Triple negative breast cancer ( TNBC) is defined by the lack of expressions of the estrogen re-ceptor(ER)、progesterone receptor(PR)and human epidermal growth factor receptor 2(HER-2).Although it is sensitive to radiation and chemotherapy ,it lacks of appropriate targeted therapy and endocrine therapy .It performs characteristics of the strong invasion ,high risk of recurrence and poor prognosis .So in recent years ,triple negative breast cancer gets more and more attention from international oncology community .In-depth study of triple nega-tive breast cancer will help the prevention ,early diagnosis ,judge the progress of the disease and improve progno-sis.TNBC drug treatment and relevant research progress are reviewed in the present article .

Objective To explore the clinical efficacy of reteplase(rPA) combined with reduced glutathione(GSH) for the treatment of acute ST-segment elevation myocardial infarction(STEMI).Methods 80 patients with STEMI received in our hospital from Feb 2010 to Feb 2013 were divided into observation group and control group according to the treatment type,with 40 cases in each group.The control group was treated with rPA for intravenous injection on the basis of conventional treatment,and the observation group was added reduced GSH intravenously on the basis of control group.The recanalization rate,myocardial enzymes levels,ventricular structure and function of the heart and major adverse cardiac events in the two groups of patients were compared.Results There canalization rate in observation group was 90％ after treatment,compared with the control group (82.5％) which showed no significant difference as compared with the control group(90％ vs.82％,P＞0.05).Serum creatine kinase-MB fraction(CK-MB),cardiac troponin(cTn) I and TcTnI and cTnT levels in observation group after 24h were significantly lower in observation group than in the control group after 24 h of treatment(t=10.44,6.008,29.63,respectively,all P＜0.05); left ventricular end diastolic diameter (LVEDd) and left ventricular end systolic diameter (LVESd) in observation group were significantly shorter and left ventricular ejection fraction (LVEF) was significantly higher in observation group than in the control group after 1 month of treatment (t =4.543,5.605,4.652,respectively,all P＜0.05).The incidence of cardiogenic shock,reinfarction,angina and arrhythmia in observation group were significantly lower in observation group than in the control group(x2=5.128,7.825,6.000,4.669,respectively,all P＜0.05).Conclusions rPA combined with reduced GSH for the treatment of STEMI had is significantly effective,safe and reliable,has fewer complications,and is worthy of clinical promotion.

50.0%.CONCLUSION:The extensive use of antibacterials results in increased drug resistance,while rational use of antibiotics is the key of decreasing drug resistance and multidrug resistance.It is of great importance to analyze the variation of bacterial drug resistance in area hospital.

Event-related potentials (ERP) is some kind of brain potentials that recorded from cranial surface when human cognitive processing an object(pay attention, memorize, thinking, etc). ERP consists of a variety of cognitive function and related components. Including early composition, mismatch negativity (MMN), N2 family, P3 family, and other related components of language processing. These components are closely related to human cognitive function,the research of ERP can lead to a deeper understanding of cognitive function of human brains and has important application value of forensic medicine.

