Currently the most effective treatment strategy for breast cancer is standardized multi-discipline comprehensive treatment. However, there are no effective models that can accurately predict prognosis, so that no guidance of individualized treatment has yet been set up, resulting in a proportion of patients with low risk who received chemotherapy with little benefit. With the development of genomics, several gene sets have been demonstrated to be helpful in predicting of breast cancer prognosis and grading the patients' benefit from chemotherapy, thus avoid overtreatment. 21-gene Oncotype Dx was reported as one of them and has been demonstrated to be effective and accurate in various clinical studies. This paper summarizes researches on 21-gene Oncotype Dx in breast cancer.

OBJECTIVETo observe the clinical efficacy of Jiakangling Capsule (JC) combined with reduction of 1311 in treatment of Graves hyperthyroidism.

METHODSTotally 387 Graves hyperthyroidism patients were randomly assigned to the treatment group (200 cases) and the control group (187 cases). Patients in the treatment group took JC combined with reduction of 131I. The 131I dosage per gram of thyroid tissue was 50-80 microCi. They additionally took JC one week after taking 1311 for one consecutive month. Patients in the control group took 131 routinely as one disposable treatment. The 131I dosage per gram of thyroid tissue was 70-120 microCi, without using JC or other anti-thyroid drugs. All patients were reexamined after 24-month treatment. Whether hyperthyroidism was cured, incurred, or permanent was observed. Efficacies of thyroglobulin antibody (TGAb) and thyroid microsome antibody (TMAb) were compared between the two groups.

RESULTSCompared with the control group, the incurred ratio increased in the treatment group [3.2% (6/187) vs. 16.0% (32/200), P < 0.01], the incurred ratio of strong positive TGAb and TMAb patients increased [3.5% (2/57) vs. 27.1% (16/59), P < 0.01], the permanent hypothyroidism ratio decreased [21.1% (12/57) vs. 3.4% (2/59), P < 0.05 ].

CONCLUSIONJC combined with reduction of 1311 was superior in treating Graves hyperthyroidism induced permanent hypothyroidism than routine 1311 treatment, especially for strong positive TGAb and TMAb patients.

Autoantibodies ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Graves Disease ; drug therapy ; Humans ; Hyperthyroidism ; drug therapy ; Hypothyroidism ; Iodine Radioisotopes

Objective:To investigate the influence of MRI examination on the position of closure devices for congenital heart diseases and to assess the effect of these devices on the image quality of MRI.Methods:Two atrial septal defect closure devices, 2 ventricular septal defect closure devices and 1 patent ductus arteriosus closure device were placed into a transparent non-metal container filled with boiling agar,with the agar completely covering the devices.The agar changed into glue after cooling,then the devices were sequentially scanned by MRI in transverse and coronal planes.The changes of agar integrity,the position of devices and the image quality were observed after scanning.Results:The surface of the agar covering the devices was smooth and had no breakage after the scanning.There was no change in the shape and position of all types of devices.The coronary, transverse scanning(T_1 WI,T_2WI)showed a few slight artifacts on the central layer,all within the contour of the device.The mesh of device near the edge was clearly showed.Conclusion:Under our experimental condition,MRI does not affect the position of closure devices for congenital heart diseases and the devices do not affect the MRI image quality.

Objective To investigate the effect of vacuum sealing drainage (VSD) technology on prevention and treatment of infection wound and to repair the infectious fracture wound in earthquake. Methods Twenty-two patients with limb fractures and open infection wound received VSD from May 12, 2008 to June 19, 2008 in West China Hospital of Sichuan University. Before the VSD, we debrided all wounds and gave effective systemic antibiotics. A -18 ～ - 14 kPa pressure was exerted to the wound, and the VSD was used for 8 ～ 10 days. We took a germiculture regularly. The capacity, color, and nature of negative pressure drainage, the regression of limb swelling, and systemic inflammatory responses were observed. Results There was no active bleeding wound or transparent film off in all patients. Three patients had drainage clogging, and were kept flowing freely using the sterile saline pipe to remove the blockage of necrotic tissues. During the VSD, granulation tissues grew well in the 13 patients with bone exposure of the wounded. Two patients whose symptom of inflammatory was not obviousy eased had another debridement to completely remove the necrosis, and the symptom was relieved. After 3-5 days of VSD, swelling and fever in the other 20 patients significantly subsided. Conclusion VSD can alleviate the wound inflammation, facilitate the growth of the fresh granulation tissue from the surrounding to the center, and reduce the flap transfer area for the Stage Ⅱ coverage of the exposed bone.

