Objective:To investigate the associations between the hormone receptors,Ki67 expression and response to neoadjuvant anthracycline-based chemotherapy in breast cancer patients.Methods:One hundred sixty-eight primary breast cancer patients received anthracycline-based neoadjuvant chemotherapy.The expression of estrogen receptor(ER),progesterone receptor(PR),and Ki67 were determined by immunohistochemistry assay in core-needle biopsy specimens prior to the chemotherapy,and pathologic response was assessed by Miller & Payne grade(G1 to G5).Results:40%(67/168)of the patients had a good pathologic response,defined as complete pathologic response(pCR or G5)and minimal residual disease(G4).Among the patients,20%(33/168)had a complete pathologic response(G5).ER or PR status was significantly associated with pathological response.Patients with PR-negative tumors had a higher pathological response rate or pCR than those with PR-positive tumors(17/67 vs 45/90,P=0.002;6/67 vs 25/90,P=0.003,respectively),whereas patients with ER-negative tumors had a higher pathological response rate than those with ER-positive tumors.Moreover,Patients with both ER-and PR-negative tumors exhibited a remarkable pathological response as compared with those with any single factor(36/17 vs 26/86,P=0.009).No association between Ki67 expression and pathological was found in this cohort of patients.There was a linear correlation between the expression of Ki-67,ER or PR status and pathologic response.Conclusion:There is a significant association between the hormone receptors and pathological response to neoadjvant anthracycline-based chemotherapy in breast cancer patients,and patients with PR-negative tumors are more likely to respond to chemotherapy.

Objective To investigate the clinical values of laryngeal electromyography (LEMG) for evaluating the amyotrophic lateral sclerosis(ALS) patients with swallowing disorder .Methods A total of 25 ALS patients with or without complaining of swallowing disorder were recruited for the study .Their right cricothyroid muscles were taken unilaterally with concentric needle electrodes by anterior cervical approach .Each patient was tested with Kub-ota drinking test too .Results Of all the 25 patients ,11 were found abnormal in the right cricothyroid muscle which presented with typical degeneration patterns ,15 cases were found abnormal by Kubota drinking test .The coinci-dence rate of the two methods was 60% ,the poisitive coincidence rate was 32% .The McNemar test showed there was some consistency between the drinking water test and LEMG (P=0 .344) ,and the Kappa coefficient was 0 .219 . Conclusion The cricothyroid muscle electromyography may also be a potential method to evaluate ALS patients since it seemed to offer an evidence of dysphagia related with abnormal sensory function of laryngeal mucosa .But there may be some limitations .

Objective To analyze the clinical and anatomic characteristics of bridging bronchus (BB) malformation in children,and to explore its diagnostic strategy,treatment and risk factors.Methods A retrospective study was performed in 23 pediatric patients with BB who were admitted to Guangzhou Women and Children's Medical Center form May 2010 to October 2016.All their clinical features,imaging examination,treatment and prognosis were reviewed and analyzed.Results (1) Among the 23 patients with BB,15 were males and 8 were females.The age range of onset was 0 to 4 years old with a median age of 3.17 months.(2)The main clinical manifestations were cough (23/23 cases,100.0％),recurrent wheezing (20/23 cases,87.0％),cyanosis (8/23 cases,34.8％) and feeding diffficulty/slow body weight growth (6/23 cases,24.6％).(3) There were 17 cases of type Ⅰ and 4 cases of type Ⅱ according to Wells,and the other 2 cases were anterior BB.There were 2 cases with atypical anatomical morphology in type Ⅰ and type Ⅱ respectively.(4) Twenty-one cases were associated with bronchial stenosis in which the origin of left main bronchus complicated with BB stenosis was the most common(5 cases).Bronchoscopy revealed bronchomalacia in 5 of the 16 patients.Sixteen patients associated with cardiac or vascular anomalies,11 of whom were compound anomalies,and the most common type was sling left pulmonary artery (SLPA) (12 cases).(5) Nine of 12 patients with SLPA received surgical management,ages ranging from 1 month to 8 years old.The respiratory symptoms remitted gradually or disappeared from 4 to 17 months after surgical management.Two died and one has been lost to follow-up among the remaining 3 patients with SLPA.Conclusions BB is a rare tracheobronchial malformation that is often associated with stenosis or bronchomalacia,and cardiac or vascular anomalies.The severity of the disease mainly depends on whether there is airway stenosis or malacia and its extent.The definitive diagnosis of BB requires the combination of different imaging modalities.The combination with simple SLPA could get better curative effect.

