Breast cancer has become the malignant tumor with the highest incidence rate among women， seriously threatening the life and health of women all over the world. The pathogenic factors and development mechanisms of breast cancer are complex and diverse. The development of breast cells from ordinary hyperplasia to atypical hyperplasia， and from pre-cancerous lesions to cancerous lesions， is a long-term progressive process. Therefore， early screening and prevention of breast cancer is particularly important. Western medicine has a relatively mature treatment program for breast cancer， which is mainly based on surgery and systemic treatment， whereas the ensuing complications and adverse reactions often bring a heavy burden to patients. For the precancerous lesions of breast cancer， surgery is also the mainstay of treatment. In recent years， traditional Chinese medicine （TCM） has increasingly highlighted its advantages in the prevention and treatment of breast cancer. Increasing studies have shown that in the prevention and treatment of breast cancer and pre-cancerous lesions， TCM compound prescriptions， single herbs or herb pairs， and active components are able to regulate a variety of intracellular signaling pathways through multi-targets to inhibit the proliferation and invasion， promote the apoptosis and autophagy of tumor cells， and regulate the cell cycle and the immune microenvironment， thus exerting anti-tumor effects. At the same time， they can significantly attenuate the toxic side effects of radiotherapy and drug resistance of patients. However， the specific mechanisms of TCM in the prevention and treatment of breast cancer and precancerous lesions have not been fully clarified. The available studies are tanglesome regarding the TCM inhibition of tumor development through the regulation of classical signaling pathways such as phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， Wnt/β-catenin， and Notch， which still need to be verified by a large number of clinical and experimental studies. Therefore， this paper reviews the research progress in the prevention and treatment of breast cancer and precancerous lesions by TCM through interfering with the relevant signaling pathways in recent years， aiming to summarize the possible mechanisms of TCM in the prevention and treatment of breast cancer and provide references for subsequent studies.

Objective:To analyze the predictive ability of model for end-stage liver disease (MELD)-sarcopenia score in short-term prognosis of patients with acute-on-chronic liver failure (ACLF).Methods:Two hundred and seventy-one patients with ACLF hospitalized in Tianjin Third Central Hospital from January 2013 to December 2019 were selected, among whom 157 cases with sarcopenia and 114 cases without sarcopenia.According to ACLF classification, the patients were divided into group A (no cirrhosis basis) of 61 cases, group B (compensated cirrhosis basis) of 99 cases, and group C (previous history of uncompensated cirrhosis) of 111 cases.The basic data, laboratory examination results, computed tomography (CT) examination results and prognosis of the patients were retrospectively collected, and the MELD score, MELD-Na score and MELD-sarcopenia score were calculated. Multivariate logistic regression, multivariate Cox proportional hazards regression, Kaplan-Meier method, log-rank method and area under receiver operating characteristic curve were used for statistical analysis.Results:Low body mass index (odds ratio ( OR)=0.93, P<0.001), complicated cirrhosis ( OR=1.14, P=0.004), complicated hepatic encephalopathy ( OR=1.31, P<0.001), high white blood cell level ( OR=1.18, P=0.009) and high platelet level ( OR=1.08, P<0.001) were independent risk factors for sarcopenia in patients with ACLF. High MELD score (hazard ratio ( HR)=1.02, P=0.001), high MELD-Na score ( HR=1.07, P=0.038), high MELD-sarcopenia score ( HR=1.14, P<0.001), high total bilirubin ( HR=1.00, P<0.001) and high international normalized ratio (INR) ( HR=1.71, P<0.001) were independent risk factors for death in patients with ACLF. In subgroup analysis, the cumulative survival rate of sarcopenia patients in group A and B was lower than that of non-sarcopenia patients ( χ2=5.97 and 8.34, respectively, P=0.015 and 0.004, respectively), while there was no significant difference in the cumulative survival rate between sarcopenia patients and non-sarcopenia patients in group C ( χ2=4.90, P=0.053). In groups A and B, the area under the curve (AUC) of MELD-sarcopenia score in predicting short-term prognosis was 0.87, which was higher than MELD score (0.78) and MELD-Na score (0.78), and the differences were both statistically significant ( Z=2.86 and 2.56, respectively, P=0.004 and 0.011, respectively). The AUC of MELD-Na score in predicting short-term prognosis in group C (0.83) was higher than that of MELD score (0.71) and MELD-sarcopenia score (0.69), and the differences were both statistically significant ( Z=2.52 and 2.64, respectively, P=0.012 and 0.008, respectively). Conclusions:Patients with ACLF with no cirrhosis basis or compensated cirrhosis basis complicated with sarcopenia have shorter survival time and worse prognosis than those without sarcopenia. For patients with ACLF with no cirrhosis basis or compensated cirrhosis basis, MELD-sarcopenia score has better predictive value for the short-term prognosis.

