Postoperative adjuvant chemotherapy for breast cancers was one of the ways to decrease the tumor recurrencerate of patients and improve the overall survival.It reviewed related articles about cost-utility analysis of postoperative adjuvant chemotherapy regimens for breast cancers before 2016,which could provide references for selecting economic and effective treatment for clinicalpractice.

OBJECTIVE: To look for the breakthrough for the implementation of national essential drugs system in China. METHODS: Based on relevant literatures, the disadvantage of establishment of National Essential Drug System and its main reason were considered. RESULTS: Five disadvantages of establishment of National Essential Drugs System were as follows: early starting, slow process and some links against essential drug system; clear direction of national drug policy without significant effectiveness; Essential Drugs List didn’t occupy high dominant position. National Essential Drugs System lacked of legal status and liability subject. CONCLUSION: National Essential Drug System should be escalated from policy of government to national policy, and legislation of National Essential Drug System should be strengthened. Government at all levels is liability subject to implement National Essential Drugs System and perform classification management system of essential drug.

Different levels of screening and treatment planning for many kinds of cancers were designed in many countries,but the screening rate was unreasonable.It reviewed the studies about analyzing stated preference for cancer screening by discrete choice experiments from January 2005 to July 2016.It introduced the background and method of DCE,identified the main factors affecting the attendance of cancer screening and provided theoretical foundation for further development of cancer screening in China.

Objective To explore the effects of seretide (salmeterol 50 μg and fluticasone propionate 500 μg) on lower airway bacterial colonization (LABC) in the patients with stable moderate-tosevere chronic obstructive pulmonary disease (COPD).Methods A total of 84 patients with moderate-tosevere COPD were divided into 2 groups,i.e.test (n =43) and control (n =41).The control group received basic treatment while the test group seretide 50/500 μg per inhalation twice daily for 2 years plus basic treatment.Induced sputum specimens were analyzed for quantitative bacteriology and bacterial culture.The pulmonary function key parameters and exacerbation frequency were compared between two groups at pre- and post-therapy.Results The test group has significantly a lower positive rate of bacterial culture in the lower respiratory tract than before(16.3％ vs.34.9％,x2 =3.9091,P =0.0480).While in the control group,the positive rate of bacterial culture stayed almost the same as compared with that at pre-therapy (x2 =0.2253,P =0.6350).The test group had significantly decreased exacerbation frequency than the control group (1.9±2.1 vs.2.9 ±2.3,t =2.0364,P =0.0449);FEV1 of the control group decreased by (0.0885 ± 0.0186)L in 2 years and decreased by (0.0807 ± 0.0165)L in the test group.Significant differences existed in two groups (t =2.0355,P =0.0450).Conclusion The treatment of seretide can decrease LABC,slow decreasing trend of lung function and improve clinical symptoms in the patients with stable moderate-to-severe COPD.

Objective To observe the influence of smoking on lower airway bacterial colonization(LABC)in stable phase of chronic obstructive pulmonary disease(COPD).Methods 104 patients with moderate or severe COPD were divided into three groups:42 cases smoking continuously were divided into A group,36 cases quit smoking were B group,34 non-smoker were C group.Induced sputum were analyzed for quantitiative bacteriology and bacterial culture,pulmonary function was evaluated at begining and in two years later.Results Smokers has higher positive rate of LABC than non-smokers;patients in B group has significantly lower positive rate of bacterialculture in quit smoking 2 years late than before,and significantly lower than that in A group;bacterial colonization in A group and B group include Streptococcus pneumoniae,Haemophilus influenzae,Moraxella catarrhalis; patients in B group quit smoking 2 years late and patients in C group has significantly lower positive rate of Pseudomonas aeruginosa,significantly decreased exacerbation frequency and decline of FEV1 than patients in A group.Conclusion Smoking increase positive rate of LABC in patients with moderate or severe COPD.Smoking is an important factor in deterioration of lung function in COPD.there is positive significance to quit smoking in patients with COPD.

