Basal-like breast carcinoma is a phenotype of breast cancer which was sub-classified according to gene expression profiling criteria, associated with specific pathological features and biological behaviour. These cancer used to be more aggressive and characterized by the absent expression of ER/PR/CerbB-2(triple negative, TG) however positive for basal cytokeratins(basal CK). We present this review to show its pathological characters, clinical progression, prognosis and response to chemotherapy, and provide convenience for pathologists and surgical colleagues be more aware of this subtype.

Objective To investigate the application of MRI in evaluation of the traumatic temporomandibular joint (TMJ) injury induced by type Ⅵ condylar fracture. MethodsMRI was performed in TMJs in 18 patients with type Ⅵ condylar fractures at days 3-14 post-injury and the MRI findings were analyzed. ResultsMRI findings of 18 patients with traumatic TMJ injury with 19 sides of type Ⅵ condylar fractures showed 15 sides of TMJ disk displacement,nine sides of capsule tear,16 sides of retrodiscal tissue tear (double-plate area) and 19 sides of joint effusion change. Conclusions MRI is very important in the diagnosis and evaluation of traumatic TMJ injury,since it can clearly display the TMJ injuries in type Ⅵ condylar fractures.Therefore,the clinical application of MRI is beneficial for selection of the therapeutic schedules.

Objective To explore the impacts of clinical pulmonary infection score (CPIS) on duration and defined daily doses (DDDs) of antibiotics in patients with bacterial severe pneumonia in intensive care unit (ICU). Methods Patients with severe pneumonia, whose antibiotic usage was prescribed with the guide of CPIS, and admitted to ICU severe respiratory and infectious disease ward of Guizhou Medical University Affiliated Hospital from May 2017 to October 2017 were enrolled as CPIS group. Patients with the first CPIS score > 5 were given antimicrobial therapy, and the score was dynamically evaluated every 2-3 days. If the CPIS score < 5, the score was evaluated again after 2 days. If the score was still < 5, the antimicrobial drugs were discontinued. Patients admitted to the same ward from November 2016 to April 2017 were regarded as controls, of whom the antibiotic usage was completely conducted by the clinical experience of the chief physician. The duration and DDDs of antibiotics were compared between patients in two groups. At the same time, the usage of ventilator and prognostic indicators (the length of ICU stay, ICU mortality) were recorded. Kaplan-Meier survival curve was drawn, and the cumulative survival rates of 28 days, 90 days and 12 months were analyzed and compared between the two groups. Results In our department, 177 and 182 patients were admitted to ICU from November 2016 to April 2017 and from May 2017 to October 2017, respectively, of whom 101 and 65 patients with severe pneumonia were collected respectively during the two stages. There was no significant difference in gender composition, age, underlying diseases, vital signs, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, or peripheral blood routine at admission between the two groups, indicating that the baseline data of the two groups were equally comparable. During the treatment process, there was no significant difference in the duration of mechanical ventilation [hours: 126.0 (69.0, 228.8) vs. 120.0 (72.0, 192.0)], the length of ICU stay [days: 7.0 (5.0, 11.0) vs. 8.0 (5.0, 14.0)], or ICU mortality [18.8% (19/101) vs. 26.2% (17/65)] between the control group and CPIS group (all P >0.05). Kaplan-Meier survival curve analysis showed that there was no significant difference in the cumulative survival rate of 28 days (log-rank test: χ2 = 0.540, P = 0.462), 90 days (log-rank test: χ2 = 0.332, P = 0.564) or 12 months (log-rank test: χ2 = 0.833, P = 0.362). Patients from CPIS guided group, however, had a shorter duration of antibiotics usage (days: 7.54±4.81 vs. 9.88±4.96, P < 0.01), and had a lower DDDs of antibiotics (17.58±13.09 vs. 22.73±18.31, P < 0.05) as compared with those in the control group. Conclusion CPIS-guided therapeutic regimen shortens antibiotic duration and decreases antibiotic DDDs in patients with severe pneumonia in ICU, indicating the values of CPIS in guiding antibiotics usage in these patients.

