The treatment of advanced breast cancer is mainly palliative treatment. Endocrine therapy is the main treatment for hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer patients without visceral crisis or life-threatening conditions. The goal of endocrine therapy is to prolong survival, improve or maintain quality of life, and delay the start of chemotherapy as much as possible. In recent years, cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have been approved and used clinically. CDK4/6 inhibitors are a new type of targeted therapy drugs, which are mainly used in HR+/HER2- breast cancer patients, making a breakthrough in related endocrine therapy models. Currently, the CDK4/6 inhibitors approved by the US Food and Drug Administration are Palbociclib, Ribociclib and Abemaciclib. Compared with traditional endocrine therapy alone, CDK4/6 inhibitor combined with endocrine therapy significantly prolongs the progression-free survival of breast cancer patients, and is well tolerated. In this paper, the clinical research progress in CDK4/6 inhibitor combined with endocrine therapy for HR+/HER2- breast cancer was introduced, and the adverse reactions of three CDK4/6 inhibitors mentioned above in clinical application were analyzed.

Silicone prostheses are the major biomaterials used in reconstructive and aesthetic breast surgery. The use of silicone gel breast implants in China was much later than that in western countries. The wide spread use of silicone gel-filled implants in the medical profession has documented in its success and usefulness, but some possible complications also occurred following this good clinical record. The main complications are rupture and leakage of silicon gel-filled mammary prosthesis, capsular contracture, implant shift and infection. Therefore, we not only pay attention to the defined complications, but also think highly of the disputing security issues.

Background and purpose:Neoadjuvant chemotherapy has become a major therapeutic strategy for the treatment of locally advanced breast cancer.Randomized trials comparing this approach to adjuvant chemotherapy have demonstrated that neoadjuvant chemotherapy was as efficacious as adjuvant chemotherapy and allowed for a higher rate of breast conservation.This study was to evaluate the efficacy and toxicity of docetaxel plus capecitabine in the neoadjuvant chemotherapy of locally advanced breast cancer(LABC) .Methods:Fifty-two patients with LABC were treated with docetaxel 75 mg/m2,d1;Capecitabine 2 000 mg/m2,d1-14.The chemotherapy was repeated every 3 weeks.Effi cacy and toxicities were reviewed after 3 to 4 cycles of chemotherapy.Results:The CR+PR rate was 80.7%.A pathological complete response in the breast was achieved in 5.8% of patients after 4 cycles of docetaxel/capecitabine.The adverse reactions were neutropenia,alopecia and hand-foot syndrome.Conclusion:The combination of docetaxel and capecitabine was well tolerated and effective in LABC for neoadjuvant chemotherapy.

Objective To investigate the characteristics of aminoglycoside resistance of extend-ed-spectrum β-lactamases(ESBLs)-producing Escherichia coli(E, cold and expression of aminoglyco-side-modifying enzyme genes. Methods The minimal inhibitory concentrations(MICs) of gentamicin,amikacin, kanamycin, tobramycin, netilmicin and neomycin for 37 strains of ESBLs-producing E. Coli were detected by agar dilution. In addition, six aminoglycoside-modifying enzyme genes were amplified by polymersae chain reaction(PCR) and verified by DNA sequencing. Results MICand MIC90 of gentamicin, amikacin, kanamycin, tobramycin and netilmicin for 37 strains of ESBLs-producing E. Co-Il all excelled 256 μg/mL, the resistance rates of the above antibiotics were 78.4%, 45.9%, 72.9%,83.8%and 64.90%, respectively. However, neomycin still had powerful antibacterial activity. In ad-dition, five modifying enzyme genes, including aac(3)-Ⅱ , aac(6′)-Ⅰ b, aac(6′)-Ⅱ , ant(2″)-Ⅰ and ant(3″)- Ⅰ genes, were found in 37 isoaltes except aac(3)- Ⅰ , and their positive rates were 56.8%,27.0 %, 2.7 %, 5.4 % and 13. 5 %, respectively. Conclusion The aminoglycoside resistance of ES-BLs-producing E. Coil may be associated with the expression of aminoglycoside-modifying enzyme genes.

Objective To investigate whether serum miRNA-720 and miRNA-484 can be used as non-invasive biomarkers of colon cancer.Methods Real time-polymerase chain reaction was used to detect the expressions of miRNA-720 and miRNA-484 in serum from 104 colon cancer patients(divided intoⅠ~Ⅱ-stage group andⅢ~Ⅳ-stage group)compared with 60 ad-ditional healthy controls.ROC curve was performed to analyse the diagnostic usefulness of both miRNAs distinguishing be-tween different stages of colon cancer patients.Results Compared with healthy controls,the miRNA-720 was upregulated close to 2 times inⅠ~Ⅱ-stage group (t=1.997,P<0.05),and was upregulated about 3 times inⅢ~Ⅳ-stage group (t=2.133,P<0.05).The miRNA-484 was downregulated almost 2 times inⅠ~Ⅱ-stage group (t=2.585,P<0.05),but was upregulated over 3 times in Ⅲ~Ⅳ-stage group (t=3.416,P<0.01).The area under the ROC curve (AUC)for the diag-nosis of colon cancer were 0.76 (95%CI:0.67~0.86)and 0.79 (95%CI:0.69~0.89)respectively.The combined use of both miRNAs could make the AUC up to 0.87 (95%CI:0.77~0.96).Conclusion Serum miRNA-720 and miRNA-484 can be used as non-invasive biomarkers to diagnose early colon cancer.They can also distinguish between different stages of co-lon cancer patients.

