Objective To study the expression of Ki-67 in T1 primary breast cancer tissue and its relationship with Her-2 and ER,evaluate the prognosis of early breast cancer.Method s Sixty cases of women T1 primary breast cancer tissues of 60 female cases from January 2008 to June 2011 were selected.The expressions of Ki-67 were detected by immunohistochemieal method and the relationships between Ki-67 and clinical-pathological fcatures,Her-2 and ER were analysed.Results The expression of Ki-67 in T1 primary breast cancer was 55% among the 60 patients.The expression of Ki-67 was not related with the clinical-pathological type of breast cancer and menopause (P＞0.05).The expression of Ki-67 in group with lymph node metastasis was higer than in group without lymph node metastasis(P =0.047 ,P ＜0.05).The expression of Ki-67 in Her-2positive group was higher than Her-2 negative group (P= 0.021,P＜0.05),and the expression of Ki-67 in ER positive group was lower than that of ER negative group (P = 0.037,P ＜ 0.05).Conclusions The expression of Ki-67 in T1 primary breast cancer indicates the possibility of lymph node metastasis,and its positive correlation with Her-2 positive expression,ER negative expression indicates poor prognosis.

Primary osteoporosis is a commonly and freguently encountered disease of the elderly People. There is no specific treatment for it at present time. The most important thing is prevention. Although there are so many prvention methods , nutritional prevention is one of important aspects of osteoporosis. In each stage of life,people should pay attention to intaking the nutrients which is beneficial to preventing osteoprosis.

Morality and Ethics are rooted in the development of human society.Scientists should be strict with their professional morality and positively face ethics-related arguments.nowadays,based on the rapid development of Science &Technology,the relationship between science and society and the recognition of "self" have been changed fundamentally,which have caused new challenges to scientists in the fields of morality and ethics.

Objective To evaluate the effects of a single IV lidocaine bolus dose on the minimal alveolar concentration (MAC)of sevoflurane. Methods Patients (n=90), aged 25-65 years whose Anesthesiologists (ASA) classification wasⅠorⅡand underwent elective surgery on trunk under general anesthesia, were randomly divided into 3 groups with 30 cases in each group:high-dose lidocaine group (group H), low-dose lidocaine group (group L) and control group (group C). They were induced by sevoflurane inhalation, and ventilated by LMA (laryngeal mask airway). After a 15 minutes equilibration period with the above sevoflurane concentration , the medication to be studied (2%lidocaine 1.5 mg/kg for group H , 2%lidocaine 0.75 mg/kg for group L, 0.9%saline 5mL for group C) was administered for 3 minutes before the skin incision. The response to skin incision (movement versus no movement) was recorded in the first minute after skin incision. The MAC for sevoflu?rane was determined using the Dixon′s up and down method. Values of mean arterial pressure (MAP), heart rate (HR), and BIS were recorded at 1 minute and 5 minutes after being monitored (average values were noted as T0), immediately before the administration of medication (T1), immediately before the skin incision (T2) and 1 minute after the skin incision(T3). Results MAC in group H (2.00%± 0.17%) was lower than that in group C (2.22%± 0.18%) by approximately 0.22%,and which was lower than that of group L ( 2.21%± 0.14%) by approximately 0.21%(F=7.054,P<0.05). No significant differ?ence in the MAC of sevoflurane was noted between group L and group C. The values of HR, MAP and BIS all decreased at T 2 and increased at T3 in all 3 groups (all P<0.05). No significant difference in HR, MAP or BIS was observed between T0 and T1 in all three groups. The values of HR and BIS were lower in group H than those in group C and group L at T2 and T3. The values of MAP were lower in group L and group H than those in group C at T2 and T3. The value of MAP were lower in group H than that in group L at T2(all P<0.05). Conclusion A singleⅣ1.5 mg/kg lidocaine decreases MAC of sevoflurane, but the decreased amplitude (11%) does not reach expectation.

