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乳腺癌是一种严重危害女性健康的恶性肿瘤。随着对乳腺癌发病机制认识的不断深入和分子生物学技术的发展，乳腺癌的治疗进入了分子靶向治疗的新时代，并不断取得新进展。目前，针对乳腺癌的分子靶向药物不断出现，主要包括针对雌、孕激素受体的内分泌治疗药物，针对表皮生长因子受体2的药物，磷脂酰肌醇3激酶(PI3K)/Akt/哺乳动物雷帕霉素靶蛋白(mTOR)信号通路抑制剂、抗血管生成药物，针对BRCA1/2突变的多聚二磷酸腺苷核糖聚合酶抑制剂，细胞周期蛋白依赖性激酶4/6抑制剂等。由于某些信号通路异常可发生于不同分子分型乳腺癌中，因此同一类分子靶向药物在不同分子分型乳腺癌中存在交叉使用。.

To investigate the characteristics of screen time and its risk factors in Chinese primary and middle school students.During April 2012 and June 2012, according to the geographical distribution, the stratified random cluster sampling method was used to select 4 provinces from eastern, central and western China, respectively. The convenience sampling method was used to select 2 primary and middle schools from urban, 2 primary and middle schools from rural in each province. In each school, all grades were included, and 2 classes were selected in each grade. A total of 51 866 students or parents were selected as study participants, and 43 771 questionnaires were valid. Information on demographics, academic performance, screen time (TV, computer and cellphone) at weekdays and weekends and the prevalence of the high screen time were compared, multivariate logistic regression was used to analyze the association between screen time2 h/d and potential influential factors.The percentage of students with screen time2 h/d at weekdays and weekends were 16.2% (7 082/43 771) and 41.5% (18 141/43 771) (χ(2)=6 280.14, P0.001), respectively. The distribution of P50 (P25-P75) for screen time at weekdays and weekends were 0.9(0.4-1.6) and 1.8(1.0-3.0) (Z=-131.26, P0.001), respectively. The results of multinomial logistic regression analysis showed that, at weekdays, subjects characterized as primary school students, boys, urban area, living in western area and sufficient vigorous physical activity ≤2 d/w had higher risk for screen time2 h/d than those characterized as elementary school students, girls, rural area, living in eastern area and sufficient vigorous physical activity3 d/w, odds ratio were 2.01, 1.54, 1.21, 1.09, and 1.07, respectively (P0.05 for all); subjects characterized as a normal or worse self rating academic performance had higher risk for screen time2 h/d than those characterized as a good self rating academic performance, odds ratioes were 1.24 and 1.73, respectively (P0.05 for all); subjects characterized as paternal education level as elementary school, middle school, high school or secondary school had higher risk for screen time2 h/d than those characterized as paternal education level as college school or high, odds ratioes were 1.41, 1.47 and 1.52, respectively (P0.05 for all); subjects characterized as maternal education level as elementary school, middle school and high school or secondary school had higher risk for screen time2 h/d than those characterized as maternal education level as college, odds ratioes were 1.40, 1.52 and 1.47, respectively (P0.05 for all). At weekends, subjects characterized as primary school students, boys, urban area and sufficient vigorous physical activity ≤2 d/w had higher risk for screen time2 h/d than those characterized as elementary school students, girls, rural area and sufficient vigorous physical activity3 d/w, odds ratioes were 2.11, 1.51, 1.20 and 1.05, respectively (P0.05 for all). At weekends, subjects characterized as a normal or worse self rating academic performance had higher risk for screen time2 h/d than those characterized as a good self rating academic performance, odds ratioes were 1.09 and 1.26, respectively (P0.05 for all); subjects characterized as paternal education level as elementary school, middle school, high school or secondary school had higher risk for screen time2 h/d than those characterized as paternal education level as college school or high, odds ratioes were 1.29, 1.30 and 1.19, respectively (P0.05 for all); subjects characterized as maternal education level as elementary school, middle school had higher risk for screen time2 h/d than those characterized as maternal education level as college school or high, odds ratioes were 1.19 and 1.16 and, respectively (P0.05 for all).The prevalence of screen time2 h/d is high; screen time at weekdays is longer than weekends, and there are significant differences among different sexes, urban or rural areas, living areas, self rating academic performance, parents education levels and physical activity groups.

