Triple negative breast cancer ( TNBC) is defined by the lack of expressions of the estrogen re-ceptor(ER)、progesterone receptor(PR)and human epidermal growth factor receptor 2(HER-2).Although it is sensitive to radiation and chemotherapy ,it lacks of appropriate targeted therapy and endocrine therapy .It performs characteristics of the strong invasion ,high risk of recurrence and poor prognosis .So in recent years ,triple negative breast cancer gets more and more attention from international oncology community .In-depth study of triple nega-tive breast cancer will help the prevention ,early diagnosis ,judge the progress of the disease and improve progno-sis.TNBC drug treatment and relevant research progress are reviewed in the present article .

Objective To investigate the preventive effect of low molecular weight heparin or tranexamic acid in the rabbits with hypercoagulation induced by impact injury and intravenous infusion of the endotoxin. Methods Combination of impact injury and endotoxin was created by strike on rabbit chest with type BIM-Ⅱ biological impact machine and injection of endotoxin via vein.Thirty-two male New Zealand rabbits were divided into four groups in a completely random design as follows:impact injury combined with endotoxin without treatment group(control group),treatment with low molecular weight heparin(L group),treatment with tranexamic acid(TA group),and treatment with low molecular weight heparin and tranexamie acid(L+TA group).The changes of interleukin-1β(IL-1β)and interleukin-6(IL-6)were observed by using the enzyme-linked immunosorbent assay;changes of antithrombin-Ⅲ(AT-Ⅲ)activity,tissue factor(TF)and tissue factor pathway inhibitors(TFPI)were detected by the chromogenic substrate method chromozym P:the content of fibrinogen was observed by coagulation analyzer.The lung and kidney were removed from the experimental animals at 24 hours post impact injury forhistopathologic observation. Results In the control group,the activity of AT-Ⅲ was decreased obviously.while the content of fibrinogen and the activity of TF and TFPl were increased,with formation of the thrombosis in the kidney after injection of PLS.Compared with control group,the activity of TF and the content of IL-1β and IL-6 were reduced but the TFPI was increased in the L group,which resulted in a decrease of TF/TFPI ratio.with decrease of formation of the micro-thrombosis in the organs.The content of IL-1β and IL-6 in the TA group were reduced,which was still higher than that in tIle L group.In the TA group.the activity of IF and TFPI Was lower than that in the L group and control group,with higher TF/TFPI ratio than the L group.The frequency of thrombosis increased in pulmonary artery and other important organs.The content of IL-1β and IL-6 in the L+TA group wag lower than that in the L group.In the L+TA group.the activity ofTF was lower than that inthe L group and control group,but the activity of TFPI was higher than that in the L group and control group.with lower TF/TFPI ratio than the L group.There found no increase of thrombus in the pulmonary arterial and other important organs. Conclusions Besides anticoagulation function,the low molecular weight heparin can inhibit the inflanunation reaction,reduce the release of TF and attenuate the coagulation reaction.On the basis of treatment with low molecular weight heparin,application of the tranexamic acid will not lead to the formation of thrombus,but the only use of the tranexamic acid would have the contrary results.The rtsults of the study provide a theoretical and experimental basis for clinical diagnosis and prevention of hypercoagulation induced by injury and infection.

Obejctive To compare the differences between conventional radiation therapy (3DCRT) and intensity modulated radiation therapy( IMRT) for locally advanced laryngeal carcinoma patients by ECLIPSE treat -ment planning system.Methods Six locally advanced laryngeal carcinoma patients ′treatment plans were de-signed as IMRT and 3DCRT according to ECLIPSE treatment planning system ,respectively.The following values were measured,such as V95%、D5%、D95%、Dmin and D mean of the target volume,and the D50,D33,D5, Dmax and Dmean of normal tissues.Results The dose coverage rate of GTV and GTVnd in the IMRT plan was compared to ECLIPSE treatment planning system with no statistical differences.However, there were obvious difference in CTV and some normal tissues.Conclusion Both IMRT and 3DCRT have good coverage to primary tumor and metastatic lymph nodes.IMRT can spare the parotid from high dose irradiation.

