Triple-negative (TN) carcinoma is a molecular subtype of breast cancer characterized by the lack of expression of estrogen receptor (ER),progesterone receptor (PR) and HER-2.It is a heterogeneous disease,not only on the molecular level,but also on the pathologic and clinical aspects.TN tumors can be further classified into two subtypes:basal-like,defined as expressing epidermal growth factor receptor (EGFR) and/or cytokeratin (CK) 5/6 by immunohistochemistry,and non-basal-like; the majority of TN tumors are basal-like.TN tumors usually have a more aggressive behaviour and poorer outcome compared with non-TN breast cancers,and lack molecular targets commonly used in targeted therapy,making this group of tumors difficult to treat.Developing novel,effective treatment strategies for these tumors is crucial for improving their prognosis.This review describes a recent study series on prognostic and predictive values of tumor biomarker susing in TN breast cancer patients.TN tumors are associated with significantly higher expression of Ki67 and p53 compared to non-TN tumors.Hormone receptor negativity rather than HER-2 negativity is associated with the increased Ki67 and p53 expression in TN tumors.Furthermore,high expression level of Ki67 ( ＞ 10％ ) but not p53,is significantly associated with nodal metastasis in TN tumors,indicating that Ki67 has better prognostic value than p53.TN tumors with distant metastases are significantly associated with lower expression of androgen receptor (AR) as compared to those with only loco-regional disease ; there is a significant negative correlation between AR and Ki67 expressions among AR expressing TN tumors.Basal-like subtype TN tumors with nodal and distant metastases are associated with significantly higher intratumoral expression of EGFR and CK5/6 as compared to those without metastases.Therefore,increased EGFR and CK5/6 intratumoral expression and decreased AR intratumoral expression,rather than the frequency of their expression,may play a role in the development of metastases and may be predictive of metastatic disease in TN breast cancer patients.Anti-EGFR and anti-AR targeted therapies may provide potential treatment options for TN carcinomas,especially those tumors not responding to chemotherapy.

Objective: Objective To study high-level expression and purification of recombinant mature human IL-18(mhIL-18)in E.coli with soluble form.Methods: The gene of mhIL-18 was amplified with PCR.Then,the recombinant expression plasmid pTYB1IL-18 was constructed by cloning mhIL-18 into pTYB1 vector and transformed to E.coli ER2566.IPTG was added into the E.coli ER2566 culture to express recombinant fusion protein.After the harvested bacteria dispersed with ultrasound,SDS-PAGE and Western blot were used to analyze the expression of recombinant fusion protein.The activity of mhIL-18 which had been purified by affinity chromatography was tested by MTT.Results:The cloned sequence of mhIL-18 was identical with the sequence in GenBank.After the induction by IPTG inducing,the fusion protein of mhIL-18 covered over 26% total bacterial proteins,which included 80% active fusion protein.Purification of recombinant expressed mhIL-18 purity was 95%,which had the activity of the mhIL-18.Conclusion: High level expression and purification of recombinant human IL-18 is succeeded which has the activity.

The WeChat service provided at present in 14 hospitals directly under the Yunnan Health and Family Planning Commission was surveyed with suggestions proposed for providing active Wechat service in hospitals in order to alleviate the difficulty to see a doctor and the tense relationship between doctors and patients.

Objective:To investigate the clinical efficacy of loratadine combined with compositus mentholi cream in the treatment of infantile with external ear eczema and evaluate the safety .Methods:Totally 96 cases of infantile with external ear eczema were ran-domly divided into the observation group (n=48) and the control group (n=48) according to a random number table .Both groups were given the conventional treatment .The control group was treated with topical compositus mentholi cream , while the observation group was treated with loratadine additionally .Both groups were treated for 10 d.The clinical efficacy , the level changes of interleukin-4 (IL-4), interferon-γ(IFN-γ) and immunoglobulin-E (IgE) before and after the treatment, the incidence of adverse reactions during the treatment and the relapse after 6-month follow-up were compared between the groups .Results:The total effective rate of the obser-vation group (95.83%) was significantly higher than that of the control group (79.17%, P<0.05); the levels of IL-4, IFN-γand IgE in both groups were significantly decreased after the treatment (P<0.05), and those in the observation group were significantly lower than those in the control group (P<0.05);there was no significant difference in the incidence of adverse reactions between the groups (P<0.05); the recurrence rate in the observation group (8.33%) was significantly lower than that in the control group (22.92%, P<0.05).Conclusion:The clinical efficacy of loratadine combined with compositus mentholi cream in the treatment of infantile with external ear eczema is reliable with promising safety .

