Objective:To investigate the relationship between 21-gene recurrence risk score (21-Gene RS) and the prognosis and clinicopathological features of hormone receptor (HR) positive, HER2-negative early breast cancer patients who did not receive neoadjuvant therapy.Methods:A total of 469 patients with HR positive and HER2-negative early breast cancer who received surgical treatment in the First Affiliated Hospital, Zhejiang University School of Medicine from January 2014 to October 2017 were selected. Their clinicopathological data were retrospectively analyzed. Tumor tissue samples were collected from patients, and the expression of 21-gene was detected by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR). The 21-Gene RS was calculated according to the Trial Assigning Individualized Options for Treatment (TAILORx) RS grouping and National Surgical Adjuvant Breast and Bowel Project B-20 (NSABP B-20) RS grouping principles. Patients were divided into low (21-Gene RS<11 or 21-Gene RS<18), intermediate (11≤21-Gene RS<26 or 18≤21-Gene RS<31) and high (21-Gene RS≥26 or 21-Gene RS≥31) risk groups, and the clinicopathological features and prognostic differences of patients in different risk groups were compared. Statistical data were compared by chi-square test. Survival analysis was performed using Kaplan-Meier curve analysis and the differences between groups were compared using Log-rank test. Multivariate analysis was conducted by COX regression analysis.Results:Based on TAILORx RS grouping, the proportions of low-risk, intermediate-risk and high-risk groups among the 469 patients were 18.8% (88/469), 48.2% (226/469) and 33.0% (155/469), respectively. Based on NSABP B-20 RS grouping, the proportion of low-risk, intermediate-risk and high-risk groups were 43.1% (202/469), 37.5% (176/469) and 19.4% (91/469), respectively. The association of 21-Gene RS with histological grading, luminal typing, Ki-67 expression, and chemotherapy and treatment modalities were statistically significant ( P<0.05) regardless of TAILORx RS grouping or NSABP B-20 RS grouping. Kaplan-Meier survival curve suggested poor prognosis in high-risk group ( P<0.05, Log-rank test). Multivariate COX regression analysis showed that surgical method and 21-Gene RS were risk factors affecting the prognosis of patients. Conclusions:21-Gene RS is significantly associated with the prognosis of patients with HR-positive, HER2-negative, early-stage breast cancer not receiving neoadjuvant therapy, as well as with their clinicopathological characteristics such as patients′ histologic grade, luminal typing, Ki-67 expression, and whether or not they are treated with chemotherapy or other treatment modalities.The 21-Gene RS threshold of 11 and 26 or 18 and 31 can be used to grade the prognosis in Chinese patients with early-stage breast cancer. More researches are needed to guide the selection of postoperative adjuvant therapy for patients with HR-positive and HER2-negative early-stage breast cancer.

Humans ; Aripiprazole/therapeutic use* ; Schizophrenia/drug therapy* ; Antipsychotic Agents/therapeutic use* ; Risperidone ; China ; Treatment Outcome

Objective To study the expression feature and clinical significance of plasma Protein C(PC) in pre‐PICC placement and post‐PICC placement in patients with cancer .Methods The levels in plasma of PC was tested by ELISA in patients with cancer in one day before PICC placement ,in one day ,30 day ,and 90 day after PICC placement ,the change of feature and clinical signifi‐cance was analyzed .Results The levels of PC in one day after PICC placement were 3 .74 ± 1 .99 μg/L ,the levels was lower than the levels of in one day before ,and in 30 ,90 day after PICC placement ,which were 5 .00 ± 2 .40 ,4 .78 ± 2 .41 and 5 .35 ± 2 .71 μg/L (q=3 .74 ,2 .85 and 4 .58 respectively ,P<0 .05);There were no statistical significance both in D‐D levels and PLT count among pre‐PICC and post‐PICC placement(P>0 .05);There were no correlation both PC levels and D‐D levels ,and both PC levels and PLT count(r= -0 .024 1 and 0 .111 0 ,all P>0 .05) .Conclusion The PC levels in one day after PICC placement were lower ,but there were no correlation both PC and D‐D ,and PLT .PICC catheter were safety .

Objective To identify the relationship between impaired glucose regulation of neuronal apoptosis in hip-pocampus and the ability of learning/memory in rats.Methods The model rats were made by high fat and sugar diet;The morris water maze was used to detect the learning and memory function;The TUNEL method was used to detect neuronal apoptosis in hippocampus .Expression of Bcl-2/Bax and Bcl-2 mRNA/Bax mRNA factor in hippo-campus neurons was detected with immunohistochemistry and in situ hybridization .Results Compared with NGT group, in IGR group the learning and memory ability were meaningfully decreased (P<0.05);the number of neuro-nal apoptosis in hippocampus was increased significantly ( P<0.05 ); the expression of Bcl-2 and Bcl-2 mRNA in hippocampus decreased significantly ( P<0.05);the expression of Bax and Bax mRNA in hippocampus increased sig-nificantly ( P<0.05 );The ability of learning and memory was positively correlated with expression of Bcl -2 ( P<0.05) and negatively correlated to the expression of Bax (P<0.05).Conclusions There is a relationship between impaired glucose regulation and the ability of learning and memory in rats , its mechanism may be potentially related to hippocampal neuronal apoptosis .

