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【Objective】 To investigate the status of occult hepatitis B virus infection(OBI) among blood donors in Quzhou, Zhejiang, and to analyze the mutation of S region in blood donors with anti-HBc+ alone and non anti-HBc+ alone. 【Methods】 The OBI samples were screened by ELISA and NAT; the HBV DNA was amplified and sequenced; 20 anti-HBc+ alone and 25 not anti-HBc+ alone samples were obtained. 【Results】 The detection rate of OBI in Quzhou was 0.10%(155/161 045), and the positive rate of anti-HBc was 74.19%(115/155). The detection rate of OBI increased with the age of blood donors(P<0.05), but was not related to gender. The positive rate of anti-HBc+ alone was 22.58%(35/155), and that of not anti-HBc alone was 51.61%(80/155). Among the 45 OBI sequencing samples, the proportion of B and C genotype was 73.33%(33/45) and 20.00%(9/45), respectively. The mutation sites of blood donors in the anti-HBc+ alone group were more than those in the not anti-HBc+ alone group, and the mutation rates of S114T and V168A on MHR were significantly different(P<0.05). 【Conclusion】 The genotype of OBI infection in Quzhou is mainly type B. The mutation sites of blood donors with anti-HBc+ alone are higher than those with not anti-HBc+ alone, which may be more suitable as one of the OBI screening indicators.
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During the development of therapeutic microRNAs (miRNAs or miRs), it is essential to define their pharmacological actions. Rather, miRNA research and therapy mainly use miRNA mimics synthesized in vitro. After experimental screening of unique recombinant miRNAs produced in vivo, three lead antiproliferative miRNAs against human NSCLC cells, miR-22-3p, miR-9-5p, and miR-218-5p, were revealed to target folate metabolism by bioinformatic analyses. Recombinant miR-22-3p, miR-9-5p, and miR-218-5p were shown to regulate key folate metabolic enzymes to inhibit folate metabolism and subsequently alter amino acid metabolome in NSCLC A549 and H1975 cells. Isotope tracing studies further confirmed the disruption of one-carbon transfer from serine to folate metabolites by all three miRNAs, inhibition of glucose uptake by miR-22-3p, and reduction of serine biosynthesis from glucose by miR-9-5p and -218-5p in NSCLC cells. With greater activities to interrupt NSCLC cell respiration, glycolysis, and colony formation than miR-9-5p and -218-5p, recombinant miR-22-3p was effective to reduce tumor growth in two NSCLC patient-derived xenograft mouse models without causing any toxicity. These results establish a common antifolate mechanism and differential actions on glucose uptake and metabolism for three lead anticancer miRNAs as well as antitumor efficacy for miR-22-3p nanomedicine, which shall provide insight into developing antimetabolite RNA therapies.
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Purpose@#Patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer can benefit from trastuzumab deruxtecan. Given the unclear prognostic characteristics of HER2-low breast cancer, we investigated the prognostic characteristics of HER2-low expression from primary tumor to residual disease after neoadjuvant chemotherapy (NACT). @*Materials and Methods@#The data of HER2-negative patients receiving NACT at our center were collected. Pathological complete response (pCR) rate were compared between HER2-0 and HER2-low patients. The evolution of HER2 expression from primary tumor to residual disease and its impact on disease-free survival (DFS) were examined. @*Results@#Of the 690 patients, 494 patients had HER2-low status, of which 72.3% were hormone receptor (HR)–positive (p < 0.001). The pCR rates of HER2-low and HER2-0 patients (14.2% vs. 23.0%) showed no difference in multivariate analysis regardless of HR status. No association was observed between DFS and HER2 status. Of the 564 non-pCR patients, 57 (10.1%) changed to HER2-positive, and 64 of the 150 patients (42.7%) with HER2-0 tumors changed to HER2-low. HER2-low (p=0.004) and HR-positive (p=0.010) tumors before NACT were prone to HER2 gain. HER2 gain patients had a better DFS compared with HER2-negative maintained patients (87.9% vs. 79.5%, p=0.048), and the DFS of targeted therapy group was better than that of no targeted therapy group (92.4% vs. 66.7%, p=0.016). @*Conclusion@#Although HER2-low did not affect the pCR rate and DFS, significant evolution of HER2-low expression after NACT creates opportunities for targeted therapy including trastuzumab.
