Objective Through researching the name,etiology,pathogenesis and therapeutic methods and prescriptions of the breast cancer in ancient medical documents to provide the theoretical basis and syndrome differentiation thinking for the treatment of breast cancer clinically.Methods By disease name searching,content analysis was used to screening the ancient literature that associated with breast cancer.The pathogenesis,treatment and medicine used of breast cancer in these ancient literatures were summarized.Results The stagnation of Qi and phlegm,blood stasis,and vital deficiency are important factors for breast cancer formation,while the deficiency of vital qi and viscera deficiency are important pathogenesis of breast cancer.Prevention before the onset of disease,eliminating pathogenic factors at the early period of the disease,supplement vital qi and eliminating pathogenic vital qi in the middle stage,and supplementing vital qi at the late stage of the disease should be emphasized.Meanwhile soothing liver to regulate mode and depression should also be paid attention.Conclusion The recognition of breast cancerby TCM and advantage of TCM in treating this disease need further literature researches.

Objective To determine the protein expression level of p-STAT1 and STAT1 in thyroid cancer and its correlation with clinical pathological parameters,especially with lymph node metastasis and relapse-free survival.Methods p-STAT1 and STAT1 protein were measured by immunohistochemical staining in 80 cases of primary thyroid carcinoma and matched normal controls.All samples were selected from the pathological storage in the Jiangdong 22nd Zone,of Zhuji People's Hospital.The correlation between p-STAT1,STAT1 and patients clinical pathological parameters was analyzed.74 out of 80 patients were followed up over 3 years to analyze the potential relationship between expression of p-STAT1 and STAT1 and relapse-free survival.Results The positive expression of p-STAT1 and STAT1 was 28.8％ and 90.0％ in thyroid cancer tissue versus 85.0％ and 50.0％ in normal thyroid tissue.The difference was statistically significant(P ＜ 0.05).The positve expression of p-STAT1 in stage Ⅲ and Ⅳ thyroid cancers was significantly lower than in stage Ⅰ and stage Ⅱ thyroid cancer(P ＜ 0.05).There was negative correlation between the expression of p-STAT1 and tumor stage and lymph node metastasis,while the expression of STAT1 was irrelevant.Furthermore,the relapse-free survival was 100％ in p-STAT1 positive patients,and 92.65％ in STAT1 positive group.Conclusion p-STAT1 protein level,negatively correlating with tumor stage and lymph node metastasis,down regulates in primary thyroid cancers,and may be a novel biomarker for thyroid cancer metatstasis.

Objective To investigate the incidence of depression in patients with advanced malignancy and its effect on quality of life.Methods Patients with advanced malignancy were evaluated with Beck depression and quality of life questionnaires.The correlation of Beck depression scoring with quality of life was analyzed.Results A total of 230 in-patients with advanced malignancy were enrolled in this study and 213 copies of valid questionnaire were collected.95.3 ％ (203/213) patients had depression.The Beck depression scoring had positive correlation with body,role,mood,cognition,society,vomiting,pain,dyspnea,agrypnia and appetite (all P ＜ 0.05),and had negative correlation with total health factors (r =-0.296,P ＜ 0.01).Conclusion Depression is prevalent in patients with advanced malignancy and correlated with quality of life.Therefore,psychological interventions are needed to relief depression and improve quality of life.

Objective To investigate the presentation and radiologic findings of acute marchiafava‐bignami disease(MBD) . Methods Three cases of acute MBD who were diagnosed and treated in our hospital were retrospectively analyzed ,including the clinical symptoms ,laboratory tests ,imaging examination(such as cranial CT ,magnetic resonance imaging(MRI) ,prognosis .Results Three cases were acute onset .The symptoms may be non‐specific ,such as consciousness disorder ,psychosis ,seizures ,delirium tremor and high fever .The imaging changes in the genu and splenium of corpus callosum could be found ,even in the bihemispheric white matter of all cases .CT revealed low‐density areas ,meanwhile MRI showed iso‐or hypo‐intensity on T1WI and ADC ,hyper‐in‐tensity on T2WI and fluid attenuated inversion recovery and restricted diffusion weighted imaging .The lesions involved in bihemi‐spheric brachium pontis in one case and in the body of corpus callosum in another case .Conclusion Acute MBD may present with various clinical forms ,but have characteristic imaging findings .

