Triple negative breast cancer (TNBC) is a special type of breast cancer.Its special clinical pathological characteristic and molecule expression type make the treatment of TNBC become an international problem.In recent years,a variety of attempts and explorations to the treatment of TNBC have made some initial results,which provides a direction for the treatment of TNBC and offers hope for the patients with TNBC.

Objective To analyze the correlation between fetal right aortic arch and chromosome ab-normality by ultrasound.Methods From January Jan 2009 to Dec 2014,nineteen cases with fetal right aortic arch were enrolled.They were all determined by chromosome karyotype analysis.The correlation of fetal right aortic arch and chromosome abnormalities detected by ultrasound were evaluated.Results Left lock,a “U”shaped vascular structure,were found in 15 cases.One case of fetal aortic arch was surrounded by a “O”shaped package.Three cases of right aortic arch showed fetal left artery catheter and brachiocephalic artery ima-ging branch.Echocardiography mainly for arterial catheter in three vessel trachea view did not show up.Artery catheter,in front of the trachea,did not form the vascular ring.Nineteen cases of right aortic arch were exam-ined by fetal karyotype analysis.Three patients with trisomy 18-karyotype presented ventricular septal defect, single artium,three tricuspid atresia,pulmonary artery stenosis.Four cases with trisomy 18-karyotype presen-ted ventricular septal defect,complete atrioventricular canal,single artium,double outlet right ventricle,pul-monary artery stenosis in atresia.Three cases with trisomy 21 -karyotype showed single ventricle,single atri-um.One case was with tetralogy of Fallot and one case with dextrocardia,aortic stenosis,accompanied by 22q 1 1.2.Conclusion In prenatal ultrasound screening,we should pay attention to three vessels-trachea view on ultrasound image,which can improve the detection rate of right aortic arch.Fetal right aortic arch and triso-my 18-,trisomy 21 -,chromosomal diseases are substantially correlated.Further analysis of chromosome kary-otype is needed to exclude chromosomal lesions,so as to achieve the purpose of prenatal and postnatal care.

AIM To investigate the effects of taurine(TAU) and propafenone(PRO) combination on experimental arrhythmias and its influence on haemodynamics of anesthesized rats' heart. METHODS Rats were pretreated respectively with intravenous administration of saline, TAU, PRO, or TAU and PRO combination. Afterwards, the rats were intravenously administrated with BaCl 2 or aconitine to induce arrhythmia. The arrhythmia lasting time and incidence were observed and recorded on the lead Ⅱ ECG. The cumulative aconitine dosage to induce premature ventricular contraction(PVC), ventricular tachycardia(VT) and ventricular fibrillation(VF) were calculated respectively. The haemodynamic parameters such as LVSP, HR, +d p /d t max were recorded continuously in anesthetized rats pretreated with iv TAU, PRO or TAU and PRO combination. RESULT In BaCl 2 arrhythmia, the arrhythmia duration was shortened significantly; and the arrhythmia incidence was decreased in the combination group, as compared with the single same dosage drug groups. In aconitine arrhythmia, the cumulative aconitine dosages to induce PVC, VT and VF were increased significantly in the combination group. Haemodynamics parameters showed that PRO(2mg?kg -1 iv) significantly decreased LVSP and +LVd p /d t max , while these parameters were not significantly changed in the combination group with same dose of PRO. CONCLUSION TAU and PRO have synergism in antiarrhythmia in both BaCl 2 and aconitine induced arrhythmia; TAU may alleviate cardiac depression exerted by PRO.

Objective To approach the effect of bed exercise for patients with intracranial aneurysm undergoing neural interventional treatment. Methods Ninety-six patients with intracranial aneurysm were divided into the test group(50 cases) and control group(46 cases).The control group received routine nursing, while the test group carried out bed exercise base on routine nursing. The incidence of complica-tions and changes of life quality were compared between the 2 groups. Results Lower incidence of com-plications took place in the test group than the control group(P ＜ 0.05).But changes in pulse rate and blood were not significant (P ＞ 0.05).The score of life quality in the physical domain and psychological domainwere not statistically different between the two groups (P ＜ 0.01 ),but no evident difference was seen in the domain of social relationship and environmental domain (P ＞ 0.05). Conclusions Bed exercise could al-leviated the anxiety and trepidation of patients with intracranial aneurysm,decrease the incidence of compli-cations such as body pain caused by absolute bed rest,thus improve patients' life quality.

