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.

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.

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 .

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.

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.

Cyclooxygenase-2 (COX-2),the rate-limited enzyme that converts arachidonic acid into prostaglandin,has been found overexpression in many malignant tumors.The overexpression of COX-2 plays an important role in tumor genesis and progression and is closely associated with tumor prognosis,so this enzyme has become one of the potential therapeutic targets.Experimental studies reveal that selective COX-2 inhibitors can enhance the tumor radiosensitivity through a variety of molecular pathways and have a protective effect for normal tissues.Selective COX-2 inhibitors are promising radiotherapy modifiers and the underlying molecular mechanisms still need to be further studied.

Objective To study the effects of perinatal exposure to bisphenol A(BPA) on the expression of estrogen receptor ? and ? mRNA in the brain of F1 male offsprings. Methods Pregnant SD rats were given BPA at 2, 20, 100 mg/kg bw per day respectively from eleventh day of gestation throughout the whole lactation by gastric gavage until their pups were weaned on postnatal day 21, F1 male pups from each group were killed on postnatal day 21 respectively, the brain was removed for detecting the expression of estrogen receptor ? and ? mRNA by RT-PCR. Results BPA treatment caused a up-regulation of ER? mRNA and ER? mRNA relative expression in the brain,especially in the middle-dose and low-dose groups it was so obvious. Conclusion Perinatal exposure to BPA can cause a change of ER? mRNA and ER? mRNA expression in the brain of the male offspring,which may be a part of the mechanism of BPA induced brain development damage.

Objective In order to provide scientific evidence for revealing the pathophysiological changes, levels of the humoral and cellular immunity and cytokines in elderly patients with bacterial pneumonia were determined. Methods The changes of immunological markers including IgA, IgG, IgM,C3, C4,T cell subpopulation (CD3 +, CD4 +, CD8 +) and CD4 +/CD8 +, IL 2, IL 6, IL 8, TNF ? were examined for the elderly bacterial pneumonia group(BPG), the aged control group(ACG) and the young control group(YCG). Results The level of CD3 +〔(53 90?7 10)% vs (62 67?6 08)%〕, CD4 +〔(33 85?4 69)% vs (3 57?3 40)%〕, IL 2〔(4 09?0 69) ?g/L vs (6 72?0 52) ?g/L〕 and IL 8〔(0 28?0 07) ?g/L vs (0 39?0 09) ?g/L〕 in ACG were significantly lower than those in YCG. The levels of IgA, IgG, IgM, C3, CD8 +, IL 8〔(0 33?0 08) ?g/L vs (0 28?0 07) ?g/L〕, and TNF ?〔(1 25?0 23) ?g/L vs (1 10?0 20) ?g/L〕in BPG were significantly higher than those in ACG; and in BPG the levels of IgG, IgM, C3, IL 8 and TNF ? were significantly higher than those in YCG. However, the levels of CD3 +, CD4 + and the ratio CD4 +/CD8 +in BPG were markedly lower than those in YCG;the IL 2(2 730?0 612 ?g/L) was much lower than that of ACG〔(6 72?0 52) ?g/L〕 and YCG〔(4 09?0 69) ?g/L〕, respectively. Conclusions The occurrence and the progress of bacterial pneumonia in the elderly are related to the immunological functioning including the excessive humoral immunity, the super activation of complement system, the dysequilibrium of T cellular immunoloregulation network and the super excretion of inflammatory cytokines.

Objective To probe the effects of hypothermia and St Thomas Hospital Ⅱ cardioplegia on immature myocardium.Methods To observe the change of hemodynamics,myocardial enzyme in the coronary effluent and myocardial biochemistry of the perfused immature rabbit heart in vitro after two or four hours ischemia at 14 degrees centigrade.Results There were no significant differences in post ischemic hemodynamics,myocardial enzyme in the coronary effluent and myocardial biochemical parameters of the perfused immature heart The myocardial protective effect provided by St.Thomas Hospital Ⅱ cardioplegia was worsen than that of hypothermia alone,marked by the elevated myocardial enzyme leakage and the decreased hemodynamics.Single dose perfusion was better than multi dose perfusion by characteristics of decreased enzyme leakege and good post ischemic hemodynamics.Conclusions Hypothermia alone can provide immature heart with satisfactory myocardial protection.St.Thomas Hospital Ⅱ cardioplegia can not afford good myocardial protection to immature heart and enhance the myocardial protective effect provided by hypothermia.The myocardial protection effect is better provided by single dose perfusion than by multi dose perfusion