According to the training objectives of higher vocational education of pharmacy and the requirements of employment knowledge and capability, the curriculum system can be divided into modular curriculum systems which correspond with the job posts. Additionally, a set of simulating practical curriculum systems with distinct characteristics should be established in line with the job posts. By means of the reform of curriculum systems and the overall optimizing of teaching contents, the overlapping and duplication in the existing curricula can be reduced and the teaching effects can be improved.

Object To identify Tadehagi triquetrum (L ) Ohashi Methods Characteristic identification, microscopic identification, and UV spectrometry were used Results Obvious variation was found in the tissue structures between the old and young leaves as well as the old and young stems Conclusion The result can be taken as the reference for identifying the quality of crude drug

Objective To investigate the destructive effect of cadmium (Cd)and the protective effect of astragaloside ( Asd) on TM3 cells.Methods The best protective concentration of Asd on TM 3 cells after Cd treatment was selected by MTT cell viability experiment .The apoptosis rate of TM3 cells was measured by flow cytometry .The expression of connexin 43(Cx43) was detected by immunohistochemistry .The morphological changes of TM3 cells were observed by electron mi-croscopy .Results The viability of TM3 cells in both control and Asd-treated group was not significantly different after 24 h or 48 h,but it was significantly decreased in Cd group .However , the viability of TM3 cells in Cd +As group was higher than that in Cd group .Flow cytometry showed that there was no significant difference in the apoptosis rate of TM 3 cells be-tween the control and Asd-treated group after 24 h,but it was obviously increased with the Cd concentration .The apoptosis rate of Cd+Asd group was lower than that in Cd group (P<0.01).Immunohistochemistry demonstrated that the average optical density (AOD) of the positive product of Cx43 in Cd-treated TM3 cells was obviously decreased (P<0.01), but the average gray value (AGV) was significantly increased when compared with the control group (P<0.01).The ultra-structural changes in TM3 cells were obvious after Cd treatment ,but those in Cd+Asd group were improved when compared with Cd group.Conclusion Cd reduces the expression of Cx 43 and damages the morphology of TM 3 cells.Asd has protec-tive effect on Cd-induced TM3 cell injury.

Objective To observe the effect of astragaloside IV (A) and SB203580 antagonize cadmium (Cd) toxicity on expression of associated protein and blood-testis barrier(BTB) in rats and to study the protective mechanism of A on it.Methods Totally 21 SD male rats were randomly divided into 7 groups, 3 rats per group:Cd [ intraperitoneally injected with 0.1%CdCl2,1mg/(kg?d)],Cd+A [at the above dose of CdCl2,at the same time with A,10mg/(kg?d)], and Cd +SB203580 [at the above dose of CdCl2,at the same time with SB203580,100μg/(kg?d)], each of the above groups was further divided into continuous five and ten days treatment groups .The control group was intraperitoneally injected with equal dosage of normal saline .The testes were studied by light , electron microscopy , immunohistochemistry and Western blotting .Results In the control group ,irregular and lightly stained nuclei of Sertoli cell ( Sc) in seminiferous tubules were observed by HE staining .A continuous electron density line of tight junction ( TJ) and normal ultrastructure of BTB were observed .After Cd treatment ,the vesicular formation in the Sc was observed .The ultrastructural damage of Sc and TJ was observed .Compared with the corresponding time point of Cd group ,these were weakened in morphology of testis and ultrastructure of TJ after Cd +A or Cd +SB203580 treatment .The positive products of zonula occludens-1 ( ZO-1 ) and claudin-11 were localized mainly in the base of the seminiferous tubule .After Cd treatment , the average absorbance (AA) of ZO-1 and Claudin-11 was decreased significantly compared with that of the control group (P<0.05).After Cd +A or Cd +SB203580 treatment,AA of ZO-1 and Claudin-11 were increased significantly compared with that of the Cd group(P<0.05),though lower than that of the control group .The result of Western blotting showed that phosphorylation-p38MAPK in Cd group was increased significantly compared with that of the control group (P<0.05).After Cd +A or Cd+SB203580 treatment, it was decreased significantly compared with that of the Cd group (P<0.05).Conclusion Cd decreases ZO-1 and Claudin-11 expression and damages ultrastructure of TJ in BTB , asⅣhas protective effect on it , and is related to inhibiting activation of p 38 MAPK pathway .

Objective To investigate the effects of reflection diary training on nurse's clinical decision-making capability.Methods A total of 489 nurses in our hospital were enrolled in the study for tests of their clinical decision capability between July 2013 and July 2015.Two hundred forty-eight of them were set as the experiment group and two hundred forty-one of them were set as the control group at random.The reflection diary training was applied in the experiment group for one year.Result After intervention,the scores on clinical decision-making ability,clinical thinking,knowledge structure,ability in nurse-patient communication were all significantly higher than those of control group (P＜0.01).Conclusion The reflection diary training can improve nurse's clinical decision-making capability and inspire their clinical thinking about the nursing problems.