Objective To compare drug therapy in patients suffering from chronic heart failure between Tianjin and Kashi region of Xinjiang autonomous region and to analyse their disparities in drug uses by guideline between the two regions.Methods All data were retrospectively taken from the hospitalized chronic heart failure cases from June 2005 to June 2006 in the 2nd Hospital of Tianjin Medical University and the 2nd People's Hospital of Kashi in Xinjiang respectively.The heart functions level NYHA Ⅱ-Ⅳ were recorded for analysis of drug use in the two regions.Results 749 cases were enrolled,491 from Tinajin and 258 from Kashi of Xinjiang.The average age of group Tianjin[(70.39±10.84)yrs]was older than that[(62.91±12.54)yrs]of group Kashi(t=8.488,P＜0.01).The distribution of≥165 cases in the group Tianjin(75.6%)was higher than that of group Kashi(51.2%)(X2=45.642,P＜0.01).The male cases in group Tianjinwere 264(53.8%)andthatwere 134(51.9%)in group Kashi with no significant differences in sex distribution between the two groups(P＞0.05).The first three etiological diseases were coronary heart disease(84.9%),rheumatic heart disease(5.9%)and dilated cardiomyopathy (3.3%)in group Tianjin,and that were coronary heart disease(63.2%),pulmonary heart disease(19.8%)and dilated eardiomyopathy(6.6%)in group Kashi respectively.The proportions of level NYHA Ⅱ,Ⅲ,Ⅳ on admission were 29.7%,39.1%and 31.2%in group Tianjin respectively,and that were 15.5%,39.5%and 45.0%in group Kashi respectively,with significant difference in heart function levels between the two groups(X2=22.770,P＜0.01).Theusages of nitrides and β-blockers in group Tianjin were more than that in group Kashi(both P＜0.01).The usages of diuretics,digitalis was more in group Kashi(all P＜0.01).There was no difference in ACEI usages between the two groups.The dosages of drugs in group Tianjin achieved the target dosages by the guideline and the dosages in group Kashi did not achieve the targets.The use frequency of β-blockers was more in male cases and＜65yrs respectively of group Tianjin.The usage frequency of uretics and aldosterone antagonist were more in＜65yrs cases of group Kashi and the usages of nitrides,ACEI,B-blockers,calcium antagonists,aldosterone antagonist of male cases were more than that of female cases(all P＜0.05)in this group.The usages of uretics,digitalis,aldostemne antagonist increased following the grading of heart function of the two groups(P＜0.05).Moreover the usage of ACEI decreased following the worsen heart function in group Tainjin and this was not the same in group Kashi.Conclusion There are differences in drug medications for chronic heart failure between Tianjin and Kashi.The majority of treatment drugs in Tianjin is approaching the guideline and there is a gap from guideline in Kashi of Xinjiang,especially on the dosage.

This study is to investigate the effects of sophoridine on NF-kappaB signaling pathway in kidney tissue of endotoxemia mice and the mechanism involved. BALB/c mice were challenged with lipopolysaccharide (LPS) caudal vein injection, then sophoridine was administered by intraperitoneal injection. Totally 50 mice were divided into 5 groups: control group, LPS model group, sophoridine treatment 12 mg x kg(-1) group, 6 mg x kg(-1) group and 3 mg x kg(-1) group. All animals were sacrificed at 6 hours after treatment. Kidney and blood samples were harvested. IKKbeta mRNA and TNF-alpha mRNA expression of renal tissue was measured by the reverse transcription polymerase chain reaction (RT-PCR), and phosphorylation IKKbeta protein (pIKKbeta) was detected by immunohistochemistry. NF-kappaB P65 protein expression and distribution of renal tissue were observed by Western blotting and immunofluorescence laser confocal microscopy. Serum TNF-alpha level was detected by radioimmunoassay. The results showed that the sophoridine significantly reduced the expression of IKKbeta mRNA and pIKKbeta protein, and inhibited the expression of NF-kappaB P65 protein and decreased the entry nuclear rate of NF-kappaB P65 in the renal tissue of endotoxemia mice. Thereby the renal TNF-alpha mRNA expression and serum TNF-alpha level were significantly reduced. These results suggest that sophoridine could inhibit inflammatory reaction induced by LPS through inhibiting activation of NF-kappaB signaling pathway.

New-onset refractory status epilepticus(NORSE) is a clinical syndrome, not a specific diagnosis of diseases in patients with new onset of refractive status epilepticus without active epilepsy or other preexisting relevant neurological disorders and is not associated with a clearly acute or active structrue, toxic or metabolic cause.Febrile infection-related epilepsy syndrome(FIRES) is a subcategory of NORSE, applicable for all ages, occurring in a prior febrile infection starting between 24 hours and 2 weeks before onset of refractory status epilepticus(RSE) with fever or not.Proposed consensus definitions are also applicable for infantile hemiconvulsion-hemiplegia and epilepsy syndrome, RSE, super-RSE, prolonged RSE and prolonged super-RSE.These consensus definitions will promote much more effective communication and multicenter research, and ultimately improve recognition and treatment of these conditions.

