OBJECTIVE:To investigate clinical efficacy and safety of trastuzumab combined with neoadjuvant chemotherapy on breast cancer,and discuss its effects on the expression of HER2 protein,B7 homolog 1(B7-H1)and IL-2. METHODS:62 patients with breast cancer confirmed by pathological biopsy,whose test results of immunohistochemistry combined with fluorescence in situ hybridization(FISH)was overexpression of HER2,were selected as the research object. They were randomly divided into observa-tion group and control group with 31 cases in each group. Control group was given carboplatin combined with docetaxel neoadjuvant chemotherapy before surgery. Observation group was additionally given Trastuzumab for injection intravenously 4 mg/kg in the first week,2 mg/kg in second-eighteenth week,once a week,for consecutive 18 weeks. Modified radical mastectomy was conducted 2 weeks after chemotherapy. Clinical efficacy and the occurrence of ADR were observed in 2 groups. The expression of HER2 protein, B7-H1 and IL-2 in tumor tissues were compared between 2 groups before and after treatment. With 1-year follow-up,tumor recur-rence rates,metastasis rates and survival rates were recorded in 2 groups. RESULTS:After treatment,total effective rate of observa-tion group was 83.87%,which was significantly higher than that of control group (58.06%),with statistical significance (P<0.05);the test result of HER2 protein in lesion tissues was non-overexpression in 19 cases (61.29%) in observation group which was significantly higher than that of control group(11 cases,35.48%),with statistical significance(P<0.05);the positive expres-sion rates of B7-H1 and IL-2 in lesion tissues of observation group were significantly lower than those before treatment and control group after treatment,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). During 1-year follow-up period,except that there was no statistically significant difference in survival rate be-tween 2 groups(P>0.05),the recurrence rate and metastasis rate of observation group were significantly lower than those of control group,with statistical significance(P<0.05). CONCLUSIONS:The application of trastuzumab combined with neoadjuvant chemo-therapy before breast cancer modified radical mastectomy can effectively improve the expression levels of HER2 protein,B7-H1 and IL-2 in lesion tissue of patients with breast cancer,promote clinical efficacy with good safety and low risk of tumor recurrence and metastasis after operation.

Objiective:Understand personnel's psychological state before and after donating blood unpaidly for the first time of different ages brackets.Methods:pay a return visit by telephone tothe recording mode of testing,Carry on the comparative analysis of SCL-90 meaningful inventory to 106 numerous blood donor and 106 blood donors for the first time.Results:The psychological condition for the investigators after donating blood for the first time can be divided into 3 kinds:①Health state;②Bad state;③Psychological obstacle;The bad psychology is shown as being afraid of ache,worrying about having bed influence on health after donating blood.Conclusion:Strengthen the propagation and education of the medical knowledge to unpaid blood donation personnel.The unpaid blood donation service and technology should be operated naturally,hospitable,thoughtful and believable.

Objective To investigate the effect of vitamin D (VD) on macrophage to phagocytize Staphylococcus aureus (SA). Method Macrophoge cell lines RAW264.7 were allocated into 3 groups:control group(C),bacterium group(B),active vitamin D+ bacterium group (VD+B). Cells in the VD+B group were incubated with 10-8mol/L active vitamin D for 24h,then cells in the VD+B group and the B group were cultured with SA for 1h,and phagocytosis rate,mitochondrial membrane potential,[Ca～(2+)]i,reactive oxygen species were determined by flow cytometry (FCM). Results The phagocytizing activity of macrophage in VD+B group was significantly higher than that in B group 1h after infection,At the same time,the mitochondrial member potential and [Ca～(2+)]i of macrophage in VD+B group were distinctly lower than that in B group; but reactive oxygen species of macrophage in the VD+B group was insignificantly different from B group. Conclusion Vitamin D can reinforce the phagocytizing activity of macrophage and inhibit the apoptosis of macrophage after phagocytize Staphylococrcus aureus.

We studied the effects of the selective thromboxane synthetase inhibitor, dazoxiben (UK-37 248), on the reperfusion arrhythmias induced by ischemia-reperfusion in rats. The results indicated that the administration of dazoxiben (2.5 mg/kg i.v.) 15 min prior to coronary occlusion significantly decreased the incidence of ventricular fibrillation induced by 5 inin ischemia and reperfusion from 11/13 in control to 4/13 in drug-treated (P

Objective To investigate the incidence,bacterial pathogen and risk factors of bacterial meningitis after major craniotomy.Methods Clinical data of patients who underwent at least one craniotomy in Huashan Hospital Affiliated to Fudan University in 2008 were collected.All subjects were ≥ 18 years old,and survived at least 7 days after surgery.Patients with only cerebrospinal fluid drainage,burr holes,cranioplasty,vascular interventional surgery,transsphenoidal or spinal surgery were excluded.Risk factors for bacterial meningitis after major craniotomy were analyzed by Logistic regression.Results A total of 691 patients were enrolled,in 60 of whom (8.68％) bacterial meningitis was identified.Among 44 samples,5 were positive in culture with 2 of Acinetobacter baumannii,1 of Enterococcus faecalis,1 of Streptococcus intermedius and 1 of Klebsiella pneumonia.Diabetes (OR =5.79,95％ CI:1.40-23.93,P =0.02),Glasgow Coma Scale score ＜ 12 (OR =6.56,95％ CI:1.17-36.80,P =0.03),external ventricular drainage (OR =4.31,95％ CI:1.57-11.82,P =0.01),and continuous lumbar cistern drainage (OR =22.82,95％ CI:10.31-50.52,P =0.00) were independent risk factors for bacterial meningitis after major craniotomy.Patients with external ventricular drainage ＞ 7 d were 11.82 times more likely to develop bacterial meningitis,and those with continuous lumbar cistern drainage ＞ 10 d were 25.50 times more likely to develop bacterial meningitis.Conclusions Bacterial meningitis remains a common complication after major craniotomy,and most are induced by Gram-negative bacilli.Diabetes,Glasgow Coma Scale score,external ventricular drainage and continuous lumbar cistern drainage may increase its incidence.

