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.

Objective To explore the mediation effect of self-esteem on the relationship between perfectionism and depression in college students.Methods Totally 292 college students completed Frost Multidimensional Perfectionism Scale (FMPS),Hewitt Multidimensional Perfectionism Scale (HMPS),Slaney Almost Perfect Scale-Revised (APS-R),Rosenberg Self-esteem Scale (SES) and Beck Depression Inventory (BDI).Results Maladaptive perfectionism was positively correlated with depression (r =0.54,P ＜ 0.01),and negatively correlated with self-esteem (r =-0.55,P ＜ 0.01).Adaptive perfectionism was not correlated with depression (r =-0.09,P ＞ 0.05),and was positively correlated with self-esteem (r =0.36,P ＜0.01).Self-esteem partially mediated the association between maladaptive perfectionism and depression.The partial mediation effect was significant (P ＜0.05).The mediation model fitted the data well (GFI =0.986,CFI =0.988,NFI =0.981,TLI =0.970,RMSEA =0.075).Conclusion Self-esteem has partially mediating effect on perfectionism and depression.

Objective To analyze the correlation between pressure ulcer during operation and operation time under lateral operation position.Methods 89 operation patients all adopted lateral position.Pressure ulcer during operation was observed and operation time was registered.Results The operations went on smoothly.Operation time lasted 1 to 8 hours.There were 42 operations exceeded 4 hours and pressure ulcer during operation was observed in 15 patients.Positive rate was 35.7％.There were 47 operations lasted less than 4 hours and pressure ulcer during operation was observed in 6 patients.Positive rate was 12.8％.Statistical differences were significant between the two groups.Conclusions For those operation patients with lateral position whose operation time would be longer,especially more than 4 hours,nursing intervention measures should be adopted to prevent pressure ulcer during operation.

OBJECTIVE To investigate the apoptosis of hepatocytes in arsenic poisoning rats caused by coal-burning and explore the effects of p53-induced mitochondrial apoptotic pathway on arsenic liver injury.METHODS Wistar rats were fed with 164.74 pp m arsenic conta minated grain at the levels of 15%,30% and 60% (arsenic contents were 25,50 and 100 mg·kg -1 ,respectively)for 90 d. The arsenic contents of urine and hair,apoptosis of hepatocytes and mRNA expression of p53,Bax and Bcl2 in peripheral blood and hepatocytes were evaluated.At the sa me ti me,protein expression of p53, Bax and Bcl2 in hepatocytes were analyzed.RESULTS The arsenic contents of urine and hair increased with the elevation of arsenic dose.The apoptotic rate of hepatocytes in arsenic 50 and 100 mg·kg -1 group were 16.49 ±2.06 and 15.83 ±1 .28,respectively which were significantly higher than the control group and arsenic 25 mg·kg -1 group (9.00 ±0.59 and 9.27 ±0.36,respectively,P <0.05).p53 mRNA expression of peripheral blood in arsenic 100 mg·kg -1 group was 2.69 ±1 .84 while p53 mRNA expression of hepatocytes in arsenic 25,50 and 100 mg·kg -1 group were 1 .63 ±0.28, 1 .91 ±0.38 and 1 .71 ±0.18,respectively which were significantly higher than the control group (0.86 ± 0.15 and 1 .22 ±0.12,respectively,P<0.05).Bax mRNA expression of peripheral blood in arsenic 50 and 100 mg·kg -1 group were 1 .36 ±0.30 and 1 .94 ±0.65 while Bax mRNA expression of hepatocytes in arsenic 100 mg·kg -1 group was 1 .34 ±0.23 which were significantly higher than the control group (0.77 ±0.15 and 0.84 ±0.34,respectively,P<0.05).Bcl2 mRNA expression of hepatocytes in arse-nic 100 mg·kg -1 group was 0.98 ±0.50 which was significantly lower than the control group (2.14 ± 1 .15,P<0.05).p53 protein expression of hepatocytes in arsenic 25,50 and 100 mg·kg -1 group were 1 .06 ±0.56,1 .15 ±0.77 and 0.74 ±0.27,respectively while Bax protein expression of hepatocytes in arsenic 50 and 100 mg·kg -1 group were 0.74 ±0.43 and 0.69 ±0.37 which were significantly higher than the control group (0.36 ±0.1 9 and 0.25 ±0.09,respectively,P<0.05).CONCLUSION Arsenic can induce hepatocytes apoptosis and p53-mediated mitochondrial apoptotic pathway may be involved in the develop ment of rat liver injury in arsenic poisoning rats caused by coal-burning.