Objective:To assess the changes in corneal endothelial cell density (CD) and morphology in patients with different stages of keratoconus.Methods:A cross-sectional study was conducted.One hundred and nineteen patients (199 eyes) with keratoconus who were treated in the Eye Hospital of Shandong First Medical University were included from March 2018 to October 2021.The 199 eyes were classified into stage Ⅰ (111 eyes of 58 cases), stage Ⅱ (41 eyes of 30 cases), stage Ⅲ (47 eyes of 31 cases) keratoconus groups according to the Amsler-Krumeich classification.In the same period, 25 age- and sex-matched healthy subjects (50 eyes) were enrolled as a normal control group.Corneal topography and anterior segment parameters such as keratometry (K), central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior chamber depth (ACD), corneal diameter and corneal volume were obtained by Pentacam 3-dimensional anterior segment imaging and analysis system.The corneal endothelial CD, percentage of hexagonal cells (6A), average cell area (AVE), maximum cell area (MAX), minimum cell area (MIN), cell area standard deviation (SD) and cell area coefficient of variation (CV) in the central area were evaluated by non-contact specular microscopy.The correlation between corneal endothelial CD, morphological parameters and corneal topographic parameters was analyzed by Spearman rank correlation.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Shandong Eye Hospital (No.SDSYKYY201803). All patients were informed of the purpose and methods of the study and written informed consent was obtained before any medical examination.Results:The CD of the normal control group and stage Ⅰ, Ⅱ, Ⅲ keratoconus groups was 2 941(2 809, 3 072), 2 825(2 667, 3 030), 2 747(2 475, 2 903) and 2 370(2 142, 2 525) cells/mm 2, respectively.With the progression of keratoconus, CD decreased gradually, and there was a significant difference in CD among the four groups ( H=94.862, P<0.001). There were significant differences in CV and 6A among the four groups ( H=45.018, 20.421; both at P<0.001). CV was significantly higher in stage Ⅲ keratoconus group than that of the normal control group and stage Ⅰ and Ⅱ keratoconus groups and 6A was significantly lower in stage Ⅲ keratoconus group than that of the normal control group and stage Ⅰ keratoconus group (all at P<0.05). With the progression of keratoconus, MAX, MIN, AVE and SD increased gradually, and there were significant differences in MAX, MIN, AVE and SD among the four groups ( H=37.905, 32.437, 110.182, 72.941; all at P<0.001). MAX and MIN in stage Ⅲ keratoconus group were significantly higher than those in stage Ⅰ keratoconus groups and normal control group (all at P<0.05). AVE and SD in stage Ⅲ keratoconus group were significantly higher than those in normal control group and stage Ⅰ and Ⅱ keratoconus groups (all at P<0.05). In patients with keratoconus, CD was moderately positively correlated with CCT ( rs=0.47, P<0.001) and TCT ( rs=0.53, P<0.001), and was moderately negatively correlated with mean keratometry (Km) ( rs=-0.59, P<0.001).6A was weakly positively correlated with CCT ( rs=0.18, P=0.01) and TCT ( rs=0.22, P=0.002), and was weakly negatively correlated with Km ( rs=-0.32, P<0.001). CV was weakly negatively correlated with CCT ( rs=-0.35, P<0.001) and TCT ( rs=-0.37, P<0.001), and was moderately positively correlated with Km ( rs=0.48, P<0.001). There was no correlation between CD, CV, 6A and ACD, or corneal volume. Conclusions:As the keratoconus progresses, the cornea protrudes and becomes thinner with CD and 6A decreasing while CV increasing.Corneal topographic parameters are related to the density and morphology of corneal endothelial cells.

Objective The aim of this study was to evaluate the effect of postoperative radiotherapy on local recurrence-free survival(LRFS)and overall survival(OS)in patients with triple-negative breast cancer (TNBC).Methods The clinical data of 186 cases for TNBC were collected from the Affiliated Tumor Hospital of Harbin Medical University from January 2003 to December 2006.These cases were confirmed by pathology.The patients were divided into radiotherapy and non-radiotherapy groups.The survival curves were plotted by Kaplan-Meier method.Log-rank test method was used to detect the difference between the radiotherapy and non-ra-diotherapy groups for 10 years.Univariate and multivariate analyses were used to determine the prognostic factors for TNBC patients.Results The 10-year LRFS of radiotherapy group and non-radiotherapy group were 80.2%and 76.0%,respectively.The 10-year OS was 86.0%and 74.0%in radiotherapy group and non-ra-diotherapy group,respectively.Both of them showed a statistically difference(P <0.05).Subgroup analysis showed that LRFS and OS were 81.8%and 81.8%in 10 years for radiotherapy in patients with T 1-2N1(1-3 lymph node metastases)M0,respectively,76.4% and 79.4% for non-radiotherapy group,respectively.No differences were observed in both of LRFS and OS in radiotherapy and non-radiotherapy groups(P>0.05). Multivariate analysis showed that radiotherapy and clinical staging were independent factors influencing the sur-vival of TNBC patients.Conclusion Radiotherapy can improve the LRFS and OS in TNBC patients,but radio-therapy does not improve LRFS and OS for TNBC patients with T 1-2N1(1~3 lymph node metastases)M0.Radio-therapy and clinical staging are independent factors that affect the prognosis of TNBC patients.

