ER, PR, HER-2 are signiifcant biological markers in guiding the choice of treatment and evaluating clinical prognosis. As the progression of tumor cells, the expressions of these receptors in recurrent tumors may be different from primary tumors. Nowadays clinicians have realized the necessity of receptor detection in the metastatic lesions. This article summarized the current research status on the above issues.

The process of tumorigenesis,local invasion and distant metastasis will produce a series of molecular changes,these genetic mutation or abnormal expression of molecules play a promoting role in hypercoagulation.At the same time,hypercoagulation also increases the risk of tumor progression.It is important to understand their specific processes and the molecular role,and it can provide theoretical basis for better management of patients,and has significance for developing more effective and security new anti-clotting drugs.

Objective:To discuss the significance of standardized treatment for cancer pain, according to the Cancer Pain Treat-ment Specification (2011 Edition) issued by the Ministry of Health, PR China. Methods:Clinical data of 126 patients with cancer pain, who were admitted to the Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, were collected to com-pare the improvement of the Numeric Rating Scale (NRS) score, number of breakthrough pain, and quality of life score after treatment. The relationships between different pain grades, disease entities, and treatment effect were analyzed. The influence factors of pain relief were also analyzed by using Logistic regression analysis. Results:1). Following standardized treatment, the improvement rate of NRS score has shown significant differences in pain grading (P=0.001) and gender (P=0.000). However, no significant differences were ob-served between different diseases (P=0.112). The improvement rate of the life quality score and the number of breakthrough pain had no significant difference after standardized treatment. 2). The grading of cancer pain and the disease entities had little effect on cancer pain relief. 3). The anti-tumor treatment and“no distant metastasis”were the independent factors that brought about the decrease in NRS and quality of life scores.“No distant metastasis”(P=0.046) was the independent factor that reduced the number of pain out-breaks. Conclusion: The standardized treatment positively affects the NRS score, number of breakthrough pain, and quality of life score. Patients who received anti-neoplastic therapy and who had no distant metastasis showed significant treatment effectiveness in pain management.

Objective To study the feasibility and indication of liver injury in children treated nonoperatively.Methods Ninteen(cases) with liver injury who underwent nonoperative management(NOM) were analyzed retrospectively.Patients with obvious trauma were reviewed.The main cause of trauma was due to traffic accident.Eleven cases(57.9%) had subcapsular hematoma and 8 cases(42.1%)had intrapararenchymatous hematoma.The treatment procedure included blood transfusion,hemostasis and monitoring the hemodynamic parameters.Results Seventeen cases(89.5%)were cured nonoperatively;2 cases underwent the operation later.Followed up for 10-24 months,patients were well recovered.Conclusions Most of cases with liver injury in children can be cured by NOM due to the physicalogical and anatomic features of children.During treatment,it is very important for the doctors to observe the vital signs closely,and(mana)-ge the combined injuries effectively and take regular imaging measurement.

Objective:To develop a catalytic system for the asymmetric Morita-Baylis-Hillman ( MBH) reaction of conjugated ni-troalkene with activated aldehyde, and screen out the chiral catalysts with high activity and enantioselectivity. Methods: Totally 21 chiral organocatalysts were applied in the asymmetric MBH reaction ofβ-nitrostyrene with ethyl glyoxylate, and the ee value was deter-mined by chiral HPLC. The effects of temperature, solvent and substrate ratio on the catalytic reaction were investigated. Results: In the presence of cinchona alkaloid catalyst (DHQ)2AQN, β-nitrostyrene reacted with ethyl glyoxylate in toluene at 0℃ affording the MBH adduct in 60% yield with good enantioselectivity (up to 56.9% ee). Conclusion: The bis-cinchona alkaloids with aromatic bridging group are the efficient catalysts for the asymmetric MBH reaction ofβ-nitrostyrene with ethyl glyoxylate, and moderate isolated yield and enantioselectivity are obtained.

By means of global budget,the disease-specific scoring method was put in place for both settlement and payment in Huaian,Jiangsu province,for the purpose of cost control by the hospitals.This reform consists of total cost accounting,rational performance-based distribution system,multi-approached regulation of medical behaviors,and individual disease management to regulate medical behavior.These efforts aim at aligning with medical insurance payment reform,so as to improve hospital management,operation quality and socio-economic outcomes.Problems found in practice were also reviewed.