MicroRNA(miRNA) is one of the non-coding RNAs with approximate 21 nucleotides in size,which can target messenger RNA (mRNA) to silence gene expression post-transcriptionally.Recent studies have shown that miRNAs play important roles in many physiological and pathological processes,including signal transduction,stem cell differentiation,tumor genesis and development,infection and immunity.Circulating miRNAs are ubiquitous and highly stable,and their profiles are specifically deregulated in different disease processes,thus having the potent to be novel biomarkers for disease diagnosis,prognosis evaluation and treatment assessment.At the same time,it will be the challengc to explore disease-associated miRNA profiles for the development of future molecular diagnostics,as well as to establish standard procedures in detection and effective external quality assessment.

Objective To analyze the results of inhaled allergens detection in children with allergic rhinitis(AR)in Changzhou ar-ea and the distribution situation of allergens in different age groups.Methods The levels of serum allergen specific IgE antibodies in 473 children cases(aged 1-12 years)of allergic rhinitis(AR)were detected by the Allergy Screen allergen screen system.The children cases were divided into the infants group(0-3 years old),preschool children(4-6 years old)and school age children(7 -12 years old)according to age.The allergen positive rates and the change tendency were compared among different age groups.Re-sults Among 473 children cases of allergic rhinitis,340 cases(71.9%)were positive.The top three allergens were house dust mite (55.6%),mixed fungi(25.8%)and house dust(18.8%).The positive rate of allergen showed the upward trend with the age in-crease.The distribution of house dust mite(χ2 =21.061,P =0.000),house dust (χ2 =15.111,P =0.000)and the cat and dog dan-der(χ2 = 7.597,P = 0.022 )was statistically significant among the three groups.Single allergen positive rate was the highest (38.5%)and the secand was double allergens(23.7%).The top three positive in single allergens was consistent with sort of total allergen positive rate.The most common double allergen was the combination of house dust mites and house dust.The multiple al-lergen positive rate had statistical significance in the distribution among groups(χ2 =13.399,P =0.001).Conclusion The inhaled allergens of AR children in Changzhou area are dominated by house dust mite,mixed fungi and house dust.The positive rate shows the increasing trend with age increase.The allergen constituents are different in different age groups.The positive single allergen is most common,followed by positive double allergens.

Objective To investigate the clinical significance of combined detection of serum sTWEAK and cystatin C in early di‐abetic nephropathy (DN) .Methods 35 patients with DN(DN group) ,56 patients with diabetes mellitus (DM ,DM group) and 40 healthy cases conducted physical examination (healthy control group) were selected and serum levels of sTWEAK and cystatin C were detected .And levels of glycosylated hemoglobin(HbA1c) and qualitative urine protein test were conducted in DM group .Re‐sults The serum sTWEAK level in DN group was lower than that in DM group ,and the serum cystatin C level was higher than that in DM group(P<0 .05) .The serum levels of sTWEAK in DM group and DM patients with negative qualitative urine protein were lower than that in healthy control group ,while the serum cystatin C levels were higher than that of control group (P<0 .05) . Compared with DM patients with HbA1C< 10% ,the serum cystatin C level was higher and serum sTWEAK level was lower of those with HbA1c>10% (P<0 .05) .Conclusion The combined detection of serum sTWEAK and cystatin C could be a sensitive index for early diagnosis of DN ,with important significance in the occurrence and development of DN .

Objective To evaluate the role of transeso phageal echocardiography(TEE) before chemical or electric cardioversion for non-vulvular atrial fibrillation. Methods Forty-three patients, confirmed non-vulvular atrial fibrillation, undertook anticoagulation or anti-platelet therapy and transthoracic echocardiography and TEE less than 24-48 hours prior to cardioversion. Results Two thrombi in the left atrial appendage and three spontaneous echo contrasts in the left atrium were evidenced. After anticoagulation or anti-platelet therapy, 39 patients undertook cardioversion therapy. Among them,31 patients received drug cardioversion,success in 19,and failure in 12;8 patients received electric cardioversion,success in 6,and failure in 2. There were no thromboembolic events during the hospitalization. Conclusions TEE performed before cardioversion for atrial fibrillation is necessary to reduce the risks of thromboembolic events and to guide for anticoagulation therapy.

Objective To determine the accuracy and usefulness of dobutamine stress echocardiography(DSE) in detecting restenosis after percutaneous coronary intervention (PCI). Methods DSE was conducted in 47 patients before coronary angiography, 6 months to 18 months after PCI. The standard protocol of DSE was 5,10,20,30 ?g?kg~(-1)?min~(-1) with subsequent incremental increases every 3 minutes to a maximum dose of 40 ?g?kg~(-1)?min~(-1). Consistency of the results was compared between DSE and coronary angiography.Results Compared with coronary angiographic results, DSE had a low sensitivity(64%) but high specificity(86%) for detection of restenosis after PCI. The total accuracy was 72%. Conclusions DSE can assess restenosis after PCI with lower cost and safety.