Objective:To explore the causes and preventive strategies of adverse reactions of blood transfusion in patients with hematological diseases.Methods:The clinical data of 150 hematological patients who received 5 184 cases of blood transfusion in Beijing No.6 Hospital from January 2014 to December 2017 were retrospectively analyzed. The blood transfusion adverse reaction reporting forms were collected, and the content of the form included the basic information of the patient, diagnosis, blood transfusion type, blood transfusion time, blood transfusion history, pregnancy history, adverse reaction history of blood transfusion as well as detailed records of clinical symptoms. The blood bank summarized the blood transfusion adverse reaction reporting forms every week.Results:A total of 112 cases of adverse reactions occurred in 5 184 cases of blood transfusion, the incidence rate was 2.16%. Sixty-eight cases (1.32%) had anaphylaxis, mainly caused by platelet transfusion, and 44 cases (0.85%) had fever, mainly caused by transfusion of red blood cells suspension, and no other adverse reactions were found. The incidence rates of adverse reactions of blood transfusion in patients with blood transfusion history and anaphylaxis history were significantly higher than those in patients without blood transfusion history and anaphylaxis history, and the differences were statistically significant [2.34% (102/4 350) vs. 1.20% (10/834), χ2 = 6.899, P = 0.009; 3.06% (98/3 200) vs. 1.42% (14/984), χ2 = 7.767, P = 0.005]; the incidence rate of adverse reactions of blood transfusion in female patients was significantly higher than that in male patients, and the difference was statistically significant [2.82% (60/2 126) vs. 1.70% (52/3 058), χ2 = 8.356, P = 0.004]; there was no significant difference in the incidence rate of adverse reactions of blood transfusion between patients < 18 years old and ≥ 18 years old [1.16% (3/259) vs. 2.21% (109/4 925), χ2 = 1.295, P = 0.255]. Conclusions:The main manifestations of adverse reactions of component blood transfusion are anaphylaxis and non-hemolytic fever. Clinical medical staff must carefully control the blood transfusion indications and select the appropriate blood components to reduce the adverse reactions of blood transfusion and ensure the safety of blood transfusion.

BACKGROUND:Due to the complexity and irregularity of bypass obturation of oval root canal and the particular stress of the post and core to the tooth, we have not yet found a reasonable post crown for dental restoration after bypass obturation of the oval root canal.
OBJECTIVE:To compare the flexural capacity of the three kinds of post-and-core repair systems (cobalt-chromium cast post and core, zirconium oxide post and core, and CAD/CAM-fabricated glass fiber post and core) after bypass obturation of the oval root canal warm gutta.
METHODS: Ninety mandibular first premolars were selected for bypass obturation of the root canal with Obtura II & System B, and then randomized into three groups that were respectively restored with cobalt-chromium cast post and core, zirconium oxide post and core and CAD/CAM-fabricated glass fiber post and core. After that, cobalt-chromium metal crown was used for ful-crown restoration. Fracture strength and fracture type were recorded in different groups.
RESULTS AND CONCLUSION: The fracture resistance was higher in the cobalt-chromium cast post and core group and zirconium oxide post and core group than the glass fiber post and core group (P < 0.05), and the former two groups had no significant difference. Cobalt-chromium cast post and core was fractured at the root of tooth, and could not be repaired; the zirconium oxide post and core was fractured at the root neck and root of tooth, which was confirmed as reparative fracture; the glass fiber post and core was fractured at the tooth neck, which could be restored. These findings indicate that the cobalt-chromium cast post and core can bear greater occlusal force, but has a higher probability of root fracture; the CAD/CAM-fabricated glass fiber post and core exhibits a lower probability of root fracture