Clinical efficacy scale of traditional Chinese medicine (TCM) should be built according to the characteristics of TCM, scientific demand, and demonstrated by practice. This paper provides some considerations of the scale.

Based on the shortcomings of graduate education in clinical medicine of our country and the characteristics of this specialty, the author point out that the cultivation of graduates in otolaryngology, head and neck surgery should be focused on the training of humanities, professional knowledge and skills. And they also make some suggestions and discussion about the reform of graduate education mode.

OBJECTIVE:To observe the clinical efficacy,safety,the maximal tolerated dose(MTD) and dose-limiting toxicity(DLT) of docetaxel(TXT) in the treatment advanced breast cancer.METHODS:Docetaxel was given by drip infusion in escalating doses from the initial dose of 65 mg?m-2 to 75 mg?m-2 and 85 mg?m-2 until the appearance of DLT.RESULTS:Among the 15 cases,1 case with CR,5 PR,4 SD,and 5 PD.The DLT of TXT was neutropenia,and its MTD was 85 mg?m-2.CONCLUSION:Docetaxel(at a dose of 75 mg?m-2) showed remarkable efficacy and good tolerance in patietns with advanced breast cancer.

Objective To evaluate the association between the expression of PTEN protein and the clinicopathological char‐acteristics of breast cancer patients .Methods All eligible studies regarding the association of PTEN protein expression with clini‐copathological features in patients with breast cancer were retrieved from PubMed ,Embase ,Cochrane Library ,CNKI and Wanfang databases .Odds ratio(OR) with corresponding 95% confidence interval(95% CI) form eligible studies were pooled .Heterogeneity and publication bias were also evaluated .All analyses were operated using RevMan 5 .2 software .Results A total of 28 articles con‐taining 3 172 patients were ultimately included for this Meta‐analysis .Our findings revealed that the expression level of PTEN was significantly correlated with estrogen receptor status(OR= 3 .16 ,95% CI:2 .01 -4 .97 ,P< 0 .01) ,progesterone receptor status (OR=2 .27 ,95% CI:1 .70 -3 .04 ,P<0 .01) ,lymph node metastasis(OR=0 .36 ,95% CI :0 .27 -0 .49 ,P<0 .01) ,clinical stage (OR=2 .59 ,95% CI:2 .04-3 .30 ,P<0 .01) and histological grade(OR=2 .19 ,95% CI:1 .74-2 .75 ,P<0 .01) .Conclusion Aber‐rant PTEN expression might have strong impacts on carcinogenesis ,tumor progression ,invasion and prognosis ,which makes it a potential biomarker for early cancer screening and endocrine therapy in breast cancer .

Brain injury of premature infant is a hot topic in the neonatal clinical study. Early diagnosis and intervention can improve the prognosis of premature infants. Although there are some interventions for brain injury of premature infants, most of them do not have evidence-based study to support the clinical application. Antenatal application of magnesium sulfate for pregnant women and application of erythropoietin for preterm infants may be the most promising interventions. Avoiding prematurity and brain damage is the key interventions for brain damage of premature infants.

Falling in the elderly is a major health problem and may cause severe consequences. Fall risk assessment is important for preventing and intervening fall incidence. Inertial Measurement Unit (IMU) has been introduced to evaluate motion/balance function and fall risk among the older people. Some researches indicated that it might have advantages over the usual tools, and can be used in the hospitals, communities, nursing homes, etc. IMU is a good way to measure gait variability, which may be strongly related with the risk of falls.