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Eye organoid refers to a structure that possesses resembling cell types and functions to intraocular tissues, which is induced by stem cells in vitro. Transplanting it into the body for eye repair and regeneration is one of the key research directions in regenerative medicine, which also provides a novel direction and strategy for the treatment of major blinding diseases. As a carrier of biological tissue or cell growth, tissue engineering scaffold could support in vivo transplantation of eye organoids and promote their maturation. Organic combination of eye organoids and tissue engineering is a critical approach to realize in vivo integration of eye organoids and reconstruct corresponding structures and functions. In this review, the latest research status of eye organoids and in vivo transplantation were summarized, and relevant studies of tissue engineering scaffold-assisted eye organoid transplantation were highlighted, aiming to provide ideas and reference for subsequent inter-disciplinary research of eye organoids and tissue engineering.
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Objective:To investigate the prognostic value of molecular subtypes in patients with resected invasive breast cancer.Methods:Between 2015 and 2018 7 869 patients with invasive breast cancer after undergoing surgery were included in this analysis. Breast cancer was classified into four subtypes according to the status of hormone receptor (HR) and HER2: HR+/HER2-, HR+/HER2+, HR-/HER2+, and HR-/HER2-. Kaplan-Meier curves and COX regression were used to compare disease-free survival (DFS) and overall survival (OS) among different subtypes.Results:The 5-year DFS and OS were 86.30% and 94.29%, respectively. Proportions of HR+/HER2-、HR+/HER2+、HR-/HER2+ and HR-/HER2- were 52.9%、17.5%、14.1%和15.5%, respectively. The 5-year DFS of HR+/HER2- subtype (88.12%) was higher than HR+/HER2+ (84.67%, P=0.026), HR-/HER2+ (84.19%, P<0.001) and HR-/HER2- (83.70%, P<0.001). The 5-year OS of HR+/HER2- (95.38%) was not different from HR+/HER2+ (95.17%, P=0.187), while it was higher than that of HR-/HER2+ (92.26%, P<0.001) and HR-/HER2- (91.69%, P<0.001). Subtype was still a significant factor regarding DFS and OS in multivariable analyses adjusting for age, sex, stage, Ki67, types and time of surgery. The DFS ( P=0.257) and OS ( P=0.511) was not different between HR-/HER2+与HR+/HER2- subtypes, while HR-/HER2+ and HR-/HER2- patients had worse DFS ( P<0.05) and OS ( P<0.05) than that with HR+/HER2-. Conclusions:Molecular subtype is a significant independent prognostic factor for DFS and OS in operable invasive breast cancer. HR+ subtypes have better prognosis compared with HR- subtypes. The DFS and OS were not different between HR+/HER2- and HR+/HER2+, or between HR-/HER2+ and HR-/HER2-.
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Objective:To evaluate the short time outcome about repairing of lateral incomplete cleft lip with two different treatments: new rotation advancement technique and Tennison technique.Methods:Twenty-seven cases of lateral incomplete cleft lip were repaired by the two different treatments, and 12 indexes were employed to evaluate the short time outcome of post-operation.Results:All the patients who were treated with the new rotation advancement technique and Tennison technique in this study obtained satisfactory lip and nasal symmetry immediately. There was no significant difference between the two techniques in the treatment of the patients with unilateral incomplete cleft lip.Conclusions:Though the new rotation advancement technique does not show the obvious improvements about repairing of lateral incomplete cleft lip, invisible incision and keeping the nostril sill will definitely benefit the patients because of reducing the risk of more scars.