To a certain extent, itemized government subsidies to public hospitals, primarily used for hospital infra-structure and large equipment investments, can alleviate the financial pressure of development expenditures and thus re-duce the medical expenditure burden on patients. To test the hypothesis, the panel data method has been adopted based on the data of 23 tertiary hospitals. Empirical results find that:(1) increases in itemized subsidies will reduce the burden of medical expenses on patients;(2) conversely, the impact of itemized subsidies on outpatient medical expenses is more sig-nificant. By sharing a portion of public hospital expenses and impacting hospital service providing behavior, itemized sub-sidies help to reduce the burden of medical expenses on patients.

The technique of chimeric antigen receptor-engineered T cells (CAR-T) is combined single chain antibody and T-cell activation modification and has specific and durable killing effect on tumors.It had achieved stunning results on clinical trials of B lymphocytic leukemias,B lymphomas and solid tumors.Meanwhile it also had potential risk on the off target effects,cytokine release syndrome,graft versus host disease and so on.This paper briefly reviews the principal of CAR-T cellular mechanism,advantages and clinical applications.

Objective To investigate the clinical characteristics and prognosis of acute myocardial infarction (AMI) combined with ventrical septal perforation (VSP).Methods Fifty-seven AMI + VSP patients were retrospectively analyzed their clinical characteristics and outcomes who were treated in the Fourth People' s Hospital of Shenyang and the First Hospital Affiliated to China Medical University from June 2000 to May 2014.Results Of all patients,43 (75.4％) VSP occurred anterior wall AMI,and 14 (24.6％) were not.Echocardiogram show the end diastolic diameter of left ventricle was (53.7 ± 9.5) mm,left ventricle ejection fraction was (48.5 ± 11.8)％,VSP diameter was (9.8 ±7.9) mm,and 37(64.9％) were with near apex.The level of cardiactroponin I,C-reactive protein,and N terminal of B type natriuretic peptide of patients were (16.7 ± 12.9) μg/L,(99.7 ± 31.40 mg/L,(3 051.2 ± 879.7) μg/L.Total mortality was 71.9％ (41/57) in 30 days and 78.9％ (45/57) in 1 year.The mortality of operation group was 73.9％ (17/23) in 30 days and 91.3％ (21/23) in 1 year.The mortality of consecutive therapy was 64.7％ (22/34) in 30 days and 76.5％ (26/34) in 1 year.Conclusion The mortality of AMI + VSP is higher and operation is the most effective therapeutic method.

[Objective]To explore the professor Yu Tugen’s experience, in order to provide reference for clinical medication and the study of atopic der-matitis. [Methods] Treatment based on syndrome differentiation. First, through the analysis of etiology and pathogenesis and clinical manifestations of atopic dermatitis, it is divided into types, respectively analyze each type, discuss the experience in the treatment of various types; then give examples of the treat-ment experience of dampness heat syndromes, analysis of diagnosis and treatment system.[Result]Atopic dermatitis is divided into the types of damp-heat accumulation, spleen deficient aggregates the skin wet, wind formation from blood deficiency. After dialectical treatment, symptom is relieved.[Conclusion] This topic comprehensively summarizes the famous expert Yu Tugen ’s academic thought and clinical experience of atopic dermatitis of the types of damp-heat accumulation, provides a more complete treatment concept based on syndrome differentiation of TCM of atopic dermatitis, to relieve pain and improve the quality of life.

Lupus nephritis (LN) is a major cause of morbidity and mortality in patients with systemic lupus erythematosus.Although the use of aggressive immunosuppression has improved both patient and renal survival over the past several decades,the optimal treatment of LN remains challenging.The therapeutic strategy and progress for patients with lupus nephritis are based on the accumulative evidences of the medicine,and must be personalized according to the patient condition.This paper discusses established and newer treatment options for LN.We also emphasize the challenges in the day-to-day management of lupus nephritis in the clinical practice.