Objective:To evaluate and summarize the best evidence of health workers respiratory protection during aerosol-generating procedures in patients with acute respiratory infectious diseases.Methods:We searched EBM Guidelines, Essential Evidence Plus, Dynamed, UpToDate, JBI, BMJ, Clinical Key, Cochrane Library, NICE, AARC, PubMed, EMbase, CKNI, Wanfang to collect related literature including guidelines,evidence summary, recommended practices, standards, consensus and systematic reviews.Results:A total of 20 articles were included, including 10 guidelines, 1 consensus, 2 standards, 2 evidence summaries, and 5 systematic reviews. 24 best evidences including aerosol-generating procedures, training of protective equipment using, principles of protective equipment using, protective equipment using, aerosol operating environment control and medical staff self-monitoring were summarized.Conclusion:The study integrated the best evidence of healthcare workers respiratory protection during aerosol-generating procedures in patients with acute respiratory infectious disease. It is recommended to combine the current status of institutional protection resources and clinical practice experience to promote the conversion of the best evidence to clinical practice.

Objective To investigate the proteins which were associated with radiosensitivity of nasopharyngeal carcinoma (NPC) cells and could be used to predict the radiosensitivity.Methods A radioresistant subclone cell line CNE-2 (R743) derived from NPC cell line CNE-2 was established.Radiosensitivity and cell cycle characteristics of CNE-2 and CNE-2 ( R743 ) were examined and compared by clonogenic survival assay and flow cytometry.The total proteins from the two cell lines were extracted and separated by two-dimensional gel electrophoresis,and the images were analyzed by Image Master 7.0analysis software.Differentially expressed proteins in the two cell lines were identified through MALDITOF/TOF peptide mass fingerprint and searched in the protein sequence database.The protein expressions were confirmed by RT-PCR and Western blot.Results Totally seven differentially expressed proteins were identified,six of which were upregulated and one downregulated in the radioresistant CNE-2 (R743),compared with those of CNE-2.Three out of the seven,Annexin A2,Tropomyosin 4 and GRP78 were upregulated in the CNE-2 ( R743 ),which were confirmed by Western blot and RT-PCR ( t =24.22,24.20,29.19,P ＜ 0.05).Conclusions Differentially expressed proteins might be involved in different radiosensitivities of nasopharyngeal carcinoma cell lines,among which Annexin A2,Tropomyosin 4 and GRP78 could be the candidate biomarkers for predicting radiosensitivity of nasopharyngeal carcinoma cells.

ObjectiveTo observe the effect and safety of arsenic trioxide (ATO) combined with all-trans retinoic acid (ATRA) in treating patients with acute promyelocytic leukemia (APL).Methods Eighty-three cases with APL treated for the first time were divided into two groups by random digits table method:observation group with 48 cases was received combination induction treatment of ATO and ATRA,control group with 35 cases was treated with combination induction treatment of ATRA and chemotherapy.The clinical effect and adverse reaction between two groups were compared.ResultsThe effective rate and early death rate were 100.0％( 48/48 ) and 0 in observation group,97.1％(34/35 ) and 2.9％( 1/35 ) in control group,which had no significant difference between two groups(P ＞ 0.05 ).The incidences of bone marrow suppression,infection,liver and kidney damage,cardiac toxicity and gastrointestinal symptoms were 8.3％ (4/48),10.4％ (5/48),12.5％ (6/48),6.2％ (3/48) and 18.8％ (9/48) in observation group,while 97.1％(34/35),65.7％(23/35),45.7％(16/35),37.1％(13/35) and 100.0％(35/35) in control group,which had significant differences between two groups (P ＜ 0.05).ConclusionCombination treatment of ATO and ATRA in APL has an obvious effect and few adverse reaction,which can be applied in clinic.

