Objective To study the clinical efficacy of epirubicin combined with paclitaxel in the treatment of three negative breast cancer.Methods 100 patients with breast cancer who were treated in Shanxi Cancer Hospital from January 2014 to December 2016 were selected as the research object in this study.They were randomly divided into the control group and the experimental group, with each group having a total of 50 patients.The control group was treated with epirubicin, and the experimental group was treated with epirubicin combined with paclitaxel.The short-term remission rate, Karnofsky score and the incidence of adverse symptoms were compared between the experimental group and the control group.Results After treatment, the Karnofsky score of the experimental group was(89.76±10.12), and the Karnofsky score of the control group was(71.23±11.67).The Karnofsky score of the experimental group was significantly higher than that of the control group (P<0.05).In the experimental group, the number of short-term remission was 44 cases, the short-term remission rate was 88.0%, and the number of patients in the control group in the recent remission was in the number of cases, the short-term remission rate was 72.0%, and the number of patients in the control group was about 36.The results showed that the short-term remission rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05).After treatment, there was no significant difference between the control group and the experimental group in the incidence of complications, which was not statistically significant.Conclusion The clinical effect of doxorubicin plus paclitaxel in the treatment of three negative breast cancer, can improve the remission rate in a large extent, improve the quality of life of patients, with further clinical promotion and application significance.

Objective To evaluate the effects ofYiqi Yangyin Huoxue Formula on clinical endpoints of diabetic nephropathy patients.Methods Totally 95 patients who were involved into the six-month DN clinical RCT for observation in 2008 were retrospectively collected and screened. There are 47 cases in the trial group, who were chronically treated by integrated traditional Chinese and Western medicine therapy which mainly adoptingYiqi Yangyin Huoxue Formula. There were 48 cases in the control group, who were chronically treated with Western medicine. Follow-up visits were conducted in 2011, 2012, 2013, and 2014 respectively. Long-term incidence rate of renal function progress/deaths were compared in the two groups.Results Five cases died in the trial group, among which one case died of renal failure. Eight cases died in the control group, among which five died of renal failure and multiple organ failure. The incidence of endpoints entering end-stage renal disease and renal function progress was much lower than that of control group. Conclusion Integrated traditional Chinese and Western medicine therapy dominated byYiqi Yangyin Huoxue Formula has good clinical efficacy of kidney protection, and can slow the progress of DN patients entering end-stage renal disease, and better than single Western medicine intervention.

Objective To explore the curative effect of acyclovir combined with pidotimod in treatment of adult varicella.Methods 80 adult patients with varicella in our hospital were randomly divided into two groups.40 cases in group A were intravenously injected acyclovir.40 cases in group B were intravenously injected acyclovir combined with oral pidotimod.The time of herpes blisters drying and completely crusted were observed in two groups.Results The time of herpes blisters drying and completely crusted of B group was shorter than A group.And the differences were statistically significant(P ＜0.01).Conclusion Acyclovir combined with pidotimod in treatment of adult varicella can significantly shorten the healing time,and show better curative effect than single use of acyclovir.

