Objective To investigate androgen receptor (AR) expression in triple negative breast cancer(TNBC) patients and its predictive value for clinical outcomes.Methods Five hundred and sixty-eight primary breast cancer patients who received surgery treatment from January 2008 to January 2010 were included in this study.Tissue sections of surgical resection specimens were underwent estrogen receptor (ER),progesterone receptor (PR),and human epidermal growth factor receptor 2 (HER2) immunohisto chemical staining,according to the judgment for triple negative breast cancer and non triple negative breast cancer.Data on age,family history,menstruation,tumor size,tumor stage,tumor grade,pathological type and lymph node metastasis were collected for analysis.Immunohistochemical analysis of AR was done in tissue sections of triple negative breast cancer patients,Kaplan-Meier method was used to compare survival between AR(+) and AR(-) groups,and Log-rank method was used to determine the association between AR-positive expression and 5-year overall survival as well as disease free survival.Results Among 568 breast cancer patients,174 (30.6％)TNBC patients were identified,including 84 patiens with AR (-) expression and 90 patients with AR (+) expression.During 5 years' follow-up,reccurrence rate was 35.7％ (30/84) in AR (-) group and 20.0％ (18/90) in AR(+) group;5-year overall survival rate was 73.8％ in AR(-) group and 81.1％ in AR(+) group.There was no significant association between AR(+) expression and 5-year death or recurrence rate,while after adjusting for age,menstruation,tumor size and lymph node metastasis,AR (+) expression was significantly associated with decreased 5-year death and recurrence rate,adjusted hazard ratio (HR) was 0.794,95CI (0.430-1.021) and 0.722,95CI (0.451-0.965) respectively.Conclusion AR (-) expression is associated with increased risk of death and recurrence and is a promising predictive marker for poor clinical outcomes.

Objective To investigate the general self-efficacy of the clinical nurses and explore the relationship between general self-efficacy and job burnout .Methods 473 clinical nurses from 13 hospitals of the third and the second grade in Leshan city were recruited and investigated with general self-efficacy scale and mashach burnout inventory .Results (1)The mean score of the clini-cal nurses′general self-efficacy was(2 .63 ± 0 .49) scores ,which was lower than that of military nurses (2 .69 ± 0 .58) scores (P<0 .05) .(2)There was a significant difference of nurses′general self-efficacy in different employment types ,administrative positions , marital statuses ,length of service and professional titles (P<0 .05) .(3)The score of general self-efficacy was negatively correlated with that of emotional exhaustion and of depersonalization (P<0 .01) ,but positively correlated with that of personal accomplish-ment(P<0 .01) .Conclusion Nurses′overall general self-efficacy was at a moderate level .Administrators could reduce nurses′job burnout more effectively by improving their self-efficacy .

Objective To investigate the 9 . 4 T of DTT in the diagnosis of SD rat C6 cerebral gliomas model about the change of CST on tumor progression and pathology confirmed. Methods ①10 μl C6 cell suspension of 106 cells number were implanted into the right caudate nucleus of brain hemisphere of 20 adult male SD rat with ster-eotactic technique. ②Application of 9. 4 T of DTT and DTI, meanwhile the routine T1-weighted imaging(T1WI), T2-weighted imaging(T2WI), contrast-enhanced T1WI,FLAIR imaging and diffusion tensor of the brain were ac-quired. Anatomic relationship between cerebral glioma and surrounding white matter fiber tracts was analyzed and measured the values of FA and MD in different areas on fractional anisotropic ( FA) map, color-coded directional map, three-dimensional (3D) white matter fiber tracts map, then stained with routine HE. Results All of SD rat C6 cerebral gliomas models 3 D white matter fiber tracts map by means of FA maps of DTI were successfully comple-ted. Apparently significant differences of FA values were found in solid tumor, surrounding edema, compared with normal white matter regions ( P<0.05 );but there was no significant difference among solid tumor and surrounding edema region (P>0.05);there were significant differences of MD values between solid tumor, surrounding edema and normal white matter region ( P<0.05 ) . Conclusion The 9 . 4 T of DTT offers the optimal visualization of An-atomic relationship between cerebral glioma and surrounding white matter fiber tracts in the different periods of the tumor moder.

The ras-mitogen activeted protein kinase pathway is responsible for regulation of many cel-lular processes, including differentiation, cytoskeletal organization, and protein trafficking. Much attention has been paid to them and their role in cancer therapy recently, and its inhibitor pathways are applied to clinical tes-ting, such as, Raf kinse inhibitors, MEK inhibitor, Src kinase inhibitor.

