The therapy to different type of breast cancer has resulted in chemoresistance which is induced by auto-phagy.Autophagy, to tumor’s generation, is a double edged sword, and it can result to chemoresistance and auto-phagic cell death through interaction with apoptosis in breast cancer chemotherapy.However, autophagy may be unrelated to chemoresistance.It will be a key research point to further explore the relationship and mechanism be-tween autophagy and chemoresistance.

Tamoxifen(TAM)is an important therapeutic strategy for the treatment of estrogen receptor(ER)-positive breast cancer.However,tamoxifen resistance is a major cause of endocrine therapy failure.The potential mechanism of TAM resistance is multifactorial and most of them are still unknown.This review presents recent advances in the mechanism of TAM resistance in breast cancer,providing valuable information and ideas for elucidating the mechanism of tamoxifen resistance and overcoming drug resistance.

Objective To investigate the distribution of interstitial Cajal-like cells(ICLC) in ampulla and the myoelectric activities of the sphincter of Oddi(SO) of adult guinea-pigs.Methods C-Kit immunohistochemical staining was carried out on whole-mount preparations of guinea-pigs' ampulla region.The myoelectric activities of SO were recorded by using the contact electrode on mucosa.Result C-Kit-positive ICLC were observed in both exterior and inner wall of ampulla.Some of these cells were distributed in the circular and longitudinal smooth muscle cell(SMC) layers assuming a spindle-like shape.Another sub-group of ICLC,which were located between the longitudinal and circular SMC layers,were shown to have oval or triangle cell bodies with projection of more than three long processes.These cells interlaced into a cellular network,closely resembling the interstitial cells of Cajal(ICCs),around the myenteric nervous plexus(ICC-MY) in the duodenum.At the inner side of circular SMC layer of the exterior wall,ICLC were similar to ICCs associated with the deep muscular plexus(ICC-DMP) of small intestine.In the inner wall of the ampulla,a large amount of ICLC were found in the SMC layers or bundles,running parallel with them.At the opening of the ampulla,a number of ICLC surrounded the opening to form a ring.The spontaneous rhythmic myoelectric activities could be recorded in the SO.Conclusion It is suggested that the ICLC might contribute to the regulation of the spontaneous rhythmic contraction,and it might be related to development of motility disorders of the SO.

Brucella organisms are facultative intracellular bacteria capable of surviving inside professional and non-professional phagocytes.Upon cell contact the bacteria is internalized via receptor molecules.Once inside cells,Brucella localizes in early phagosomes,where it avoids fusion with late endosomes and lysosomes.Then,the bacterium redirects its trafficking to autophagosomes and finally reaches the endoplasmic reticulum,the replicating niche.Once inside the endoplasmic reticulum,Brucella extensively replicates without restricting basic cellular functions or inducing damage to cells.Invasion,intracellular trafficking and replication of Brucella organisms in professional and non-professional phagocytes and the molecular determinants involving Brucella intracellular life are reviewed in this article.

Abstract: Objective　To analyze the etiological characteristics and drug resistance of patients with bloodstream infection (BSI) in the bacterial resistance monitoring network in Hainan Province from 2018 to 2020, so as to provide laboratory data for clinical diagnosis and treatment. Methods　The clinical data of the subjects were collected, and the etiological characteristics of BSI patients and drug resistance of commonly used drugs in clinical treatment were analyzed retrospectively. SPSS 26.0 software was used for statistical analysis. Results　A total of 877 strains were isolated, including Gram-negative bacteria (584 strains, 66.6%), Gram-positive bacteria (239 strains, 27.2%) and fungi (54 strains, 6.2%); male patients (591 cases, 67.4%), female patients (286 cases, 32.6%); inpatients (780 cases, 88.9%), outpatient and emergency patients (97 cases, 11.1%); the main primary diseases of BSI patients were hypertension, cerebral infarction and type 2 diabetes, and the main primary infections were pulmonary infection and urinary system infection. Intensive care unit (25.2%, 221 cases), emergency department (10.9%, 96 cases), oncology department (9.1%, 80 cases), nephrology department (6.8%, 60 cases) and hepatobiliary and pancreatic surgery department (4.3%, 38 cases) had the highest proportion of pathogenic bacteria. Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, coagulase-negative Staphylococcus, Viridans group streptococci and Candida albicans were the most frequently isolated pathogens. The detection rates of carbapenem-resistant Klebsiella pneumoniae, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii were 3.4%, 15.2% and 36.4% respectively. The carbapenem-resistant Escherichia coli was not checked out. The detection rates of methicillin resistant Staphylococcus aureus and methicillin resistant coagulase negative Staphylococcus were 18.5% and 79.1% respectively. Conclusions　Gram-negative bacteria are the most common pathogens of BSI, and inpatients are the main source of BSI. Age, underlying diseases and primary infection are the risk factors of BSI. Clinical laboratories should strengthen the etiological monitoring of high-risk patients with BSI, and the resistance analysis of common antibiotics can provide a basis for the rational use of antibiotics in clinical practice.

