The results of chemotherapy in the treatment of soft tissue sarcoma seem to have reached a plateau.Targeted therapy is the key to improve curative efficacy.Although there are many kinds of targeted therapy drugs of the first generation,only several targeted drugs that target angiogenesis and the epidermal growth factor receptor have showed survival benefits in prospective,randomized,phase Ⅲ clinical trials.Recent data suggest that multitargeted inhibitors might have greater activity owing to their ability to simultaneously block several key signaling pathways.Preliminary results of such agents in clinical trials show that they have a well tolerated toxicity profile,and might have a promising vahle in the treatment of soft tissue sarcoma.

Congenital heart disease (CHD) is the most common heart disease in children, which does great harm to children's health. Tetralogy of Fallot(TOF) is the primary form of cyanosis CHD, with the incidence rate of 10% ～ 15% in CHD. Tissue Doppler lmaging(TDI) ,a new type of Doppler echocardiography, is a noninvasive and a promising method in determination of right and left ventricle constriction and dilatation function quantificationally, which will improve the development of acquainting with heart disease and guid the clinical treatment of CHD. This review is to summarize the status quo of TDI in congenital heart disease especially in TOF.

Objective To review the status and controversy on skin-sparing mastectomy (SSM) for breast cancer. Methods The pertinent literatures about SSM published recently to comprehend its relevant techniques and improvements in comparison with non-skin-sparing mastectomy (NSSM) were analyzed and also the safety of SSM by analyzing the relationships between SSM and ductal carcinoma in situ, restrict nipple-areola complex reservation, and postmastectomy radiotherapy were discussed. Results Skin-sparing mastectomy combined with immediate breast reconstruction is a safe operative modality for T1/T2 tumor without skin adhesion, multicentric tumors, and ductal carcinoma in situ. What is more, it does not defer adjuvant therapy. However, it may be prudent to reserve the nipple-areola complex only for peripherally located T1/T2 tumors and some other less serious invasion degree. Since the effect of SSM and immediate breast reconstruction on postmastectomy radiotherapy is confusing, there are still controversies on whether the patients who have already been operated should take radiotherapy. Conclusion SSM is a safe operative modality for selected patients with breast cancer, and delayed reconstruction may be a good choice for patients who would take postmastectomy radiotherapy.

Objective To investigate difference of clinical curative effect between laparoscope combined with choledochoscope and traditional laparotomy in treatment of cholecystolithiasis and choledocholithiasis.Methods The clinical data of 80 patients with cholecystolithiasis and choledocholithiasis were retrospectively analyzed,among whom 48 patients were given laparoscopic cholecystectomy (LC) ± laparoscopic common bile duct exploration (LCBDE) (observation group),and 32 patients were given traditional laparotomy (control group).The curative effect was compared between 2 groups.Results There were no statistical differences in operating time,calculi clearance rate and cost of hospitalization between 2 groups (P ＞ 0.05).The intraoperative bleeding,postoperative length of hospital stay,and rate of postoperative complication in observation group were significantly lower than those in control group:(28 ± 5) ml vs.(32 ± 11) ml,(6.0 ± 1.1) d vs.(7.0 ± 1.2) d,4.17％ (2/48) vs.18.75％ (6/32),and there were statistical differences (P ＜ 0.05).Conclusion Laparoscope combined with choledochoscope is an effective treatment method of cholecystolithiasis and choledocholithiasis.

China ; Combined Modality Therapy ; Esophageal Neoplasms ; pathology ; surgery ; therapy ; Esophagectomy ; methods ; Humans ; Lymphatic Metastasis ; Neoplasm Staging ; Survival Rate

Based on the theory of cancer stem cells (CSCs),people have been searching for the treatments of malignant cancers.Gastric cancer side population cells (SP) have the characteristics of CSCs.Searching for the molecular targeted therapy strategy of gastric cancer which embarks from the gastric cancer SP and is based on the theory of CSCs provides a new direction for the treatment,early diagnosis,therapeutic effect and prognosis of gastric cancer.

