Objective To determine the investigation progression on exemestane in the treatment of breast cancer. Methods The literatures of recent years on the studies of exemestane were reviewed. Results Exemestane is an effective steroidal aromatase inactivator with superior tolerability, safety and efficacy in the adjuvant, neo-adjuvant and metastatic therapy of breast cancer. Conclusion With the progression of clinical trial with exmestane, exemestane will be regarded as an important drug in comprehensive therapy of breast cancer.

Objective To review the recent studies on the multidrug resistance of breast cancer. Methods The literatures of recent years on the studies of multidrug resistance, multidrug resistance protein and breast cancer resistance protein were reviewed. Results Multidrug resistance resulted from multiple factors. How to identify the sensibility of chemotherapy drugs and select individual therapeutic regime early were important to improve the survival rate and life quality of breast cancer patients.Conclusion These studies on multidrug resistance of breast cancer are helpful to predicting the effect and outcome of chemotherapy and overcoming the barrier of drug resistance.

Objective To compare the clinical effectiveness between puncture drainage and surgery in the treatment of pyogenic liver abscess.Methods Clinical date of 81 patients with pyogenic liver abscess were retrospectively analyzed.Patients were divided into the ultrasound-guided puncture drainage group (48 patients) and open surgical drainage group (33 patients).The demographic data,laboratory examination,efficient rate,complication rate,mortality,time for body temperature returned to normal and hospital stays were compared between the two groups.Results Klebsiella pneumoniae was positive in 45.45％ cases by blood culture,and in 62.50％ cases by pus culture.There was no statistically significant difference in the effective rate and mortality (x2 =0.91,2.05,P ＞ 0.05).For patients with puncture drainage hospital stay was (14 ± 5) days,significantly shorter than (17 ± 5) days in surgery group (t =-3.20,P ＜ 0.05).Time to normal temperature was (5.1 ± 1.6) days in puncture drainage group,which was shorter than (6.0 ± 1.1) days in open surgery group (t =-2.85,P ＜ 0.05).Postoperative complications were fewer in the puncture drainage group (6 cases) than open surgery group (10 cases) (x2=3.91,P ＜ 0.05).Conclusions Ultrasound-guided puncture drainage for liver abscess is safe,feasible,effective of low complication rate for the treatment of pyogenic liver abscess.

Objective:To study the social psychology of people when facing severe acute respiratory syndrome(SARS),a sudden social crisis.Methods:Using the social psychological methods,we analyzed the manifestations,causes and hazards of the public fear derived from the outbreak of SARS in China.Results:Sudden outbreak of SARS made people full of uncertainty and fear,and such fear would bring adverse effects to the society.It affected not only the daily life of people,but aslo their physical, mental stability and behavior reaction.Conclusion:SARS makes us realize the importance of psychology and psychiatry to individuals and to the society.It is imperative to establish a comprehensive provention and intervention system of diseases to maintain the social stability and the well being of individuals.

Objective To investigate the expression of MTSS1 in cholangiocarcinoma tissue and its relationship with the prognosis of patients.Methods The specimens of bile duct of 49 patients with hilar cholangiocarcinoma who received surgical excision at the Eastern Hepatobiliary Surgery Hospital from January 2003 to December 2005 were collected.Tissue microarrays of the 49 samples of hilar cholangiocarcinomas and the 10samples of adjancent normal bile duct epithelial tissue were constructed.The expression of MTSS1 was detected by the immunohistochemical staining.The pcDNA3.1-MTSS1 was transferred into the RBE cells and the abilities of proliferation of REB cells were measured by MTT assay.The patients were followed up via out-patient examination and telephone till May 2012.The measurement data were analyzed using the t test,and the count data were analyzed using the chi-square test,the survival curve was drawn by the Kaplan-Meier method,the survival was analyzed using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The results of immunohistochemical staining showed that the expression rate of MTSS1 was 10/10 in the adjacent normal epithelial tissue of bile duct,while 59.2％ (29/49) in the cholangiocarcinoma tissues.The proliferative rate of cholangiocarcinoma cells transfected with MTSS1 was 1.55 ±0.05,which was significantly lower than 2.32 ±0.08 of cholangiocarcinoma cells without transfection of MTSS1 (t =4.454,P ＜ 0.05).Gender,age,TNM stage,T stage,differentiation,neural invasion and diameter of tumor did not influence the expression of MTSS1 (x2=0.211,3.471,0.507,0.507,0.368,0.882,0.660,P ＜ 0.05),while lymph node metastasis influenced the expression of MTSS1 (x2=10.436,P ＜ 0.05).All the patients were followed up for 1-59 months,and the median time for follow-up was 16 months.The median tumor-free survival time was 17.9 months in patients with positive expression of MTSSI,and 11.3 months of patients with negative expression of MTSS1,with no significant difference (Log-rank value =3.707,P ＞ 0.05).The median survival time was 34.9 months in patients with positive expression of MTSS1,which was significantly longer than 18.7 months of patients with negative expression of MTSS1 (Log-rank value =5.671,P ＜0.05).Multivariate analysis showed that MTSS1 was not the independent risk factor influencing the prognosis of patients (x2 =0.406,P ＞ 0.05).Conclusions The expression of MTSS1 is decreased in cholangiocarcinoma tissue,which negatively correlates with lymph node metastasis.MTSS1 could be used as a biomarker in predicting the prognosis of patients with cholangiocarcinoma.

