ObjectiveTo evaluate the characteristics,treatment and prognosis of metachronous bilateral primary breast cancer(mBPBC). MethodsClinical materials of 48 patients were performed with retrospective study. ResultsIn 48 patients,43 cases taken both sides modified radical mastectomy and 5 cases taken lumpectomy and axillary dissection in the second side.All patients were treated with chemical treatment and treated with radiotherapy in accordance with lymph node metastasis.Besides a part of patients were treated with endocrine therapy in accordance with the expression of estrogen receptor(ER)and progesterone receptor(PR).The follow-up time was 6 ～ 48 months and the average time was 21.9 months.No died and 5 cases found distant metastasis. ConclusionmBPBC should be diagnosed earlier,taken appropriate treatment and followed up actively,so it would have a better therapeutic effect.

Leptin,the product of the obese gene,is a protein produced and secreted primarily by adipose tissue.Leptin initiates several biological effects by binding to its receptors.Many studies have shown that leptin can reduce fat accumulation,but its mechanism is still unclear.This article reviewed the effects of leptin on lipogenesis,and especially on proliferation and differentiation of preadipocytes.

Objective To observe the therapeutic effects and side effects of FLAG regimen(fludarabine, Ara-C, and granulocyte-colony stimulating factor( C-CSF) for refractory or relapsed acute myeloid leukemia( AML). Methods Twenty-six AML were treated with fludarabine plus intermediate-dose Ara-C and G-CSF,of whom 15 cases belonged to refractory and 11 cases belonged to relapsed. Results After two courses of treatment, 14 cases were completely relieved (53. 8% ) and 5 cases were partially relieved (19.2% ). The overall effective rates was 73.1%. The main side effects were severe myelosuppression and non-hematological toxicity was mild. Conclusion FLAG regimen was very effective for refractory or relapsed acute myeloid leukemia and was well tolerated. The treatment-related mortality rate was low,so it provided a treatment choice for these patients.

Objective To observe the effect of Dachengqi decoction combined with β-aescine on pulmonary function in patients with acute lung injury (ALI) after chest trauma.Methods Ninety-five patients with ALI after chest trauma admitted to the Department of Thoracic Cardiothoracic Surgery of Dingxi People's Hospital of Gansu from April 2013 to May 2016 were enrolled, and they were divided into a Dachengqi decoction group (47 patients) and a control group (48 patients) by random number table. The control group patients were treated with conventional therapy and β-aescine 0.4 mg/kg+ 10% Glucose (250 mL) intravenous drip, while the Dachengqi decoction group patients were additionally treated with Dachengqi decoction on the treatment of the control group (rhubarb 12 g, magnolia officinalis 24 g, fructus aurantii immaturus 12 g, mirabilite 9 g), one dose daily, taken twice in a day, once in the morning and once in the evening orally, both groups were treated for one week. Before and after treatment, the changes of esophageal pressure, respiratory dynamics, the indexes of pulmonary function and blood gas analysis were observed. Results Compared with those before treatment, the levels of plateau pressure (Pplat), mean airway pressure (mPaw), airway resistance (Raw) and arterial partial pressure of carbon dioxide (PaCO2) of the two groups after treatment were significantly reduced, but the levels of lower esophageal sphincter pressure (LESP), peak airway pressure (PIP), the first second forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEF), the mean maximum expiratory flow (MMEF), pulse oxygen saturation (SpO2), arterial partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2) were all increased significantly; the changes of the above indexes in the Dachengqi decoction group were more significant than those in the control group [LESP (mmHg, 1 mmHg = 0.133 kPa):18.64±2.79 vs. 15.46±3.09, Pplat (cmH2O, 1 cmH2O = 0.098 kPa): 14.27±1.68 vs. 16.00±1.87, PIP (cmH2O): 40.23±5.03 vs. 32.19±4.45, mPaw (cmH2O): 8.57±0.67 vs. 9.41±1.23, Raw (cmH2O·L-1·s-1): 6.76±1.01 vs. 9.31±1.43, FEV1 (L): 1.73±0.27 vs. 1.46±0.25, FVC: (3.95±0.51)% vs. (3.30±0.46)%, PEF (L/s): 3.81±0.47 vs. 3.11±0.38, MMEF (L/s): 0.93±0.16 vs. 0.77±0.12, SpO2: 0.96±0.06 vs. 0.91±0.05, PaO2 (mmHg): 97.82±10.13 vs. 74.73±8.02, PaCO2 (mmHg): 36.49±4.28 vs. 47.13±5.46, PaO2/FiO2 (mmHg): 362.47±20.82 vs. 259.79±17.61, allP < 0.05]. Conclusion Dachengqi decoction combined with β-aescine can reduce the respiratory intensity of patients with ALI after chest trauma and improve the lung function and blood oxygen level.

BACKGROUND: A number of studies have suggested that lycopene is an antioxidant which is used to decrease the risk of age-related chronic diseases.OBJECTIVE: To establish a rat model of postmenopausal osteoporosis, and to investigate the effects of lycopene in preventing bone loss in ovatiectomized rat models of osteoporosis.METHODS: The 6-month-old female Wistar rats, SPF grade, which had never given birth, were divided into sham and ovatiectomized groups. The ovatiectomized rats were further sub-divided into four groups which were administered with corn oil orally as model group, lycopene (10 mg/kg, 20 mg/kg, daily) or treated by intraperitoneal injection with estradiol benzoate (25 mg/kg, twice).RESULTS AND CONCLUSION: After 12-week administration, as compared with the model group, the uterus weight of high-dose and low-dose lycopene groups significantly increased (P < 0.05); the Ca, P, superoxide dismutase levels, percent trabecular area,and trabecular number were obviously higher, and serum alkaline phosphatase, urine deoxypyridinoline, malondialdehyde,trabecular separation and number of osteoclasts were obviously lower in the lycopene groups than the model group (P < 0.05). The bone mass index, bone bio-mechanics and bone histomorphometry were better in the lycopene groups than the model group (P < 0.05). These findings indicate that lycopene has a definite antiosteoporotic effect on ovatiectomized rats.