Objective To investigate the effect of CT perfusion (CTP) imaging guidance in the treatment of acute cere?bral infarction. Methods Patients (n=200) with acute cerebral infarction who visited our clinic within 6 hours underwent CTP examination and were divided into two groups:penumbra group and non-penumbra group according to their CTP imag?ing (presence of penumbra or not). Recombinant tissue plasminogen activator (rt- PA) was administrated for intravenous thrombolysis in both groups. NIHSS (The NIH Stroke Scale), BI (Barthel Index), mRS (modified Rankin Scores) and hemor?rhagic transformation events of two groups were determined before and after thrombolysis to evaluate its effect and prognosis in these two group. Results Compared with non penumbra group, NIHSS was reduced in penumbra group from 7 days after rt-PA (6.67±3.46 vs 4.76±2.04), and this decrease became obvious at 4 weeks after rt-PA (6.67±3.46 vs 3.68±1.93). Effi?ciency rate at 4 week (60.3%) and good prognosis rate at 3 months(71.7%)were both significantly improved in penumbra group than those in non penumbra group(34.7%,56.8%). Conclusion rt-PA under CTP guidance is effective and safe in the treatment of acute cerebral infarction. The thrombolytic therapy window can be enlarged according to the presence of pen?umbra or not and the bleeding conversion rate remains at low level.

Objective Ti explire the periiperative cimplicatiins and nursing ciuntermea-sures in elderly patients with hip replacement.Methods The periiperative cimplicatiins,han-dling methid and nursing ciuntermeasures if 150 senile patients with hip replacement were retri-spectively analyzed.Results In all patients,there were 12 patients with varying degrees if liwer bliid pressure because if bine cement reactiin,15 patients with delirium,13 patients with thrim-bisis if deep vein,2 patients with pulminary embilism,3 patients with dislicatiin if hip jiint. After timely and effective nursing,there were 1 patient with pulminary embilism and 1 dead pa-tient caused by dislicatiin if hip jiint,and the ithers were all healed.Conclusions Predictive preventiin frim the periiperative cimplicatiins with priper nursing ciuntermeasures can help se-nile patients ti get thriugh periiperative periid,prevent pistiperative cimplicatiin and ti imprive the clinical curative rate.

Objective Ti explire the periiperative cimplicatiins and nursing ciuntermea-sures in elderly patients with hip replacement.Methods The periiperative cimplicatiins,han-dling methid and nursing ciuntermeasures if 150 senile patients with hip replacement were retri-spectively analyzed.Results In all patients,there were 12 patients with varying degrees if liwer bliid pressure because if bine cement reactiin,15 patients with delirium,13 patients with thrim-bisis if deep vein,2 patients with pulminary embilism,3 patients with dislicatiin if hip jiint. After timely and effective nursing,there were 1 patient with pulminary embilism and 1 dead pa-tient caused by dislicatiin if hip jiint,and the ithers were all healed.Conclusions Predictive preventiin frim the periiperative cimplicatiins with priper nursing ciuntermeasures can help se-nile patients ti get thriugh periiperative periid,prevent pistiperative cimplicatiin and ti imprive the clinical curative rate.

Objective To analyze the clinical characteristics and resistance of group B hemolytic streptococcus septicemia in neonates,and to provide the evidence for clinical treatment.Methods 7 neonates with group B hemolytic streptococcus septicemia hospitalized from Jan.2001 to Aug.2011 were enrolled in this study.The clinical data and laboratory results of antimicrobial sensitivity were analyzed retrospectively.Results There were 4 cases of early-onset infection and 3 cases of late-onset infection,6 cases with leukopenia,6 cases with c-reactive protein elevated,4 cases with suppurative meningitis,3 cases with septic shock and 2 cases with disseminated intravascular coagulation.All strains were sensitive to penicillin, vancomycin and linezolid.Conclusion Attention should be paid to neonatal group B hemolytic streptococcus septicemia.Penicillin and vancomycin are first choice for this type of infection.

Objective To summarize the expression of CK19, HBME-land 34βE12 in papillary carcinoma of the thyroid (PCT) and their differential diagnostic value. Methods Clinical data of papillary carcinoma of the thyroid,nodular goiter and paraeareinoma were reviewed. All HE slides were reexamined and immunostains for CK19, HBME-land 34βEI2 were performed in selected case. Staining results were evaluated. Results Those cases typically showed complex papillary structures and interstitial fibrosis, while nuclear features included ground class appearance, grooves and nuclear pseudoinelusion. The positive rates for CKI9, HBME-1 and 34βE12 in PCT were 100.0 %, 89.4 % and 42.6 % respectively, the differences were statistically significant(P <0.01). Conclusion PCT occurs preferentially in the group of middle-aged women. The diagnosis of PCT should be distinguished from other plesiomorphous benign papillary lesions. Combined detection of CK19, HBME-1, 34βE12 can be most helpful for diagnosis for of PCT.

A total of 203 hypertensive patients with established health files received standard disease management for 1 year. We found that the patients who underwent grade 2 or 3 management showed statistically significant difference in exercise, salt and oil restriction, body mass index (BMI), waist to hip ratio, blood pressure, and blood-lipid from baseline (all P < 0.05). Hypertension awareness, behavior improvement, and disease control had statistically significant difference from baseline in all the patients (P < 0.05 or P < 0.001). After one year's intervention, the patient number in each grade was largely changed. Our study suggests that hierarchical hypertension management might be practical and effective in communities.