Despite more than a century of intensive study, the mechanisms of successful pregnancy remain unclear. Recent research suggests that NF-κB (nuclear factor kappa B) plays an important role in embryo implantation. In the current study, we aimed to identify SNPs that contribute to genetic susceptibility for recurrent implantation failure (RIF). Thus, we examined the potential associations between RIF and ten SNPs (rs28362491, rs3774932, rs1598856, rs230528, rs230521, rs3774956, rs4648055, rs3774964, rs4648068, and rs3774968) of the NF-κB gene. Participants included 209 patients with RIF and 395 controls. Our results revealed that there were statistically significant differences observed in the allelic and genotypic frequencies of the rs28362491 promoter in the NF-κB gene. The frequency of the del/ del genotype was significantly higher in RIF patients than in healthy controls (P = 0.004). Compared with healthy controls, the RIF patients carried a higher frequency of the rs28362491 del allele (P = 0.010). Furthermore, strong linkage disequilibrium was observed in the three identified haplotype blocks (D' > 0.9). Particularly, in block 1 (rs230528-rs230521), the A-C haplotype occurred significantly more frequently (P = 0.029) in subjects with RIF (P = 0.0003). In contrast, the A-G haplotype occurred significantly less frequently (P = 0.008) in RIF subjects. These findings support an important role for G-712A polymorphisms of NF-κB in RIF, and may guide future studies that aim to characterize genetic risk factors for RIF.

To explore the correlation between thyroid peroxidase antibody(TPOAb)and outcomes during pregnancy and the effects of treatment on outcomes.PubMed, Cochrane Library, Science Direct, Embase, Chinese Biomedicine, and Wanfangdata had been searched. Case-control and cohort studies about TPOAb and pregnancy outcomes were searched according to the inclusion and exclusion criteria. Fifty studies were finally recruited(all of cohort-studies, 10 for English and 5 for Chinese). Review Manager 5.3 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models.Meta-analysis showed TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery, OR calculated were 2.02(95%CI: 1.13-3.62, P=0.001)and 1.39(95%CI: 1.11-1.76, P=0.005), while showed no relative risk to hypertensive disease, placental abruption in pregnancy and fetal growth restriction, OR calculated were 1.29(95%CI: 1.00-1.67, P=0.080), 0.42(95%CI: 0.12-1.43, P=0.210)and 1.61(95%CI: 0.23-11.12, P=0.100). TPOAb(+)with normal thyroid function increase miscarriage in in vitro fertilization and embryo transfer(IVF-ET), OR calculated were 2.14(95%CI: 1.43-3.21, P=0.000). Levothyroxine(LT4)for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes, OR calculated were 0.43(95%CI: 0.22-0.85, P=0.020).TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery. TPOAb(+)with normal thyroid function increase miscarriage in IVF-ET. LT4 for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes.

