Objective To elevate the efficacy and complications of partial splenic embolization(PSE) using the alginate microglobe(AMG) as embolic material for hypersplenism in cirrhosis.Methods 42 patients with hypersplenism and cirrhosis were treated by PSE,AMG of 250～450 ?m were injected into the arteries of inferior splenic pole,the embolization degree was ranging from 40% to 70%.Results 42 times of embolization were performed in 42 patients,after operation, 35 patients had fever and lasted for 3~15 d,38 patients had abdominal pain,of them, 27 patients needed treatment with analgesic.Treatable a little hydrothorax appeared in 6 ,and no serious complication occurred.WBC and PLT counts were increased 24 hour later(P

Triple-negative breast cancer ( TNBC ) is a subtype of breast cancer,and it is characterized by an aggressive clinical course with a poor prognosis.Treatment for TNBC has attracted much attention in recent years,however,there is no standard treatment for TNBC in clinical setting.The pCR rates of neoadjuvant chemotherapy in TNBC ranges from 12％ to 48％ in the current published data,and it is higher than that in other types of breast cancer,however,the fluctuating range of the TNBC ’s pCR is large in literature.Although the administration of adjuvant chemotherapy for early TNBC is controversial,the regimen without anthracyclines is reported to be suitable for early TNBC patients.Standard cytotoxic agents including taxanes and anthracyclines are still the main choices for TNBC salvage treatment,and the combination with gemcitabine or capecitabine may improve the overall survival.Poly (ADP-ribose) polymerase (PARP) is a new molecular target for TNBC in ongoing studies.Further research on the target-inhibitors such as BSI-201and Olaparib will provide more effective choices to clinical treatment.

Skin toxicities are the most common adverse effects of epidermal growth factor receptor inhibitors(EGFRI).It can result in significant physical and psyehological discomfort,and even leads to interruption or dose modification,and consequently affect the curative effect. Nowadays this adverse effect has attracted lot of attention.It is proposed that clinical management and treatment measures for skin toxicities should be further studied to improve the patients life quality,and guarantee the continuity and best curative effect of the treatment.But more researches on the pathogenesis and its prognostic significance are still expected.

Recent studies suggest that astrocyte elevated gene 1 ( AEG-1 ) is almost highly expressed in all types of malignant solid tumors and correlates with poor prognosis,which becomes a prognostic marker for many kinds of tumors.As a strongly basic protein,AEG-1 possesses a transmembrane domain and multiplenuclear localization signals.It is present in the cell membrane,cytoplasm and nucleus.As an oncogene,AEG-1 palys an important role in a virety of malignant biological behaviors of cancer,which range from cell proliferation,apoptosis,migration,adhesion,invasion to tumor angiogenesis and chemotherapy resistance.Its critical role in tumor genesis and progression has made it a potential therapeutic target.

Cytokine-induced killer(CIK)cells are characterized by rapid proliferation, high and broad anti-tumor activities and mild toxicities. Some clinical trials demonstrate that the infusion of a large amount of CIK cells enhances the auto-immune of function in patient, which might help to clean up the remaining tumor cells and minor metastatic tumors and delay the recurrence of tumor with improved curative effects.

In recent years,tumor immunotherapy has attracted more attention because of its remarkable curative effect in patients with advanced cancer,but often accompanied by immune related adverse events.Understanding the immune related adverse reaction rate,possible mechanism and adverse reaction evaluation criteria and treatment principle of the immune checkpoint inhibitors such as Ipilimumab,Nivolumab and Pembrolizumab,has important significance for the treatment of malignant tumor.

The uptake of oral administered drugs primarily occurs in the small intestine,which also has the capability to metabolize drugs.Both phase Ⅰ and phase Ⅱ metabolic enzymes were expressed in the intestinal mucosa,and cytochromes P450(CYP450s) are the principle enzymes attributed to the biotransformation of drugs.CYP3A and CYP2C are the most abundant subfamilies,accounting for approximately 80% and 16% of total CYP450s in the intestine.Compared to the liver,the expression and activity of CYP450 enzymes in the intestine was susceptible to inducers or inhibitors,leading to drug-drug interaction.This article reviews the expression of CYP enzymes in small intestine and the role of the gut wall in CYP-mediated xenobiotic metabolism.Possible drug-drug interactions due to induction or inhibition of CYP enzymes in the small intestine are also addressed.

Objective To assess the benefit of intraoperatively placed nasointestinal feeding tubes for early postoperative enteral nutrition.Methods The retrospective study was carried out on 19 cases of in-fants with long gap esophageal atresia who underwent one-stage operation in Xinhua Hospital from January 2006 to December 2013.Patients were divided into two groups according to whether the transanastomotic na-sointestinal feeding tubes(TNFT)were placed.Demographics,associated anomalies,operative findings,com-plications,duration of enteral nutrition(EN),length of stay were analyzed.Results Thirty-seven patients had long gap esophageal atresia and nineteen underwent one-stage operation.Eight patients were identified as TNFT group while eleven patients were identified as nonfeeding tube(NFT)group.There was no significant differences between the two groups in gestational age,birth weight,associated anomalies,anastomotic leak, weight gain,ICU-free days and length of stay(P>0.05).But the ventilator-free days(23.5 d vs.19.3 d), first EN time(0.8 d vs.9.1 d)and total EN feeding time(15.9 d vs.21.4 d)between the two groups were significantly different(P<0.05 ).Conclusion Intraoperatively placed TNFT may lead to earlier EN feeding and shorter parenteral nutrition duration,but a larger prospective study would be required to prove the benefits and ensure the safety.

Objective To understand the environmental lead pollution status in Tongzhou and the biological burden of lead in children living in the lead polluted area.Methods The 353 pupils aged 7-14 years were randomly selected in Zhangzhishan town central elementary school that was near to steel wire factories,283 pupils were selected as the control by using the same methods in an elementary school around where there is no any steel wire factory.Every students were investigated by questionnaires,meanwhile their hair were collected to determine lead with ASS method.Results In the polluted area group,hair lead of 77 pupils exceeded the normal level,the median was 4.437 ?g/g,the rate of exceeding the normal level(≤10 ?g/g)was 21.81%,and 65 pupils with lead poisoning related symptoms(18.41%).In the control group,the median was 3.965 ?g/g,the rate of exceeding the normal level was 11.31%,38 pupil with lead poisoning related symptoms(13.43%).After controlled the passive smoking confounder,the difference of hair lead level between these two groups was still significant(P

OBJECTIVE:To explore the role of clinical pharmacists participating in the prevention and treatment of sotalol-in-duced QT prolongation in aged patient with heart failure. METHODS:Clinical pharmacists participated in the treatment for a aged patient with heart failure,and assisted physicians to identify and assess the risk of sotalol-induced QT prolongation. According to the clinical symptoms and laboratory indexes,it was suggested to continue to use sotalol for antiarrhythmic,adjust the hepatoprotec-tive drug,given pharmaceutical care of ECG,electrolyte level monitoring,drug education and so on. RESULTS:Physicians adopt-ed the suggestions of clinical pharmacists to relive the illness without malignant arrhythmia and discharged after 11 d. CONCLU-SIONS:The patient with heart failure should be dominated by improving cardiac function and maintaining hemodynamic stability;combined with related guidelines and documentation,clinical pharmacists can assist physicians to identify the drug that induced QT prolongation,asses the risk of torsades de pointes ventricular tachycardia and other bad consequences,develop and optimize the regimen and strengthen pharmaceutical care to ensure the safe and effective treatment.