Hormone receptor-positive and human epidermal growth factor receptor 2-positive (HR + HER2 +) breast cancer is a highly heterogeneous disease, accounting for about 10% of breast cancers. The molecular biological characteristics, therapeutic effect and prognosis of all subtypes have significant differences. This paper reviews the research progress of molecular biological characteristics, diagnosis and treatment condition and single-cell level in HR + HER2 + breast cancer from the perspective of heterogeneity.

Objective To study the proportion of cyclic vomiting syndrome(CVS) developing to migraine by the medium term prognosis,and explore the relationship between CVS and migraine.Methods Twenty-eight of 38 cases who had identified in our clinical records were traced ,each child was matched to a control,and they all conducted a telephone interview by a standardized question.Results Ninteen(46%) of the subject had continued CVS and(or) migraine,the prevalence of past or present migraine in subjects(46%)was significantly higher than that in control group(10.7%)(P=0.003).Conclusion The progonosis of CVS is closely related to migraine,many of the suffers of CVS tend to develop migraine.

Objective:To study the sealing effect of penetrating resin and fluid resin on the exposed dentin with self-etching and to-tal-etching methods,respectively.Methods:60 fresh extracted teeth were randomly divided into 4 groups(n =15).The enamel layer at the tooth neck was cut off,the dentin layer was exposed and adhered with penetrating resin Icon-Infiltration following Icon-Etch etching(group A),Icon-Infiltration following SE-Bond etching(group B),FiltekTMZ350X following SE-Bond etching(group C)and Prime &Bond NT combined with FiltekTMZ350XT following Gluma acid etching(group D),respectively.The morphological change of the dentin-resin interface was examined by the scanning electron microscope.The thickness of adhensive layer hybrid layer and the length of resin tag were measured.Data were statistically analysed.Results:Tight adhesion layer was observe in all groups.The hy-brid layer of the adhesive interface of group D was thicker than that of other groups(P <0.05);the resin tags in the dentin tubules of group A were longer than those of other groups(P <0.05);the bonding agent layer of group C was the thickest(P <0.05).Conclu-sion:The penetrating resin can form more effective protection layer on the exposed dentin surface and longer resin tags pernertrating in-to the dentin tubules than self-etch/total-etch bond system with fluid resin.

Acute Disease ; Adult ; Ethylene Oxide ; poisoning ; Female ; Humans ; Male ; Middle Aged

Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; pathology ; Male ; Middle Aged ; Neoplasms, Muscle Tissue

Objective To analyze the complications and short-term effects of laparoscopic surgery for achalasia.Methods The clinical data of 41 patients with achalasia who were treated by laparoscopic surgery were analyzed retrospectively.Results The 41 patients were no deaths.All patients underwent Heller cardiomyotomy and fundoplication,39 patients with Dor anterior fundoplication,2 patients had the presence of hiatal hernia with Toupet fundoplication.The mean surgical time was 142 min.Intraoperative complications occurred in 7 cases,including 6 cases of mild complications.The mean follow-up was 21 months.The clinical efficacy excellent in 27 cases,good in 7 cases,generally in 5 cases,poor in 2 cases.Conclusions Heller cardiomyotomy should be the treatment of choice in achalasia patients,because of its short and medium term outcomes,and its low morbidity.

Objective To assess the effects of radiofrequency ablation (RFA) and bipolar cord coagulation (BCC) on the prognosis and complication rate of complicated monochorionic twins.Methods A retrospective review was undertaken in 58 cases of complicated monochorionic twins treated with RFA or BCC at the First Affiliated Hospital of Sun Yat Sen University,from January 2008 to August 2013.Non-parametric Wilcoxon test,Chi-square test,Fisher exact test or multi-variant Logistic regression analysis were used for statistical analysis.Results Indications for selective termination in the 58 cases were:twin reversed arterial perfusion sequence in 12,severe twin to twin transfusion syndrome in 28,discordance of fetal anomalies in 10,selective intrauterine growth restriction in 7 and twin anemia-polycythemia sequence in 1.Forty-three cases were managed with BCC and 15 with RFA.Preterm labor was more common in the BCC group than in the RFA group [86.0％(37/43) vs 9/15,respectively; x2=4.598,P=0.032).Premature rupture of the membranes occurred in 48.8％(27/43) of the BCC group vs.4/15 of the RFA group (x2=2.229,P=0.135).The median procedure-todelivery time was 48 (1-150) days for the BCC group vs.101(14-138) days for the RFA group (Z=-2.245,P=0.025).Overall survival rate was 62.8％(27/43) in the BCC group vs 11/15 in the RFA group (x2=0.547,P=0.460),which was not significantly different.Neurodevelopmental delay was detected in two neonates in BCC group and in one neonate in RFA group.Logistic regression analysis showed that delivery before 28 gestational weeks was an independent risk factor for the poor prognosis of the co-twins (OR=192.720,95％CI:18.610-994.000,P ＜ 0.01).Conclusion Compared with BCC,RFA does not improve the prognosis of complicated monochorionic twins significantly.

