Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients (aged 3-12 years and weighing 10-40 kg) scheduled for elective ear-nose-throat or urological surgery were randomly divided into two groups (n =15 each):2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ).Anesthesia was induced with intravenous injection of propofol 2 mg/kg and TCI of remifentanil.Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentration of remifentanil was set at 2 or 4 ng/ml.Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness.The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil,intravenous infusion of propofol and intermittent intravenous injection of boluses of vecuronium.The target plasma concentration of remifentanil remained unchanged and bispectraI index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 through adjusting the infusion rate of propofol.Arterial blood samples were taken at 5,10,20,30,40,50 and 60 minutes after TCI of remifentanil was started for determination of blood remifentanil concentrations by high performance liquid chromatography.Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated.Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations jn both groups (P ＜ 0.05).The MDPE,MDAPE and wobble were 20.0％,30.0％ and 25.0％ respectively in group Ⅰ,and 17.5％,17.5％ and 12.5％ respectively in group Ⅱ.The MDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ (P ＜ 0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old,the accuracy is not high.

ObjectiveTo study the expression of Twist in invasive ductal carcinoma of breast and its relationship with cell proliferation and angiogenesis.MethodsThe expression of Twist and Ki-67 was detected in 60 cases with invasive ductal carcinoma of breast by immunohistochemistry.Ki-67 index and microvascular density(MVD) were calculated.ResultsThe positive expression rate of Twist was 56.7％ (34/60) in invasive ductal carcinoma of breast.Ki-67 index and MVD in the patients with positive expression of Twist was higher than those in the patients with negative expression of Twist[(57.05 ± 16.37)％ vs.(25.32 ± 16.16)％,(34.30 ± 12.25)％ vs.(23.04 ± 10.45)％,P＜ 0.05 ].ConclusionsThe overexpression of Twist is found in invasive ductal carcinoma of breast.To stimulate cell proliferation and angiogenesis may be one of the pathways of Twist to contribute to the invasion and metastasis of breast cancer.

Objective To evaluate the accuracy of remifentanil target-controlled infusion (TCI) system in children.Methods Thirty ASA Ⅰ patients, aged 3-12 yr, weighing 10-40 kg, scheduled for elective ear-nosethroat or urological surgery, were randomly divided into 2 groups with 15 patients in each group:2 ng/ml remifentanil group (group Ⅰ) and 4 ng/ml remifentanil group (group Ⅱ). Anesthesia was induced with iv injection of propofol 2 mg/kg and TCI of remifentanil. Remifentanil was administered with a specific TCI system incorporating the pharmacokinetic parameters of Minto.The target plasma concentrations of remifentanil were set at 2 or 4 ng/ml. Tracheal intubation was facilitated with vecuronium 0.1 mg/kg after the children lost consciousness. The children were mechanically ventilated.Anesthesia was maintained with TCI of remifentanil, iv infusion of propofol and intermittent iv boluses of vecuronium. The target plasma concentration of remifentanil remained unchanged and bispectral index value was maintained at 45-65 or auditory evoked potentials index value ＜ 30 by adusting the infusion rate of propofol.Arterial blood samples were taken at 5, 10, 20, 30, 40, 50 and 60 min after TCI remifentanil was stared for determination of blood remifentanil concentrations by high performance liquid chromatography. Median prediction performance error (MDPE),median absolute performance error (MDAPE) and wobble of remifentanil TCI system were calculated. Results The measured concentrations of remifentanil were significantly higher than the target plasma concentrations in both groups (P＜0.05). The MDPE, MDAPE and wobble were 20.0% , 30.0% and 25.0% respectively in group Ⅰ , and 17.5%, 17.5% and 12.5% respectively in group Ⅱ . TheMDAPE and wobble were significantly decreased in group Ⅱ compared with group Ⅰ(P＜0.05).Conclusion When remifentanil is administered using a specific TCI system incorporating the pharmacokinetic parameters of Minto in children of 3-12 years old, the accuracy is not high.

