Clinical efficacy scale of traditional Chinese medicine (TCM) should be built according to the characteristics of TCM, scientific demand, and demonstrated by practice. This paper provides some considerations of the scale.

Objective To evaluate the association between the expression of PTEN protein and the clinicopathological char‐acteristics of breast cancer patients .Methods All eligible studies regarding the association of PTEN protein expression with clini‐copathological features in patients with breast cancer were retrieved from PubMed ,Embase ,Cochrane Library ,CNKI and Wanfang databases .Odds ratio(OR) with corresponding 95% confidence interval(95% CI) form eligible studies were pooled .Heterogeneity and publication bias were also evaluated .All analyses were operated using RevMan 5 .2 software .Results A total of 28 articles con‐taining 3 172 patients were ultimately included for this Meta‐analysis .Our findings revealed that the expression level of PTEN was significantly correlated with estrogen receptor status(OR= 3 .16 ,95% CI:2 .01 -4 .97 ,P< 0 .01) ,progesterone receptor status (OR=2 .27 ,95% CI:1 .70 -3 .04 ,P<0 .01) ,lymph node metastasis(OR=0 .36 ,95% CI :0 .27 -0 .49 ,P<0 .01) ,clinical stage (OR=2 .59 ,95% CI:2 .04-3 .30 ,P<0 .01) and histological grade(OR=2 .19 ,95% CI:1 .74-2 .75 ,P<0 .01) .Conclusion Aber‐rant PTEN expression might have strong impacts on carcinogenesis ,tumor progression ,invasion and prognosis ,which makes it a potential biomarker for early cancer screening and endocrine therapy in breast cancer .

Brain injury of premature infant is a hot topic in the neonatal clinical study. Early diagnosis and intervention can improve the prognosis of premature infants. Although there are some interventions for brain injury of premature infants, most of them do not have evidence-based study to support the clinical application. Antenatal application of magnesium sulfate for pregnant women and application of erythropoietin for preterm infants may be the most promising interventions. Avoiding prematurity and brain damage is the key interventions for brain damage of premature infants.

OBJECTIVE:To observe the clinical efficacy,safety,the maximal tolerated dose(MTD) and dose-limiting toxicity(DLT) of docetaxel(TXT) in the treatment advanced breast cancer.METHODS:Docetaxel was given by drip infusion in escalating doses from the initial dose of 65 mg?m-2 to 75 mg?m-2 and 85 mg?m-2 until the appearance of DLT.RESULTS:Among the 15 cases,1 case with CR,5 PR,4 SD,and 5 PD.The DLT of TXT was neutropenia,and its MTD was 85 mg?m-2.CONCLUSION:Docetaxel(at a dose of 75 mg?m-2) showed remarkable efficacy and good tolerance in patietns with advanced breast cancer.

Based on the shortcomings of graduate education in clinical medicine of our country and the characteristics of this specialty, the author point out that the cultivation of graduates in otolaryngology, head and neck surgery should be focused on the training of humanities, professional knowledge and skills. And they also make some suggestions and discussion about the reform of graduate education mode.

Falling in the elderly is a major health problem and may cause severe consequences. Fall risk assessment is important for preventing and intervening fall incidence. Inertial Measurement Unit (IMU) has been introduced to evaluate motion/balance function and fall risk among the older people. Some researches indicated that it might have advantages over the usual tools, and can be used in the hospitals, communities, nursing homes, etc. IMU is a good way to measure gait variability, which may be strongly related with the risk of falls.

Objective This paper aims to assess the clinical efficacy of pemetrexed maintenance therapy in patients with advanced non-small cell lung cancer( NSCLC) through Meta analysis.Me thods Systematic lit-erature searches were performed in Cochrane、Pubmed,Web of science, Embase and ClinicalTrials databases.The related references had been traced.We made quality assessment of qualified randomized controlled trials( RCTs) of pemetrexed maintenance therapy compared with best supportive care( BSC) in advanced NSCLC.Besides,we u-tilized stata 12.0,Revman 5.3 and GRADEpro software to evaluate the overall quality of the evidence,according to the Cochrane collaboration to perform Meta-analysis.Resutl s Three RCTs were eligible and included 1257 patients.Meta-analysis results suggested that:compared to BSC,pemetrexed maintenance therapy had a statisti-cally significant benefit in improving progression-free survival(PFS)(HR =0.55,95% CI:0.48~0.64)and overall survival(HR=0.76,95%CI:0.65~0.88).The objective response(ORR)did not reach statistical signif-icance(RR=0.97,95%CI:0.86~1.10).Conclusion Compared with BSC,pemetrexed maintenance therapy statistically significantly improve PFS and OS,but has no demonstrable impact on ORR in patients with advanced NSCLC.