OBJECTIVE: To analyze the hotspots and related situations of pneumoconiosis research in China from 2001 to2017. METHODS: China National Knowledge Infrastructure and Wanfang Data were used to retrieve relevant literature on China's pneumoconiosis research from 2001 to 2017. Bibliometrics was used to analyze the distribution of publication time,regions,hotspots,authors and their institutions,carrier journals,keywords,etc. RESULTS: A total of 10 208 literature articles on pneumoconiosis research were screened. The number of published literature in 2001-2017 showed an upward trend year by year( P < 0. 01). Provinces in the Eastern area have the largest number of publications. The areas that have the largest number of publications were in Shandong Province,Beijing City and Hebei Province,followed by Anhui Province,Guangdong Province,Jiangsu Province,Liaoning Province,Shanxi Province and Henan Province. Beijing City,Hebei Province,Tianjin City,Liaoning Province,Anhui Province,Jiangsu Province,Hubei Province and Shanghai City are the hotspots for research on pneumoconiosis. The publications were seen in 1 173 journals. Five occupational medical professional periodicals such as Occupation and Health,Chinese Journal of Industrial Hygiene and Occupational Diseases,China Occupational Medicine,Chinese Journal of Industrial Medicine and Industrial Health and Occupational Diseases publish' the most literature on pneumoconiosis research,accounting for 26. 99% of the effective literature.Occupational disease prevention institutions and hospitals are the main organizations for publishing literatures. The focuses of pneumoconiosis research are silicosis and coal worker's pneumoconiosis,etc. CONCLUSION: Generally,the literature on the research of pneumoconiosis in China from 2001 to 2017 is increasing and is focus on some specific hotspots.Pneumoconiosis research has been specialized. An important carrier for publishing research results has been formed.

OBJECTIVE: To analyze transforming growth factor-β1( TGF-β1)-induced differentially expressed genes( DEGs) in human embryonic lung fibroblast( IMR-90) using microarray,and to screen the key genes and signaling pathways related to trans-differentiation of fibroblast.METHODS: The gene chip GSE17518,attained from TGF-β1 stimulated IMR-90 cells,was downloaded from the Gene Expression Omnibus database.The DEGs were screened by GENE-E software.Then,the DEGs were imported into the DAVID online database for Gene Ontology( GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes( KEGG) pathway enrichment analysis.The proteinprotein interaction( PPI) network was constructed and the hub genes were screened using STRING database and Cytoscape software.RESULTS: A total of 394 DEGs related to TGF-β1 stimulation were identified,including 171 down-regulated genes and 223 up-regulated genes.The results of GO analysis showed that the DEGs were widely distributed in cytoplasm,cell membrane,extracellular matrix( ECM) and exosomes,regulating biological functions such as ECM organization,cell migration and adhesion,cell proliferation and apoptosis.The results of the KEGG pathway analysis indicated that most of DEGs were enriched in cell focal adhesion,ECM-receptor interaction and phosphoinositide 3 kinase-Protein kinase B( PI3K-Akt) signaling pathways.The PPI network screened 10 core genes,included nucleolar protein 2( NOP2),succinate dehydrogenase B,glutamyl-prolyl-tRNA synthetase( EPRS),FtsJ homolog 3( FTSJ3),prefoldin subunit 4,Ras-related C3 botulinum toxin substrate 2,signal recognition particle receptor subunit beta,succinate-Co A ligase GDPforming beta subunit,pumilio RNA binding family member 3( KIAA0020),and general vesicular transport factor p115.NOP2,EPRS,FTSJ3,KIAA0020 were mainly distributed in M1 module.The NOP2 is the core gene with the highest number of nodes in M1 module.CONCLUSION: A total of 10 core differential genes and 7 signaling pathways related to TGF-β1 stimulation were screened.Among them,focal adhesion,ECM-receptor interaction,PI3K-Akt and NOP2,EPRS,FTSJ3,KIAA0020 may provide new direction for research of mechanisms of abnormal activation of fibrotic diseases including silicosis in incidence and development of multiple lung fibrotic diseases.