Acute kidney injury (AKI) is common in critically ill patients and it is directly related to the patient's prognosis and survival. Despite remaining uncertainties regarding the prevalence of AKI in intensive care unit (ICU), the overall incidence of AKI is relatively high, and prompt recognition is necessary to ensure the risk assessment, early diagnosis, clinical outcome, and treatment of critically ill patients. Doppler-based renal resistive index (RRI) mainly reflects vascular bed resistance state, which can be indirect to the extent of the damage of renal parenchyma. It is a relatively objective and quantitative evaluation, and is widely used in clinical prognosis of acute or chronic renal damage evaluation and judgment. This paper reviews the definition of RRI, the measurement methods of RRI, the application and progress of RRI in the field of AKI, the advantages and disadvantages of ultrasonic measurement of RRI, the long-term application of RRI, the effectiveness of RRI in predicting AKI, and the progress in clinical application.

Objective To evaluate the therapeutic effect of endovenous laser ablation (ELA) combined with foam sclerotherapy (FS) and mucopolysaccharide polysulfate (MP)cream on stasis dermatitis.Methods From December 2015 to May 2017,52 patients with 60 lesional limbs were enrolled from Department of Dermatology of Sichuan Provincial People's Hospital.The 60 lesional limbs were randomly and equally divided into 3 groups by a random number table and remainder grouping:combination group,MP group and control group.All the 3 groups were firstly treated with ELA in the main great saphenous vein.Then,the combination group was treated with FS followed by topical MP cream for 4 weeks.After the laser therapy,the MP group was treated with topical MP cream for 4 weeks,and the control group was treated with topical mometasone furoate cream alone for 4 weeks.The eczema area and severity index (EASI) and visual analogue scale (VAS) for itching scores in the above 3 group were recorded before treatment and 4 weeks after treatment.Statistical analysis was done by paired t-test for comparisons before and after treatment,one-way analysis of variance (ANOVA) for intergroup comparison,and least significant difference (LSD)-t test for multiple comparisons.Results No significant difference was observed before treatment among the combination group,MP group and control group in the EASI (9.64 ± 4.58,9.94 ± 4.18,9.50 ± 4.41 respectively,F =0.052,P ＞ 0.05) or VAS scores (7.25 ± 1.29,7.50 ± 1.19,7.45 ± 1.32 respectively,F =0.218,P ＞ 0.05).After 4-week treatment,the combination group,MP group and control group all showed significantly decreased EASI (3.54 ± 1.57,5.86 ± 2.39,7.04 ± 2.75 respectively) and VAS scores (2.35 ± 0.67,3.85 ± 0.67,4.65 ± 1.23 respectively) compared with those before treatment (t =4.30-18.80,all P ＜ 0.05).After 4-week treatment,the EASI score was significantly lower in the combination group than in the MP group and control group (both P ＜ 0.05),while there was no significant difference between the MP group and control group (P ＞ 0.05).Additionally,the VAS score was significantly lower in the combination group than in the MP group and control group (both P ＜ 0.05),as well as in the MP group than in the control group (P ＜ 0.05).Conclusions ELA combined with FS and topical MP cream shows better short-term efficacy for the treatment of stasis dermatitis compared with ELA combined with topical MP cream or mometasone furoate cream.The combination with topical MP cream is superior to that with topical mometasone furoate cream in improving itching.The long-term efficacy needs to be observed further.

