Objective To study the effect of Qizhen capsule combined with docetaxel injection on the neoadjuvant chemotherapy of breast cancer and its effects on cyclooxygenase (COX-2), cancer antigen 15-3 (CA15-3),and vascular endothelium growth factor (VEGF).Methods 84 patients with breast cancer were selected in our hospital from January 2015 to August 2016, those patients were divided into observation group and control group according to coin method.The control group received docetaxel injection, epirubicin injection, cyclophosphamide neoadjuvant chemotherapy, the observation group was treated with Qizhen capsule on the basis of the control group.The clinical efficacy, COX-2, CA15-3 and VEGF levels, quality of life and adverse reactions were compared between the two groups.Results After treatment, the total effective rate in the observation group (90.48%) was significantly higher than the control group (57.14%) (P<0.05).After treatment, the levels of COX-2, CA15-3 and VEGF in the observation group were significantly lower than the control group (P<0.05).The scores of cognitive function, emotional function, social function, role function and physical function of life quality in the observation group were significantly higher than the control group ( P<0.05 ) .Cardiac toxicity, nausea and vomiting, thrombocytopenia, alopecia, neutropenia and leukopenia were significantly lower in the observation group than the control group (P<0.05). Conclusion Qizhen capsule combined with docetaxel injection can significantly reduce the levels of COX-2, CA15-3 and VEGF in the neoadjuvant chemotherapy of breast cancer, and the clinical curative effect is good, which can effectively improve the quality of life of patients and reduce the adverse reaction rate.

Objective To observe the clinical efficacy of deproteinized calf blood extractive injection combined with hyperbaric oxygen in patients with severe traumatic brain injury.Methods 74 patients with severe traumatic brain injury from January 2013 to March 2015 in Wenzhou hospital of Chinese traditional medicine were randomly divided into observation group and control group, 37 cases in each group.The control group received hyperbaric oxygen on the basis of conventional therapy, the observation group received deproteinized calf blood extractive injection on the basis of control group.The Glasgow coma scale ( GCS) , Barthel, hs-CRP, TNF-α, IL-6 and prognosis were compared between two groups.Results The GCS score and Barthel index scores post-treatment in observation group were (13.67 ±1.73),(65.73 ±4.02) points, which were higher than (9.66 ±1.24), (50.69 ± 3.76) points in control group, and the difference was significant (P<0.05).The serum hs-CRP, TNF-α, IL-6 post-treatment in observation group were (4.55 ±0.76)mg/L,(1.21 ±0.05)μg/L,(0.21 ±0.01)μg/L, which were better than those of control group (6.43 ±1.01)mg/L,(1.36 ±0.06)μg/L,(0.28 ±0.02)μg/L (P<0.05).The rate of favorable prognosis in observation group was 48.65%, which was higher than that of control group (P<0.05).Conclusion The deproteinized calf blood extractive injection combined with hyperbaric oxygen has the exact efficacy, which was better than hyperbaric oxygen alone in the treatment of severe traumatic brain injury.

Objective:To investigate the expression of interleukin-10 (IL-10) and chemokine receptor 7 (CXCR7) in papillary thyroid carcinoma (PTC) tissues and their correlation with invasion and metastasis.Methods:According to the inclusion and exclusion criteria, 68 cases of cancer tissues (cancer tissue group) and para-cancer tissues (para-cancer tissue group) collected from PTC patients in Wenzhou Hospital of Traditional Chinese Medicine from Jun. 2015 to Jun. 2018 were selected. Meanwhile, pathological specimens from 32 cases of thyroid follicular adenoma patients (thyroid follicular adenoma group) undergoing thyroidectomy during the same period were also enrolled. Immunohistochemical SP staining was used to observe the expression of IL-10 and CXCR7 in different tissues, and the correlation between the expression of IL-10 and CXCR7 and the pathological characteristics of tumor was analyzed.Results:The positive expression rates of IL-10 and CXCR7 in cancer tissues were significantly higher than those in para-cancer tissues and thyroid follicular adenoma group (88.24% vs. 14.71% vs. 0.00%, 75.00% vs. 32.35% vs. 15.63%; P<0.05) . Among 68 PCT patients, 38 (55.88%) had high expression of IL-10, 30 (44.12%) had low expression of IL-10, 32 (47.06%) had high expression of CXCR7, and 36 (52.94%) had low expression of CXCR7. IL-10 expression was positively correlated with tumor multifocal, TNM stage, central lymphatic metastasis, central + cervical lymphatic metastasis, invasion degree and tumor maximum diameter ( r=0.486, 0.509, 0.468, 0.422, 0.629, 0.674, P<0.05) . CXCR7 expression was positively correlated with tumor multifocal, TNM staging, central lymphatic metastasis, central + cervical lymphatic metastasis, and infiltration (r=0.425, 0.563, 0.490, 0.287, 0.481, P<0.05) . Conclusions:IL-10 and CXCR7 are highly expressed in cancer tissues of PTC patients, among which IL-10 expression level is closely related to tumor differentiation degree, TNM stage, cervical lymphatic metastasis, infiltration degree and tumor maximum diameter. CXCR7 is related to TNM stage, cervical lymphatic metastasis and infiltration degree, both of which may be involved in the occurrence and development of tumor.