Objective To investigate the association between Down's syndrome(DS) and congenital heart diseases(CHD).Methods A total of 575 cases with DS from Jan.1997 to Mar.2013 in Children's Hospital of Chongqing Medical University were recruited.Retrospective study was conducted to analyze the prevalence and types of CHD in DS children,the relationship between the karyotype of DS and the types of CHD,and pulmonary hypertension (PH) and operation treatment.Results There were 370 cases(64.35％,370/575 cases) with CHD in 575 cases with DS.Among the 370 cases of CHD,322 cases (87.03 ％) were septal defects.In which,57 cases (15.41％) were atrial septal defects,36 cases (9.72％) were ventricular septal defects,12 cases (3.24％) were atrioventricular septal defects,and 157 cases(47.30％) were complex septal defects.Forty-eight cases(12.97％,48/370 cases) were nonseptal defect types of CHD (including patent ductus arteriosus,tetralogy of Fallot,double outlet right ventricle,pulmonary atresia,and so on).There was no statistical significance between the karyotype of DS and the types of CHD.There were 246 cases(66.49％,246/370 cases) with PH.Seventy cases(18.92％,70/370 cases) had interventional or surgical operations.All of them had descending pulmonary artery pressure after operation.Forty cases had other malformations such as gastrointestinal tract malformation,polydactylism / polydactyly,visual impairment,and so on.Conclusions The most common type of CHD with DS was atrial septal defect,and the second one was ventricular septal defect.There was no relationship between the karyotype of DS and the types of CHD.The patients with CHD in DS were prone to develop PH.So the comprehensive treatment plan should be developed as early as possible.

The present paper has reviewed and researched on 112 gynecological records from volume 17 ofZhang-Yuqing’s medical records, and has found that there were 9 common methods of treating gynecological diseases, namely dredging and regulatingqi and blood, adjusting qi to nourish ying, soothing the liver wood, harmonizing the liver and spleen (stomach), tonifying spleen and kidney, nourishing liver and kidney, regulating vital and conception vessels, eliminating dampness and phlegm, and nourishing Yin and clearing away heat.The treatment of gynecological diseases reflects the holistic concept and dialectical concept, and the valuable experience still has a high theoretical value, as well as clinical value, which is worth exploring and discussing.

Objective]This article discussed Professor Xie Jianguo's survival with tumor experience on advanced lung cancer treatment in the last decade. [Methods]To observe Professor Xie Jianguo's survival with tumor experience of advanced lung cancer on the clinical treatment process, and organize related cases, which summarized the unique thoughts of treatment, commonly used empirical prescriptions and demonstrated with typical clinical cases. [Resluts] Professor Xie Jianguo's theoretical guidance on advanced lung cancer treatment, included tumor inhibition, anticancer effect, survival with tumor. Treatment methods, included recruitment of the vital qi, adjusting the internal environment, the phlegm, stasis toxin factors, with rigorous thinking, sophisticated medication. [Conclusion] Professor Xie Jianguo's survival with tumor experience on advanced lung cancer treatment has remarkable significance in guiding clinical treatment.

Cerebralischemiacaninducecelnecrosisincoreoftheinfarction,andapoptosisinthe ischemic penumbra. The mitogen-activated protein kinases (MAPKs) signaling pathw ays are activated after cerebral ischemia, causing programmed cel death, including apoptosis. This article review s the relationship betw een the MAPKs signaling family and neuronal apoptosis after cerebral ischemia.

Objective To observe the clinical efficacy of qi-based acupuncture treatment in treating chronic gastritis due to liver-stomach disharmony. Methods Totally 120 patients with chronic gastritis due to liver-stomach disharmony were randomized into group A, group B, and group C, 40 in each group. Group A was intervened by qi-based acupuncture treatment; group B was by medication;group C was by sham acupuncture by selecting points 1 cm away from the points selected in group A. The therapeutic efficacies were evaluated after 4-week treatment. Results The total effective rate was 95.0%in group A, versus 75.0%in group B and 45.0% in group C, and the total effective rates in group A and B were significantly different from that in group C (P<0.01, P<0.05). The total effective rate in group A was significantly different from that in group B (P<0.05). Conclusions Qi-based acupuncture treatment is an effective approach in treating chronic gastritis due to liver-stomach disharmony.

Objective To investigate the effects of combined general and epidural anesthesia on intestinal barrier function in patients with obstructive jaundice after surgery.Methods Forty patients with obstructive jaundice,male 1 5 cases,female 25 cases,aged 26-65 years,of ASA Ⅰ-Ⅲ,with TBIL >100 μmol/L were randomly divided into two groups (n =20):the general intravenous anes-thesia group (group GA)and the combined general and epidural anesthesia group (group GE).Pa-tients of group GA with oxygen mask rapid intubate induction of endotracheal after general anesthesia. Patients of group GE take left side line of T8~9 or T9 ~1 0 segmental epidural puncture and insert cathe-ter,after changing the hypothesis to be 2% lidocaine 5 ml for test quantity,confirm without anesthe-sia complications and other abnormalities after general anesthesia 5 minutes later.Peripheral venous blood was sampled when entering the operating room (T1 ),and at the end of operation (T2 ),24 hours after operation(T3 )and 48 hours after operation (T4 ).The concentration of D-lactate (D-LA) was measured using ELISA method.Also polymerase chain reaction (PCR)was performed for quali-tative detection of Escherichia coli specific beta galactosidase gene BG.Results Compared with T1 , Plasma D-LA level in two groups at T2-T4 were increased gradually and it was significantly higher in group GA than in group GE at T2-T4 with significant difference (P <0.05).The Escherichia coli DNA test was negative at T1 ,the positive rate of Escherichia coli DNA gradually increased,and it was significantly higher in group GA than in group GE at T4 with significant difference(P <0.05).Conclusion Compared with the general intravenous anesthesia, general anesthesia combined with epidural anesthesia may relieve the intestinal barrier injury in patients with obstructive jaundice after surgery.