Objective:To explore the correlation of serum albumin level at admission with clinical prognoses in patients with acute traumatic brain injury (TBI).Methods:One hundred and fifty-four patients with acute moderate-extreme severe TBI (Glasgow Coma Scale [GCS] scores of 3-12 at admission) in Department of Neurosurgery, General Hospital of Western Theater Command from January 1, 2019 to December 31, 2020 were chosen. The comprehensive clinical data of these patients were collected, including age, gender, GCS scores, serum albumin level (hypoalbuminemia defined as<35 g/L), hemoglobin level, comorbidities, treatment measures, and prognoses 6 months after discharge (poor prognosis defined as Glasgow outcome Scale [GOS] scores of 1-2, and good prognosis defined as GOS scores of 3-5). Univariate and multivariate Logistic regressions were used to identify the independent factors for clinical prognoses of these patients, and differences in poor prognosis rate, length of ICU stay, and total hospital cost were compared between different groups.Results:Among the 154 patients, 43 had poor prognosis and 111 had good prognosis. Serum albumin level at admission ( OR=0.916, 95% CI: 0.843-0.996, P=0.001) and GCS scores at admission ( OR=0.701, 95% CI: 0.594-0.828, P<0.001) were independent factors for prognosis. Patients with hypoalbuminemia ( n=70) displayed significantly higher poor prognosis rate, longer ICU stays, and increased total hospitalization cost compared with those without hypoalbuminemia ( n=84, P<0.05); specifically, in patients with GCS scores of 9-12 at admission ( n=58), those with hypoalbuminemia ( n=27) exhibited significantly higher poor prognosis rate, longer ICU stays, and higher total hospitalization cost than their non-hypoalbuminemia counterparts ( n=31, P<0.05); similarly, in patients with GCS scores of 3-8 at admission ( n=96), those with hypoalbuminemia ( n=74) had significantly higher poor prognosis rate than their non-hypoalbuminemia counterparts ( n=22, P<0.05). In patients with good prognosis, those with hypoalbuminemia ( n=56) showed significantly longer total hospital stays, prolonged ICU stays, and increased total hospitalization cost compared with those without hypoalbuminemia ( n=55, P<0.05). Conclusion:Low serum albumin level at admission is likely to lead to poor prognosis, prolonged ICU stays and increased total hospitalization cost in patients with acute TBI.

Objective:To explore the application of sound thinking combined with Sandwich teaching in oncology nursing practice teaching.Methods:A total of 68 nursing students who were interns in the Department of Oncology, The First Affiliated Hospital of Air Force Medical University from 2020 to 2021 were included in the study, and they were divided into a control group ( n=34) and an observation group ( n=34). The control group took routine teaching for interns, while the observation group took sound thinking combined with Sandwich teaching. The examination results, critical thinking abilities, and the evaluation of nursing teaching effectiveness of the two groups of nursing interns were evaluated. SPSS 22.0 was used for Chi-square test and t-test. Results:The examination scores of nursing students in the observation group were higher than those in the control group ( t=3.44, 2.87, 3.45, P<0.05). Compared with those before training, the scores of critical thinking ability of nursing interns in both groups increased after the training, and the observation group was better than the control group ( t=0.180, 3.64, 0.61, 2.92, 0.31, 2.74, 0.45, 2.65, 0.25, 3.58, 1.16, 2.85, 0.36, 3.20, 0.33, 2.38, P<0.05). The scores of autonomous learning ability, communication and collaboration ability, independent thinking ability, clinical reasoning ability, and problem-analyzing and -solving ability in the observation group were higher than those in the control group ( t=2.82, 3.46, 2.68, 3.29, 2.44, P<0.05). Conclusion:Combining sound thinking with Sandwich teaching in nursing clinical practice teaching in department of oncology can improve the examination scores of nursing students, improve their critical thinking abilities, and enable them to give a high evaluation of nursing teaching effectiveness.