[Summary] Chronic suppurative otitis media affects patients ’ quality of life, and is life-threatening in patients with cholesteatoma which causes intracranial or extracranial complications .The purpose of surgery is to clear up all the lesions and to reconstruct hearing function .Tympanoplasty is the main surgical method , which includes basically canal wall down ( CWD) and canal wall up (CWU) styles.CWD provides lager surgical field but impairs normal auditory canal structure ; CWU preserves the posterior wall of external auditory canal and provides better quality of life although it has higher possibility of recurrence of cholesteatoma .We reviewed the surgical methods , surgical effects , recurrence rates , and surgical indications of canal wall up mastoid-tympanoplasty , hoping to provide meaningful reference for clinical application .

Objective To explore the relationship between the subjective well-being and personality characteristics of nurses,and provide the basis for managers to implement humanized management and improve the nurse happiness from the perspective of positive psychology.Methods A total of 190 nurses were selected from a hospital of Zhongshan city by convenience sampling technique.And General Situation Questionnaire,Happiness Scale and the revised Eysenck Personality Questionnaire-Short Form (Chinese version) were used in the investigation.Results The average score of general happiness was (54.91± 9.18) points for male nurses,which was lower than that of the national norm.The sense of happiness between male and female nurses showed statistical difference.The emotional stability of nurses with different marital status showed significant difference.Nurses' subjective well-being and personality characteristics had a significant causal relationship by multiple stepwise regression analysis.Conclusions The general wellbeing about nursing staff is lower than the national norm,male nurses' happiness was lower than that of female and married nurses' emotional instability is higher than unmarried nurses.The nurses' personality is an important factor that affect their happiness.Managers should be under the guidance of the positive psychology,pay attention to the nurse' personality characteristics to improve the nurse' happiness,improve the level of nurse' mental health,to stabilize and optimize the nursing team,and improve the quality of nursing.

Objective To study the immunomodulation effects of different dosage of dexmedetomidine (Dex)in the septic shock model of rats after cecal ligation and puncture (CLP).Methods After CLP, 48 wistar rats were randomly (random number)allocated in four groups:(1)CLP group;(2)small-dose Dex group [2.5 μg/(kg·h)];(3)medium-dose Dex group [5.0 μg/(kg·h)];(4) large-dose Dex group [10.0 μg/(kg·h)].HLA-DR (human leukocyte antigen-DR)and plasma cytokine (IL-4, IL-6,IL-10 and TNF-α)were measured,meanwhile mean arterial blood pressure (MAP),heart rate (HR)and mortality were also documented at 1,3,and 5 h after the CLP procedure.Results There were no obvious differences in HLA -DR level,levels of inflammatory mediators,MAP and HR among there Dex treatment groups.Compared with CLP group,HLA-DR level decreased in three Dex treatment groups (P =0.020)and pro-inflammatory mediator (IL-6)increased at 3 h (P =0.011 )then declined at 5 h with decreased HR (P <0.01),and without obvious change in MAP (P =0.124),and all of them led to a significantly decrease in the mortality.The mortalities in CLP group,small dose group,medium dose group and large dose group were 91.7%, 66.7%, 25.0% and 18.0%, respectively. Conclusions Dexmedetomidine used in rats with septic shock rats partially induced immunomodulation initiated within 5 h after CLP evidenced by decreased HR,maintenance of MAP and reduction of mortality rate in dose-dependent fashion.

SUMMARY Salivary gland tumors are a group of the most common tumors in the oral and maxillofacial region with obvious characteristics of clinical , histopathologic , and therapeutic aspects .During the past 50 years, our research group performed a systemic study on salivary gland tumors including imaging diag-nosis, fine needle aspiration cytology , FT-mid-IR fiber optics spectroscopy , histopathologic features and biological behaviour of the tumors , functional parotid surgery , and 125 I seed implant branchytherapy . More reasonable principles of management for various types of the tumors were put forward based on the histopathologic features of the tumors .The surgical techniques were modified and the postoperative com-plications were reduced obviously .Thus, the quality of life of the patients was improved greatly .

Her-2 targeting therapy is an important part of the treatment for breast cancer with Her -2 overexpression.However,the therapeutic effectiveness is largely influenced by Her -2 resistance.Previous studies have confirmed that PI3K/AKT/mTOR signaling pathway is activated during the process of drug resistance to Her-2-targeting therapy.Therefore,investigating the PI3K/AKT/mTOR signaling pathway and drugs -targeted pathway are important for the treatment of breast cancer .

OBJECTIVE:To discuss the role of hospital pharmacists in the clinical drug trial.METHODS:The role of hospital pharmacists in publicizing and training of Good Clinical Practice(GCP),in the formulation of each standard operating instruction and in each stage of clinical drug trial was analyzed.RESULTS&CONCLUSION:Hospital pharmacists played a key role in clinical drug trial.They can get to know the basic research methodology from participating in the clinical drug trial,meanwhile their consciousness on scientific research can be strengthened.