A novel targeting drug carrier (FA-BO-PAMAM) based on the PAMAM G5 dendrimer modified with borneol (BO) and folic acid (FA) molecules on the periphery and doxorubicin (DOX) loaded in the interior was designed and prepared to achieve the purposes of enhancing the blood-brain barrier (BBB) transportation and improving the drug accumulation in the glioma cells. 1H NMR was used to confirm the synthesis of FA-BO-PAMAM; its morphology and mean size were analyzed by dynamic light scattering (DLS) and transmission electron microscope (TEM). Based on the HBMEC and C6 cells, cytotoxicity assay, transport across the BBB, cellular uptake and anti-tumor activity in vitro were investigated to evaluate the properties of nanocarriers in vitro. The results showed that the nanocarrier of FA-BO-PAMAM was successfully synthesized, which was spherical in morphology with the average size of (22.28 ± 0.42) nm, and zeta potential of (7.6 ± 0.89) mV. Cytotoxicity and transport across the BBB assay showed that BO-modified conjugates decreased the cytotoxicity of PAMAM against both HBMEC and C6 cells and exhibited higher BBB transportation ability than BO-unmodified conjugates; moreover, modification with FA increased the total uptake of DOX by C6 cells and enhanced the cytotoxicity of DOX-polymer against C6 cells. Therefore, FA-BO-PAMAM is a promising nanodrug delivery system in employing PAMAM as a drug carrier and treatment for brain glioma.

Objective To investigate the diagnostic value of B-mode ultrasonography in detecting middle hepatic vein(MHV)in chronic liver disease patients.Methods 80 chronic liver disease patients were divided into 2 groups(chronic hepatitis and liver cirrhosis).Liver biopsies and the inner diameter(ID)of MHV was detected with B-mode ultrasonography.The ID of MHV was compared in the chronic hepatitis and liver cirrhosis groups,different liver fibrosis stages and compensation/non-compensation liver cirrhosis.The ability of ID of MHV in auxiliary diagnosis liver cirrhosis was analyzed with the receiver operating characteristic curve(ROC).Results The size of ID of MHV in liver cirrhosis(3.82±1.84)mm was smaller than that of chronic hepatitis(6.15±1.67)mm(P＜0.01).The size of ID of MHV in non-compensation liver cirrhosis(2.98±1.15)mm was smaller than that of compensation liver cirrhosis(4.42±2 20)mm(P＜0.05).There was midrange negative correlation with liver fibrosis stages and the ID of MHV(rs=-0.465,P＜0.01).The cutoff point of ID of MHV diagnosis liver cirrhosis was 4.7mm.The area under ROC(AUC)achieved 0.813(P＜0.01).The sensitivity(Se),specificity,(Sp),positive predictive value (PPV),negative predictive value(NPV)and Youden index were 67.5%,90.0%,88.0%,73.5% and 57.5%,respectively.Conclusion There is well clinical value with B-mode ultrasonography detecting ID of MHV for the auxiliary diagnosis of chronic liver disease.

ObjectiveTo study the amplification and expression of HER-2 gene and protein in breast cancer and to investigate the relationship between HER-2 gene and Ki-67 、P53 、ER、PR、lymph node metastasisandTNMstaging.MethodsFluorescenceinsituhybridization(FISH) and immunohistochemistry(IHC) method were used to detect the amplification and expression of HER-2 and the expression of Ki-67、P53、ER、PR in 150 cases of breast cancer. Results49 out of 150 cases were amplificated,positive rate of HER-2 gene was 32.68％.In the 32 patients whose expression of HER-2 protein was ( + + + ),HER-2 gene was expressed in 28 cases.In The 46 patients whose expression of HER-2 protein was ( + + ),HER-2 was expressed in 16 cases.In the 26 patients whose expression of HER-2 protein was ( + ),HER-2 was expressed in 3 cases.In the 47 cases that the expression of HER-2 protein was negative,there were 45 cases that the expression HER-2 gene was negative.The expression of HER-2 was correlated with ER,PR expression and TNM staging,but not significantly related with age,Ki-67,P53 and lymph node metastasis.ConclusionsFISH and IHC correlate well with each other in the determination of HER-2 gene amplication and protein expression in cases of invasive breast cancer.