To investigate the incidence, influencing factors and intervention of gestrinone-related abnormal uterine bleeding at different dosage of gestrinone in the clinical treatment.This was a multicenter, randomized, control study of 195 Chinese women with endometriosis or adenomyosis from June 2011 to November 2013. The subjects were randomized into three groups with oral administration of gestrinone, 2.5 mg dose at one time; twice a week group: 67 cases with oral administration twice a week last three months; double dose first month group: 67 cases with oral administration triple times a week at first month, then twice a week for two months; three times a week group: 61 cases with oral administration three times a week last three months. The improvement of the abnormal uterine bleeding, the changes in estrogen, liver function and blood coagulation were evaluated. At the same time, B-ultrasound examination evaluation were performed.(1) Three months later, the incidence of abnormal uterine bleeding in twice a week group was 30% (20/67), in double dose first month group and three times a week group were 7%(5/67) and 16% (10/61) respectively, there were significant difference between three groups (P0.05). The incidence in double dose first month group was the most lower. (2) Univariate analysis showed that the dosage and ovarian size were the significant factors for abnormal uterine bleeding (OR=0.461,P= 0.003;OR=0.303,P=0.016); logistic regression analysis demonstrated that the risk of abnormal uterine bleeding in double dose first month group was the lowest when compared with twice a week group and three times a week group, the risk in twice a week group was 5-fold higher than that in double dose first month group (OR=0.211,P=0.011). The incidence of abnormal uterine bleeding in participants with abnormal ovarian volume results from ovarian cyst or ovarian surgery was significantly lower than those with normal ovarian volume (OR=0.304,P=0.018). (3) After the treatment of three months, there were no significant difference in alanine transaminase level between the groups (P0.05). The body mass index significantly increased in three group (P0.05), but there were no significant differences between the groups (P0.05). As for blood coagulation, there were also no significant differences between the groups (P0.05).Double dose of gestrinone in the first month could significantly decrease the incidence of gestrinone-related abnormal uterine bleeding. It is a more optimied dosage of gestrinone and without severe side effects.Chinese Clinical Trial Registry, registration number: ChiCTR-TRC-12002327.

At the peak of the SARS epidemic in Hong Kong, hospital workers were under high risks of contraction of the infection. Herbal preparations had been used historically in China to treat influenza-like diseases. During the SARS outbreak, herbal preparations had been used jointly with standard modern treatment in China. As a means to protect the at-risk hospital workers, an innovative herbal formula was created and consumed by 3160 of them in two weeks. During the two weeks, symptoms and adverse effects were close monitored; 37 of them had their serum checked for immunological responses. The results showed that none of the herb consumers contracted the infection, compared to 0.4% among the non-consumers. Adverse effects had been infrequent and mild. There were hardly any influenza-like symptoms and the quality of life improved. In the group who volunteered to have their immunological state checked, significant boosting effects were found. It was concluded that there might be a good indication for using suitable herbal preparations as a means of preventing influenza-like infection. The mode of preventive effect could be treatment of the infection at its very early stage instead of producing a period of higher immunological ability, as in the case of vaccination.

A patient with sternal fibrous dysplasia was treated via subtotal sternectomy using a sandwich titanium micromesh and polypropylene mesh to repair the chest wall defect. Pectoralis muscle flaps were created to cover the prosthesis. The patient had a normal postoperative course with good stability and postoperative cosmesis.

Transplantation of myelin-forming cells is a promising strategy for the treatment of myelin disorders. In this study, transplantation of glial cell progenitors into the cerebral ventricles of the embryonic myelin-deficient rat, a model of Pelizaeus-Merzbacher disease, was performed to assess the ability of these cells to incorporate into the developing brain and produce myelin. The donor cells migrated into the white and gray matter and produced myelin at widespread sites ranging from the corpus callosum and optic nerve to the cerebellum. These data suggest that myelin repair might be achieved by intraventricular delivery and transependymal incorporation of myelin-producing cells. Because these cells were genetically transduced to express a reporter gene, similar ex vivo manipulation with genes known to promote survival, migration, or proliferation of the transplanted cells could be used to enhance repair. Such a therapeutic strategy may be feasible in patients with inherited myelin disorders or in multiple sclerosis, particularly where the lesions are periventricular.

60 eyes of 60 cases with complicated retinal detachment were treated by vitrectomy combined with silicone oil tamponade, including grade D of proliferative vitreoretinopathy (PVR) in 27, giant retinal tears with posterior flaps folded up in 15, posterior polar or macular holes in 13 and traumatic PVR in 5 eyes. After 3-24 months of follow-up, it is shown that 48 eyes obtained anatomic reattachment, the success rate being 80%, and the post-operative visual acuities improved in 43 eyes of which 32 eyes achieved0.05. The authors consider that vitrectomy and membrane peeling create a situation for silicone oil tamponade to play its role fully, vitrectomy is perfected by the combination of silicone oil tamponade and the rate of success of the retinal detachment operation is increased. The theory, indications, advantages and disadvantages of silicone oil tamponade were briefly discussed.