Objective To explore the clinical curative effect and complications of digital three-dimensional molding of titanium mesh for repairing skull defect. Methods The clinical data of 42 patients having underwent repairing skull defect with three-dimensional molding of titanium mesh were retrospectively analyzed. Results The average operation time was about 2 h, and 42 patients were operated successfully. The bilateral skull was symmetry and the appearance was good. In 42 patients, subcutaneous dropsy occurred in 1 case, epilepsy occurred in 3 cases, and intracranial bleeding again surgery occurred in 1 case. Patients were satisfied with the results of cranioplasty. Conclusions Repairing skull with digital three-dimensional molding of titanium mesh is simple, with shorter operation time, lower operation risk, and lower postoperative complication, and the clinical curative effect is satisfactory.

For the establishment of chemical library of protoberberines provided for the bio-activity screening, the target compounds were synthesized by thermal degradation and nucleophilic substitution reactions with the bio-active alkaloid, palmatine (1), as the raw material, and their structures were identified and conformed by 1H-NMR and MS spectra. Among them, 13 compounds were new.
Berberine Alkaloids ; chemical synthesis ; chemistry ; Drugs, Chinese Herbal ; chemical synthesis ; chemistry ; Molecular Structure

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy combined with limited open repair of medial collateral ligament (MCL) for the treatment of multiple ligament injuries of knee joints.

METHODSFrom March 2006 and June 2012,the data of 14 patients (14 knees) with multiple injuries of ACL, PCL, and MCL were collected. There were 8 males and 6 females with an average age of (31.8 +/- 8.1) years old (ranged, 20 to 49 years old). All the patients were performed with X-ray and MRI examination, and the results showed that 10 patients had combined with injuries of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL); 4 patients had ALC,PCL and posterolateral corner (PLC) injuries. Four patients had medial meniscus injuries and 2 patients had lateral meniscus injuries. The MCL,PLC and meniscus injuries were treated with operation on the first stage, and functional exercises were performed 3 weeks after fixation. The reconstruction operation of ACL and (or) PCL was performed at the second stage under arthroscopy 3 to 6 months later when the movement range of knee joint recovered to the normal level with obvious relaxation.

RESULTSAll incisions healed by primary intention. All the patients were followed up with a mean duration of 48.9 months (ranged, 24 to 80 months). The Lysholm score was improved from preoperative 19.6 +/- 0.9 to the latest follow-up 87.1 +/- 2.8 (t=12.3, P<0.01). The International Knee Documentation Committee (IKDC) rating: 9 cases nearly recovered to normal, 5 cases were abnormal.

CONCLUSIONFor multiple ligament injuries in the knee, staged repair and reconstruction can effectively restore knee joint stability and function.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective To explore the change of dietary intake and nutritional status before and after hematopoietic stem cell transplantation (HSCT) in pediatric patients to assess the importance of nutritional interventions.Methods In this observational cohort study,65 children undergoing HSCT between January 2012 and November 2012 in the Department of Hematology and Oncology,Shanghai Children's Medical Center were enrolled.The data collected before preconditioning were considered as the baseline data.We also collected data twice a week between preconditioning and 30 days after HSCT,and once a week from 30 days to 100 days after HSCT.Dietary analysis and urea nitrogen analysis were conducted in parallel.Results The baseline level of energy intake was (5 844.9 ±2 490.4) kJ/d,protein intake was (56.4 ±28.6) g/d,fat intake was (49.7 ±38.9) g/d,and carbohydrate intake was (190.9 ± 91.1) g/d.With the hematopoietic reconstruction,the oral nutrients intake significantly decreased compared with the baseline levels (all P =0.000).During the recovery period after HSCT,the energy intake showed no significant difference when compared with the baseline level in the 6th postoperative week,protein in the 13th week,carbohydrate in the 4th week,and fat in the 6th week.The urine nitrogen was (3.9 ± 2.4) g/d before HSCT,which increased to (16.7 ± 11.0) g/d after preconditioning (P=0.000).In the 1st postoperative week,the weight (P =0.000),triceps skin fold thickness (P =0.003),mid-upper arm circumference (P =0.000),serum albumin (P =0.000) and prealbumin (P =0.000) of the patients all significantly decreased compared with the baseline levels.In the 9th postoperative week,the fat-free body weight percentage (P =0.010),muscle percentage (P =0.001) and protein percentage (P =0.000) were significantly lower than the baseline levels,while the body fat percentage was higher than the baseline level (P =0.002).Conclusions Children undergoing HSCT exhibit a marked reduction in nutrient intakes at the early stage of HSCT,which may gradually return normal during the recovery period.This process may be slow,especially for the protein,and therefore may affect the serum protein level in these pediatric patients.Thus,more careful nutrition guidance is necessary during HSCT for pediatric patients,emphasizing oral nutrients intakes,and high protein dietary or formula may be helpful.

Objective To investigate the value of diffusion weighted imaging (DWI) in detecting acute intracerebral hemorrhage with 3.0T MR. Methods A total of 105 patients with acute strokes underwent MR examination within 3 days after on set. The detectability and reliability of intracerebral hemorrhage with the DWI b0 sequence was assessed. The results were compared with the gradient-echo (GRE) sequence. The results of the GRE sequence were used as the standard. Results DWI b0 images of 47 cases displayed clearly in 48 acute intracerebral hemorrhage patients. For the detection of acute intracerebral hemorrhage, DWI b0 images had a sensitivity of 97.92%, specificity of 100%, the positive predictive value of 100%, and the negative predictive value of 98.25%. Deoxyhemoglobin-induced hypointense rim was characteristic on DWI b0 images, the next was GRE. Conclusion In the setting of acute stroke, DWI can clearly distinct intracerebral hemorrhage and non-intracerebral hemorrhage with 3.0T MR scanner. With a more rapid and accurate MRI strategy to evaluate acute stroke including DWI, T1WI and T2WI sequences without GRE is helpful in clinical decision making.