0.05).However,50.0% of T1 patients with TNBCs had lymph node metastasis,which was much higher than the other 2 groups.The recurrence rate in TNBC,non-TNBC or Her-2 positive patients were 57.1%,40.5% and 44.2%,respectively.The triple negative group had higher tumor recurrence rate than the other two groups(P=0.03).The overall 3 year survival rate of the TNBC group was 58.9%,which was much lower than the other two groups(76.4% for the luminal a and b group and 74.8% for the Her-2 positive group(P=0.04).Conclusion:The TNBCs was higher in premenopausal patients well as a higher lymph nodes metastasis rate with small tumor size.Moreover,three years recurrence and mortality rates in this group is higher than the non-TNBC groups.

Objective To investigate the preventive and therapeutic effects of vesiculation moxibustion on rat hepatic fibrosis (HF).Methods Thirty rats were randomly allocated to treatment, model and control groups, 10 rats each. A rat model of HF was made by intraperitoneal injection of carbon tetrachloride. At three weeks after model making, the treatment group was treated by vesiculation moxibustion 6 hrs twice a week, for a total of 4 weeks. Body weight, liver wet weight, liver index, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) contents, and serum and liver typeⅢ procollagen (PCⅢ), typeⅣ collagen (Ⅳ-C), hyaluronic acid (HA) and laminin (LN) contents were measured in every group of rats.Results There were statistically significant differences in HF severity grade and HF tissue collagen analysis indices between the model group of rats and the treatment group or the control group (P<0.01,P<0.05). There were statistically significant differences in body weight, liver wet weight and liver index between the model and control groups of rats (P<0.01). There were statistically significant differences in liver wet weight and liver index between the treatment and model groups of rats (P<0.01). There were statistically significant differences in serum ALT and AST contents, and serum and liver PCⅢ,Ⅳ-C, HA and LN contents between the model and control groups of rats (P<0.01,P<0.05). There were statistically significant differences in serum ALT and AST contents, and serum and liverⅣ-C, HA and LN contents between the treatment and model groups of rats (P<0.01,P<0.05). There was a statistically significant difference in serum PCⅢ content between the treatment and model groups of rats (P<0.01).Conclusion Vesiculation moxibustion has some preventive and therapeutic effects on rat hepatic fibrosis.

Objective:To investigate the progression pattern of acquired resistance to osimertinib and the treatment method as well as the therapeutic effect of salvage therapy in advanced lung cancer patients with epidermal growth factor receptor (EGFR) sensitive mutation or T790M mutation after the treatment of tyrosine-kinase inhibitor (TKI).Methods:The data of 145 patients with advanced lung cancer treated with osimertinib in Jiangsu Cancer Hospital between April 2017 (the approval time of osimertinib in China) and May 2019 were collected. At the last follow-up (December 2019), a total of 87 (60.0%) patients had acquired resistance to osimertinib, 61 (70.1%) of whom received salvage treatment; for patients with dramatic progression after resistance, chemotherapy was mainly given in the salvage therapy; for patients with gradual or local progression after resistance, the continuing targeted drug therapy and the local therapy were given. Imaging evaluation and Kaplan-Meier method were used to analyze the progression pattern of acquired resistance to osimertinib and the survival status, and to compare the salvage treatment results among subgroups.Results:The median follow-up time of 61 patients receiving salvage therapy was 11 months (4-32 months), among which 58 (95.1%) patients again had resistance to osimertinib, and 24 (39.3%) patients died of lung cancer. The median progression-free survival (PFS) time and overall survival (OS) time for the whole cohort was 2.5 months (95% CI 2.1-3.0 months) and 19.0 months (95% CI 13.7-26.3 months), respectively. The 1-year and 2-year OS rate was 72.1% and 41.7%, respectively. Among 61 patients receiving salvage therapy, 8 (13.1%) , 30 (49.2%) and 23 (37.7%) cases had dramatic progression, gradual progression and local progression, respectively; when given timely and proper salvage treatment, there were no statistically differences in PFS and OS of the patients in the above three subgroups (all P>0.05). There were no statistically differences in PFS and OS between patients receiving local therapy (24 cases) and patients not receiving local therapy (37 cases) after the progression occurred (all P>0.05). Among 58 patients with resistance to osimertinib again after the salvage therapy, 6 patients with gradual or local progression had more than 6-mouth PFS after the salvage therapy. Conclusions:Dramatic, gradual and local progression are the main patterns in patients with acquired resistance to osimertinib. The therapeutic efficacy of salvage therapy still shows some disappointing results.

Objective:To explore the implementation path of scientific and technological achievement empowerment for researchers in public hospitals.Methods:Through literature research, theoretical research, policy research, etc, current situation and progress of the ownership management reform of scientific and technological achievements at home and abroad were sorted out, and the difficult problems in the empowerment of scientific and technological achievements were summarized in combination with its practice in domestic public hospitals.Results:The following problems existed in the empowerment of scientific and technological achievements in public hospitals: weak awareness of medical staff′s ownership protection imperfect empowerment system, lagging construction of management personnel, and constraints of state-owned assets management.Conclusions:It is suggested to improve the coordination mechanism of government departments, optimize related policy and law environment and innovation atmosphere, implement a categorized and tiered empowerment strategy for job scientific and technological achievements, set up a management platform of medical scientific and technological achievements, build a complete support service system, establish a mechanism for cultivating and producing high-value achievements, and strengthen the construction of achievement management personnel.

This paper summarized the experience of ZHANG Zhiyuan， a master of traditional Chinese medicine， in treating gastric diseases with Daizheshi （Haematitum）. It is believed that the treatment of gastric diseases should focus on restoring the purification and descent of stomach qi， and Daizheshi， as the essential medicine for directing stomach qi and counterflow downward， is especially suitable. Commonly， Daizheshi is used in combination with herbal medicinals Chaihu （Radix Bupleuri） and Wuzhuyu （Fructus Evodiae） to relieve constraint and direct counterflow downward， with Dahuang （Radix et Rhizoma Rhei） and Gualou （Fructus Trichosanthis） to disperse phlegm and direct qi downward， with Chenxiang （Lignum Aquilariae Resinatum） to regulate qi and unblock the center， and with Renshen （Radix et Rhizoma Ginseng） to open congestion and supplement deficiency. For the syndrome of disharmony between the liver and stomach， the addition of Daizheshi to liver soothing and qi regulating medicinals can lower liver Qi and calm Chong Qi（冲气）， restore the unblock and purge nature of stomach qi. For the syndrome of disharmony between the gallbladder and stomach， adding Daizheshi to the medicinals for gallbladder function promoting and phlegm resolving can direct phlegm turbidity downward， and promote gallbladder fire to reach the stomach， permitting the clear qi of the gallbladder rising naturally.For spleen and stomach disharmony syndrome， adding Daizheshi to the medicinals for spleen fortifying and stomach warming can calm the counterflow and the center， allowing the deficiency can be replenished. For lung and stomach disharmony， the addition of Daizheshi to medicinals for lung moistening and stomach clearing can directing stomach qi downward and harmonizing yin， direct repulsion of hyperactive fire， assist metal to purify qi， bank up earth to generate metal， and help with transformation of body fluids.