BACKGROUND: The high incidence of urinary fistula following renal transplantation not only influence on wound healing, but also result in local or systemic infection, even renal allograft loss or death. Therefore, it is necessary to establish a standard for diagnosing and treating of urinary fistula. OBJECTIVE: To retrospectively analyze the diagnosis and treatment of urinary fistula following renal transplantation in 95 cases. METHODS: In 95 cases, there were 59 males and 36 females, aged from 19 to 61 years, urinary fistula occurred at days 1-40 after renal transplantation, including 74 simple fistulas and 21 complex fistulas. Besides of our clinical experiences and routine methods, the "five-step procedure protocol" for diagnosis and treatment of urinary fistula reported by Li Qian-sheng was also referred. RESULTS AND CONCLUSION: Totally 56 cases were managed by conservative treatment, 45 of whom were cured. 50 cases (including 11 cases those failed to cure by conservative treatment) were managed by surgical treatment, 45 of whom were cured. Of the remaining 5 cases, 2 grafts were removed because of graft rupture and massive hemorrhage caused by uncontrolled acute rejection, and 3 recipients died of severe pneumonia shortly after transplantation. 71 of the 90 cases were received long-term follow up, ranging 2 to 11 years. Of the simple urinary fistula cases, 56 were on regular follow up; 41 kept a normal graft function, 10 were diagnosed of chronic allograft nephropathy, 4 returned to hemodialysis and 1 died of lung cancer. Of the complicated ones, 15 were on regular follow up. 8 kept a normal graft function, 4 were diagnosed of chronic allograft nephropathy, and 3 returned to hemodialysis. The design of "five-step procedure protocol" makes urinary fistula diagnosis and treatment more ordered and standard, which can obtain excellent therapeutic efficiency.

Objective To evaluate the relationship between resistin and hepatic fibrosis in nonalcoholic fatty liver disease (NAFLD) subjects.Methods Serum resitin and Interleukin (IL)-18's concentrations were measured in 144 subjects (70 NAFLD pa-tients and 74 healthy controls) with enzyme-linked immunosorbent assay (ELISA) and their serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting blood glucose (FBG), HbA1c, triglyceride (TG), total-cholesterol (TC), low density lip-oprotein ( LDL) , high density lipoprotein ( HDL) , homeostasis model assessment of insulin resistance ( HOMA-IR) , hyaluronic acid , IVcollagen, height, body weight, waist circumference, and hip circumference were also measured .Their waist-to-hip ratio (WHR) and body mass indes (BMI) were calculated.Results There were higher levels of systolic blood pressure (SBP), WHR, BMI, TG, ALT, AST, HOMA-IR, hyaluronic acid, IV collagen, resistin, and IL-18 in the NAFLD patients than those of the healthy controls ( P <0.05 ) .The serum resistin level was significantly and positively correlated with WHR , BMI, ALT, HOMA-IR, TG, IV collagen , and IL-18 ( r =0.231 , 0.341 , 0.223 , 0.264 , 0.213 , 0.315 , and 0.669 , P <0.05 ) .After adjustment for body fat and IL-18 , the serum resistin level was still significantly and positively correlated with ALT and IV collagen ( r =0.222 , 0.0.326 , P <0.05 ) . Conclusions Resistin might take part in the development of NAFLD insulin resistance and its pro -inflammation.

UNLABELLEDOBJECTIVE To compare anti-oxidative effects of acupuncture at different Shichen (traditional twelve two-hour periods) accordin-17:00), You (17:00-19:00), Xu (19:00-21:00), Hui (21:00-23:00) periods according to the eight methods of the intelligent turtle, once each day, for 7 consecutive days. Changes of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity after treatment were observed.

RESULTSSOD activities and MDA contents at the 12 periods were different in the healthy guinea pigs, SOD activity at Wu period was the highest and the lowest at Zi period; MDA content was the highest at Zi period and the lowest at Wu period. The needling method according to eight methods of the intelligent turtle could increase SOD activity in the guinea pigs. The increasing amplitude of SOD activity was the largest at Mao period and the smallest at the Wu period; it also could decreased MDA content, the decreasing amplitude of MDA was the largest at Wu period and the smallest at Hai period.

CONCLUSIONAcupuncture at different periods according to eight methods of intelligent turtle has different effects on serum SOD and MDA, which can increase SOD activity and decrease MDA content in the healthy guinea pig.

Acupuncture Therapy ; Animals ; Female ; Guinea Pigs ; Male ; Malondialdehyde ; blood ; Superoxide Dismutase ; blood ; Time Factors

Objective:To understand the molecular pat hophysiology of hepatocellular carcinoma and pancreatic cancer.Methods: We studied novel gene expression by cDNA microarray method. The PCR pro ducts of 4 096 genes and 12 800 gene were spotted onto a kind of chemical-mater ial-coated-glass slide in array. Both the mRNAs from 5 cases of hepatocellular carcinoma and 3 cases of pancreatic cancer were reversely transcribed to cDNAs with the incorporation of fluorescent-labeled dUTP to prepare the hybridization probes. After hybridization, BioDoor4096 and BioDoor12800 cDNA microarray were scanned for the fluorescent intensity. Tumor invasion-related gene expression w as screened through the analysis of difference in gene expression profile.Results:Among 4 096 and 12 800 target genes, there were 15 genes who se expression level differed from normal and carcinoma tissues. Therefore, they might be associated with metastasis.Conclusion:Further analysis of these differentially expressed metastasis-associated genes will be helpful for understanding the molecular mechanism of malignant carcinoma.