Objective To evaluate the influence of precise liver resection techniques on intestinal permeability in the diseases needing liver resection.Methods Eighty-seven patients needing liver resection were randomized to receive the precise liver resection (n =58,PLR group) or the conventional liver resection (n =29,CLR group).D-lactate and and endotoxin in abdominal fluid were detected in all the patients.The abdominal fluid bacteria cultures were performed.Results The postoperative hospitalization time,the needed time of blood routine,temperature,and oppetite resuming were significantly shorter in PLR group than those in CLR group (t ≥7.36,P ＜ 0.01) ; The postoperative abdominal effusion was significantly less in PLR group than that of CLR group(t ≥ 14.17,P ＜0.01).The abdominal fluid concentrations of D-lactate and endotoxin in operation or at 1d after operation were significantly higher than those at 5d after operation in both groups(t ≥10.41,P ＜0.01).Those parameters decreased significantly at 2d after operation,returned to the normal level at 3d after operation in PLR group,and those parameters were significantly lower in PLR group than those in CLR group at the same time phase after postoperative 2 or 3 days (t ≥9.23,P ＜0.01) ; Those parameters began to drop at 3d after operation,returned to the normal level at 5d after operation in CLR group.The positive rate of abdominal fluid bacteria cultures was significantly lower in PLR group than that in CLR group(13/29) (x2 =23.51,P ＜ 0.01).Conclusions The precise liver resection techniques had an important influence on intestinal permeability in the diseases needing liver resection.

Objective To study the coagulation of patients with lung cancer or esophagus cancer in thoracotomy during perioperative period.Methods Variables [reaction time(R),clotting time(K),? angle,maximum amplitude(MA)]detected by thrombelastography were measured in 10 cases of lung cancer and 10 cases of upper or median esophagus cancer before anesthesia(T0),at the end of 1 h after operation beginning(T1)and 30 min after operation(T2).The control group consisted of 10 healthy volunteers.Results In lung cancer group and esophagus cancer group,R was shorter than control group(P

In this study, we investigated the pharmacokinetics parameters of SPIO-shRNA dual functional molecular probe and observed the main organ distribution by MRI in vivo. Eighteen New Zealand white rabbits were randomly divided into three groups and injected intravenously with different doses of SPIO-shRNA molecular probe, respectively. The blood samples were collected to analyze the pharmacokinetic parameters by measuring the iron content at 30 minutes before and after the injection. Twenty-four Kun Ming (KM) mice were randomly divided into 4 groups: the control group was injected intravenously with physiological saline 200 µL per mouse via the tail vein, the other 3 groups were injected intravenously with different doses of SPIO-shRNA molecular probe. MRI observation was performed in 24 hours, and the liver, spleen, kidney, brain and muscle were collected for iron quantification with Prussian blue staining to determine distribution of the SPIO-shRNA molecular probe in the main organ in vivo. Our results suggest that the molecular probe blood half-life is more than 3 hours. The data of MRI suggest the probe was distributed in liver and spleen, and the MRI signal was reduced with the increase in probe's doses (P < 0.05). The results of Prussian blue staining confirmed the results of MRI. Most of the probe could escape the phagocytosis of mononuclear phagocyte system. Our data provide the pharmacokinetic and distribution of SPIO-shRNA molecular probe in organs. Meanwhile, it suggests the choice of the time and dose of probe for MR imaging of tumor in vivo.

Objective To summarize the practices of national emergency medical rescue team in the fourth ASEAN regional forum disaster relief exercise.Methods The establishing principle and training mode of national emergency medical rescue team were introduced,and the advantages and disadvantages of the team were described in the preparation for exercise and rescue practice.Results The experience in Malaysia improved the team in emergency support.Conclusion The medical preparedness and rescue practice in transnational disaster relief are of great value for rapid response of national emergency medical rescue team.

Objective To investigate the diagnostic values of imaging techniques and endoscopy in detection the causes of post-hepatic obstructive jaundice.Methods The clinical data of 57 patients with post-hepatic obstructive jaundice were retrospectively studied.The causes of the obstruction and the findings of uhrasonography(US),computerized tomography(CT),magnetic resonance imaging(MRI)or MRIcholangiopancreatography(MRCP),endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasonography(EUS)were compared.Results The causes of 57 patients with post-hepatic obstruetive jaundice were benign obstruction in 42(including stones in common bile duct in 38,ascariasis of CBD in 1,postoperative stricture in 2 and chronic pancreatitis in 1),and malignant lesions in 15(including pancreatic head carcinoma in 11 and ampullary carcinoma in 4).The diagnostic accuracy in terms of lesion location of US,CT,MRI+MRCP,ERCP and EUS were 71.93%(41/57),88.00%(22/25),94.59% (35/37),100.00%(47/47)and 96.77%(30/31),respectively;the diagnostic accuracy of cause of obstruction were 63.16%(36/57),80.00%(20/25),83.78%(31/37),100%(47/47)and 96.77% (30/31),respectively.Conclusion Benign diseases are the main causes of post-hepatic obstructive jaundice,but malignant ones are not rare.It is important to combine miscellaneous imaging techniques and endoscopy in diagnosis.

