Objective To study the clinical application value of advanced breast cancer which resistence CAF regimen,treated with semimonthly regimen for paclitaxel combined with 5-fluorouracil/leucovorin 48-hour continuouse infusion.Methods 80 paients with CAF-regimen-resistant ABC were treated with paclitaxel combined with 5-fluorouracil/leucovorin continuouse infusion,paclitaxel 95mg/m2,d_1,LV 200mg,d_1,5-fluorouracil 3g/m2,continuouse infusion for 48 hours with infusion pump.every cycle lasted 2 weeks,at least 4 cycles.Results Of 80 patients,there were 9 complete and 26 partial responses,32 cases remained stable and 13 progressive.The overall response rate of 43.8%.The median time to progression was 8 months.The median survival time was 16.7 months,the patients with soft tissue,lung,pleura,bone,liver obtained response rat was 46.7%(21/45),38.5%(5/13),31.3%(5/16),40%(4/10),20%(2/10).Conclusions semimonthly regimen for paclitaxel combined with 5-fluorouracil/leucovorin 48-hour continuouse infusion is effective and acceptable toxicity,it could be considered as one of the standard chemotherapy for advanced breast cancer which resistence CAF regimen.

Background and purpose:The incidence of thyroid cancer (TC) is increasing worldwide. However, there were some differences among different regions. The purpose of this study was to investigate the incidence trends and clinicopathological characteristics of TC in Qingdao, a typical eastern coastal city, and to analyze the change in etiological spectrum of surgical thyroid diseases in recent years.Methods:A total of 2 251 patients who underwent thyroidectomy in 2014 due to thyroid nodules at the Affiliated Hospital of Qingdao University were retrospectively reviewed. The clinico-pathological characteristics were further analyzed among 1 306 patients with TC and compared with the corresponding data from the Surveillance Epidemiology and End Results (SEER) database as well as previous data from this hospital.Results:With the increasing number of thyroidectomy in Qingdao, there was also an increase in the proportion of TC in patients after thyroidectomy, from 34.8% in 2010 to 59.0% in 2014. Among those with TC, the male-to-female ratio was 1∶2.80, with a relatively high incidence among 20-54 year-old adults, who were younger than those reported in terms of distribution of age in SEER database (U=2 289,P=0.000). About 50.2% of the TC patients were overweight or obese, 78.2% TC patients had only asymptomatic nodules detected by ultrasound at initial diagnosis, while 16.6% had visible or palpable thyroid nodules. Only 5.2% presented hoarseness or other repression symptoms. Micro-carcinoma accounted for 61.7% of TC in 2014 at this hospital, which was significantly higher than the proportion in 2010 (37.7%). Lymph node involvement was significantly more frequent at this hospital than in SEER database (49.5%vs 26.0%,χ2=11.806,P=0.001). Even among patients with micro-carcinoma, 31.3% already presented lymph node metastases. The proportions of papillary, follicular, medullary and anaplastic carcinoma were 97.5%, 1.1%, 1.0% and 0.5%, respectively, among which the percentage of papillary carcinoma was higher than that in SEER database (U=4 654.5,P=0.055).Conclusion:There was an increase in the number of thyroidectomy in Qingdao, and the preoperative diagnostic accuracy of TC in this area kept rising. The in-cidence of TC was relatively high in a younger population, with more common lymph node involvements and an overweight trend. The increasing proportion of micro-carcinoma might be related to the popularization of health examination. However, the frequent lymph node metastasis in patients with micro-carcinoma is an important indicator of the invasive behavior of micro-carcinoma, which should not be overlooked.