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Objective:To evaluate the diagnosis and critical value reporting of ruptured tubal pregnancy by ultrasound.Methods:The clinical and ultrasound data of 70 patients with ruptured tubal pregnancy diagnosed by surgery in Peking Union Medical College Hospital from August 2017 to May 2021 were retrospectively analyzed to evaluate the diagnosis and critical value reporting of ruptured tubal pregnancy by ultrasound.Results:Among the 70 patients, 68 patients underwent gynecological ultrasonography and two patients did not. Sixty-three cases (92.6%, 63/68) were accurately diagnosed as adnexal ectopic pregnancy mass, abdominal and pelvic effusion/blood clot, and 5 adnexal ectopic pregnancy masses (7.4%, 5/68) were missed.Among the 5 missed cases, 4 cases (80%, 4/5) were heterotopic pregnancy (2 cases of IVF-ET 2 embryos, 1 case of patient taking ovulation induction drugs, 1 case of gravida with twin family history) and 1 case (20%, 1/5) of single tubal pregnancy. Critical values were reported in the all 63 cases of ruptured tubal pregnancy diagnosed by preoperative ultrasound.Conclusions:Ultrasound could accurately diagnose tubal pregnancy and assess its rupture, and timely report the critical value, effectively guarantee the medical safety. The particularity and complexity of ultrasound diagnosis in early pregnancy with assisted reproductive technique deserve more attention.
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OBJECTIVE:To investiga te the clinical efficacy and safety of donepezil monotherapy versus donepezil combined with memoriam in the treatment of Alzheimer ’s disease (AD). METHODS :Totally 100 patients with moderate and severe AD who received medical care in Sichuan Academy of Medical Sciences & Sichuan Provincial People ’s Hospital (East Hospital )from March 2018 to March 2020 were enrolled as study subjects ,and then were divided into control group and treatment group randomly. Control group was given donepezil monotherapy treatment (initial dose of 5 mg/d,before bedtime ;after 4 weeks,the dose was changed to 10 mg/d before bedtime ;the total medication time was 6 months). Treatment group was treated with memantine(initial dose was 5 mg/d,the dose of those without adverse reactions was increased by 5 mg until 20 mg/d,for 6 months)on the basis of the control group ,with 50 patients in each group. Montreal cognitive assessment scale (MoCA)score, MMSE score ,ADL score ,treatment response rate and the occurrence of ADR were compared between 2 groups before and after treatment. RESULTS :Compared with same group before treatment ,MoCA score ,MMSE score and ADL score of the two groups were significantly improved after treatment (P<0.05). After treatment ,compared with control group ,MoCA score ,MMSE score , ADL score and total response rate in the treatment group were significantly increased (P<0.05),while the incidence of ADR was decreased significantly (P<0.05). CONCLUSIONS :Donepezil combined with memantine has better clinical efficacy than donepezil monotherapy in the treatment of moderate and severe AD ,and is helpful to improve the neurological function of AD patients,with good safety.
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Objective:To investigate the effect of a breathing pattern intervention (RPI) on the oral feeding of pre-term infants with suck-swallow-breath (SSwB) coordination disorder.Methods:Sixty pre-term infants with SSwB coordination disorder were divided into an observation group ( n=30) and a control group ( n=30) using a random number table. Both groups were given routine feeding training, including oral exercise intervention, non-nutritive sucking training, and swallowing induction training during nursing, while the observation group was additionally provided with 15 minutes of breathing pattern training once a day, including breathing pattern observation, resistive breathing training prior to eating and passive breathing pattern intervention during eating. Before and after the 7-day intervention, the Pre-term Infant Oral Feeding Readiness Assessment (PIOFRA) was used to evaluate each subject′s oral feeding ability. Rate of transfer (RT), proficiency (PRO), minimum oxygen partial pressure (SaO 2) and SaO 2 fluctuations were also recorded during the feeding process. Results:After 1 week of the intervention, significant improvement was observed in both groups. In the observation group the average RT (2.76±0.36ml/min), PRO, minimum SaO 2, the number of SaO 2 fluctuations, and PIOFRA score (33.28±0.58) were all significantly better than the control group′s averages. Conclusion:Breathing pattern intervention based on routine feeding training can enhance breathing coordination during swallowing and ultimately improve the oral feeding of pre-term infants with SSwB coordination disorders in a relatively short period of time.