Objective:To explore the effects of superparamagnetic iron oxide-short hairpin RNA ( SPIO-ShRNA) dual functional molecular probes of different concentrations on morphology and biological beha -vior of ovarian cancer SKOV3 cells in vitro.Methods:The dual functional molecular probes at an iron concentration of 5, 15, 30, 45, 75, and 100 mg/L were transfected into SKOV3 cells.The transfection rate of the probe was observed by fluorescence microscope .The distribution and content of iron particles in SKOV3 cells were determined by Prussian blue staining , atomic adsorption spectrometer and electron microscopy .Cell viability was observed by cell counting kit-8 ( CCK-8 ) .The apoptosis was detected by flow cytometry .The expression of protein within the cells was detected by Western blot .The changes of the signal intensity were measured by magnetic resonance imaging (MRI).Results: The SPIO-ShRNA dual functional molecular probe was uptaken in aconcentration-dependence manner within a certain range (5-30 mg/L) .When the concentration of the probe was 45 mg/L, the labeling rate of the cell was close to 100%;With the increase of the concentration of probe , the cell survival rate decreased gradual-ly.The cell survival rate of each experimental group were 94.626%±1.050%, 93.373%±1.180%, 91.700%±3.122%, 75.100%±4.362%, 72.983%±3.233%, 71.010%±2.910%,5, 15, 30mg/L cell survival rate was not significantly decreased , the difference was not statistically significant (P=0.226, P=0.068, P=0.475);When the concentration of the probe was greater than or equal to 45 mg/L,the survival rate decreased obviously ( P<0.001);Group of 45 mg/L protein expression rate was 68.905%± 3.510%, When the concentration of the probe was greater than or equal to 45 mg/L, the inhibition rate of the protein expression level of epidermal growth factor receptor was obviously higher than those of 5, 15, and 30 mg/L groups, the difference was statistically significant (P<0.001, P=0.001, P=0.003, all P<0.01);the MRI displayed that the signal intensity was decreased with increasing concentrations of the probe.The signal intensity of 45 mg/L group was 165.55 ±4.92, compared with the blank control group (same volume of phosphate buffer saline ), normal group(unlabeled ovarian cancer SKOV3 cells), 5, 15, and 30 mg/L groups , the signal intensity of 45 mg/L group decreased significantly (all P<0.001).Con-clusion:The dual functional molecular probe can effectively transfect and specifically inhibit the expression of SKOV3 cell lines at the iron concentration of 45 mg/L, and can also be detected by MRI .The role of diagnosis and treatment of the dual functional molecular probe has been initially confirmed .

Objective Various factors may affect the effects of cardiac resynchronization therapy or cardiac resynchronization and implantable cardioverter-defibrilator ( CRT/CRTD) in chronic heart failure patients ( CHF) .The aim of our study was to explore the correlation of age and gender with the effects of CRT/CRTD in chronic heart failure patients. Methods This study included 136 CHF patients, 92 males and 44 females, treated by CRT/CRTD from January 2005 to March 2015.We divided the patients into three age groups:≥70 yr (n=29), 50-70 yr (n=77), and <50 yr (n=30), and compared the baseline characteristics, CRT respon-ding rate and all-cause mortality among different groups.The CRT response was defined as the decrease of NYHA cardiac function≥1 grade and left ventricular ejection fraction ( LVEF) improvement ≥5%. Results In the 136 CHF patients, there were 72 CRT responders (53%), 52%in the≥70 yr group, 55%in the 50-70 yr group, and 50%in the <50 yr group, with no statistically sig-nificant differences among the three groups (P>0.05).However, the CRT responding rate was remarkably higher in the female than in the male patients (66%vs 47%, P=0.027).Cox multivariate and Kaplan-Meier analyses revealed no significant differences in all-cause mortality between different genders or age groups.Multivariate logistic regression analysis showed that the left ventricular diastolic diameter and base QRS duration were independent factors of the CRT response. Conclusion Age does not affect the CRT response in chronic heart failure patients, while female patients have a higher CRT respon-ding rate than male patients.