Neoadjuvant chemotherapy is one of the common means in multidisciplinary treatment of locally advanced breast cancer,with anthracyclines and taxanes as main chemotherapeutic drugs.In recent years,molecular target agents have significantly improved the efficacy of chemotherapy,as well as have provided more choices and ideas for clinical treatment.Currently,the widely studied molecular targeted drugs include trastuzumab,lapatinib,pertuzumab,T-DM1 and bevacizumab.

Tumor multidrug resistance (MDR) is the leading cause of clinical chemotherapy failure and death.Researches show that the occurrence of MDR is related to P-glycoprotein,multidrug resistance-associated proteins,breast cancer resistance-associated proteins,lung resistance-related proteins and other factors.Now the reversal strategies of MDR include chemical drugs reversal,gene reversal,immune reversal,traditional Chinese medicine reversal and drug-loaded nano-system reversal,which make some progress and help to improve the effect of cancer chemotherapy.

Objective To observe the pharmacokinetic feature of Radix Acanthopanacis Senticosis suspension(RASS). Methods The research was conducted with pharmacodynamic endpoint approach and pharmacodynamic approach and adopted with phagocytic index as pharmacological parameter. Results Pharmacodynamic endpoint approach: K_(el)=0.2d~(-1), K_a=2.5 d~(-1), AUC(S_0)=10.4g?kg~(-1)?d, VRT=19.3d~2.Pharmacodynamic approach: K_(el(ef))=0.1d~(-1), K_(a(ef))=2.9d~(-1), AUC(S_0)_((ef))=62.7(%)?d, VRT_((ef))=43.2d~2. The data obtained by pharmacodynamic approach differed from that by pharmacodynamic endpoint approach, indicating the delay of drug effect. Conclusion Pharmacokinetic Data of RASS are first obtained in this article, which show that pharmacodynamic endpoint approach and pharmacodynamic approach is feasible.

Protein kinase C (PKC) is a group of phospholipid-dependent serine/threonine protein kinases, which togeth-er with protein kinase A (PKA) and protein kinase G (PKG) constitute a superfamily of serine/threonine protein kinase AGC. PKC includes classic PKC, novel PKC, atypical PKC and some members of kinase associated with PKC (PRK). PKC is wide-ly distributed in mammalian tissues and cells, which plays an important biological role in growth and metabolism, prolifera-tion and differentiation of cells. A series of studies have demonstrated that variations of multiple cells, occurrence and devel-opment of diseases are related to the abnormal expression of PKC. Therefore, designing and searching for efficient PKC inhib-itors have very important implications for synthesis of many kinds of effective drugs and treatment of a variety of clinical dis-eases including cancer, cardiovascular, and hypertension, et al. In recent years, the research on PKC inhibitors has become the focus of domestic and foreign research. A large number of literatures have reported many kinds of effective PKC inhibi-tors, and analyzed their function site, mechanism, clinical trial data and so on. The discovery of these PKC inhibitors has im-portant implications for structural analysis of PKC and the treatment of diseases. So in this paper, the efficient PKC inhibi-tors are summarized.

Objective To evaluate the effects of continuous quality improvement (CQI) management on nutritional status,renal function progression,and compliance of low protein diet in patients with chronic kidney disease (CKD).Methods Totally 115 CKD patients who were regularly followed up in CKD clinic services were recruited in this study.Plan,Do,Check,and Act (PDCA) method was adopted to manage the dietary of these patients for 12 months.The clinical indicators and diet compliance before and after receiving CQI management were compared.Results After receiving the CQI management,the nutritional status of patients was well maintained;meanwhile,the average hand strength and the hemoglobin,serum albumin,total cholesterol,and triglyceride levels showed no significant changes (all P ＞ 0.05).Subjective feelings of patients were improved.The modified Subjective Global Assessment of Nutrition (mSGA) score was decreased from 7.0 (7.0,8.0) to 7.0 (7.0,7.0) (P =0.000).The estimated glomerular filtration rate (eGFR) calculated by formula of modified MDRD was decreased from (40.74 ± 14.49) to (37.94 ± 16.86) ml/(min · 1.73 m2) (P =0.000),and the average descended speed was (2.81 ±7.42) ml/(min · 1.73 m2) per year.The creatinine clearance rate had no statistical difference between pre-and post management (P =0.910),and the average descended speed was (0.19 ± 17.01) ml/min per year.The daily protein intake (DPI) and protein equivalent of nitrogen appearance rate (PNA) were both significandy descended:DPI/kg decreased from (0.79 ± 0.27) to (0.64 ± 0.15) g/ (24 h · kg) (P =0.000),and PNA/kg dropped from (1.02 ± 0.32) to (0.82 ± 0.24) g/ (24 h · kg) (P =0.000).The scores of awareness and compliance of patients on low protein diet were significantly increased after CQI management (P =0.000).Conculsion Applying CQI on dietary and nutrition management in CKD patients can maintain the good nutritional status and improve the compliance of low protein diet.

