Objective To observe the effect of IMRT combined with astragalus polysaccharide (ASP) injection on cervicocerebral tumor,radiation side effects and its influence on immune function. Methods 61 head and neck tumor patients were randomly divided into two groups.One groups received the IMRT combined with Astragalus Polysaccharide (ASP) injection (n=30) while the other group only received the IMRT(n=31). The recent effect, immune function and the side effects of radiotherapy between the 2 groups were observed and compared , changes of T-lymphocyte subsets, natural killer (NK) cell activity and the dermatitis,oral mucosa reaction,thirsty condition on patients in intraoperative or postoperative period were also observed and compared. Results The total effective rate in experimental group and the control group were 83.0% and 80.6% respectively.The cell viability of peripheral blood lymphocyte and NK cell as well as the T3、T4、NK cell value increased in IMRT-ASP group (P<0.05) after treatment. While T3、T4、NK cell value in peripheral blood decreased (P<0.05). Mucosa,dermatitis and salivary gland damage showed in IMRT-ASP group were significantly better than in control group after 3 weeks treatment (P<0.05). Conclusion ASP can improve immune function effect in head and neck tumor patients during RT, and can also eliminate the side effects of radiotherapy.

Objective To study the clinical application value of advanced breast cancer which resistence CAF regimen,treated with semimonthly regimen for paclitaxel combined with 5-fluorouracil/leucovorin 48-hour continuouse infusion.Methods 80 paients with CAF-regimen-resistant ABC were treated with paclitaxel combined with 5-fluorouracil/leucovorin continuouse infusion,paclitaxel 95mg/m2,d_1,LV 200mg,d_1,5-fluorouracil 3g/m2,continuouse infusion for 48 hours with infusion pump.every cycle lasted 2 weeks,at least 4 cycles.Results Of 80 patients,there were 9 complete and 26 partial responses,32 cases remained stable and 13 progressive.The overall response rate of 43.8%.The median time to progression was 8 months.The median survival time was 16.7 months,the patients with soft tissue,lung,pleura,bone,liver obtained response rat was 46.7%(21/45),38.5%(5/13),31.3%(5/16),40%(4/10),20%(2/10).Conclusions semimonthly regimen for paclitaxel combined with 5-fluorouracil/leucovorin 48-hour continuouse infusion is effective and acceptable toxicity,it could be considered as one of the standard chemotherapy for advanced breast cancer which resistence CAF regimen.

Thrombotic microangiopathy(TMA) is a group of clinical and pathological syndromes, characterized mainly by hemolytic anemia, thrombocytopenia, and multiple organ dysfunctions caused by a variety of factors.Classic types of TMA include hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura(TTP). HUS is a critically ill glomerular disease.Depending on the pathogenesis, HUS is currently divided into 2 categories, namely typical and atypical HUS.Atypical HUS is at a rapid onset and is a type of dangerous disease, which tends to recur easily, and has high mortality in its acute phase.TTP is a rare but fatal entity of TMA.The pathophysiology of the disease is based on a severe functional deficiency of a disintegrin and metalloprotease with thrombospondin type 1 repeats, member 13(ADAMTS-13), the specific von Willebrand factor(VWF)-cleavage protease.This deficiency may be either acquired or congenital.The activity of plasma ADAMTS-13<10%is the only definitive method for diagnosing TTP.This article reports the recent advances on the diagnosis and treatment of severe TMA in children.

Objective:To investigate the prognostic value of molecular subtypes in patients with resected invasive breast cancer.Methods:Between 2015 and 2018 7 869 patients with invasive breast cancer after undergoing surgery were included in this analysis. Breast cancer was classified into four subtypes according to the status of hormone receptor (HR) and HER2: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Kaplan-Meier curves and COX regression were used to compare disease-free survival (DFS) and overall survival (OS) among different subtypes.Results:The 5-year DFS and OS were 86.30% and 94.29%, respectively. Proportions of HR+/HER2-、HR+/HER2+、HR-/HER2+ and HR-/HER2- were 52.9%、17.5%、14.1%和15.5%, respectively. The 5-year DFS of HR+/HER2- subtype (88.12%) was higher than HR+/HER2+ (84.67%, P=0.026), HR-/HER2+ (84.19%, P<0.001) and HR-/HER2- (83.70%, P<0.001). The 5-year OS of HR+/HER2- (95.38%) was not different from HR+/HER2+ (95.17%, P=0.187), while it was higher than that of HR-/HER2+ (92.26%, P<0.001) and HR-/HER2- (91.69%, P<0.001). Subtype was still a significant factor regarding DFS and OS in multivariable analyses adjusting for age, sex, stage, Ki67, types and time of surgery. The DFS ( P=0.257) and OS ( P=0.511) was not different between HR-/HER2+与HR+/HER2- subtypes, while HR-/HER2+ and HR-/HER2- patients had worse DFS ( P<0.05) and OS ( P<0.05) than that with HR+/HER2-. Conclusions:Molecular subtype is a significant independent prognostic factor for DFS and OS in operable invasive breast cancer. HR+ subtypes have better prognosis compared with HR- subtypes. The DFS and OS were not different between HR+/HER2- and HR+/HER2+, or between HR-/HER2+ and HR-/HER2-.