OBJECTIVE: To investigate the differentially expressed microRNAs(miRNAs) in human embryonic lung fibroblast MRC-5 cells stimulated by transforming growth factor-β1(TGF-β1) using microarray chip, and screen for key genes and signaling pathways of fibroblast trans-differentiation. METHODS: The miRNA expression gene chip dataset GSE43992 on TGF-β1 stimulated MRC-5 cells were downloaded from high-throughput Gene Expression Omnibus(GEO) database of National Center for Biotechnology Information of the United States. The R language Limma package was used to screen the differentially expressed miRNAs. Corresponding target genes were predicted by miRWalk database performed by Gene Ontology(GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) signaling pathway enrichment analysis. The protein-protein interaction(PPI) network was constructed by the search tool for the Retrieval of Interacting Genes database. RESULTS: A total of five differentially expressed miRNAs were identified, including four up-regulated miRNAs and one down-regulated miRNA; and 42 corresponding differentially expressed target genes were predicted. GO analysis indicated that the target genes were significantly enriched in collagen catabolic process, extracellular matrix organization, membrane organization, collagen fibril organization, and cellular response to amino acid stimulus. The results of KEGG pathway analysis showed that the signaling pathways corresponding to miRNAs and target genes were mainly concentrated in 18 signaling pathways, that were mainly related to the age-ethnic signaling pathways and protein digestion and absorption miRNAs in tumors and diabetic complications. The core genes transfected into the myofibroblasts by the three fibroblasts screened by the PPI network were threonine kinase 1, estrogen receptor 1 and β-catenin. CONCLUSION: Five differentially expressed miRNAs, 42 target genes, 18 signaling pathways, and 3 core genes related to TGF-β1-induced MRC-5 cell trans-differentiation were screened. It can provide new reference for the treatment and research of many diseases including pneumoconiosis and pulmonary fibrosis.

Objective To explore the factors affecting the operation of coronary artery bypass grafting with heart beating and improve the effect of the operation. Methods From January 2012 to June 2016, 898 patients with coronary heart disease who received cardiovascular surgery in the Second Affiliated Hospital of Jilin University were analyzed retrospectively. All patients only underwent coronary artery bypass grafting with beating heart. Among them, 797 patients underwent the off-pump coronary artery bypass grafting (an OPCABG group, 592 males and 205 females, with an average age of 60.5±8.4 years); another 101 patients received on-pump beating heart coronary artery bypass grafting (an OPBH group, 77 males and 24 females, with an average age of 61.5±8.2 years). Results The average number of grafts in the OPCABG group was 3.36±0.74, and in the OPBH group was 3.71±0.69 (P<0.05). The postoperative ventilation time (10.8±9.5 hvs. 20.6±12.3 h), ICU stay (28.8±15.5 h vs. 37.4±30.8 h), hospital stay (10.9±4.8 d vs. 14.8±8.6 d), mortality (1.1% vs. 3.0%), the utilization rate of intra-aortic balloon pump (2.4% vs. 8.9%) and extracorporeal membrane oxygenation (0.5% vs. 5.0%) were significantly different between the OPCABG group and OPBH group (all P<0.05). Twelve patients died after surgery, and the total bloodless operation ratio was 91.3%. Conclusion The results show that most patients can achieve good results with the help of apical fixation and myocardial fixator, improved surgical techniques and methods, good anesthesia management as well as flexible and accurate use of vasoactive drugs. But extracorporeal circulation is necessary in the patients with large left ventricle, low ejection fraction and hemodynamic instability after intraoperatively moving the heart.