Objective To investigate the relationship between coexisting depression and anxiety (CDA)and quality of life of female nurses in general hospitals.Methods Seven hundred and ninety-three female nurses completed Zung' s Self-rating Depression Scale (SDS),Zung' s Self-rating Anxiety Scale (SAS) and the World Health Organization' s Quality of Life Questionnaire-Brief Version (WHOQOL-BREF).According to the cut-off scores of SDS and SAS,all subjects were divided into 4 groups (non-depression and non-anxiety,pure depression,pure anxiety,and CDA).Group differences in SDS,SAS and WHOQOL-BREF scores were compared.Results Of these 4 groups,CDA group had the highest SDS and SAS scores (P ＜ 0.001) (SDS scores:(34.3 ±5.4),(47.1 ±4.0),(39.4 ± 2.4) and (49.7 ±4.2)) and the lowest WHOQOL-BREF scores (P≤0.033)(WHOQOL-BREF physical domain scores:(15.6 ± 2.0),(13.8 ± 2.0),(13.6 ± 1.6) and (12.1 ± 2.0)).The corresponding stratification analysis (controlling for confounding factors) showed consistent results.Conclusion CDA nurses have the most severe depressive and anxious symptoms and the worst quality of life,and thus are the key target population of mental health service.

ObjectiveTo investigate the effect of remifentanil on hepatic ischemia-reperfusion (I/R) injury in rats with liver cirrhosis.MethodsThirty male SD rats weighing 260-300 g were randomly divided into 3 groups (n =10 each):group liver cirrhosis (group C); group liver cirrhosis + hepatic I/R (group I/R) and group remifentanil (group R).Liver cirrhosis was produced in all animals in the 3 goups.I/R injury was induced by 20 min occlusion of the hepatic artery and portal vein entering the middle and left lobes of the liver followed by 4 h reperfusion at 1 week after establishment of hepatic cirrhosis in I/R and R groups.In group R remifentanil was infused iv at 1 μg·kg-1 ·min-1 starting from 10 min before ischemia until the end of 4 h reperfusion.Venous blood samples were taken from inferior vena cava at the end of 4 h reperfusion for measurement of serum ALT and AST activities.The animals were then sacrificed and liver specimens were taken from middle lobe for determination of Bcl-2 and Bax expression (by immuno-histochemistry) and hepatocyte apoptosis (by TUNEL) and microscopic examination.Apoptosis index (percentage of apoptotic cells) was calculated.ResultsI/R significantly increased serum ALT and AST activities,Bax expression and apoptosis index and decreased Bcl-2 expression in group I/R as compared with group C.Remifentanil significantly attenuated the I/R-induced changes in serum ALT and AST activities,Bax and Bcl-2 expression and apoptosis in group R as compared with group I/R.Remifentanil also ameliorated I/R-induced liver damage.ConclusionRemifentanil can auenuate hepatic I/R injury in rats with liver cirrhosis by up-regulating Bcl-2 expression and down-regulating Bax expression and inhibiting apoptosis.

Objective To analyze the proportion of incidence of etiological agents in 133 cases with constitutional delayed puberty.Methods Clinical data of etiological agents in 133 patients with constitutional delayed puberty were retrospectively analyzed.Results Etiological agents in 133 cases with constitutional delayed puberty were as follows:Hypo-gonadotrophic hormone group(56.39%,n=75):39 cases with unknown reason(idiopathy,3 cases were female),intrapartum asphyxia/hypoxia or hemorrhage(n=23),pituitary glands dysplasia(n=6),cephal trauma(n=3),postoperative craniopharyngioma(n=2),empty sella turciea(n=2),combined hormone deficiency(n=59).Hyper-gonadotrophic hormone group(17.29%,n=23):17 cases with chromosomal disorders(n=17,male:female=7:16),3 cases with unknown reason(idiopathy).31 cases with constitutional delayed puberty(23.31%),4 cases with functional delayed puberty(3.01%).Conclusion Many etiological agents could result in delayed puberty,different origins of delayed puberty had different therapies.Classification of etiological agents in patients with constitutional delayed puberty phyed an important role in guiding option of clnical treatment.

Objective: To explore the related factors of quality of life(QOL) among rural elderly population in Shandong Province and explore the relationship among these factors.Methods: In this cross-sectional study,a sample of 451 elderly peple(aged from 60 to 92,without hearing or mental problems) was selected by a stratified cluster random sampling method.The 36-item Short Form Health Survey(SF-36) was used to measure QOL,and the AMOS 5.0 was used to carry out path analysis.Results: The QOL average score of all subjects was(78.5?15.4);QOL scores of males was higher than that of females [(81.2?13.0) vs.(77.5?16.3),P=0.003].There was a significant decrease of the QOL score with increasing age [60-69 years,(82.2?13.3);70-79 years,(77.0?16.0);≥ 80 years,(71.4?16.4);P

Objective To investigate effects of Naoxintong drip pill (NDP) in activating blood and removing blood-stasis and on myocardial and cerebral ischemia. Methods The in-vivo effect of NDP on thrombosis, aggregation of platelets, blood viscosity, microcirculation, acute myocardial and cerebral ischmia and the focal cerebral-infarction were observed for study the pharmacodyamic effect of NDP. Results NDP could significantly inhibit the formation of thrombosis and maximal aggregation rate of platelets, and decrease viscosity in whole blood and plasma in rats with blood stasis. It could also promote auricular microcirculation, prolong the survival time of mice with cerebral ischemia, improve the electrocardiogram of ischemic rats, reduce the focal cerebral-infarction area and improve behavior disorder. Conclusion NDP possesses actions of activating blood and removing blood-stasis and improving myocardial and cerebral ischemia and focal cerebral-infarction.