Objective In order to provide scientific evidence for revealing the pathophysiological changes, levels of the humoral and cellular immunity and cytokines in elderly patients with bacterial pneumonia were determined. Methods The changes of immunological markers including IgA, IgG, IgM,C3, C4,T cell subpopulation (CD3 +, CD4 +, CD8 +) and CD4 +/CD8 +, IL 2, IL 6, IL 8, TNF ? were examined for the elderly bacterial pneumonia group(BPG), the aged control group(ACG) and the young control group(YCG). Results The level of CD3 +〔(53 90?7 10)% vs (62 67?6 08)%〕, CD4 +〔(33 85?4 69)% vs (3 57?3 40)%〕, IL 2〔(4 09?0 69) ?g/L vs (6 72?0 52) ?g/L〕 and IL 8〔(0 28?0 07) ?g/L vs (0 39?0 09) ?g/L〕 in ACG were significantly lower than those in YCG. The levels of IgA, IgG, IgM, C3, CD8 +, IL 8〔(0 33?0 08) ?g/L vs (0 28?0 07) ?g/L〕, and TNF ?〔(1 25?0 23) ?g/L vs (1 10?0 20) ?g/L〕in BPG were significantly higher than those in ACG; and in BPG the levels of IgG, IgM, C3, IL 8 and TNF ? were significantly higher than those in YCG. However, the levels of CD3 +, CD4 + and the ratio CD4 +/CD8 +in BPG were markedly lower than those in YCG;the IL 2(2 730?0 612 ?g/L) was much lower than that of ACG〔(6 72?0 52) ?g/L〕 and YCG〔(4 09?0 69) ?g/L〕, respectively. Conclusions The occurrence and the progress of bacterial pneumonia in the elderly are related to the immunological functioning including the excessive humoral immunity, the super activation of complement system, the dysequilibrium of T cellular immunoloregulation network and the super excretion of inflammatory cytokines.

Objective To study the effects of perinatal exposure to bisphenol A(BPA) on the expression of estrogen receptor ? and ? mRNA in the brain of F1 male offsprings. Methods Pregnant SD rats were given BPA at 2, 20, 100 mg/kg bw per day respectively from eleventh day of gestation throughout the whole lactation by gastric gavage until their pups were weaned on postnatal day 21, F1 male pups from each group were killed on postnatal day 21 respectively, the brain was removed for detecting the expression of estrogen receptor ? and ? mRNA by RT-PCR. Results BPA treatment caused a up-regulation of ER? mRNA and ER? mRNA relative expression in the brain,especially in the middle-dose and low-dose groups it was so obvious. Conclusion Perinatal exposure to BPA can cause a change of ER? mRNA and ER? mRNA expression in the brain of the male offspring,which may be a part of the mechanism of BPA induced brain development damage.

Objective To investigate the dynamic changes of metallothionein(MTs)gene expression and explore the important significance of MTs during hepatocarcinogenesis.Methods One hundred and twenty-five SPF 5 -8-week old male C57BL/6J mice were randomly divided into control group and model group.Diethylnitrosamine (DEN) was given to the mice at a dose of 100 mg/kg, ip, and 50 mg/kg, ip, in the first and next week, respectively.The mice were given ethanol (53%, 5 mL/kg/day, 5 days/week) from the third week of experiment till 35 weeks.At 1, 3, 9, 13, 24 and 35 weeks of the experiment, liver samples were taken for histopathological examination of liver damages and incidence of HCC. The liver index and malondialdehyde (MDA) of liver homogenate were determined.All liver tissue samples were examined by histopathology using hematoxylin and eosin (HE), Masson and reticular fiber staining.Real-time RT-PCR was used to analyze the mRNA expression level of liver metallothionein-1 /2 (MT-1 /2) in different periods.Results Progressive liver damages in model group mice were identified in different periods.Hepatocytes abnormal tission and abnormal liver plate structure, architecture often characteristic of HCC could be seen in approximately 50% of mice at 35 weeks.In addition to these, a higher liver index also were seen at 35 weeks.Increased MDA levels in the mouse liver tissues were observed in each stage.Real-time RT-PCR analysis showed that significantly increased transcription of MT-1 and MT-2 at 1, 3 and 9 weeks, then gradually declined and even below the normal level.Conclusions MTs gene expression levels in mouse liver tissues are changed from significantly increased in the early stage of injury to decreased expression combined with distinct fibrosis. Our findings further demonstrate that the down-regulation of MTs level is closely correlated with hepatocarcinogenesis.