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Ubiquitin specific peptidase 28 (USP28) is closely associated to the occurrence and development of various malignancies, and thus has been validated as a promising therapeutic target for cancer therapy. To date, only few USP28 inhibitors with moderate inhibitory activity have been reported, highly potent and selective USP28 inhibitors with new chemotypes remain to be discovered for pathologically investigating the roles of deubiquitinase. In this current study, we reported the synthesis and biological evaluation of new [1,2,3]triazolo[4,5-]pyrimidine derivatives as potent USP28 inhibitors. Especially, compound potently inhibited USP28 (IC = 1.10 ± 0.02 μmol/L, = 40 nmol/L), showing selectivity over USP7 and LSD1 (IC > 100 μmol/L). Compound was cellularly engaged to USP28 in gastric cancer cells. Compound reversibly bound to USP28 and directly affected its protein levels, thus inhibiting the proliferation, cell cycle at S phase, and epithelial-mesenchymal transition (EMT) progression in gastric cancer cell lines. Docking studies were performed to rationalize the potency of compound . Collectively, compound could serve as a new tool compound for the development of new USP28 inhibitors for exploring the roles of deubiquitinase in cancers.
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Objective:To investigate the correlation between ipsilateral metastatic supraclavicular lymph nodes(ISLN) pathologically complete response (spCR) and the prognosis in breast cancer after neoadjuvant chemotherapy(NAC) and lymphadenectomy.Methods:Clinical data of 234 breast cancer patients with ISLN at the time of diagnosis and receiving supraclavicular lymph node dissection following NAC were retrospectively analyzed.Results:All patients were female, with a median age of 52 years. The spCR rate was 52.6%. Multivariate analysis showed that the expression level of Ki67, the pathological status of breast and axillary nodes and the dissection number of supraclavicular lymph node were independent relate factors for spCR (all P<0.05). After a median follow-up of 16.6 months, the risk of recurrence and metastasis in the spCR group was 51%. It was lower than that in the non-spCR group ( HR=0.49, 95% CI 0.27-0.89, P=0.020). It was mainly manifested in hormone receptor negative patients. Supraclavicular spCR was an independent prognostic factor for DFS. Conclusions:The expression level of Ki67, pathological state of breast and axillary node and the dissection number of supraclavicular lymph node were independent related factors of spCR, which was also an independent predictor of DFS.
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Objective:To survey the application of an intelligent consultation system for common eye diseases and evaluate its applicational effectiveness on an internet hospital platform.Methods:A cross-sectional study was performed in Zhongshan Ophthalmic Centre of Sun Yat-sen University.Natural language processing technology was applied to develop the intelligent consultation system for common eye diseases.Its efficiency and quality were evaluated.The survey data were collected from February 1 to 29, 2020 to analyze the demographic information, consultation time, consultation category, consultation content, service satisfaction.This study protocal was approved by an Ethic Committee of Zhongshan Ophthalmic Centre of Sun Yat-sen University(2020KYPJ095).Results:The intelligent consultation system for common eye diseases was developed and successfully deployed in Internet Hospital of Zhongshan Ophthalmic Center.The repeatability and accuracy of the intelligent consultation system were 100.0% and 99.8%, respectively.During February 1 to 29, 2020, the intelligent consultation system served 6 462 patients, including 3 082 males(47.7%) and 3 380 females(52.3%). The average age of patients was 32.3 years old.Total of 1 135(17.6%) patients used the intelligent guidance consultation, and 5 375(82.4%) patients used the intelligent outpatient consultation.The intelligence consultation system was applied by 223 patients per day with a maximum of 74 patients per hour.The survey showed that 25.6% and 36.4% of the patients felt very satisfied and relatively satisfied with the efficiency of the intelligent consultation service, respectively; 24.3% and 37.8% of the patients were very satisfied and relatively satisfied with the quality of the intelligent consultation service, respectively.Conclusions:Intelligent consultation system for common eye diseases can meet the needs of patients because of its high repeatability and accuracy.Patients are satisfied with the service efficiency and quality of the intelligent consultation system, which avoids the risk of cross infection and releases the burden of medical staff.