Objective To investigate the association between TLR4,C-Jun N-terminal kinase,tumor necrosis factor-α(TNF-α),Leptin changes and chronic intermittent hypoxia(CIH). Methods Twenty-four SD rats were divided into 3 groups (n=8):control group,CIH 6 weeks group, CIH 8 weeks group. After the modeling,the change of blood pressure and renal artery were observed by the use of non-invasive blood pressure analyzer and HE staining. ELISA was employed to determine the production of TNF-αand Leptin in sera of these animals. The expressions of TLR4 and JNK mRNA were detected by real time quantitativer everse transcription-polymerase chain reaction ( QRT-PCR) method in the adipose tissue. Results The blood pressure in intermittent hypoxia group was signifi-cantly higher than those in control group(P<0.01), and the renal artery pathological changes in intermittent hy-poxia group were significantly heavier than those in control group;the content of TNF-α and Leptin in intermittent hypoxia was significantly higher than those in control group(P<0.01),and the content of TNF-α and Leptin was significantly increased with the days of hypoxia;the expression of TLR4 and JNK at mRNA levels in intermittent hy-poxia was significantly higher than those in control group(P<0.01),and the expression of TLR4 and JNK at mR-NA levels was significantly increased with the days of hypoxia. Conclusion TLR4,JNK,TNF-α,Leptin may be in-volved in the inflammatory response of chronic intermittent hypoxia in rats.

Clinical Clerkship is the necessary stage from theory to clinical practice,As teaching hospital of Nanjing Medical University.we explore various kinds of methods of clinical practice quality improvement by emphasizing practice training,developing multiform teaching activities,highhghting autonomic learning and strengthening intemship management.

Aim To study the dopaminergic neuroprotection of quercetin-3-O-sophoroside and total flavonoids derived from Poacynum hendersonni in MPTP-induced mice model of Parkinson's disease.Methods To inject MPTP intraperitoneal to C57/bl6 mouse at 30 mg·kg~(-1)·d~(-1) 5 days for PD model preparation, qercetin-3-O-sophoroside(25 mg·kg~(-1))and total flavonoids(250 mg·kg~(-1))were treated through intragastric administration 7 days before.Watching the mice behavior change through autonomic activities and pole test after final treatment, dopamine content in striatum was determined with fluorescence photometer.The neurons pathological change in substantia nigra(SN)was observed by pafaffin slice and immunohistochemistry staining to analyze the dopaminergic neuroprotective effects of Poacynum hendersonni.Results Treatment of quercetin-3-O-sophoroside for 7 days in advance, can improve PD mice motivation and dopamine concentration in striatum, tyrosine hydroxylase immune-reactive neurons in SN increased as well.Conclusion Quercetin-3-O-sophoroside can attenuate the impairment of MPTP in mice model of PD.

Objective To investigate the dynamic changes of metallothionein(MTs)gene expression and explore the important significance of MTs during hepatocarcinogenesis.Methods One hundred and twenty-five SPF 5 -8-week old male C57BL/6J mice were randomly divided into control group and model group.Diethylnitrosamine (DEN) was given to the mice at a dose of 100 mg/kg, ip, and 50 mg/kg, ip, in the first and next week, respectively.The mice were given ethanol (53%, 5 mL/kg/day, 5 days/week) from the third week of experiment till 35 weeks.At 1, 3, 9, 13, 24 and 35 weeks of the experiment, liver samples were taken for histopathological examination of liver damages and incidence of HCC. The liver index and malondialdehyde (MDA) of liver homogenate were determined.All liver tissue samples were examined by histopathology using hematoxylin and eosin (HE), Masson and reticular fiber staining.Real-time RT-PCR was used to analyze the mRNA expression level of liver metallothionein-1 /2 (MT-1 /2) in different periods.Results Progressive liver damages in model group mice were identified in different periods.Hepatocytes abnormal tission and abnormal liver plate structure, architecture often characteristic of HCC could be seen in approximately 50% of mice at 35 weeks.In addition to these, a higher liver index also were seen at 35 weeks.Increased MDA levels in the mouse liver tissues were observed in each stage.Real-time RT-PCR analysis showed that significantly increased transcription of MT-1 and MT-2 at 1, 3 and 9 weeks, then gradually declined and even below the normal level.Conclusions MTs gene expression levels in mouse liver tissues are changed from significantly increased in the early stage of injury to decreased expression combined with distinct fibrosis. Our findings further demonstrate that the down-regulation of MTs level is closely correlated with hepatocarcinogenesis.