Objective To explore the clinical results and complications of the traditional skeletal traction through olecranon on treating the irreducible humeral supracondylar fracture in children with of ulna.Methods Ninety-eight children patients of humeral supracondylar fracture with failure of reduction manipulation were selected as our subjects.The towel clamp-skeletal traction through olecranon of ulna was applied as the additional treatment methods.Meanwhile 5-24 months' follow-up were performed.Results According to Flynn elbow joint function evaluation standard.The curative effect was as followed.71 patients (74.7％) got the excellent outcome,17 patients (17.9％) for good outcome and 7 patients for improved utcome(7.3％).Therefore,the ratio of excellent operation reached to 92.6％.Conclusion The towel clampskeletal traction through olecranon of ulna might be an effective method to treat reliable fixation regarding of its high curing rate and simple process of performance.

Objective To study the protective effect of Astragalus membrance on mice infected with tachyzoites of Toxoplasma gondii. Methods ICR mice were infected intraperitoneally with 10 5, 10 3, 10 2 tachyzoites of virulent RH strain of Toxoplasma gondii, and the mice were orally treated with Astragalus membrance 0 075 g/d per mouse or Azithromycin [150 mg/(d?kg)] each day starting from day 1 post-infection for 10 days. The survival rate and period were investigated. The parasite loads of livers and lungs of the mice infected with 10 2 tachyzoites were determined by fluorescence PCR methods at 4 day-post-infection (dpi) and 8 dpi. Results When infected with 10 5, 10 3 tachyzoites, treated with Astragalus membrance, the average survived days of the mice were 5 57 days and 6 23 days, and treated with azithromycin were 6 96 days and 8 12 days respectively. The azithromycin group but not the astragli group survived significantly longer than the control(P

In view of the actual situation of our university,we carried out an experimental physiology teaching reform.By ways of preparing experiment guidance,setting conventional and potential experiment material,increasing choice of content and the opportunity for students to design experiments and optimizing experiment teaching processes in purpose of strengthening students' skills and promoting the training of application ability and innovation ability,we achieved high efficiency and low consumption of experimental physiology and improve the teaching quality.

BACKGROUNDSleeve recestion for lung cancer can get similar tumor and lymph node resection rate as pneumonectomy, with less influence on pulmonary function and much improvement of quality of life. The aim of this study is to compare the 5-year survival and complications of sleeve resection and pneumonectomy for lung cancer.

METHODSSurvival analysis was used to investigate the 5-year survival of 173 patients undergoing sleeve resection and 435 patients undergoing pneumonectomy from January 1990 to December 2000. Their complication and perioperative motality were also analyzed.

RESULTSThe overall 5-year survival for sleeve resection and pneumonectomy was 42.3% and 30.9%, respectively (P=0.007). 5-year survival of right lung sleeve resection was better than that of left lung [P=0.004 (N0), 0.025 (N1), 0.042 (N2)]. In left lung cancer patients without nodal involvement, the survival after sleeve resection was better than that after pneumonectomy. There was no survival difference between N1 and N2 lung cancer patients. Survival was not significantly different for bronchoplasty and pulmonary arterioplasty and pneumonectomy. The incidence rate of pneumonia and arrhythmia for sleeve resection was less than those for pneumonectomy (P=0.0019), and no significant difference of mortality was observed between the two groups.

CONCLUSIONSIn lung cancer patients suitable for sleeve resection or pneumonectomy, sleeve resection should be performed for right lung cancer and left lung cancer of stage I. Bronchoplasty and pulmonary arterioplasty don't prolong the survival of lung cancer patients compared with pneumonectomy.

