The therapy to different type of breast cancer has resulted in chemoresistance which is induced by auto-phagy.Autophagy, to tumor’s generation, is a double edged sword, and it can result to chemoresistance and auto-phagic cell death through interaction with apoptosis in breast cancer chemotherapy.However, autophagy may be unrelated to chemoresistance.It will be a key research point to further explore the relationship and mechanism be-tween autophagy and chemoresistance.

Objective To investigate drug metabolism distribution of flurbiprofen axetil(FA) in uterine fibroids and its effect on prostaglandin E2 (PGE2).Methods A total of 86 patients with uterine fibroids from January 2014 to February 2016 in The NO.2 Hospital of Ningbo were randomly divided into control group of 44 cases and observation group of 42 cases.The control group and the observation group were given 0.9% sodium chloride solution and 1 mg/kg FA at 15 min before operation,detection of the active metabolite of FA flurbiprofen (FP),and the concentration of PGE2 in tissue homogenate was detected by ELISA.Results The observation group FP concentration of normal and tumor tissue were (0.70 ±0.13)μg/mL and (1.72 ± 0.13)μg/mL,significantly higher than the control group(0.00 ±0.00)μg/mL and (0.00 ±0.00)μg/mL, the difference was statistically significant(P<0.05), the FP concentration of tumor tissue in the observation group was significantly higher than that in the normal group, the difference was statistically significant(P<0.05), the normal tissue and tumor tissue PGE2 concentration in the observation group were (189.29 ±26.38) pg/mL and (260.01 ±46.63) pg/mL,which were significantly lower than those in the control group(210.03 ±35.22)pg/mLand(390.20 ±92.10)pg/mL, the difference was statistically significant(P<0.05), the observation group plasma FP was (5.50 ±0.72)μg/mL,significantly higher than the control group (0.00 ±0.00)μg/mL, the difference was statistically significant(P <0.05),and PGE2 was (602.38 ±84.09) pg/mL,significantly lower than the control group(920.13 ±89.05)pg/mL, the difference was statistically significant(P <0.05).Conclusion FA in the uterine fibroids have a certain distribution of targeted,can reduce the concentration of PGE2 ,so as to alleviate the pain of patients.

Objective To compare the clinical pathological characteristics in young and old patients with colorectal cancer (CRC) and investigate their relationship with prognosis. Methods A retrospective review was made in 68 CRC patients less than 35 years old and 322 CRC patients older than 65 treated in our hospital from July 1993 to July 2003. Their clinical manifestation, pathological feature, Dukes staging, misdiagnosis rate and results of following-up were compared. Results The main manifestation in young group was abdominal pain (69.1%), but in old group was hemafecia or mucous bloody stools (53.7%). The ratio of poorly differentiated neoplasm was obviously higher in young group (48.5%) than in old group (20.5%) (P

Procalcionin ( PCT) is a soluble protein liberated into the circulation of patients in response to severe systemic in-fection, in particular by bacterial infection.It is used as the most accurate biomarker for the diagnosis of sepsis.This review briefly de-scribes the induction of PCT, the comparison of PCT and other markers of sepsis, the application of PCT measurement in confirmation or exclusion of diagnosis of sepsis, the assessment of severity and treatment effectiveness of systemic infection, the application of PCT in guiding individual and specific treatment of antibiotics, and the anormaly situation of elevated levels of PCT in patients who do not have sepsis.

Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.

Total paeony glycoside (TPG) is extracted and purified from a traditional Chinese herbal medicine. It has many biological and pharmacological activities. However, there are few dosage forms of TPG in the market because of its low bioavailability. Self-microemulsifying drug delivery system (SMEDDS) is a vital tool in solving low bioavailability of poor absorption drugs. So the objective of this study is to develop a new TPG-SMEDDS for the oral delivery of poorly soluble TPG. Through the construction of pseudo-ternary phase diagrams, the optimum prescription was obtained, which consisted of 18.70% TPG, 16.27% ethyl oleate as oil, 43.34% Cremophor RH40 as surfactant and 21.73% Transcutol P as cosurfactant. The characterizations of TPG-SMEDDS including morphological characterization, droplet size, zeta-potential, emulsification time, and dissolution study of TPG-SMEDDS were evaluated. The results showed that TPG-SMEDDS is stable and its release rate is high in four different media (0.1 mol x L(-1) HCl, pH 6.8 PBS, pH 7.4 PBS, and water). The relative bioavailability of SMEDDS was dramatically enhanced in an average of 1.52-fold that of TPG-suspension. It is concluded that the bioavailability of TPG is enhanced greatly by SMEDDS.