Objective To investigate the clinical value of cardiopulmonary resuscitation (CPR) with abdominal lifting and compression on patients with breathing and cardiac arrest induced by severe chest trauma.Methods Sixty-six breathing and cardiac arrest patients induced by severe chest trauma admitted to the General Hospital of Jingyuan Coal Industry Group Company from October 2011 to October 2016 were enrolled,and they were divided into abdominal lifting and compression group (n =32) and unarmed abdominal compression group (n =34) by random number table.The patients in both two groups were given the airway open,respiration support,defibrillation treatment,venous access establishment,vasoactive drugs application and other conventional treatments.On the basis of the routine treatment,the patients in abdominal lifting and compression group were given application of abdominal lifting and compression device with 100 times/min frequency and continuously alternating press down to lift the abdomen,the amplitude of pressing and pulling were 3-5 cm below or above the original level of the abdomen.Those in unarmed abdominal compression group were given abdominal CPR pressing method by hand,the frequency of pressing and depth of subsidence was the same as abdominal lifting and compression group.Heart rate (HR) and arterial blood gas at 30 minutes after CPR as well as the success rate of resuscitation were compared between the two groups.The changes in HR,mean arterial pressure (MAP) and pulse oxygen saturation (SpO2) before and 30 minutes and 60 minutes after CPR were dynamically observed in patients with restoration of spontaneous circulation (ROSC) after abdominal lifting and compression CPR treatment.Results Compared with the unarmed abdominal compression group,HR (bmp:136.13±6.14 vs.148.45±5.16) and arterial partial pressure of carbon dioxide [PaCO2 (mmHg,1 mmHg =0.133 kPa):48.51 ±2.60 vs.62.51 ±2.50] at 30 minutes after CPR in abdominal lifting and compression group were significantly lowered,and arterial partial pressure of oxygen (PaO2) was significantly increased (mmHg:88.07±3.92 vs.74.12±2.12,all P ＜ 0.05).Four patients with ROSC were found in abdominal lifting and compression group,and 2 in unarmed abdominal compression group.The success rate of resuscitation in abdominal lifting and compression group was significantly higher than that of unarmed abdominal compression group (12.50％ vs.5.82％,P ＜ 0.05).In 4 patients with ROSC after abdominal lifting and compression CPR showed a downward trend in HR and an upward trend in MAP and SpO2 with CPR time prolongation.Conclusions The effect of abdominal lifting and compression CPR is better than that of unarmed abdominal compression CPR,which is of great value for the life saving of patients with breathing and cardiac arrest induced bv severe chest trauma.

Objective To evaluate the significance of positive autoantibodies number in antinuclear antibodies(ANAs) spectrum for the diagnosis of systemic lupus erythematosus(SLE).Methods A total of 1 297 patients were included in this study,among them 148 cases were SLE,317 cases were non-SLE rheumatic diseases,99 cases were nephropathy,210 cases were hematological diseases,and 523 cases were other diseases as the control group.The ANAs level in each group was detected by immunoblotting.The rate comparison adopted the chi square test.The value of positive autoantibodies number in diagnosing SLE was analyzed by receiver operating characteristic(ROC) curve.Results The positive autoantibodies number had good diagnostic value for SLE.The area under the curve was 0.934;the positive rate of autoantibodies(AAbs) in the SLE group was 93.92 ％,which was much higher than that in other groups(P＜0.01).When the number of positive-AAbs was ≥3,the positive likelihood ratio was greater than 10(72.78),showing a very good predictive value for the diagnosis of SLE.Conclusion Three or more kinds of positive-AAbs is highly suggestive of SLE.