Research on the relationship between obesity and breast cancer has been deepened in recent years.Obese breast cancer patients have poorer prognosis than normal-weight patients.Weight variation is correlated with relapse in breast cancer survivors.The role of adipokines in this process can not be ignored.The correlations between adipokines,estrogen,cell proliferation,angiogenesis and breast cancer prognosis are reviewed in this article.

Objective To investigate the risks and anesthetic management of scar uterus undergoing cesarean section.MethodsOne hundred pregnant women(aged 24-43 years old)with scar uterus underwent cesarean section.Epidural anesthesia was used in 90 cases(group A)and general anesthesia in 10 cases(group B).The monitorings included ECG,BP,HR and SpO_2.CVP was measured in the high risk cases.The time from skin incision tO neonatal delivery(I-D).the time from uterine incision to delivery(U-D),and Apgar scores of neonates were recorded.Results Incomplete blockade was seen in 20 cases(22％).The I-D time was shorter in group B than that in group A[(7.5±2.0)min vs.(12.3±2.6)min](P<0.01).Intraoperative hypotension occurred in 32 cases (32％).Neonatal asphyxia happened in 21 cases(21%).Apgar scores of 11 neonatals werc less than 3,of whom 5 neonates died.Apgar scores were 4 to 7 in 10 cases,8 to 10 in 79 cases.Subtotal uterectomy was performed in 2 cases.Repair of injuried bladder had to be done in one case.Intraoperative huge bleeding took place in 15 cases.Conclusion The scar uterus undergoing cesarean section has a high risk for mothers and neonates.The incidence of incomplete epidural blockade is higher.Effectively preventing and managing the risk factors are the keys for reducing maternal and neonatal complications and mortality.

The process of late lung development is disturbed in bronchopulmonary dysplasia (BPD).One of the keys in late lung development is secondary septation, in which secondary septa arise from primary septa, producing plenty of small alveoli, which significantly increase the surface area of gas exchange.Secondary septation,together with architectural changes to the vascular structure of the lung which minimize the distance between the blood and the inspired air, are the targets of late lung development.BPD is a disease of premature infants in which development of the alveoli is stunted caused by many factors including volutrauma,inflammation,and oxygen toxicity.Compared with early lung development, the later development of the immature lung remains unclear.This paper is to emphasize remarkable latest research of arrested late lung development and BPD.

AIM: To study the effectiveness of urapidil and nitroglycerine on controlling the cardiovascular responses to tracheal intubation/extubation in patients with essential hypertension. METHODS: 45 patients with essential hypertension undergoing general anesthesia were divided randomly into control (C, without depressor, n=15), urapidil (U, 0.5 mg?kg -1 , n=15), and nitroglycerine (N, 1 ?g?kg -1 , n=15) groups. The SBP, DBP, MAP, HR and RPP were measured during intubation and extubation and at the induction of anesthesia and the end of operation respectively. RESULTS: The SBP, DBP, MAP, HR and RPP increased markedly (P

Objective To study the clinical effect of escitalopram oxalate in treating patients with depression accompanied with anxiety disorder.Methods Sixty-four patients with depression accompanied with anxiety disorder (met DSM-IV diagnostic criteria)were randomly divided into study group (n =32)who were treated with escitalo-pram oxalate 5-20mg/d and control group (n =32)with mirtazapine 15-45 for eight weeks.Clinical effect was evalua-ted with the Hamilton Depression Scale (HAMD)and the Hamilton Anxiety Scale (HAMA)as well as the adverse reactions with the Treatment Emergent Symptom Scale (TESS).Results There were no statistically significant differ-ences (P >0.05)in HAMD and HAMA scores between the study group and control group before treatment,but after treatment for 8 weeks,HAMD score showed statistically significant difference (P =0.000)and the difference of HAMA score was statistically significant (P =0.010).The total effective rate of the study group was 93.8%,which of the control group was 87.5%,the clinical effect had no statistically significant difference (P =0.391 ).The study group and the control group had equal effect,and there were no serious adverse reactions.Conclusion Escitalopram oxalate has high anti-depressant and anxiolytic effect,fewer adverse reactions,good tolerability and compliance,there-fore,escitalopram oxalate can be popularized in treating patients with depression accompanied with anxiety disorder.