Objective: To investigate the prevalence and molecular characteristics of Shiga toxin-producing Escherichia coli (STEC) in a large dairy farm and market-sold raw livestock meats in Suzhou City, so as to provide the evidence for evaluating human health risks of STEC. Methods: Bovine stool samples and breeding environmental samples were collected from a large dairy farm in Suzhou City, and beef, pork and mutton samples were collected from markets in Suzhou City. STEC strains were isolated and virulence genes were characterized in STEC strains using quantitative fluorescence PCR assay. The sensitivity to common antibiotics was tested using the broth microdilution plate method, and the genotypes of STEC were characterized using pulsed-field gel electrophoresis (PFGE). Results: A total of 624 samples were collected, including 110 adult cow stool samples, 170 calf stool samples, 60 farm environmental samples, 126 beef samples, 100 minced beef samples, 15 pork samples, 15 minced pork samples, 18 mutton samples and 10 ground mutton samples. A total of 12 non-O157 STEC strains were isolated, with a detection rate of 1.92%, and the detection rates of non-O157 STEC strains were 4.12%, 1.59% and 3.00% in calf stool samples, beef samples and minced beef samples, respectively, while non-O157 STEC strains were not detected in adult cow stool samples, environmental samples, pork samples, minced pork samples, mutton samples, or minced mutton samples. Among the 12 STEC strains, there were 4 strains carrying stx1 gene, 4 strains carrying stx2 gene and 4 strains carrying stx1 and stx2 genes. The 12 STEC strains showed the highest prevalence of resistance to ampicillin, ampicillin/sulbactam, cefotaxime and cefazoline (all were 41.67%), and were sensitive to imithiomycin, polymyxin, azithromycin, cefoxitin and ciprofloxacin, and there were 5 strains with multidrug resistance (41.67%). The 12 STEC strains were characterized with 11 genotypes and had no unique gene fingerprint patterns, with the Dice similarity coefficient ranging from 61.3% to 92.7%. Conclusions The detection of non-O157 STEC strains is high in calf stools, and non-O157 STEC strains show a level of resistance to common antibiotics and present molecular polymorphisms. The monitoring and management of STEC strains should be strengthened.

Objective To explore the effect of double silicone balloon catheter used as nasal packing materials after functional endoscopic sinus sur?gery(FESS). Methods Totally 80 patients(47 males and 33 females,median age of 43 years)with bilateral chronic sinusitis who underwent en?doscopic surgery under general anesthesia were randomly divided into two groups,each group with 40 patients. The hemostatic sponge group used he?mostatic sponge for postoperative nasal packing and the hemostatic catheter group used double silicone balloon catheter plus medical sponge. Patients were observed for postoperative pain,ventilation and bleeding after packing removal to evaluate efficacy. Results Double silicone balloon catheter was superior to hemostatic sponge in ventilation maintenance(mean scores:78.8 vs 2.32)and pain relief(mean scores:0 vs 5.26),the difference was statistically significant(P<0.05). Moreover,double silicone balloon catheter was also superior to hemostatic sponge regarding to nasal bleeding after packing removal. Conclusion Double silicone balloon catheter is a preferable material for nasal packing after endoscopic surgery,which has reliable hemostatic effect and can better maintain the nasal ventilation,reduce pain in patients,and improve the patient's quality of life during treat?ment.

Objective To explore the efficacy of group cognitive behavioral therapy for improving depressive symptoms and social functional in patients with major depressive disorder.Methods A total of 160 patients with major depressive disorder were randomly divided into intervention group (n=80) and control group (n=80).Intervention group was treated with conventional antidepressants combined with group cognitive behavioral therapy.Control group was treated with one conventional antidepressants.All participants were assessed with Hamilton Depression Scale (HAMD)and Scale of Social function of Psychosis Inpatients (SSFPI) before and 8 weeks after the treatment.Results After 8 weeks treatment,the scores of HAMD (14.76±9.48) was significantly reduced and the scores of SSFPI(30.09±4.34) were significantly increased in intervention group compared with the baseline ((37.91± 10.58),(12.40±2.56),all P＜0.01).The scores of HAMD were significantly lower and the scores of SSFPI were significantly higher in intervention group than that in control group((20.71±7.85),(22.63±3.63),all P＜0.01).Conclusion Group cognitive behavioral therapy is effective for major depressive disorder patients by reducing depressive symptom and improving social function.