Objective To explore the clinicopathological characteristics,recurrence,metastasis and survival of triple negative breast cancer (TNBC),and to analyze the correlation factors affecting the prognosis.Methods Data of 378 breast cancer patients treated from Jan.2008 to Dec.2011 were retrospectively analyzed.According to immunohistochemical staining of estrogen of receptor (ER),progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2),they were divided into TNBC group (61 cases) and non-triple negative breast cancer group (non-TNBC,317 cases).The two groups were compared in terms of clinicopathological characteristics,prognosis and survival.Results Patients in TNBC group had significant differences in the following aspects:ratio of patients with newly diagnosed age ＜35 years old,patients with family history of breast cancer,the maximum diameter of tumor more than 5 cm,positive preoperative axillary lymph node status,tumor in clinical stage m,histological grade of tumor in level Ⅲ,Ki67 overexpression and P53 overexpression,while there was no statistical difference in the aspects of menstrual status,pathological type or surgical method between them.The local recurrence and distant metastasis rate were obviously higher in TNBC group than in non-TNBC group.5-year diseasefree survival (DFS) and 5-year overall survival (OS) were significantly lower in TNBC group than in non-TNBC group.Univariate analysis showed that factors related to 5-year DFS in TNBC group were:age,the maximum diameter of tumor,the preoperative axillary lymph node status,clinical staging of tumor,and P53 overexpression.The maximum diameter of tumor,the preoperative axillary lymph node status and clinical staging of tumor were recognized as the influence factors of 5-year OS.Independent factors affecting 5-year DFS in TNBC group were:the maximum diameter of tumor,and the preoperative axillary lymph node status.The maximum diameter of tumor and the preoperative axillary lymph node status were the independent factors influencing 5-year OS.Conclusions The clinicopathological characteristics of TNBC include:younger onset age,family clustering of breast cancer,the larger maximum of tumor diameter,larger portion of positive preoperative axillary lymph node,later clinical staging of tumor,higher histological grade of tumor,easier local recurrence and distant metastasis,lower 5-year DFS and 5-year OS.The factors of age,the maximum diameter of tumor,the preoperative axillary lymph node status,clinical staging of tumor,P53 overexpression especially the maximum diameter of tumor and the preoperative axillary lymph node status play the important clinical roles in judging the prognosis of TNBC.

ObjectiveTo investigate the clinical features of patients with acute-on-chronic liver failure （ACLF） and bacterial infection and early warning indicators associated with multidrug-resistant infections. MethodsA retrospective analysis was performed for 130 patients with ACLF and bacterial infection who attended The Second Affiliated Hospital of Air Force Medical University from January 1， 2010 to December 31， 2021， and according to the drug susceptibility results， the patients were divided into multidrug-resistant （MDR） bacterial infection group with 80 patients and non-MDR bacterial infection group with 50 patients. General information and laboratory examination results were compared between the two groups to screen for the early warning indicators associated with MDR bacterial infection. The Student’s t-test was used for comparison of normally distributed continuous data with homogeneity of variance between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data or continuous data with heterogeneity of variance between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The binary logistic regression analysis and the receiver operating characteristic （ROC） curve were used to assess the predictive value of early warning indicators. ResultsAmong the 130 patients with ACLF and bacterial infection， sputum （27.7%） was the most common specimen for detection， followed by blood （24.6%）， urine （18.5%）， and ascites （17.7%）. Bacterial infections were dominated by Gram-negative bacteria （58.5%）. Of all bacteria， Escherichia coli （18.5%）， Klebsiella pneumoniae （14.6%）， and Enterococcus faecium （13.8%） were the most common pathogens. Gram-positive bacteria had a high resistance rate to the antibacterial drugs such as erythromycin （72.2%）， penicillin （57.4%）， ampicillin （55.6%）， and ciprofloxacin （53.7%）， while Gram-negative bacteria had a high resistance rate to the antibacterial drugs such as ampicillin （73.3%）， cefazolin （50.0%）， and cefepime （47.4%）. The patients with ACLF and bacterial infection had a relatively high rate of MDR bacterial infection （61.5%）. Comparison of clinical data between the two groups showed that compared with the patients with non-MDR bacterial infection， the patients with MDR bacterial infection had significantly higher levels of alanine aminotransferase （Z=2.089， P=0.037）， aspartate aminotransferase （Z=2.063， P=0.039）， white blood cell count （Z=2.207， P=0.027）， and monocyte count （Z=4.413， P<0.001）. The binary logistic regression analysis showed that monocyte count was an independent risk factor for MDR bacterial infection （odds ratio=7.120， 95% confidence interval ［CI］： 2.478‍ ‍—‍ ‍20.456，P<0.001） and had an area under the ROC curve of 0.686 （95%CI： 0.597‍ ‍—‍ ‍0.776） in predicting ACLF with MDR bacterial infection（P<0.001）， with the optimal cut-off value of 0.50×10⁹/L， a sensitivity of 0.725， and a specificity of 0.400. ConclusionACLF combined with bacterial infections is mainly caused by Gram-negative bacteria， with the common pathogens of Escherichia coli and Klebsiella pneumoniae and a relatively high MDR rate in clinical practice. An increase in monocyte count can be used as an early warning indicator to distinguish MDR bacterial infection from non-MDR bacterial infection.