Objective To explore the relationship between the stimulated thyroglobulin ( sTg) and site, number and diameter of metastatic lesions in patients with differentiated thyroid carcinoma (DTC) before the first 131 I treatment, and to evaluate the predictive value of sTg for different metastatic sites. Methods A total of 567 DTC patients (179 males, 388 females; age: (45.3±12.3) years) who received the first 131Ⅰ treatment between January 2012 and June 2017 were included. Thyroglobulin antibody (TgAb), sTg and thyroid stimulating hormone ( TSH) were determined within 1 week before 131 I treatment. Metastases were detected by ultrasonography, CT or 18 F-fluorodeoxyglucose ( FDG ) PET/CT, 131 I whole-body scan, SPECT/CT imaging and pathology. sTg levels of patients with different metastatic sites and different metasta-sis numbers or lesion diameters were compared ( Kruskal-Wallis H test) . Spearman correlation analysis was performed on the number, diameter and sTg level of metastases. The receiver operating characteristic ( ROC) curve was used to explore the predictive value of sTg before the first 131 I treatment for DTC metasta-sis. Results The median values of sTg in the bone, lung, lymph node metastases groups and non-metasta-sis group were 500.00, 104.40, 27.45, 2.39μg/L, respectively, and there were significant differences, ex-cept for bone and lung metastases groups ( H range: -294.605 to 175.162, all P<0.05) . The sTg levels of lung metastasis group and lymph node metastasis group were both decreased by the order of metastasis num- bers (≥3, =2, =1;H range:-57.887 to 48.763, all P<0.05) . As to the diameter of metastases, the sTg levels of >2.0 cm, 1.1-2.0 cm, and≤1.0 cm subgroups in the lung metastasis group and lymph node me-tastasis group were also decreased in order ( H range: -69.935 to 61.043, all P<0.05) . Spearman correla-tion analysis showed that the number ( rs=0.568, 0.606) and diameter ( rs=0.806, 0.664) of the metasta-ses in the lung and lymph node metastases group were positively correlated with sTg (all P<0.05). Areas under ROC curves for sTg to predict bone, lung and lymph node metastasis were 0.935, 0.843 and 0.791 re-spectively. The threshold values were 197. 65, 23. 21 and 10. 96 μg/L respectively. The sensitivities and the specificities were 91.70％, 79.60％, 67.20％ and 97.20％, 80.80％, 82.70％ respectively. Conclusions Tg level before the first 131 I treatment has a certain predictive value for the metastasis, metastatic site and num-ber or diameter in DTC patients.

Objective:To investigate the effects of methyltransferases like 3(METTL3)mediated m6A modification of double homology cassette A pseudogene8(DUXAP8)on the proliferation,migration and invasion of salivary adenoid cystic carcinoma SACC-LM cells and its potential molecular mechanisms.Methods:Whole-transcriptome sequencing showed that DUXAP8 was highly ex-pressed in SACC than in para-cancerous tissues(P＜0.05).The m6A modification sites on DUXAP8 were predicted using the SRAMP website,and the mRNA and protein expression of m6A-modified genes and the genes associated with the epithelial-mesen-chymal transition(EMT)was measured by qRT-PCR and Western blot,respectively.METTL3 and DUXAP8 was knocked down or overexpressed in SACC-LM cells,and the proliferation,migration,and invasion of the cells were assessed by CCK-8,scratch and Transwell assays.The correlation between METTL3 and DUXAP8 was evaluated using MeRIP-qPCR.Results:The expression of DUXAP8 in SACC tumor was higher than that in para-cancerous tissues(P＜0.05).Knockdown of DUXAP8 reduced proliferation,migration and invasion of SACC-LM cells,as well as the expression of EMT-related genes(P＜0.05).Multiple m6A modification sites of high confidence were found on DUXAP8.METTL3 was highly expressed in tumor tissues,more than other related genes(P＜0.05)and enzyme-encoding genes in SACC-LM cells(P＜0.05).METTL3 was found to function as a methyltransferase to regulate the expression of DUX-AP8,and downregulation of METTL3 inhibited prolifera-tion,migration and invasion of SACC-LM cells and partially reversed the promotion of these activities induced by DUX-AP8 overexpression(P＜0.05).Conclusion:METTL3-me-diated m6A modification upregulated DUXAP8 expression,which promotes the proliferation,migration and invasion of SACC cells.