Objective To evaluate the accuracy of chemical shift imaging (CSI) and MR spectroscopy (MRS) for fat quantification in phantom model. Methods Eleven phantoms were made according to the volume percentage of fat ranging from 0 to 100% with an interval of 10% . The fat concentration in the phantoms were measured respectively by CSI and MRS and compared using one-sample t test The correlation between the two methods was also analyzed. The concentration of saturated fatty acids ( FS), unsaturated fatty acids (FU) and the polyunsaturation degree (PUD) were calculated by using MRS. Results The fat concentration was (48.0 ±1.0)%, (57.0 ±0.5)%, (67.3±0.6)%, (77.3 ±0.6)%, (83.3±0.6)% and (91.0±1.0)% respectively with fat volume of 50% to 100% by CSI. The fat concentration was (8.3 ±0.6)%, (16.3 ±0.7)%, (27.7 ±0.6)%, (36.0 ±1.0)%, (43.5±0. 6)% and (56. 5 ±1. 0)% respectively with fat volume of 10% to 60% by MRS, the fat concentration were underestimated by CSI and MRS (P < 0.05 ), and had high linear correlation with the real concentration in phantoms ( CSI: r = 0. 998, MRS: r = 0.996, P < 0.01 ) . There was also a linear correlation between two methods (r = 0. 992, P < 0. 01 ) but no statistically significant difference ( pairedsamples t test, t = -0. 125 ,P = 0.903). By using MRS, the relative ratio of FS and FU in fat were 0. 15and 0. 85, the PUD was 0. 0325, respectively, and highly consistent with these in phantoms. Conclusion Both CSI and MRS are efficient and accurate methods in fat quantification at 7.0 T MR.

Scleroglucan produced by Sclerotium spp. is a non-ionic polysacchari de biopolymer which has excellent viscosifying power in a wide variety of reservoi r brines snows high shear resistance and possesses good thermal stability. This article reviews the production of Scleroglucan , the influence of the conditions to the fermentation, and the application in the oil field.

Objective:To summarize the development of the HIV/AIDS designated hospital system, analyze the main issues and explore solutions for this system. Methods:184 leaders/experts of three levels of healthcare facilities ( provinces, cities and counties) from 30 provinces engaged in AIDS prevention and control for over five years, and 2,432 people living with HIV/AIDS(PLWHA) from seven provinces were investigated through two different question-naires. Results:According to the staff responses, the issues of surgery and hospitalization are difficult and outstand-ing for PLWHA due to the current designated hospital system with scores of 6. 49 in severity. Of the ten largest prob-lems, ranked third is the need for improved AIDS prevention and control. 2 367 (97. 3%) PLWHAs had an aware-ness of the designated hospitals, 1,376 received treatment in the designated hospitals, and 85. 5% believed that the illness was effectively treated, while 9. 0% thought that the medical technology of the designated hospital was limited;18 . 7% of hospitalized HIV/AIDS patients or those who received surgery experienced prevarication by the non-des-ignated hospitals. Policy analysis shows that China’s designated hospital system for PLWHA has developed gradually with the characteristics of periodic and temporary changes. Conclusion:The designated hospital system for PLWHA in China has played an important role, but there are still several problems. The government should improve the existing system by strengthening the comprehensive medical service capacity of designated hospitals, improving the mechanism of consultation and referrals, coordinating the non-designated hospitals to provide technical support, reducing dis-crimination and fear from medical staff against HIV/AIDS, decreasing the risk of occupational exposure, and enhan-cing the communication among hospitals, CDCs and patients.