Objective To investigate the performance of DNA microarray in identifying 6 common Candida spp. and validating ERG11 mutations resulting in fluconazolc-resistance in Candida albicans. Methods Oligonucleotide probes were designed and synthesized targeting the species-specific sequence in the internal transcribed spacer 2 (ITS2) region of rDNA of Candida albicans, Candida tropicalis, Candida glabrata, Candida dubliniensis, Candida parapsilosis and Candida krusei, as well as 6 sequences embracing the following mutations respectively in ERG11 gene leading to fluconazole-resistance, i.c., T541C, A 1090G, C1361T, G1537A, G1547A, and T1559C, then arranged onto a chip. Twelve 50-base-pair oligonucleotides were artificially synthesized based on the above specific sequences, and utilized to hybridize with the DNA microarray. Thirty-lbur Candida strains, including 29 C. albicans, 1 Candida tropicalis, 1 Candida glabrata,1 Candida dubliniensis, 1 Candida parapsilosis and 1 Candida krusei, were detected with microarray. Genomic DNA was extracted from these tested strains and underwent multiple PCR for the amplification of ITS2 region and ERGI 1 gene. Sequencing was performed to analyze the sequence of ERG11 in 29 strains of C. albicans and the results were compared with those of DNA microarray hybridization. Results Multiple PCR successfully produced ITS2 fragment of 307-415 bp from all the 34 strains, as well as ERG11 fragment of 1712 bp from 29 C. albicans strains. DNA microarray hybridization offered the same results in species identification of the 34 strains with their given information, as well as in mutation detection of the 29 strains of C. albicans with ERG11 sequencing results. Also, the 6 synthesized oligonucleotides containing the muta- tions were identified precisely as T541C, A1090G, C1361T, G1537A, G1547A, and T1559C, and the 6 species specific oligonucleotieds were identified correctly as C. albicans, C. tropicalis, C. glabrata, C. dubliniensis, C. parapsilosis and C. krusei Both the sensitivity and the specificity of the microarray were 100%. Conclu- sion DNA microarray is a quite reliable method to identify Candida spp. and fluconazole resistance-associ- ated mutations in the ERG11 gene of C. albicans.

Objective To investigate the effect of silencing Annexin A2 gene expression by small interfering RNA (siRNA) on the radiosensitivity of nasopharyngeal carcinoma cells CNE-2 (R743).Methods siRNA targeting the Annexin A2 gene was chemically synthesized and transfected into R743 cells by HiPerFect.The mRNA and protein levels of Annexin A2 before and after transfection were measured by RT-PCR and Western blot,respectively.The change in radiosensitivity of R743 cells was analyzed by colonyforming assay.Cell cycle distribution and apoptosis after X-ray irradiation were analyzed using flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labeling assay,respectively.Results The results from RT-PCR and Western blot showed that the expression of Annexin A2 was down-regulated after transfection.The colony-forming assay indicated that the D0,Dq,and SF2 in transfected cells were significantly lower than those in untransfected cells with radiation alone and in cells transfected with control siRNA.The sensitization enhancement ratios (D0 ratios) of transfected cells relative to untransfected and control siRNA transfected cells were 1.30 and 1.27,respectively.After X-ray irradiation,the proportion of cells in G2/M phase was significantly higher in the transfected cells thin in untransfected and control siRNA transfected cells (32.46％ vs.9.17％ and 9.42％,respectively;P =0.000 and 0.000).The apoptosis rate was also significantly higher in the transfected cells than in the untransfected and control siRNA transfected cells (35.20％ vs.10.87％ and 11.33％,respectively;P=0.000 and 0.000).Conclusions Silencing Annexin A2 gene expression by siRNA can increase the radiosensitivity of R743 cells,which may be associated with DNA damage repair and change in cell cycle distribution.

Objective To explore the effect of Enhanced Recovery after Surgery in patients undergoing thoracoscopic lobectomy with pain management. Methods A total of 160 patients with lung cancer admitted from September 20 to July 2017 at the Affiliated Chest Hospital of Shanghai Jiaotong University were randomly divided into observation group and control group. The observation group was treated with enhanced recovery care and the control group was treated with routine care. Results The incidence of postoperative complications, hospitalization time and hospitalization decreased, the difference was not statistically significant (P>0.05). The early postoperative ambulation time, postoperative exhaust time, postoperative nausea and vomiting, postoperative pain intensity at 6h, postoperative pain intensity at 12 h, postoperative pain intensity at 24 h and postoperative pain intensity at 48 h were (18.35 ± 7.18) h, 28.75％,(1.17 ± 0.84) points, (1.79 ± 1.36) points, (2.45 ± 1.12) points and (2.14 ± 1.26) points in research group,(28.11 ± 9.07) h, (36.35 ± 16.95) h, 45.00％(36/80), (1.91 ± 0.88) points, (3.05 ± 1.33) points, (4.20 ± 1.31) points and (3.89 ± 1.20) points in controlled group. There was significant difference between the two groups (t=-7.36-78.34,χ2=4.54, P<0.05). Conclusions The idea of Enhanced Recovery after Surgery for thoracoscopic lobectomy has a good clinical effect. It can reduce the perioperative stress, shorten the hospital stay and reduce the hospital cost, and have the clinical value.