Objective:To compare the efficacy of internal fixation using cannulated screw combined with fibular allograft and internal fixation using cannulated screw alone in the treatment of femoral neck fracture in young and middle-aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 75 young and middle-aged patients with femoral neck fracture admitted to the Third Hospital of Hebei Medical University from January 2020 to December 2022, including 44 males and 31 females, aged 34-56 years [(46.1±12.7)years]. According to Garden classification, 26 patients were classified as type II, 35 type III and 14 type IV. According to the Pauwels classification, 9 patients were classified as type I, 31 type II and 35 type III. Forty-nine patients were treated with internal fixation using three cannulated screws alone (cannulated screw group) and 26 with internal fixation using three cannulated screws combined with double-barrel fibular allograft (cannulated screw combined with bone grafting group). The operation time, intraoperative blood loss, length of hospital stay, and quality of fracture reduction were compared between the two groups. At 4, 8 months after operation and at the last follow-up, grading of femoral neck shortening, number of patients walking with crutches, Barthel index, and Harris hip function score were evaluated. The incidence of complications was measured at the last follow-up.Results:All the patients were followed up for 16-37 months [(23.2±4.5)months]. The operation time of the cannulated screw combined with bone grafting group was (86.3±16.1)minutes, longer than (76.9±20.8)minutes of the cannulated screw group ( P<0.05). The intraoperative blood loss was 100.0(50.0, 200.0)ml in the cannulated screw combined with bone grafting group, more than 50.0(50.0, 100.0)ml in the cannulated screw group ( P<0.01). There were no significant differences in the length of hospital stay or the quality of fracture reduction between the two groups ( P>0.05). At 4 months after operation, grading of the femoral neck shortening in the cannulated screw combined with bone grafting group [24 patients (92.3%) with grade 1, 2(7.7%) with grade 2, and 0(0.0%) with grade 3] was better than that in the cannulated screw group [18 patients (36.7%) with grade 1, 28(57.1%) with grade 2, and 3(6.2%) with grade 3] ( P<0.01). At 8 months after operation, grading of femoral neck shortening in the cannulated screw combined with bone grafting group [22 patients (84.6%) with grade 1, 3(11.5%) with grade 2, and 1(3.8%) with grade 3] was better than that in the cannulated screw group [13 patients (26.5%) with grade 1, 27(55.1%) with grade 2, and 9(18.4%) with grade 3] ( P<0.01). At the last follow-up, grading of femoral neck shortening in the cannulated screw combined with bone grafting group [19 patients (73.0%) with grade 1, 5(19.2%) with grade 2, and 2(7.6%) with grade 3] was better than that in the cannulated screw group [8 patients (16.3%) with grade 1, 31(63.2%) with grade 2, and 10(20.4%) with grade 3] ( P<0.01). At 4, 8 months after operation and at the last follow-up, 12(46.2%), 8(30.8%) and 5(19.2%) patients in the cannulated screw combined with bone grafting group and 38(77.6%), 27(55.1%) and 20(40.8%) patients in the cannulated screw group had to walk with crutches, respectively, showing significant difference between the two groups at the other two time points ( P<0.05 or 0.01) except for at the last follow-up ( P>0.05). The Barthel index values were 85.3±3.2, 90.3±4.3, and 95.3±3.9 in the cannulated screw combined with bone grafting group at 4, 8 months after operation and at the last follow-up, significantly higher than 80.8±7.3, 85.4±7.4, and 90.9±7.8 in the cannulated screw group ( P<0.05 or 0.01). The Harris hip scores were (87.0±2.9)points, (92.0±2.9)points and (91.3±2.4)points in the cannulated screw combined with bone grafting group at 4, 8 months after operation and at the last follow-up, significantly higher than (81.0±6.1)points, (85.7±5.8)points, and (89.6±2.0)points in the cannulated screw group ( P<0.01). At the last follow-up, the complication rate was 3.8%(1/26) in the cannulated screw combined with bone grafting group, significantly lower than 22.4%(11/49) in the cannulated screw group ( P<0.05). Conclusion:For femoral neck fractures in young and middle-aged patients, compared with internal fixation using cannulated screw alone, internal fixation using cannulated screw combined with fibular allograft has more advantages in correcting femoral neck shortening, restoring independent living activities and hip joint function, and reducing the incidence of complications despite its longer operation time and more intraoperative blood loss.