The recent development and wide application of ultrasonography and ultrasonography-guided fine needle aspiration biopsy have greatly facilitated the detection of papillary thyroid microcarcinoma (PTMC).Currently, the occurrence, development and pathological features of PTMC are not clearly understood.Therefore, no consensus on the diagnosis and treatment has been reached.Patients with PTMC are suggested to be closely observed and periodically examined with ultrasonography in some countries such as Japan, and these patients are to be operated when the tumor enlarged or new lymphatic metastasis are found.Operation is the first choice in the European and American countries, and the long-term survival rates of these patients are nearly 100％.For the PTMC patients with the risk factors such as thyroid capsule invasion, lymphatic metastasis,multi-focal lesion, higher degree of malignancy, thyroid stimulating hormone suppression therapy was given after operation, which may reduce the local recurrence rate.In China, we should hold well thelimitation and choose the best way for different patients according to the personalized principle in clinical practice.

OBJECTIVE:To compare the efficacy and safety of desloratadine citrate disodium and acrivastine decremental thera-py in the treatment of chronic urticaria. METHODS:132 patients with chronic urticaria were randomly divided into group A(62 cases)and group B(70 cases). Group A was orally given 8.8 mg Desloratadine citrate disodium tablet in 12 2 weeks,once a day;8.8 mg in 3-4 weeks,once every 2 days;8.8 mg in 5-6 weeks,once every 3 days;8.8 mg in 7-8 weeks,once every 4 days;and 8.8 mg in 9-10 weeks,once every 5 days. Group B was orally given 8 mg Acrivastine capsule in 12 2 weeks,3 times a day;8 mg in 3-4 weeks,twice a day;8 mg in 5-6 weeks,once a day;8 mg in 7-8 weeks,once every 2 days;and 8 mg in 9-10 weeks, once every 3 days. The treatment course for both groups was 10 weeks. Clinical efficacy,and plasma histamine levels and total scores of signs and symptoms before and after treatment in 2 groups were observed,and recurrence and incidence of adverse reac-tions after 4 weeks of stopping drugs in 2 groups were followed-up. RESULTS:There were no significant difference in the total ef-fective rate and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the total scores of signs and symptoms in 2 groups were significantly lower than before,the difference was statistically significant(P<0.01),and there was no significant difference between 2 groups(P>0.05). The recurrence rate in group A was significantly lower than group B,the difference was sta-tistically significant(P<0.05). CONCLUSIONS:Both efficacy and safety of desloratadine citrate disodium and acrivastine decre-mental therapy in the treatment of chronic urticaria are good,however,desloratadine citrate disodium is better than acrivastine in re-ducing recurrence rate.

OBJECTIVE:To study the immunosuppressive chemical constituents from the n-butanol extract of the debark root of Tripterygium wilfordii hook.f.METHODS:Several compounds were isolated from the n-butanol extract by columns of silica gels and Sephadex LH-20,their structures were identified by NMR,MS spectral analysis and comparing with standard substances on TLC,and the immunosuppressive activity was determined.RESULTS:One of the compounds was identified as emodin,an anthraquinone,it had marked immunosuppressive effect on animal.CONCLUSION:Emodin is obtained from the plants of Tripterygium wilfordii hook.f.for the first time.

Objective To study the feasibility of using chelating resins D751 and D403 to remove the heavy metals from the extracts of Folium Ginkgo (FG). Methods Heavy metal removal experiments were performed on automatic control platform in industry mode. With dry ointment yield,total content of flavones,comparability of HPLC and removal rate of heavy metal as the indexes,the effects of two kinds of chelating resins on removing heavy metal were compared. Result After removing heavy metal by resins D751 and D403,the loss rate of the dry extract were less than 6%,and the heavy metal contents were lower than national limits;HPLC similaritites were higher than 0.98,and the loss rates of total flavones were less than 5%. Conclusion Chelating resins D751 and D403 can be used to remove heavy metal from extracts of Folium Ginkgo.

Objective To observe the effects of leptin on the proliferation and differentiation of human preadipocyte in vitro, and to explore the possible mechanism of the generation of obesity regulated by leptin. Methods The human preadipocytes were isolated from human subcutaneous adipose tissue of abdomen and cultured in vitro. The effects of leptin (0-1 000 ng/ml) on the proliferation, lipid accumulation and the mRNA expression of PPAR-γ2 and C/EBP-α, which are the differentiation and transcription factor of human preadipocyte, were analyzed by the methods of MTT, cell counting, extracting stained intracytoplasmic lipid with oil red O and RT-PCR. Results Leptin (1 000 ng/ml) could stimulate the proliferation, lipid accumulation and the mRNA expression of PPAR-γ2 and C/EBP-α (P<0. 05). There were not obvious effects on the proliferation and lipid accumulation in the groups of lower (10 ng/ml) and common (100 ng/ml) concentration (P>0. 05). Conclusion Leptin in higher concentration can stimulate the proliferation and differentiation of preadipocye in vitro, which indicates that leptin may regulate the generation of obesity through acting on the proliferation and differentiation of preadipocyte at the pathologic state of leptin resistance and high leptin concentration in serum.