Objective To determine the effects of cyclooxygenase-2 (COX-2) on risk stratification and prognosis of patients with gastrointestinal stromal tumor (GIST).Methods Literatures in the Cochrane libraries of clinical comparative trials,PubMed,EMBASE,Cancer Lit and Chinese BioMedical Literature from 1966 to 2012 were retrieved using the Cochrane systematic evaluation method.The original data were extracted and crosschecked by 2 reviewers.The indicator for assessment including positive rates of COX-2 in GIST patients with different tumor diameters (＜5 cm versus ≥5 cm),mitosis of cancer cells (＜5/50 HPF versus ≥5/50 HPF) and National Institute of Health (NIH) risk stratifications (very low + low versus intermediate + high).The relationship between COX-2 expression and recurrence and metastasis of GIST was evaluated.All the data were analyzed using the RevMan 5.1 software with Meta analysis.The heterogeneity between studies was analyzed using the I2.The binary data were presented by odds ration (OR) and 95％ confidence interval (95 ％ CI).Results Seven articles with a total of 415 patients were included in the analysis.The COX-2 expression did not correlate with the tumor diameters,NIH risk stratifications and tumor metastasis and recurrence (OR =0.60,0.72,2.46,P ＞ 0.05),but with the mitosis of cancer cells (OR =0.46,P ＜ 0.05).Conclusion COX-2 expression is partly correlated with risk stratification of GIST,but has no effect on the prognosis.

Objective To investigate the effects of interventions on psychological stress factors of nurses in the emergency department of general hospital. Methods Symptom checklist 90(SCL-90)was used for investigation. The corresponding interventions were conducted based on the found problems. Results The mental health of the nurses in general hospital emergency department was worse than that of the general population. Each factor score, the total average score and the number of items after intervention had significant difference than that before intervention respectively. The incidence rate of top 10 symptoms was significantly decreased after the intervention than that before. Conclusions Implementation of comprehensive intervention can significantly improve the mental health of the nurses in emergency department of general hospital.

Objective To compare the effects of different doses of amino acids and fat emulsions in parenteral nutrition on the incidence of complications and prognosis in very low birth weight infants (VLBWI). Methods The clinical data of 328 VLBWI who received nutrition support therapy for at least 5 days starting in 72 h after birth during January 2005 to December 2014 , were retrospectively analyzed. According to the dosage in parenteral nutrition, patients were divided into low-dose group and high-dose group. The incidence of complications and prognosis between two groups were compared. Results There were 204 cases in low-dose group and 124 cases in high-dose group. Compared with the low-dose group, the incidence of complications was lower in high-dose group during hospitalization and the incidence of intracranial hemorrhage was reduced most;the incidence of developmental retardation was lower at discharge;the overall incidence of metabolic complications of parenteral nutrition was higher, among which the incidence of high blood glucose, electrolyte disturbance and cholestasis were increased and the incidence of hypoglycemia was lower, and the differences were all statistically signiifcant (P??0 . 05 ). Conclutsions VLBWI can tolerate early aggressive parenteral nutrition which can reduce the incidence of extrauterine growth retardation and premature complications.

Objective This research puts the academic leader under the competency background to investigate the current status of academic leaders in tertiary hospitals in Shanghai,combines the theories a-nalysis with practice on the Correlative Research,takes evaluation of academic leaders as the target to deep into the discussion,studies the application value and special significance of the competency model on culti-vation,introduction and evaluation of academic leaders in tertiary hospitals in Shanghai area.Methods Core elements of competency of the academic leaders were investigated by literature reviews,expert inter-views,behavioral event interview,and questionnaires.The questionnaire of the competency of academic leaders was prepared and the numbers and induction relevant to characteristic items of the competency were obtained.Results The notion of six feature families is proposed by study of the competency model which composed 18 relative characteristic items.Six feature families are leadership,organization team with coordi-nation,innovation and implement of project,strategic thinking and overall outlook,self-control and self-management,pursuit excellence and development.Conclusions The academic leader not being lack of professional quality,it is the deep characteristics under the Iceberg Model that influenced the development degree,efficiency,effects of subjects.The study on the competency of the academic leader is helpful for e-valuation of academic leaders'comprehensive abilities and put forward some proposal about stuff rundle con-struction for reference in hospital.