0.05).SF-36 data revealed significant postoperative improvement(P0.05).Main complications included deep infection in one case,deterioration of spondylolisthesis in two cases,conjunctional stenosis in one case,and broken pedicle screws in two cases.Six patients received revision surgery.[Conclusion]Surgical treatment of DLSS may result in satisfactory outcome.Transpedicular screw fixation may not improve the clinical outcomes and posterior instrumentation should be adopted cautiously and properly.

Immune checkpoint is one of the most effective research targets for tumor immunotherapy. Immune checkpoint inhibitors, mainly programmed death receptor 1 and its ligand 1, have achieved good response rates in various tumor treatments, but some tumors still have low response rates. In recent years, bispecific antibodies have developed rapidly in the field of tumor research, because they can target multiple targets and play a combined role in tumor therapy, and can effectively inhibit tumor immune escape. This article reviews the research progress and clinical status of bispecific antibodies targeting immune checkpoints.

Echinoderm microtubule associated protein like 4-anaplastic lymphomakinase ( EML4-ALK) rearrangement is another driver-mutation in non-small-cell lung cancer (NSCLC) besides epidermal growth factor receptor (EGFR).Accu-rate identification of EML 4-ALK lung adenocarcinoma is essential for the selection of appropriate therapy .Immunohisto-chemistry (IHC), fluorescence in situ hybridization (FISH), and polymerase chain reaction (PCR) are the main three assay methods for clinical practice .Recently, researchers have done lots of work on the exploration of detection , diagnosis, and treatment prediction of carcinoma based on serum proteomics .In this paper, recent developments in these fields are reviewed.

Objective To compare the clinical outcomes between proximal femoral nail antirotation (PFNA) combined with risedronate sodium and isolated PFNA for the treatment of intertrochanteric fractures in elderly patients.Methods Clinical data of 62 elderly patients with intertrochanteric fracture from January 2011 to April 2013 were prospectively studied.Patients were randomly divided into two treatment groups:risedronate sodium group (the combined PFNA and risedronate) and control group (isolated PFNA).According to AO classification,32 patients in risedronate sodium group (15 males and 17 females,with an average age of 78 years) were divided into type A1 (n=10),type A2 (n=18) and type A3 (n=4).30 patients in control group (13 males and 17 females,with an average age of 77.5 years) were divided into type A1 (n=9),type A2 (n=16) and type A3 (n=5).Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry before and 1 year after operation.The hip joint function was assessed by Harris hip score.Complications and subsequent fragility fractures were evaluated postoperatively.Results 60 patients (30 patients in risedronate sodium group and 30 patients in control group) were followed up for at least one year.All fractures were healed at 6 months after surgery.No significant difference was found between the two groups in BMD in contra-lateral hip before treatment [(-2.58±0.41)kg/m2 vs.(-2.56±0.36)kg/m2,P＞0.05].BMD in contra-lateral hip had significant difference between the risedronate sodium and control groups one year after surgery [(-0.66±0.37)kg/m2 vs.(-1.13 ±0.28)kg/m2,P=0.000].There was no significant difference between the two groups in Harris hip score (P=0.238).During the follow-up,no patient in risedronate group suffered from subsequent fragility fracture after surgery,while lumbar compression fracture occurred in 1 case,distal radius fracture occurred in 1 case,the contralateral hip fractures occurred in 2 cases,postoperatively.Conclusions PFNA treatment combined with risedronate sodium can effectively improve BMD and reduce the risk for refracture,and has a good effect on intertrochanteric fracture in elderly patients.

Objective To investigate the treatment of proximal femoral nail antirotation (PFNA) in pertrochanteric hip fractures with unstable lateral-wall.Methods Thirty-two cases were included from the April 2009 to May 2011.Recorded operation period,blood loss volume,and complications and evaluated the effect of the methods.Arrange referral at 6 weeks,3 months,6 months,12 months respectively after operation,to check limb function and conventional camera hips,lateral X-ray film.Postoperative functional evaluation using the Harris hip score.Measure the last follow-up neck shaft angle and compare with postoperative's.Results The average operation period was (60-190) min,average was (80 ± 5) min ; blood loss volume was (90-250)ml,average was (120 ± 9) ml ; Average hospital periods was (15 ± 7) days; weight loading time was (6.3 ± 1.2)weeks after surgery and average time of union of fracture was 3.6 months.All patients obtained union of fracture without complications such as varus,internal fixation cutting out.Conclusion PFNA was proved to be an effective way for treating unstable lateral-wall of pertrochanteric hip fractures due to its advantages of stable fixation,minor trauma,less complications.