ObjectiveTo analyze the clinicopathological features and prognosis of gastric cancer patients with metastatic nodules of perigastric soft tissue. MethodsIn this study,1025 cases of gastric cancer received radical resection.According to the metastasis of perigastric soft tissue,patients were divided into metastatic group ( group MP,n =334 ),non-metastatic group ( group NMP,n =691 ).The clinicopathological features and prognosis were compared between the two groups. ResultsIn group MP,the ratio of upper,middle,lower,total gastric cancer was 25.8％,22.0％,51.4％,0.9％ and the ratio in group NMP was 33.2％,21.3％,41.3％,4.2％ respectively,showing significant higher ratio of upper and total gastric cancer in MP group(P =0.000). In group MP 47.3％ cases with tumor size ≥5 cm,significantly higher than that in NMP group(27％ ) (P =0.000).Lymph node metastatic ratio between 21％ -40％ and 41％ -100％ was found in 24.4％ and 37.3％ in MP group respectively,significantly higher than that of 12.9％,10.8％ in NMP group(P =0.000).20.1％ cases had distal metastasis in group MP,significantly higher than that of 4.1％ in group NMP(P=0.000).In group MP and NMP group,the ratio of Borrmann infiltration typing was 82.1％ vs.64.6％,the ratio of positive CEA was 21.2％ vs.11.4％,the ratio of lower or undifferentiation typing was 78.7％ vs.64.2％,all with significant difference (P =0.000 ). COX regression analysis showed the infiltration depth,organic invasion,lymph node metastatic ratio,M staging,Borrmann typing,metastatic nodules was the independent prognostic factors.Prognosis was significantly poorer in the cases with perigastric soft tissues than without ( P =0.000 ).Stratified analysis showed that irrespective of tumor size,infiltration depth,lymph node metastatic ratio,CEA value,Borrmann typing,differentiation degree,the mean survival time was significantly shorter in MP group than that in group NMP(P ＜ 0.005).In cases without distal metastasis,the prognosis was significant poorer in group MP than that in group NMP ( P =0.000 ),however,there was no significant difference between two groups in cases without distal metastasis ( P =0.076).ConclusionsPerigastric soft tissue metastasis was common in gastric cancer,more frequently seen in tumor ≥5 cm,or with organic invasion,lymph nodemetastaticration ≥ 21％, distalmetastasis, Borrmanninfiltrationtyping, loweror undifferentiation typing,positive CEA. Perigastric soft tissues metastasis was the independent prognotic factor for gastric cancer.

The International League Against Epilepsy (ILAE) 2017 classification of seizure types is introduced to provid guidance on how to employ the classification.The main framework includes basic and extended versions of the classification.Key signs and symptoms of seizures are used as basis for categories of seizures that are focal or generalized from onset or with unknown onset.Any focal seizure optionally characterized by whether awareness is retained or impaired is further divided into a focal awareness seizure and focal impaired awareness seizure.Focal seizures can become bilateral tonic-clonic.Generalized seizures comprise the onset of motor and nonmotor (absence) seizures.Seizures of unknown onset may be classified as motor,nonmotor,tonic-clonic,epileptic sPasms,or behavior arrest.

Objective:To explore the value of Astograph challenge test and small airway functional parameters to diagnose asthma.Methods:86 asthmatics were enrolled along with 40 non-asthmatic patients as a control group from January 2018 to March 2019 in People′s Hospital of Nanhai Economic Development Zone, Foshan Chancheng District Central Hospital and Affiliated Hospital of Guangdong Medical University. All subjects were required to complete data acquisition, impulse oscillometry (IOS), pulmonary function test, and Astograph challenge test. The routine pulmonary function indexes, pulse oscillation indexes and reaction threshold (Dmin) were compared between asthma group and non asthma group, and the correlation between each index was analyzed.Results:The Dmin, max expiratory at 50% forced vital capacity (MEF 50%), max expiratory at 75% forced vital capacity (MEF 25%), maximal mid expiratory flow (MMEF) of asthma group were significantly lower than those of non-asthmatic group ( P<0.05). The IOS parameters such as respiratory impedance (Zrs), resistance at 5 Hz (R 5), resistance at 20 Hz (R 20), peripheral resistance (R 5-R 20), reactance at 5 Hz (X 5), the resonance frequency (Fres) showed no statistical significance between the asthmatics and the non-asthmatics ( P>0.05). Response threshold (Dmin) was positively correlated to MEF 50, MEF 25 and MMEF respectively (0.295, 0.306, 0.381, all P<0.05). A receiver operating characteristic (ROC) analysis indicated the area under ROC curve (AUC) of Dmin in diagnosis of asthma was 0.978 (95% CI: 0.950-1.000), the best cutoff point of Dmin was 13.609 Units, with sensitivity in diagnosing asthma 94.6%, specifity 96.8%. The AUC for MEF 50, MEF 25, MMEF were 0.674, 0.738, 0.683, with the best cutoffs 3.990 L, 1.685 L, 3.445 L, respectively. Conclusions:Astograph challenge test, which is fast, safe and precise, can assist in the diagnosis of asthma. MEF 50 and MEF 25 may be associated with the diagnosis of asthma and can predict airway hyper-responsiveness while IOS parameters could not, which make MMEF, MEF 50 and MEF 25 superior to IOS parameters in the diagnosis of asthma.