Nco-adjuvant endocrine therapy has provided opened new alternatives for locally advanced breast cancer, especially for patient groups such as the elderly, those who are not suited for chemotherapy, and those whose response may not be optimal. The latest generation of endocrine therapy for breast cancer,aromatase inhibitors, has proved superior to tamoxifen in terms of toxicity and efficacy in the adjuvant setting.Compared with neo-adjuvant chemotherapy, the appropriate patients to receive nco-adjuvant endocrine therapy can achieve similar short-term benefit. However, because of fewer long-term follow up results, the overall prognosis is not clear.

Transcatheter closure as an alternative to medical surgery has become a preferred therapeutic method to atrial septal defect (ASD).However,thrombopoiesis after occluder implantation has been reported comprehensively and causes a series of serious complications such as cerebral embolism、myocardial infarction,pulmonary embolism and so on.Reasons of device thrombopoiesis are closely associated with atrial fibrillation,persistent atrial septal aneurysm,occluder type,activated coagulation system and occluder endothelialization process.This paper summarizes correlation factors of occluder thrombopoiesis and current related prevention proposal after transcatheter closure of ASD,and provides theoretical and experimental foundation for prevenition of device thrombopoiesis after occluder implantation of ASD.

Objective: To analyze the efficiency and differences of China Community Health Service, to analyze the shares of eastern-middle-western regional differences and the difference within each region in the total efficiency difference. Methods: The super efficiency DEA model and decomposition of Gini coefficient by Subgroups are used to analyze the provincial data in China from 2008 to 2011. Results: The eastern-central-western regional difference is the major cause of the efficiency differences in China Community Health Service. In the meantime, the shares of the difference within each region in the total efficiency difference are also non-negligible. Conclusion: To narrow the efficiency differences among eastern, central and western areas; improve the inter-regional flow of community health service resources; improve the support and supervision on the backward regions; make regional policies to coordinate the internal resources of community health services and strengthen the assessment mechanism using efficiency as the indicator.

New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Objective To discuss the antitumor mechanism preliminarily by observing effects of Celastrus orbiculatus extracts (COE) on vascular endothelial growth factor (VEGF) mRNA and protein expression in hepatoma (Hepal-6) cells of mice.Methods Hepa1-6 cells were treated with COE at different nontoxic concentration (0, 10, 20, 40, 80, and 160 μg/mL) for 16 h. The mRNA and protein expressions of VEGF were detected by reverse transcription-PCR and Western Blotting,respectively. Results COE significantly inhibited VEGF expression at both mRNA and protein levels in a dose-dependent manner. Conclusion COE can inhibit VEGF expression in Hepa1-6 cells, therefore suggest that VEGF could be chosen as an therapeutic target for COE in the context of cancer chemoprevention and anticancer therapy.

Objective:To evaluate the present situation and trend of antifungal medicines used in 34 hospitals in Wuhan area. Methods:The sales volume,market share,DDDs and DDC of antifungal medicines in 34 hospitals in Wuhan area during 2012 and 2014 were statistically analyzed. Results:The consumption sum and growth rate of the medicines were increased year by year, and those of pyrrolic medicines were the highest. The sales volume of voriconazole ranked the first. The DDDs of clotrimazole vaginal tablets and nifuratel-nysfungin suppositories ranked the top two. Conclusion:The consumption of antifungal medicines in Wuhan area has been increased greatly and the consumption structure is relatively stable. The utilization evaluation of antifungal medicines should be enhanced. Antifungal medicines should be rationally used to prevent or slow down the spread of drug resistant bacteria.

Triple negative breast cancer (TNBC)is difficult to benefit from endocrine therapy or tras-tuzumab targeted drug therapy.Biological overexpression of breast cancer susceptibility gene 1,p53 gene,vas-cular endothelial growth factor and microRNA suggests that TNBC is easy to metastasis and recurrence and has a poor prognosis.Exploring the molecular subtypes of TNBC,setting out the treatment plan for subtypes and finding the corresponding monoclonal antibody targets are the research direction of TNBC in the future.

