Triple-negative breast cancer(TNBC) has distinct biological and clinical characteristics. Therapeutic strategies for TNBC remain a challenge. Studies about epidemiology,molecular characteristics,chemotherapy and targeted-therapy are ongoing,In particular,preliminary results of stage II or III clinical trials indicate new chemotherapy or combination targeted therapy may have a good efficacy.

Objective To prospectively study the minimally invasive hematoma stereotactic aspiration and the recovery of neurological deficits after conservative medical treatment alone, as well as the incidence of post-stroke depression (PSD) in patients with intracerebral hemorrhage, so as to investigate the effect of minimally invasive hernatorna stereotactic aspiration on the recovery of neurological deficits and the incidence of PSD. Methods Fifty-five patients with intracerebral hemorrhage received minimally invasive hematoma stereotactic aspiration (n =25) and conservative medical treatment (n = 30), respectively. The neurological deficits of the patients were assessed by the National Institutes of Health Stroke Scale (NIHSS) at admission, day 14 and 90. The decreased values (all compared to baseline score) of the NIHSS scores were calculated at day 14 and 90, respectively; the modified Rankin Scale (mRS) was used to assess the disabled degree at day 90; the 17-item Hamilton Depression Rating Scale (HAMD) was used to assess the PDS status at day 14 and 90. The correlation between PSD and the degrees of neurological deficit and disability in patients was analyzed. Results The decreased value of the NIHSS score in the stereotactic group at day 14 and 90 was significantly higher than that in the conservative treatment group (all P ＜0. 05), and the value of the mRS score was significantly lover than that in the conservative treatment group at day90 (P＜0. 05). The incidence and the total incidence of PSD in the stereotactic group at day 90 were significantly lover than those in the conservative treatment group (all P ＜0.05). There were significant positive correlation between HAMD and NIHSS scores and HAMD and mRS scores. Conclusions The recovery of neurological deficits was faster after the minimally invasive hematoma stereotactic aspiration. The degree of disability in patients was lower, and the incidence of PSD was also lower than that in the conservative treatment group. PSD was closely correlated with the degrees of neurological deficits and disability.

It has been shown that the PIK3CA mutation in HER2 positive breast cancer is up to 25%, and thus activates PI3K-Akt signaling pathway,promotes HER2 mediated tumor cell epithelial transformation, alters the intrinsic phenotype of HER2 overexpression breast cancer,and finally leads to resistance to anti HER2 targeted therapy.Some studies have shown that the PIK3CA gene mutation is associated with the efficacy of anti-HER2 targeted therapy.Therefore,real-time monitoring of PIK3CA gene mutation will promote indivi-dualized anti-HER2 targeted therapy.

[Absract] Objective This paper was designed to reveal the new mechanism on ASI Ⅱ triggered CD4+T cells activation via regulating CD45 molecular and provide a basis for the theoretical foundation of antitumor immunotherapy of Astragalus.Methods The CD4+T cells were randomly divided into negative group,stimulated control group,ASI Ⅱ group,CD45 inhibitor group,and the combination of ASI Ⅱ and CD45 inhibitor group.Besides negative group,the cells from other groups were activated by anti-CD3/CD28 antibody.ASI Ⅱ group was treated with 10 nmol/L ASI Ⅱ,CD45 inhibitor group was treated with 0.8 μmol/L CD45 inhibitor,and the combination group were treated with 10 nmol/L ASI Ⅱ and 0.8 iμmol/L CD45 inhibitor.After 36h culture,the proliferation of CD4+T cells was detected by Ki-67 intracellular staining assay.Cytokine production of Th1 and Th2 were examined ELISA method.The proportion of surface marker (CD44 and CD25)and Th1 intracellular cytokines (IFN-γ) were detected by flow cytometry.Results Compared with stimulated group,Astragaloside Ⅱ group in CD4+Ki67+T positive proportion (5.37％ ± 0.92％ vs.1.19％ ± 0.23％),in CD4+CD25+ positive proportion (50.23％ ± 4.65 ％ vs.15.89％ ± 1.13％),in CD4+CD44+ positive proportion (33.16％ ± 6.08％ vs.15.36％ 4 1.45％),in CD4+IFN-γ+ positive proportion (1.42％ ± 0.44 ％ vs.0.38％ ± 0.06％) were significntly increased.And the secretion of IFN-γ,IL-4 and IL-2 in ASI Ⅱ group were higher than stimulated group.The anti-mouse CD45 Ab treatment markedly blocked the proliferation and Th1 cytokines production which induced by ASI Ⅱ.Furthermore,the anti-mouse CD45 Ab treatment significantly decreased the expression of surface marker (CD44 and CD25).Conclusions Activating CD45 protein tyrosine phosphatase may be involved in ASI Ⅱ triggered CD4+T cells activation.This study will provide a basis for antitumor immunotherapy of Astragalus.

Objective: To revised the Taiwan version successful aging inventory (SAI), and verify its reliability and validity in urban elderly in mainland China. Methods: SAI was adjusted by culture and revised by pre-test to form a formal questionnaire. A sample of 600 elderly people in Guangzhou was chosen for a face-to-face questionnaire survey through convenient sampling. Half of the sample (n=300) was randomly selected for exploratory factor analysis, and the other was used to confirm the structural validity of SAI. Results: Exploratory factor analysis extracted six common factors, including health autonomy, economic security, life adaptation, society and relative relationship, study and family. The cumulative contribution rate of six common factors was 65.366%. The fitting indexes of confirmatory factor analysis were χ²/df=1.861, CFI=0.930, IFI=0.930, TLI=0.923, GFI=0.823, RMSEA=0.054, RMR=0.073. There were significant ceiling effects in the four dimensions of health autonomy, economic security, life adaptation, and family. The internal consistency coefficient (Cronbach's α) of SAI was 0.930, and the test-retest reliability was 0.943. An average score of SAI ≥ 3.95 points was considered successful aging. Conclusion Reliability and validity of SAI are good, which can be used to measure the successful aging status of Chinese elders and track the effectiveness of health promotion measures.