Objective To study the expression of eyelooxygenase-2(COX-2)in invasive duetal carcinoma of breast and its relationship with cell prolireration and angiogenesis. Methotis Expression of COX-2 and Ki-67 was detected in 52 cages of breast cancer tissue by immunohistochemistry. CD34 marking vascular endothelial cell was used to measure the miemvascular density(MVD).Results The positive COX-2 expression was 57.7%in invasive duetal carcinoma of breast.The Ki-67 index was (56.07±17.37)%in COX-2 positive group while(27.32±16.28)%in the negative group,and the MVD W88 32.46±12.59 in COX-2 positive group while 25.04±10.48 in the negative group.The positive group of COX-2 protein had higher Ki-67 and MVD than that in negative group(P＜0.05).Conclusion The overexpression of COX-2 protein Were found in invasive ductal carcinoma of breast.To stimulate cell prolireration and angiogenesis may be one of the pathways of COX-2 protein to contribute to the invasion and metastasis in human breast cancer.

Objective To study the correlation between expression of COX-2,Ki-67 and neoadjuvant chemotherapy in breast cancer.Method COX-2 and Ki-67 were examined by immunohistochemical staining in 48 breast cancer samples.Results The overall response rate and clinical benefit rate to neoadjuvant chemotherapy were 70.8% and 95.8%,respectively.The expression of COX-2 and Ki-67 after the chemothempy [41.7% and (33.23±18.11)%] was significantly lower than those in prechemotherapy [62.5% and (46.81±23.17)%],P<0.05.Ki-67 index Was higher in COX-2 positive tumom than that in the COX-2 negative ones before and after neoadjuvant chemotherapy,P<0.01.The effect of neoadjuvant chemotherapy had a significantly negative correlation with COX-2 expression.Patients with high expression of Ki-67 were more likely to respond to treatment.Conclusion The expression of COX-2 and Ki-67 as molecular markers could be a guide for chemotherapy and prediction for neoadjuvant's response to chemotherapy in breast cancer.

CCL20 and CCR6 are chemokines produced by a variety of cells. CCL20 and CCR6 combine to stimulate a series of downstream pathways, participate in the occurrence and development of various malignant tumors, and also play an important role in the invasion and metastasis of breast cancer and the process of chemotherapy resistance. Epithelial-mesenchymal transformation (EMT) is a key step in the process of tumor cell metastasis, which is characterized by loss of cell adhesion, down-regulation of E-cherherin expression, up-regulation of mesenchymal markers and fibrinectin expression, and enhancement of cell motor ability and invasion ability. This article reviews the research of CCL20-CCR6 biological axis and EMT on invasion and metastasis of breast cancer cells.

Breast cancer is the most common cancer among women worldwide, and it seriously threatens women′s life and health. circular RNA (circRNA) play a key role in the development and drug resistance of various cancers, including breast cancer. circRNA is an endogenous RNA molecule with a single-stranded closed structure, which has unique biological characteristics and function, and is a current research hotspot. This article will review circRNA as potential biomarkers to predict breast cancer drug resistance and therapeutic targets.

Epithelial mesenchymal transition is a kind of important pathophysiological phenomenon,which refers to a biological processe that epithelial cell turns into another cell with mesenchymal phenotype undergoing a specific procedure.Once the tumor cell acquires mesenchymal cell molecular phenotype,it will enable stationary epithelial cells to gain the ability to migrate and invade as single cells,being easy to break away from the original tumor and move to the distal organs with blood flow.The occurrence of epithelial mesenchymal transition involves a variety of signal transduction pathways,which relates to inducing factors,transcription factors and so on.The occurrence and development of breast cancer is influenced by many factors and many signal transduction pathways.In recent years,the research of tumor suppressor and tumor resistance is more extensive.In this paper,a review of epithelial mesenchymal transition related signaling pathways in breast cancer is presented.

Gastric cancer is one of the common malignant tumors in China. Among all gastric cancer patients, locally advanced gastric cancer (LAGC) accounts for a high proportion. For this group of patients, the efficacy of surgery alone is limited, and the risk of postoperative recur-rence is high. With the continuous development of therapy mode, various clinical trials and new treatment concepts have emerged, leading to a shift in treatment approaches of LAGC from the previous single chemotherapy to various combination therapies and other novel treatment moda-lities, with the aim to improve efficacy and extend survival of patients. The authors review the current status and progress of neoadjuvant chemotherapy and conversion therapy for LAGC.