Objective·To discusses the high risk factors and therapy strategies for ovarian hyperstimulation syndrome (OHSS). Methods·Seventy-seven cases with moderate and severe OHSS were collected to be retrospectively analyzed in Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2010 to December 2016. Results·Compared with non-pregnant patients, pregnant patients were more likely to have severe OHSS (P<0.05). Embryo transfer patients who underwent ovulation induction and oocyte retrieval became severe OHSS much more easily and had a much longer hospital stay than oocyte retrieval patients (P<0.05). Pumping ascites and pleural effusion or not has no effect on the length of hospital stay and the usage of low molecular dextran for patients with severe OHSS. Conclusion·The risk of OHSS should be evaluated to determine whether or not to carry out a fresh embryo transfer in patients who underwent ovulation induction and oocyte retrieval. For OHSS patients who have undergone embryo transfer or pregnancy, more attention should be paid to the progress of the disease, and individualized treatment is required.

Objective To detect the incidence and monality of the pediatric sepsis/severe sepsis,and to investigate the risk factors for poor prognosis in these patients.Methods From Jan.1 to Dec.31,2008,all pediatric patients admitted to PICU in Beijing Children's Hospital were prospectively surveyed.Both Chinese pediatric critical care scoring system and American guidelines for PICU admission and discharge were applied for screening subjects.The diagnosis criteria of pediatric sepsis/severe sepsis were made according to the definition determined on the International Pediatric Sepsis Consensus Conference held in the United States in early 2002.The qualified subjects were surveyed by questionnaire until discharge.After three months,the subjects were followed up by telephone.Results In a total of 742 children were screened.545 cases were critically ill,143 cases (26.2%) developed sepsis,and 104 cases (19.1%) deteriorated into a state af severe sepsis.Hospital mortality of severe sepsis was 21.2%,and that of sepsis was 0.7%.At the end of three months after discharged from hospital,mortality of severe sepsis was 30.8%.and that of sepsis was 1.4%.Patients under 3-year-old accounted for 72.5%.Pneumonia was the most common primary disease.The respiratory dysfunctions in severe sepsis cases were most common organ dysfunction (73.1%) . In surviving patients with severe sepsis,the PICU stay was significantly longer than that in deceased patients,and the PICU costs and average per capita costs were higher than the critically ill patients.Muhiple stepwise logistic regression analysis showed that pediatric critical illness score (PCIS score),capillary refilling Lime,respiratory dysfunction and hypoalbuminemia were the risk factors for death.Conclusions Sepsis/severe sepsis are common in the PICU,which have high mortality,high hospital charges.Infants and young children were the most commonly affected.Pneumoma was the most common primary disease.PCIS score.capillary filling time,respiratory dysfunction and hypoalbuminemia were the risk factors for death.

Objective To investigate the expression of CIP2A and c‐Myc and their correlation in cervical carcinoma .Methods We detected CIP2A and c‐Myc expression using immunohistochemistry in 72 samples of cervical carcinoma and 12 samples of normal cervix tissues .Correlation between proteins and clinicopathologic features and relation between CIP2A and c‐Myc expression were analyzed .Results The positive expression of CIP2A and c‐Myc in cervical carcinoma tissues were 52 .8% and 56 .9% ,respec‐tively .While their positive expression in normal cervix tissues were 8 .3% and 25 .0% ,respectively .The differences had statistical significance(χ2 =8 .169 ,P=0 .004 ;χ2 =4 .208 ,P=0 .040 ,respectively ) .Clinicopathological analysis suggested that CIP2A and c‐Myc protein expression were associated with histopathological differentiation and clinical stage(P<0 .05) in cervical carcinoma ,but the protein expression was not related to age ,lymph node metastasis and pathological type .CIP2A was significantly positive correla‐ted with c‐Myc protein in cervical carcinoma(r=0 .673 ,P=0 .001) .Conclusion The high‐expression of CIP2A is correlated with malignant clinicopathologic characteristics ,and CIP2A is positively associated with c‐Myc ,suggesting that CIP2A may promote tumor initiation and development through maintaining c‐Myc protein in cervical carcinoma .