Objective To assess the efficacy and safety of autologous drainage blood reinfusion in total knee arthroplasty(TKA). Methods Computers were used to search the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and VIP. The randomized controlled trials (RCTs) of autologous drainage blood reinfusion and vacuum suction without reinfusion after TKA were collected. And the results were analyzed by using the software RevMan5.1. Results Eight RCTs met the criteria for meta-analysis. Use of autologous drainage blood reinfusion significantly reduced the average amount of units of homologous blood transfusion, the length of hospital stay, and the number of patients requiring homologous blood transfusion. The rates of DVT formation and incision infection did not differ significantly between the two groups. Conclusions Autologous drainage blood reinfusion is a safe, effective procedure with less blood transfusion and medical cost. It can lower volume of allogeneic blood transfusion , shorten length of hospital stay, and avoid occurrence of complications.

Reading therapy in hospital libraries, academic libraries and public libraries was described in terms of its theoretical study and practical study,and its significance in hospital library was elaborated by comparative analysis.

Every year, waters on earth receive large quantities of wastewater from industry, agriculture, fish and poultry raising, and municipal sewage treatment plants. Consequently, the aquatic environment on the earth is under a serious challenge from a very large quantity of pollutants such as antibiotics, insecticides, herbicides, hydrocarbons, etc., contained in the domestic wastewater, industrial and agricultural waste water and illegal effluents. In particular, with the development of intensive aquiculture and poultry, the effluent pollution has recently become more and more serious with more attentions. Furthermore more and more chemical pollutants discharged into aquatic environment have been detected with the advancement of analytical techniques. These chemicals can cause toxic effects on water habitats after discharged into aquatic environment. However, microorganisms have many key functions in pollution control. In this review, applications of microorganism in the degradation of chemicals in aquatic environments are reviewed. It was concluded that most applications of microorganisms degrading chemicals focused on aquaculture waters, whereas other aquatic systems (such as river, lake, sea, coastal waters) have been scarcely studied.

Pancreatic abscess(PA)is the most serious complication of severe acute pancreatitis(SAP),which can lead to systemic and/ or local complications,and even death. PA cannot be resolved automatically after the formation. Once diagnosed,early drainage,anti-infection and nutrition support should be undertaken,the most important is early drainage. In the past,the treatment of PA was mainly based on surgical treatment. With the development of minimally invasive techniques,endoscopic ultrasound(EUS)guided drainage and percutaneous catheter drainage(PCD)offer a new way for the treatment of PA. Preventing and early diagnosis of PA become a challenge in the treatment of SAP. This article reviewed the progress in diagnosis and treatment of SAP complicated with PA.

Antitumor drugs that target the signaling of vascular endothelial growth factor and its receptors have attracted increasing attention with the development of antiangiogenic targeted therapy. Apatinib is a second-generation vascular endothelial growth factor receptor-2 inhibitor and a potent antiangiogenic agent. Apatinib is one of the recent oral molecular targeted anti tumor drugs. Clinical studies have indicated that apatinib exhibits high bioavailability and a tolerable safety profile. A series of large-scale randomized and controlled clinical trials before and after the release of the drug in the market have demonstrated encouraging objective response rate and survival benefit across a broad range of malignancies, including non-small cell lung cancer, breast cancer, and gastric cancer. Apa-tinib was approved and launched in China in 2014 as a subsequent-line treatment for patients with advanced gastric cancer. Apatinib is currently undergoing phase II/III clinical trials for the treatment of numerous cancer types, such as gastric carcinoma, lung cancer, he-patocellular carcinoma, esophageal cancer, and colorectal cancer. These clinical trials are conducted to determine the antitumor activi-ty of apatinib when administrated alone or in combination with other therapies. This review summarizes the latest research progress of apatinib, including antitumor mechanisms, clinical effects on different tumor types, safety profile and adverse effects, drug interac-tions, as well as drug resistance and biomarkers. This article presents a deeper understanding of the clinical application of apatinib in anti tumor treatment, and provides reference for future clinical practice in therapeutic options for cancer patients.

Objective To analyze the clinical efficacy of compound 18 norgestrel combined with estrogen in treatment of dysfunctional uterine bleeding. Methods 78 cases of patients with dysfunctional uterine bleeding in Beijing Ji Shui Tan Hospital and Dongguan city people's hospital of guangdong Province were divided into control group (n=39)and observation group (n=39)by using randomized single-blind allocation. The control group was only given estrogen,the observation group was used compound 18 norgestrel combined with estrogen. The clinical efficacy of the two groups was compared. Results 31 cases were cured and 7 cases were valid of the study group,the total effective rate was 97.4%,significantly higher than the control group's total efficiency of 71.8%,the difference was statistically significant (P<0.05). Each index of observation group and the control group were improved after treatment,the difference was statistically significant (P<0.05 );After treatment,the menstrual cycle in observation group was (29.7 ±7.1)d,the menstrual period was (5.6 ±0.5)d,hemoglobin content was (135.5 ±21.7)g/L,endometrial thickness was (0.63 ±0.15)mm, significant changes than the control group,the difference was statistically significant (P<0.05 ). Conclusion Compound 18 levonorgestrel combined with estrogen has a better effect in patients with dysfunctional uterine bleeding and it can significantly improve patients'hemoglobin,the menstrual cycle and the uterus film thickness and other indicators which is worth promoting in clinical.