Objective To analyze the expression of interleukin (IL)-31 in tuberculous pleural effusion,and to evaluate its diagnostic value of tuberculous effusion.Methods Seventy-one patients with pleural effusion were enrolled,including 40 cases of tuberculous pleural effusion and 31 cases of malignant pleural effusion.Luminex method was applied to detect the IL-31 expression in pleural effusion.IL-31 levels were compared using non-parametric Mann-WhitneyU test,and the receiver operator characteristic (ROC)curve was used to elvaluate the diagnostic value of IL-31 .Results IL-31 expression in tuberculous pleural effusion was significantly higher than that in malignant pleural effusion with statistical significance (529.4 ng/L vs 13.8 ng/L,U =62,P <0.01 ).Based on the level of IL-31 expression,area under the ROC curve was 0.95 with the optimum cut-off value of 67.5 ng/L.Thus,the sensitivity and specificity of IL-31 ≥67.5 ng/L for diagnosis of tuberculous pleurisy were 82.5 % (95 %CI :73.3% - 94.2%)and 100.0% (95 %CI :91 .4%-100.0%),respectively.Conclusion IL-31 is highly sensitive and specific for the diagnosis of tuberculous pleural effusion, which favors the differentiation of tuberculosis from malignance.

Objective To explore the relationship between histological chorioamnionitis(HC),fetal vasculitis(FV)and the morbidity of neonatal respiratory distress syndrome(RDS).Methods Three hundred and forty-seven cases of infants at the gestational ages of 28 +0 to 31 +6 weeks who were admitted to the Neo-natology Department of our hospital from October 2009 to June 2013 were analyzed retrospectively.They were divided into four groups according to the occurrence of HC and FV,namely,HC positive group and HC negative group,FV positive group and FV negative group.The patients in the HC positive group were further divided into FV positive group and FV negative group according to the occurrence of FV.The morbidity of RDS among above-mentioned groups was compared.Results The clinical characteristics including propor-tion of male,gestational age,birth weight,cesarean delivery,antenatal corticosteroid use,gestational hyperten-sion,gestational diabetes and cholestasis of pregnancy showed no statistically significant difference among all the groups(P 〉0.05).The incidence of RDS in the HC positive group(145 cases)was 49.6%(72 cases), which was significantly lower than that in the HC negative group(67.3%,126 /202,P 〈0.05).The incidence of RDS in FV positive group(64 cases)was 42.2%(27 cases),which was significantly lower than that in FV negative group(63.3%,179 /283,P 〈0.05)In the HC positive group(145 cases),the incidence of RDS in FV positive group (64 cases)was 42.2% (27 cases),and 55.6% (45 cases)in FV negative group (81 cases),which showed no significant difference(P ﹦0.01 ).Conclusion (1 )HC or FV can reduce the incidence rate of RDS in premature infants.(2)HC combined FV cannot furtherly reduce the incidence of RDS.

Objective To explore the role of basic leucine zipper ATF-like transcription factor (BATF) in active tuberculosis, and to provide clues for diagnosis and therapy of tuberculosis.Methods Sixteen patients with active tuberculosis (ATB), ten cases of latent tuberculosis infection (LTBI) and fourteen healthy controls (HC) were included in this study.Flow cytometry was applied to detect the expressions of BATF and programmed death-1 (PD-1) in T lymphocytes, and the changes of BATF by blockade of PD-1/PD-L pathway using specific blocking antibody antiPD-1, antiPD-L1 and antiPD-L2.The expressions of BATF were compared using Mann-Whitney U test.And the relation of BATF and PD-1 was analyzed using Pearson correlation analysis.Results The CD4+ T lymphocytes expressing BATF accounted for 5.16% (2.96%,8.71%) of CD4+ T lymphocytes in ATB group, which was higher than 1.05% (0.40%,1.27%) in LTBI group and 0.71%(0.43%,1.21%) in HC group, and the difference were statistically significant (U value were 6.5 and 9.0, respectively, both P<0.01).The CD8+ T lymphocytes expressing BATF accounted for 4.10% (2.27%,8.17%) of CD8+ T lymphocytes in ATB group, which was higher than 0.55% (0.34%,1.18%) in LTBI group and 0.84% (0.41%,1.29%) in HC group, and the difference were statistically significant (U value were 5.0 and 8.0, respectively, both P<0.01).Furthermore, the percentage of BATF+ PD-1+ CD4+ T lymphocytes in the peripheral blood of ATB was significantly higher than those in the peripheral blood of LTBI and HC, the difference were statistically significant (Uvalue were 16.0 and 14.5, respectively, both P<0.01), and the percentage of BATF+ PD-1+ CD8+ T lymphocytes in the peripheral blood of ATB was significantly higher than those in the peripheral blood of LTBI and HC, the difference were statistically significant (Uvalue were 10.0 and 16.5, respectively, both P<0.01).In addition, there was a positive correlation between the percentage of BATF+ T cells and PD-1+ T cells, both in CD4+ T cells (r=0.676,P=0.016) and CD8+ T cells (r=0.610,P=0.035).The expressions of BATF both in CD4+ T cells and CD8+ T cells were decreased followed by blockade of PD-1/PD-L pathway (P<0.05).Conclusions BATF may be involved in the regulation of immune pathogenesis of tuberculosis.In order to provide a theory for anti-tuberculosis immunotherapy fargeting BATF, further research need to be proceeded.