Objective To investigate the clinical features and effective treatment of patients with severe type A H1N1 flu in Wenzhou. Methods The clinical data of 42 hospitalized patients with severe type A H1N1 flu were analyzed and the clinical features were summarized. Results A total of 42 patients with severe type A H1N1 flu all began with fever and cough. The symptoms of expectoration, pharyngalgia, chilly accounted for 92. 9%, 90. 5% and 42. 9%, respectively. The peripheral leucocyte counts were normal or reduced. C-reactive protein and erythrocyte sedimentation rate levels both increased in 30 patients (71.4%). About 95.2% (40/42) patients had changes of pulmonary imaging. All of the patients were treated with oseltamivir and effective antibiotic drugs as well as symptomatic management. No patients was treated with glucocorticoid. The patients with underlying diseases were given proper treatment. Three cases were treated with antifungal therapy and 3 pregnant patients were timely terminated of pregnancy. Conclusions Severe type A H1N1 flu progresses rapidly and the lower respiratory tract is involved soon after onset. Therefore, the patient should be diagnosed early and treated promptly after presenting fever, which will lead to good prognosis.

ObjectiveTo observe the effect of acetylcholine (ACh) on lipopolysaccharide (LPS) induced inflammatory model of rat alveolar macrophages, and to observe the effect of the acetylcholinesterase inhibitor physostigmine (Phy) on the anti-inflammatory effect of ACh.Methods The rat alveolar macrophages NR8383 were cultured in vitro, which were divided into five groups: blank control group, LPS group (stimulated with 1 mg/L LPS for 12 hours), LPS+ ACh group (0.01, 0.1, 1, 10, 100μmol/L of ACh were added for 5 minutes before LPS stimulation), LPS+ Phy group (1 mmol/L Phy was added for 5 minutes before LPS stimulation), and LPS+ ACh+ Phy group (1 mmol/L Phy and 10μmol/L ACh were added for 5 minutes before LPS stimulation). The supernatants were collected in each group, the enzyme-linked immunosorbent assay (ELISA) was used to assay the contents of tumor necrosis factor-α (TNF-α), interleukins (IL-1β, and IL-6). The activity of acetylcholine esterase (AChE ) in the supernatant was also determined.Results① The contents of TNF-α (ng/L: 605.09±57.13 vs. 34.07±8.62), IL-1β (ng/L: 377.09±28.55 vs. 32.33±10.62) and IL-6 (ng/L: 558.04±77.45 vs. 42.62±11.21) in the LPS group were significantly higher than those in the blank control group (allP< 0.05). These results indicated that the inflammatory model of rat alveolar macrophages was constructed successfully.② ACh with the final concentrations of 0.01, 0.1, and 1μmol/L had less influence on the production of TNF-α, IL-1β and IL-6 in the culture supernatants of alveolar macrophages stimulated with LPS compared with LPS group (allP> 0.05). Nevertheless, 10μmol/L and 100μmol/L ACh notably reduced the production of TNF-α (ng/L: 451.19±30.67, 332.19±32.19 vs. 604.96±22.56), IL-1β(ng/L: 261.08±24.78, 143.98±28.39 vs. 367.06±10.44) and IL-6 (ng/L: 342.75±54.60, 235.48±29.75 vs. 562.69±63.34) in the culture supernatants compared with the LPS group (allP< 0.05).③ The activity of AChE in the LPS group was significantly higher than that in the blank control group (kU/L: 5.21±0.63 vs. 3.09±0.10,P< 0.05). The activity of AChE was successfully inhibited by 1 mmol/L acetylcholinesterase inhibitor Phy pretreatment compared with that in the LPS group (1.51±0.12 vs. 5.21±0.63,P< 0.05).④ The level of TNF-α (ng/L: 183.17±35.44 vs. 451.19±30.67), IL-1β (ng/L: 91.49±12.27 vs. 261.08±24.78) and IL-6 (ng/L: 108.17±22.82 vs. 342.75±54.60) in the culture supernatants of LPS+ ACh+ Phy group was significantly decreased as compared with LPS+ ACh group (allP< 0.05).Conclusions ACh with the final concentrations of 10μmol/L and 100μmol/L can inhibit the LPS induced inflammatory reaction in alveolar macrophages. The acetylcholinesterase inhibitor Phy can reinforce the ACh-mediated anti-inflammatory effect on alveolar macrophages inflammatory model.