Objective To investigate the relationship between the levels of serum procalcitonin (PCT) and cardiac troponin I (cTnI) in patients with sepsis.Methods According to the severity of the disease, 126 patients with sepsis in the Department of Critical Care Medicine of Hubei Provincial Hospital of Integrated Chinese and Western Medicine from June 2013 to February 2015 were divided into three groups: sepsis, severe sepsis and septic shock groups, 42 cases in each group. The changes of lactate (Lac) and central venous oxygen saturation (ScvO2) were monitored in the three groups within 72 hours after admission, the mortality and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours after admission, the levels of serum PCT and cTnI were compared among the three groups, and the correlations between serum PCT, cTnI levels and APACHE Ⅱ score were analyzed.Results Along with the increase of patients' severity in the three groups, the levels of Lac (mmol/L) were gradually increased (prior treatment: 5.82±2.42, 7.97±3.76, 10.30±2.82; 6 hours after treatment: 3.63±1.54, 5.08±1.98, 7.50±1.35; 12 hours after treatment: 2.70±1.55, 4.13±1.96, 6.23±1.16; 24 hours after treatment: 2.58±1.35, 3.95±2.44, 5.25±1.13; 48 hours after treatment: 2.15±1.82, 3.86±2.36, 4.12±1.72; 72 hours after treatment: 1.83±1.04, 3.78±1.84, 3.74±0.87), while the levels of ScvO2 were gradually reduced (prior treatment: 0.556±0.102, 0.502±0.095, 0.402±0.092; 6 hours after treatment: 0.627±0.062, 0.557±0.083, 0.504±0.075; 12 hours after treatment: 0.658±0.076, 0.601±0.083, 0.595±0.072; 24 hours after treatment: 0.676±0.059, 0.625±0.084, 0.603±0.050; 48 hours after treatment: 0.704±0.049, 0.656±0.066, 0.615±0.035; 72 hours after treatment: 0.755±0.053, 0.707±0.066, 0.629±0.048). The higher the Lac, the lower the ScvO2, and the differences among the three groups were of statistical significance (allP < 0.01). The mortalities of patients in the septic, severe septic and septic shock groups were as follows: 11.9% (5/42), 21.4% (9/42), 38.1% (16/42); serum PCT (μg/L): prior treatment: 5.21±2.92, 17.20±4.81, 40.71±5.22; 4 days after treatment: 2.51±1.52, 10.72±3.83, 46.45±4.25; the levels of cTnI (μg/L): prior treatment: 5.31±0.82, 9.50±0.31, 15.12±3.15; 4 days after treatment: 1.16±0.62, 5.35±0.53, 9.24±1.25; APACHE Ⅱ score: prior treatment: 10.41±3.72, 20.15±5.14, 35.17±4.58; 4 days after treatment: 7.25±2.22, 14.15±4.16, 28.12±3.13. Their levels were also increased along with the increase of the septic severity. The correlation analyses showed that the serum levels of PCT was significantly positively correlated with cTnI and APACHE Ⅱ score (r value was respectively 0.922, 0.921, bothP < 0.01).Conclusion Myocardial damage often easily occurs in patients with sepsis, and the more serious the illness, the more prominent the injury.

OBJECTIVE To monitor the hand contamination after dressing change for the infected wound and to explore an effective way for hand hygiene. METHODS Caregivers were divided into three groups after applying dressing on infected wound:group 1(no hand-washing),group 2(regular hand-washing),and group 3(standard hand-washing),the pathogens in hands were monitored and the effects of two ways of hand-washing were compared. RESULTS The rate of hand-carrying pathogens after dressing change for the infected wound was 100.0%,the qualified rate of regular hand-washing was only 47.9% and that of standard hand-washing (six-steps method)was 97.9%. CONCLUSIONS The standard hand-washing is more effective than regular hand-washing. Correct hand hygiene should be emphasized to prevent and control nosocomial infection.

The peptidyl prolyl cis/trans isomerase Pin1 specifically binds phosphorylated Ser/Thr-Pro protein motifs and catalyzes the cis/trans isomerization of the peptide bond,changes the conformation and influences the stability and activity of the substrates.To date,a subset of proteins has been identified as substrates for Pin1.Pin1 interacts with its substrates and plays crucial roles in cell cycle,neural pathology and immune response.Accumulating studies have revealed that Pin1 isomerase activity is regulated by its post-translational modifications,including phosphorylation and oxidation.Over-expression or regulative imbalance of Pin1 plays an important role in the pathogenesis and therapeutics of human diseases such as cancer and AD.

MAPKKK (MEKK1 or ASK1)/MAPKK (SEK1 or MKK7)/JNK signal cascade is an important pathway which mediates apoptosis. MAPK phosphotase can deactivate JNK by dephosphorylation of JNK.The interaction between JNK and c-Jun can also be negatively regulated by NO through S-nitrosylation. SGK1 or Akt can result in deactivation of SEK1 through its phosphorylation at the Ser78 site.The c-FLIPL can block this cascade through binding with MKK7.GST Mu1-1 interferes and suppresses MEKK1-mediated apoptosis. GST Pi 1-1 and TRX have a dose-dependent inhibitory effect on ASK1 through forming protein complex. The deactivation of JNK can enhance drug resistance of tumor cells and counteract the injury from a wide variety of stimulus. Here,how these proteins induce deactivation of the pathway and mediate anti-apoptosis has been discussed.