemical fiber factories were higher than those in other factories, the morbidities for musculoskeletal symptoms of workers in garments and diamond factories were lower than those in other factories. The morbidities for musculoskeletal symptoms in neck, shoulders and wrists of female workers were significantly higher than those of male workers (P < 0.01). There were significant differences of the morbidities for musculoskeletal symptoms in body sites among workers with different educational levels (P < 0.05 or P < 0.01). There were significant differences of the morbidities for musculoskeletal symptoms in neck, shoulders, wrists, hip/buttocks and knee among groups with different age or different working years (P < 0.01), and the morbidities for musculoskeletal symptoms increased with age and working years. The proportions of unhealthy working postures and high working load among workers in refractory material and chemical fiber factories were higher; but those in garments and diamond factories were lower.

CONCLUSIONThe morbidities for musculoskeletal symptoms in waist, neck, shoulder and wrists of workers in manufacturing workers were higher; the gender, education level, age and working years could influenced the morbidities for musculoskeletal disorders.

Adult ; Female ; Humans ; Industry ; Male ; Musculoskeletal Diseases ; epidemiology ; Occupational Diseases ; epidemiology ; Posture ; Surveys and Questionnaires

OBJECTIVETo observe influence of JAK2/STAT3 signal pathway mediating curcumin in cartilage cell metabolism of osteoarthritis and mitochondria oxidative stress resistance;also explore the role of JAK2/STAT3 signal pathway and effect of curcumin in this process.

METHODSFifteen male SPF C57BL/6 rats rweighted from 10.05 to 15.00 g with an average of 12.80 g were collected and randomly divided into control group, OA group(modeled as OA by Glasson SS), curcumin with OA group (100 mg/kg curcumin were performed intraperitoneal injection every day based on OA group), 5 rats in each group. Rats were taken off the neck after 4 weeks, morphologic change were observed, specimens changes were observed by histochemical methods;p-JAK2, p-STAT3 and Bax protein expression were detected by Western blot;At the same time, the changes of mitochondria oxidative stress index such as succinate dehydrogenase(SDH) and cytochrome C oxydase(COX) in each group were detected.

RESULTSAfter 4 weeks, cartilage tissue showed translucent shape, no swelling and congestion, the number of cartilage cell increased, nuclei liked oval, chromatin arranged uniform in control group;in curcumin with OA group, joint showed slightly swelling without congestion, the formation of cartilage cell was regular, and number of cell decreased;while in OA group, the surface of joint was roughness with mild damage, cell arrangement was a bit disorder, nuclear was disappeared under vision and dyeing was uneven. Compared with control group, p-JAK2, p-STAT3 protein expression was decreased in OA and curcumin with OA group(<0.05), Bax protein expression was increased (<0.05), SDA and COX protein expression were reduced (<0.05). Compared with OA group, p-JAK2, p-STAT3 protein expression was increased in curcumin with OA, Bax protein expression was decreased (<0.05), SDA and COX protein expression were increased (<0.05), and had statistical differences among three groups.

CONCLUSIONSJAK2/STAT3 signal pathway is closely associated with pathology course of osteoarthritis, curcumin could stimulate JAK2/STAT3 signal pathway and promote mitochondria oxidative stress. It could obviously relieve degeneration of articular cartilage and slow lower progress of OA.

We report a case of ovarian function fluctuation during long-term follow-up in a patient with premature ovarian insufficiency (POI). The patient finally obtained clinical pregnancy with subsequent uneventful full-term delivery after several intracytoplasmic sperm injection-embryo transfer (ICSI-ET) cycles. This case demonstrates that hormone replacement therapy (HRT) and assisted reproductive therapy should be applied as soon as possible to young patients with POI who have a strong desire for pregnancy in the absence of contraindications. This strategy helps such patients obtain pregnancy and delivery before the exhaustion of ovarian function.

Objective:To explore the predictive value of various specific sonographic features on molecular subtypes for invasive breast carcinoma(IBC).Methods:Sonographic and clinicopathological data were retrospectively reviewed for 500 IBC patients who accepted surgical therapy in Fudan University Shanghai Cancer Center from January 2014 to March 2016. All tumors were divided into 5 molecular subtypes. The relationships of sonographic variations associated with the molecular subtypes for IBC were analyzed by univariate and multivariate Logsitic regression analyses.Results:Specific sonographic features for triple-negative subtype included regular shape ( OR=2.06, P=0.018), no spiculated/angular margin ( OR=1.98, P=0.029), posterior acoustic enhancement ( OR=2.26, P=0.005), and no calcification ( OR=2.13, P=0.006). Specific sonographic feature for human epidermal growth factor receptor-2 positive (HER2) subtype was posterior acoustic enhancement ( OR=2.23, P=0.006). Specific sonographic features for Luminal A subtype included spiculated/angular margin ( OR=2.24, P=0.001), posterior acoustic shadow ( OR=1.84, P=0.026), and no calcification ( OR=1.89, P=0.016). There were no specific sonographic features for the Luminal B with HER2 negative subtype, while that for the Luminal B with HER2 positive subtype was calcification ( OR=3.61, P<0.001). However, when used these sonographic features to predict molecular subtypes of breast cancer, the sensitivity values were 8.4%-57.3%, and positive predictive values were 9.5%-53.3%. Conclusions:The variety of sonographic features is associated with molecular subtypes of IBC.However, due to the overlap of sonographic features between different subtypes, molecular subtypes of IBC cannot be predicted by sonographic features.