Objective To analyze the clinicopathological features of bilateral primary breast cancer (BPBC) by molecular subtypes.Methods Clinical data of 145 BPBC patients were reviewed focusing on the clinicopathological features of different molecular subtype and the concordance of molecular subtype between first and second primary breast cancers.Results Of the first primary breast cancers ( FPBC),91 cases (62.8％ ) were Luminal A subtype,Luminal B subtype in 13 cases (9.0％ ),Human epidermal growth factor receptor 2 (HER-2) subtype in 14 cases (9.7％ ),triple negative breast cancer (TNBC) in 27 cases ( 18.6％ ).Of the second primary breast cancers ( SPBC ),Luminal A subtype was found in 93 (64.1％ ) cases,Luminal B subtype in 10(6.9％ ) cases,HER-2 subtype in 14(9.7％ ) cases and TNBC in 28( 19.3％ ) cases.Most TNBC patients were young ( age ≤ 50 ) with high frequency of grade Ⅲ in FPBC.Molecular subtypes do not vary with tumor size,clinical stage,lymph node status and pathological types ( P ＞ 0.05 ).Most FPBC of Luminal A and TNBC were concordant same subtypes in SPBC ( K ＞ 0.04 ),while Luminal B and HER-2 subtypes often had discordant phenotypes in SPBC ( K ＜ 0.04).BPBC were more likely to have concordant subtypes if the two tumors developed in short time interval.Conclusions The distribution and clinical leatures of each subtype in BPBC is similar to unilateral breast cancer.Patients whose FPBC are Luminal A or TNBC often have concordant phenotypes for their SPBC,a short time interval between two cancers also predicts concordance.

Objective:To investigate the clinical efficacy and effects on hemorheology of acupuncture therapy combined with gaba-pentin in the treatment of patients with tension headache. Methods:Totally 92 cases of patients with tension headache were randomly divided into the observation group (n=46) and the control group (n=46) according to the random number table. The control group was given gabapentin, while the observation group was treated with acupuncture therapy on the basis of treatment in the control group. The treatment course was 4 weeks. The clinical efficacy, changes of the headache indices, VAS score and hemorheology levels before and after the treatments in the two groups were compared, and the incidence of adverse reactions was observed as well. Results:The to-tal effective rate of the observation group (93. 48%) was significantly higher than that of the control group (73. 91%, P<0. 05). Af-ter the treatment, the headache indices in both groups significantly decreased (P<0. 05), and the decrease in the observation group was more significant than that in the control group (P<0. 05). The VAS scores in both groups significantly decreased after the treat-ment (P<0. 05), and the decrease in the observation group was more significant than that in the control group (P<0. 05). The plas-ma viscosity, hematocrit and platelet aggregation rate in both groups significantly decreased after the treatment (P<0. 05), and the decrease in the observation group was more notable than that in the control group (P<0. 05). No severe adverse reactions were shown in both groups during the treatment course. Conclusion: Acupuncture therapy combined with gabapentin in the treatment of patients with tension headache shows striking effects, which can improve hemorheology with promising safety and deserves further studies.

Objective:To explore the role of Mycoplasma pneumoniae (MP) in hospitalized children with community-acquired pneumonia (CAP) in Suzhou.Methods:Pathogen data of 2 367 patients with bronchiolitis, bronchopneumonia, lobar pneumonia, and interstitial pneumonia were retrospectively analyzed from January 2017 to December 2018 in Children′s Hospital of Soochow University. The detected pathogens were MP, respiratory syncytial virus (RSV), adenovirus (Adv), influenza A, B, parainfluenza virus (PIV) 1, 2 and 3, human metapneumovirus (hMPV), boca virus (HBoV) and bacteria.Results:The most common pathogen of bronchiolitis was RSV (34.9%, 249/713), followed by MP (15.8%, 113/713) and hMPV (11.4%, 85/713). The most common pathogen of bronchial pneumonia was Streptococcus pneumoniae (Sp, 14.8%, 180/1 220), followed by RSV (13.1%, 160/1 220) and MP (10.2%, 124/1 220). The most common pathogen of lobar pneumonia was MP (47.8%, 141/295), followed by Sp(12.9%, 38/295). The most common pathogen of interstitial pneumonia was MP (35.3%, 49/139), followed by RSV (23.0%, 32/139) and Adv (6.5%, 9/139). Compared with non-MP infections, children with MP infections were older, and had higher percentage of fever and less shortness of breath. The adjusted OR(95% CI) was 2.4 (1.1-3.5), 5.1 (3.2-10.4) and 0.2 (0.0-0.4), respectively. Conclusions:MP is the most common pathogen of lobar pneumonia and interstitial pneumonia and the second most common cause of bronchiolitis. MP infections are usually associated with older age, higher percentage of fever and less shortness of breath.