Professor WU Liang-cun is good at the treatment of primary hepatic carcinoma. He views that the main pathogenesis of primary hepatic carcinoma is liver and kidney deficiency. Therefore, treatment should be based on enriching water to nourish wood, with soothing the liver and regulating qi, clearing the gallbladder and removing dampness, promoting blood circulation for removing blood stasis, detoxicating and resolving masses.

Objective To evaluate the effects of early tracheostomy and late tracheostomy on the prognosis of patients with cervical spinal cord injury,so as to provide evidence based guidance for the timing of tracheostomy.Methods Relevant literatures studying the timing of tracheostomy in patients with cervical spinal cord injury were searched in PubMed,Embase,Medline,Cochrane Library,Chinese Biological Medical Literature database (CBM),China National Knowledge Infrastructure database (CNKI),and VIP journal database with time range from journal establishment to March 2018.The retrieved articles were screened according to the inclusion and exclusion criteria.The article quality was rigorously evaluated according to the Newcastle-Ottawa scale (NOS).Meta analysis was conducted using Review Manager 5.3 software to compare the mechanical ventilation time,ICU stay,incidence of pneumonia,incidence of complications,and mortality between early and late tracheostomy in patients with cervical spinal cord injury.Results A total of eight articles of cohort study including 466 patients were included,with 241 patients in the early tracheostomy group and 225 patients in the late tracheostomy group.The eight articles were all determined as high quality studies according NOS.The results of Meta analysis showed that there were significant differences between the two groups in terms of the total mechanical ventilation time (MD =-12.28,95％ CI-20.09--4.47,P ＜ 0.01),post tracheostomy mechanical ventilation time (MD =-9.92,95％ CI-14.27--5.57,P ＜ 0.01),total ICU stay (MD =-10.30,95％ CI-17.12--3.47,P ＜ 0.01),post tracheostomy ICU stay (MD =-5.79,95％ CI -6.53--5.05,P ＜ 0.01),incidence of complications (RR =0.56,95％ CI 0.38-0.83,P ＜ 0.01),and mortality (RR =0.34,95％ CI 0.15-0.78,P ＜ 0.05).However,no significant differences were detected between the two groups in the incidence of total pneumonia (RR =0.77,95％ CI 0.57-1.05,P ＞0.05) and the incidence of post tracheostomy pneumonia (RR =0.80,95％ CI 0.51-1.26,P ＞0.05).Conclusion Early tracheostomy can shorten the mechanical ventilation time,ICU stay,incidence of complications,and mortality,but it cannot reduce the incidence of pneumonia.

OBJECTIVETo investigate the effects of rabbit limbs ischemia/reperfusion on myocardial necrosis and apoptosis in vivo.

METHODSThirty-six healthy new zealand rabbits were randomly divided into 3 groups: (1) Sham group; (2) I/R(Ischemia/reperfusion) group; (3) RPostC (remote postconditioning) group. The activity of blood serum creatine kinase (CK) and lactate dehydrogenase (LDH) were measured at baseline, the end of ischemia after 60 min and 120 min of reperfusion respectively. The extent of myocardial ischemia and the scope of myocardial infarction were assessed by evans blue and Triphenyl tetrazolium chloride (TTC). The myocardial cell's apoptosis at the area of myocardial ischemia was estimated by Tunel. Protein expression of caspase-3, Bcl-2 and Bax in myocardial ischemic area were analyzed with the method of immunohistochemistry.

RESULTSCompared with I/R group, the myocardial infarct size and the CK activity were significantly reduced in RPostC group. The Tunel positive index of RPostC group in ischemic myocardium was significantly lower than that in I/R group (21.79% +/- 1.07% vs 35.81% +/- 1.10%, P < 0.05). Caspase-3 positive cells index was calculated with randomly selected five regions in each slide and then the positive cells in per hundred cells were calculated. The RPostC group of caspase-3 positive cells was significantly lower than that in I/ R group(25.03% +/- 1.16% as 39% +/- 2.43%, P < 0.05). Compared with the sham group, the Bax protein expression index and the Bcl-2 protein expression index of I/R group and RPostC group were increased. The Bax/Bcl-2 ratio of RPostC group decreased, while it was increased in I/R. Compared with the I/R group, the Bax protein expression and Bax/Bcl-2 ratio of RPostC group significantly reduced, but the expression index of Bcl-2 ratio was significantly increased, the differences were statistically significant.

CONCLUSIONLimbs ischemia/postconditioning could significantly reduce necrosis and apoptosis of ischemia/reperfusion myocardium. The mechanism of reducing the myocardial cell apoptosis may have relation to inhibiting the activation of pro-apoptotic gene caspase-3 and increased expression of Bcl-2.

Animals ; Apoptosis ; Caspase 3 ; metabolism ; Creatine Kinase ; blood ; Ischemic Postconditioning ; L-Lactate Dehydrogenase ; blood ; Lower Extremity ; Male ; Muscle, Skeletal ; blood supply ; Myocardial Reperfusion Injury ; pathology ; Necrosis ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rabbits ; bcl-2-Associated X Protein ; metabolism