Dideoxynucleosides ; False Positive Reactions ; Fluorine Radioisotopes ; Fluorodeoxyglucose F18 ; Humans ; Inflammation ; diagnosis ; Neoplasm Staging ; Neoplasms ; diagnosis ; metabolism ; pathology ; radiotherapy ; Positron-Emission Tomography ; methods ; Radiotherapy, Intensity-Modulated ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To determine the effects of urapidil on L-type calcium current(I_(Ca-L))in rat cardiomyocytes.Methods Ventricular myocytes were isolated from SD rats of either sex(250-280g)by retrograde perfusion of the hearts via aorta with calcium-free Tyrode solution containing enzyme as described elsewhere.Rod shaped cells with clear borders and striations were selected.Eighteen cells were randomly divided into 3 groups(n =6 each):A urapidil group;B urapidil+methysergide group and C methysergide group.All the cells in the three groups were peffused first with Tyrode solution for 1 min(T_1).In group A and C cells were then peffused with Tyrode solution containing 0.4 ?mol?L~(-1) urapidil(A)or 40 nmol?L~(-1) methysergide(C)for 1 min(T_2) while in group B cells were perfused fwst with Tyrode solution containing 0.4 ?mol?L~(-1) urapidil for 1 min (T_2) then with Tyrode solution containing methysergide 40 nmol?L~(-1) for 1 min (T_3).Finally the cells were again perfused with regular Tyrode solution for 1 min(T_4)to wash out the drugs.The peak of I_(Ca-L) was recorded at T_(1-4) by means of the whole cell patch clamp technique with use of Axo patch 200B.Results In group A,B and C the peak of I_(ca-L) at T_2 was significantly lower than that at T_1 but there was no significant difference between the peak of I_(ca-L) at T_1 and T_4.In group B the peak of I_(Ca-L) at T_3 was significantly lower than that at T_2.Conclusion Urapidil inhibits L-type calcium current in rat isolated cardiomyoeytes.It's inhibitory effect may not be mediated by 5-H_(1A) receptor.

The cervical sagittal balance is a description of cervical spine at the standing position. The position of cervical spine is measured by the corresponding sagittal parameters. The commonly used sagittal parameters of cervical spine include cervical lordosis (CL), cervical sagittal vertical axis (cSVA), T 1 Slope (T 1S), etc. Cervical sagittal balance is closely related to the overall balance of the spine, and the imbalance of sagittal parameter is also related to the progression of cervical disease, the choice of surgical methods and the postoperative efficacy. In recent years, more and more researchers have begun to pay attention to the sagittal balance of the cervical spine, especially the variation of sagittal parameters after cervical surgery, which can predict the postoperative neurological recovery and the change of long-term efficacy or complications. However, due to the variety of cervical surgery methods and the variety of cervical sagittal balance parameters, the existing studies can only reflect the relationship between the two from a certain aspect, while lacking overall and comprehensive description. In this paper, the relationship between sagittal plane balance and cervical surgery was reviewed by systematically searching literatures and screening relevant studies. According to our review, the cervical sagittal parameters have different tendency after different cervical surgery. Generally, anterior cervical surgery can maintain or improve the sagittal plane balance of the cervical spine, among which anterior cervical discectomy and fusion (ACDF) surgery has a best effect.After posterior cervical surgery, the cervical sagittal parameters tend to be unbalanced or compensated, and patients with preoperative sagittal imbalance, advanced age, and complex OPLL are more likely to have postoperative imbalance or imbalance aggravation. Therefore, attention should be paid to preoperative evaluation and reasonable surgical design in clinical practice to prevent the occurrence of sagittal imbalance of patients after surgery.

ObjectiveTo investigate the mechanism of cerebral white matter damage in premature rats induced by intrauterine infection.Methods30 mature pregnant Wistar-Imamichi rats were divided into the experimental group (n=18) and control group (n=12). The rats of the experimental group were injected with lipopolysaccharide (LPS) 0.2 mg/kg in abdomen on 15th and 16th day after gestation. Those of the control group were injected with distilled water in equal volume. 45 premature rats born in the experimental group and 45 full-term rats born in the control group were tested with RIA for interleukin-6 (IL-6). The brain tissues of another 47 premature rats and 41 full-term rats were stained with HE method. Finally water content in brain tissue were tested in 50 premature rats and 50 full-term rats.ResultsIL-6 concentration of brain tissue of the premature rats in the experimental group was significantly higher than that in the control group ( P<0.01); and water content of the premature rats' brain was also higher than that of the full-term rats ( P<0.01). The edema of periventricular white matter, loose neuropil, decreased cell numbers, broaden intercellular space, and cell swelling and rupture were found in the brain tissue of the premature rats, no abnormal form and structure were found in the control group.ConclusionWhite matter damage of premature rats can be caused by endotoxin, and accompanied by IL-6 and water contents increasing.