This study reviews the results of common bile duct exploration (CBDE) in 43 cases for suspected stones in the process of laparoscopic cholecystectomy (LC). Stones found and removed laparoscopically in 32 cases were 4.0-25.0mm in diameter and with the number ranging from 1 to 40 in a single patient. Exploration was negative in 11 patients (25.6%). AT-tube was inserted into the CBD in all patients exception 9. Two patients suffered from postoperative peritonitis including in one occurring in post-operation day 1 because of dislocated T-tube, and in the other after removing the tube 5 weeks postoperatively. Two patients had a retained stone. Our results suggest that laparoscopic CBDE is a feasible and effective measure for patients with choledocholithiasis.

Using the indirect immunofluorescent assay, we observed the variation of T-lymphocyte subsets of peripheral blood in 100 patients of primary bronchogenic carcinoma and 31 cases with active pulmonary tuberculosis. Serum CEA were measured simultaneously. The decrease of OKT3+, OKT4+, OKT8+ lymphocytes were significant in patients with lung cancer than that in healthy controls (P less than 0.01). The ratio of OKT4+/OKT8+ increased. It suggested that both cellular immunoincompetence and immunoregulatory abnormality were present in patients with lung cancer. After the resection of tumors 65 cases, the percentage of OKT4+ cells increased at the first week. Fourty seven cases were observed continuously for six months, it was found that OKT8+ cells increased (P less than 0.01). After anticancer chemotherapy, the patients with small cell carcinoma revealed a similar changes too. After operation and chemotherapy, serum CEA level decreased significantly too.

Chromosome breakage can lead to teratology and neoplasia, although mutagenicity is not identical with carcinogenicity. The human chorionic villus micronucleus (CVMN) test was first developed in 1987 to study the mutagenicity of smoking, drinking, and contraceptives on offspring. 507 couples were studied, and human chorionic villi were taken from abortion material of women aged 18-43 with gestation of 10 weeks. None of these women drank; however, among their husbands there were 172 smokers (2-40 cigarettes/day for 2-20 years), 15 who drank (.5-3 liters of liquor/month for 2-20 years), 107 smoked and drank (1-40 cigarettes/day for 2-10 years and .5-3 liters of liquor/month for 2-15 years), and 115 nondrinking and nonsmoking controls. Micronuclei (MN) were scored according to Countryman's standard, and 2000 interphase was observed in each subject of CVMN frequency. 1,014,000 interphase cells were scored. There was no correlation between CVMN frequency and maternal age. The difference of the correlation coefficient between CVMN frequency and pregnancy was not statistically significant. 105 women had aborted before, 9 had had spontaneous abortion, and 113 had neither. There were no statistical differences between these women and no correlation with CVMN frequency. The gestation ranged from 32 days to 79 days; again, no correlation was found. The mean frequency of CVMN was significantly higher in those with smoking husbands than in nonsmokers and nondrinkers. The CVMN frequency of women with drinking husbands was also high but without statistical significance. The group with husbands who both smoked and drank had the highest CVMN frequency, but this did not differ significantly from controls. The mutagens and carcinogens of cigarettes linger in the smoke. In addition to effect on the function and MN frequency in the sperm of smokers, the ova and embryo of passive smokers may be affected as damage in the DNA and spindle apparatus of chorionic villi increases the frequency of MN.

50 cases (50 eyes) of various complex retinal detachments (RD) were treated with a combination of vitrectomy, membrane peeling, intraocular air tamponade and scleral encircling. RD with opaque media, RD with proliferative vitroretinopathy, traction RD due to trauma or other factors, RD with posterior breaks, and giant tears were included. During the follow-up periods of 3-12 months, 27 cases (54%) obtained anatomic reattachment, 23 failed (46%). Of the successful case, 24 eyes achieved improvement, 2 eyes remained unchanged, and one eye became worse in their vision. The surgery complications were: retinal haemorrhage, choroidal haemorrhage, iatrogenic tears, and the development of cataract.