AIM:To investigate the role of microRNA-132 (miR-132) on alveolar macrophage inflammation. METHODS: Rat alveolar macrophage cell line NR8383 was transfected with miR-132 mimic, mimic negative control ( NC) , miR-132 inhibitor, or inhibitor NC.The cells were divided into transfection group, transfection +lipopolysaccha-ride ( LPS) group, and transfection +LPS +acetylcholine ( ACh) group.The mRNA expression of acetylcholinesterase ( AChE) was detected by real-time PCR.The protein levels of AChE, signal transducer and activator of transcription 3 (STAT3) and phosphorylated STAT3 (p-STAT3) in the cells, and nuclear factor-κB (NF-κB) in the cytoplasm and nu-cleus were analyzed by Western blot.The activity of AChE in the culture supernatant was measured by AChE activity assay kit.The nuclear translocation of NF-κB was detected by immunofluorescence assay.RESULTS: Up-regulation or down-regulation of miR-132 had no effect on the mRNA expression of AChE.However, up-regulation of miR-132 decreased the protein level of AChE compared with mimic NC group (P<0.05).Transfection with miR-132 inhibitor increased the pro-tein expression of AChE compared with inhibitor NC group ( P<0.05 ) .In the alveolar macrophages treated with LPS+ACh, the inhibition of nuclear translocation of NF-κB p65 in miR-132 mimic group was more effective than that in mimic NC group ( P<0.05) .The inhibitory effect in miR-132 inhibitor group was weaker than that in inhibitor NC group ( P<0.05 ) .The inhibitory effect of miR-132 mimic on the protein levels of STAT3 and p-STAT3 was stronger than that of mimic NC (P<0.05).CONCLUSION:miR-132 in LPS-stimulated alveolar macrophages reinforced ACh-mediated anti-inflam-matory reaction by targeting AChE to suppress ACh hydrolyzation, which was related to the suppression of NF-κB and STAT3 activation.

Objective To prospectively determine the feasibility of high-resolution in vivo MR imaging in the evaluation of esophageal carcinoma invasion at 3.0 T.Methods One hundred and eighteen patients with esophageal carcinoma,proven by the gastroscopic biopsy,were prospectively studied using 3.0 T MR.The esophageal specimens were sectioned transversely to keep consistent in the orientation with the MR images,the histopathological stage was made and the thickness of the tumor on the largest diameter of the slice were measured.The MR images were reviewed in the transverse plane.According to the seventh American joint committee on cancer,the MR stage was made and the tumor's thickness was measured.The MR images and the histopathological slices were matched.The staging diagnostic efficacy of the MR imaging was evaluated with the histopathological results as the standard reference,Kappa test was used to compare the stage of MR imaging with that at the histopathological analysis.Bland-Altman scatterplots were used to compare the thickness of tumor measured on the MR images with that at the histopathological measurement.Results Ninety seven cases(82.2％,97/118) of MR stage were accurately made,including 7 T1a,15 T1b,18 T2,25 T3 and 32 T4a cases,furthermore,14 cases were over staged and 7 cased were underestimated.The MR stage was highly consistent with the histopathological stage (Kappa=0.772).The sensitivity for the staging of high-resolution MR imaging at 3.0 T was 58.3％(7/12) to 100.0％(32/32),the specificity was 95.3％ (82/86) to 98.1％ (104/106),and the accuracy was 91.5％ (108/118) to 96.6％ (114/118),respectively.Bland-Altman scatterplots demonstrated that the discrepancy of the mean thickness between the value obtained by three radiologists respectively and the histopathological analysis were 2.0,2.6 and 2.1 mm,which demonstrated a good consistency.Conclusion High-resolution MR images obtained at 3.0 T can be used to evaluate the depth of carcinoma invasion and provide excellent diagnostic accuracy for preoperative staging.