Antibody drug conjugations (ADCs) are a new class of drugs with both targeted specificity and high activity of chemotherapy drugs, which has gradually become a novel generation of therapeutic models with great clinical application prospects. In recent years, ADCs composed of monoclonal antibodies against different tumor cell surface antigens and small molecule potent cytotoxic drugs have shown superior therapeutic effects on recurrent / metastatic breast cancer. This article reviews the clinical application and research progress of ADCs with different molecular targets in the field of breast cancer.

Objective: To investigate the clinicopathological characteristic and risk factors for recurrence in different subtypes of mucinous breast cancer(MBC). Methods: Clinical data of 97 MBC patients at Zhejiang Cancer Hospital from August 2005 to November 2012 were retrospectively analyzed. All of patients were divided into 3 subtypes according to the mucinous components in the tumors, named as partial mixed MBC with less than 50% of mucinous components, main mixed MBC where the mucinous component accounted for 50% to 90%, and pure MBC with more than 90% of mucinous components. In this study, 43, 16 and 38 patients were included in partial mixed MBC, main mixed MBC, and pure MBC, respectively. Follow-up was collected by out-patient, in-patient system and phone call. The relationship between different subtypes and clinicopathological significance were analyzed by χ² test. Kaplan-Meier curve combined with Log-rank test was used to evaluate the risk factors of relapse free survival(RFS) at 3- and 5-year. Cox proportional hazard regression model was used for multivariate analysis. Results: The median follow-up time was 65 months (range 24-125). Of the 97 patients, 14 patients were relapse or metastasis at the end point. The 3- and 5-year RFS were 90.7% and 85.7%, respectively. Tumor size, number of involved lymph nodes (LN), axillary LN metastasis, TNM stages and p53 mutant status were all related with subtypes of MBC(all of P<0.05). There was no correlation between subtypes of MBC and the other parameters, including age at surgery, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth factor receptor-2 (HER-2) overexpression, menstruation status, and the relapse of disease(all of P>0.05). Univariate analysis showed menstruation status and TNM stages were associated with the relapse of breast cancer(P<0.05). The patients with menopause and stage Ⅲ-Ⅳ showed significantly shorter RFS time(both of P<0.05). Multivariate Cox proportional hazard regression analysis revealed that tumor size, PR status and postoperative radiotherapy were the independent prognostic factors for the relapse of MBC. Conclusions Tumor size, status of axillary LN metastasis, TNM stages, and p53 mutation status are differ among different subtypes of MBC. The tumor size (>30 mm), PR status and postoperative radiotherapy are the independent risk factors for recurrence, whereas the proportion of the mucinous component is not associated with relapse in MBC patients.

ObjectiveIn the treatment of acute gouty arthritis （AGA）， western medicine is mostly used for anti-inflammatory and analgesic purposes to control the blood uric acid level， but some patients are still at risk of poor control and recurrent attacks. Chinese medicinal prescriptions， potent in resisting inflammation and relieving pain， are able to stabilize the blood uric acid level， reduce acute attacks， and improve the clinical efficacy of western medicine. However， there is a lack of evidence to support their use as evidence-based medicine. This study employed network Meta-analysis （NMA） to evaluate the efficacy and safety of common Chinese medicinal prescriptions in the treatment of AGA， aiming to provide evidence-based medical evidence for the clinical use of Chinese medicinal prescriptions in the treatment of AGA. MethodChinese and English databases were searched for prospective cohort studies and randomized controlled trials （RCTs） on Chinese medicinal prescriptions against AGA from database inception to December 1， 2022. Stata software and Review Manager were used for statistical analysis. ResultForty-four papers with 3 564 cases involved were included in the current NMA. In terms of reducing blood uric acid， the cumulative probability results showed that Mahuang Lianyao Chixiaodou Tang showed optimal efficacy （87.60%）. In terms of relieving joint pain， Danggui Niantongtang and Guizhi Shaoyao Zhimutang showed optimal efficacy （92.00% and 82.30%）. In terms of improving erythrocyte sedimentation rate （ESR）， Simiaowan was superior to other prescriptions （87.00%）. In terms of reducing C-reactive protein （CRP）， Simiaowan and Baihutang modified with Guizhitang showed superior efficacy （76.00% and 66.10%）. In terms of safety， except for the basic treatment group， Mahuang Lianyao Chixiaodou Tang had the lowest probability of adverse events， and Danggui Niantongtang had the highest probability of adverse reactions during treatment. According to the results of cluster analysis， Mahuang Lianyao Chixiaodou Tang and Simiaowan are effective and safe. ConclusionAccording to the results of NMA， Chinese medicinal prescriptions can assist in the treatment of AGA and improve the effectiveness of western medicine. For patients with AGA， clinicians can choose Mahuang Lianyao Chixiaodou Tang or Simiaowan as an auxiliary drug for routine western medicine treatment.