Acidosis, Renal Tubular ; complications ; diagnosis ; Child ; Diagnostic Errors ; Female ; Humans ; Medullary Sponge Kidney ; complications ; diagnosis ; Rickets ; diagnosis

Dental Bonding ; methods ; Dentin ; Dentin-Bonding Agents ; chemistry ; Electricity ; Humans

Total paeony glycoside (TPG) is extracted and purified from a traditional Chinese herbal medicine. It has many biological and pharmacological activities. However, there are few dosage forms of TPG in the market because of its low bioavailability. Self-microemulsifying drug delivery system (SMEDDS) is a vital tool in solving low bioavailability of poor absorption drugs. So the objective of this study is to develop a new TPG-SMEDDS for the oral delivery of poorly soluble TPG. Through the construction of pseudo-ternary phase diagrams, the optimum prescription was obtained, which consisted of 18.70% TPG, 16.27% ethyl oleate as oil, 43.34% Cremophor RH40 as surfactant and 21.73% Transcutol P as cosurfactant. The characterizations of TPG-SMEDDS including morphological characterization, droplet size, zeta-potential, emulsification time, and dissolution study of TPG-SMEDDS were evaluated. The results showed that TPG-SMEDDS is stable and its release rate is high in four different media (0.1 mol x L(-1) HCl, pH 6.8 PBS, pH 7.4 PBS, and water). The relative bioavailability of SMEDDS was dramatically enhanced in an average of 1.52-fold that of TPG-suspension. It is concluded that the bioavailability of TPG is enhanced greatly by SMEDDS.

Objective To compare the changes in blood coagulation, fibrinolysis and endothelial damage in patients undergoing laparoscopic cholecystectomy with different durations of carbon dioxide pneumoperitoneum. Methods Sixty-four ASA Ⅰ orⅡpatients, aged 23-60 yr, weighing 45-82 kg, scheduled for elective laparoscopic cholecystectomy, were randomly divided into 3 groups according to the duration of pneumoperitoneum: duration of pneumoperitoneum ≤30 min group (group Ⅰ, n=21), 30 min ＜ duration of pneumoperitoneum ＜ 60 min (group Ⅱ, n=23) and duration of pneumoperitoneum≥ 60 min (group Ⅲ , n=20).The intra-abdominal pressure was maintained at 12-14 mm Hg. Venous blood samples were taken before surgery (baseline, T0 ),at the end of surgery(T1), and at 1, 2 and 3 d after surgery (T2-4) for determination of prothrombin time, activated partial thromboplastin time, concentrations of prothrombin fragment 1+2(F1+2), fibrinogen (Fib), tissue plasminogen activator and plasminogen activator inhibitor type-1 (PAI-1), and activities of antithrombin Ⅲ(AT-Ⅲ)and von Willebrand factor(vWF).Results Compared with groupⅠ , the vWF activity and PAI-1 concentration at T2 , concentrations of Fib, F1+2, PAI-1 and activity of vWF at T3 and concentrations of Fib and F1+2 at T4 were significantly increased, while the AT-IE activity at T3 was significantly decreased in group Ⅲ(P＜0.05) .Conclusion When the duration of pneumoperitoneum is short, no obvious changes in the blood coagulation, fibrinolysis and endothelial damage are observed postoperatively in patients undergoing laparoscopic cholecystectomy, and along with the prolongation of the duration of pneumoperitoneum, increased blood coagulation, reduced fibrinolysisand aggravated endothelial damage are observed postoperatively.

Objective To investigate the influencing factors of learning adaptability of nursing student in the emergency department and come up with relevant countermeasures. Methods Two hundred nursing student in the emergency department participated in the survey. A self-designed questionnaire on their learning adaptability and the results were analyzed. Result The job category, work environment, disease of the patients, internship time, teaching method and the professional identification were the top six factors influencing their learning adaptability situation. Conclusion Such measures as strengthening the orientation of student nurses, cultivating their observation ability and communication skills, enhancing the consciousness about law, increasing practice time appropriately, improving teaching methods and ability, and strengthening sense of identity can guarantee effective internship and adaptability of the nursing student in emergency department.