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MicroRNAs (miRNAs or miRs) are small noncoding RNAs derived from genome to control target gene expression. Recently we have developed a novel platform permitting high-yield production of bioengineered miRNA agents (BERA). This study is to produce and utilize novel fully-humanized BERA/miR-328-3p molecule (hBERA/miR-328) to delineate the role of miR-328-3p in controlling nutrient uptake essential for cell metabolism. We first demonstrated successful high-level expression of hBERA/miR-328 in bacteria and purification to high degree of homogeneity (>98%). Biologic miR-328-3p prodrug was selectively processed to miR-328-3p to suppress the growth of highly-proliferative human osteosarcoma (OS) cells. Besides glucose transporter protein type 1, gene symbol solute carrier family 2 member 1 (GLUT1/), we identified and verified large neutral amino acid transporter 1, gene symbol solute carrier family 7 member 5 (LAT1/) as a direct target for miR-328-3p. While reduction of LAT1 protein levels by miR-328-3p did not alter homeostasis of amino acids within OS cells, suppression of GLUT1 led to a significantly lower glucose uptake and decline in intracellular levels of glucose and glycolytic metabolite lactate. Moreover, combination treatment with hBERA/miR-328 and cisplatin or doxorubicin exerted a strong synergism in the inhibition of OS cell proliferation. These findings support the utility of novel bioengineered RNA molecules and establish an important role of miR-328-3p in the control of nutrient transport and homeostasis behind cancer metabolism.
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OBJECTIVE:To establish a method for the content determination of diosgenin in Dioscorea zingiberensis,and to compare the contents of diosgenin in wild D. zingiberensis from different habitats. METHODS:HPLC method was adopted. The determination was performed on Inertsil ODS-3 column with mobile phase consisted of acetonitrile-water (50 ∶ 50,V/V) at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃. The detection wavelength was set at 203 nm,and sample size was 10 μL. Established method was used to determine the contents of diosgenin in wild D. zingiberensis from different habitats (Shaanxi Shangluo,Shaanxi Ankang,Henan Neixiang,Yunnan Xuanwei,Sichuan Deyang,Hubei Shiyan,Hunan Zhangjiajie,Hunan Changde). The differences of diosgenin content were compared. RESULTS:The linear range of diosgenin were 4.16-165.6 μg/mL (r= 0.999 9). RSDs of precision,reproducible and stability tests were all lower than 2% (n=5 or n=6). The average recovery of diosgenin was 101.18% (RSD=1.27%,n=6). The content of diosgenin in wild D. zingiberensis from different habitats were in descending order,i.e. Sichuan Deyang (1 405.36 μg/g)>Shaanxi Shangluo (1 201.79 μg/g)>Hunan Zhangjiajie (1 035.18 μg/g)>Shaanxi Ankang (632.64 μg/g)>Hunan Changde (598.64 μg/g)>Yunnan Xuanwei (425.34 μg/g)>Henan Neixiang (350.13 μg/g)>Hubei Shiyan (338.39 μg/g). CONCLUSIONS:Established method is simple,accurate and suitable for the content determination of diosgenin in D. zingiberensis. The contents of diosgenin in wild D. zingiberensis from different habitats are different significantly,and the content of diosgenin in the samples from Sichuan Deyang is the highest.
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Objective@#Non-suicidal self-injury (NSSI) in adolescents appeared prevalent and multifactorial. This study was to examine the associations between exposure to suicidal behaviors and NSSI in the Chinese adolescents.@*Methods@#Participants included for analyses were 5 154 adolescent students who participated in the baseline survey in 2015 and the first follow-up survey in 2016 of the Shandong Adolescent Behavior and Health Cohort, but with no history of NSSI at the baseline survey. A self-administered structured questionnaire was used to collect data on demographics, behavioral and emotional problems, lifetime and last-year NSSI. Data on the history of exposure to suicide attempt or death of a family member, friend, or close acquaintance were also collected. Multivariate logistic regression methods were used to examine the associations between exposure to suicidal behaviors and NSSI.@*Results@#In the baseline survey, mean age of the 5 154 participants was (14.49±1.48) years, with 48.5% of the participants as girls. Of the participants, 9.0% reported having been exposed to suicidal behaviors, including 6.0% reported to suicide attempt, 4.9% to suicide death, 7.3% to suicidal behaviors of friends/close acquaintances, and 3.1% to suicidal behaviors of relatives. The prevalence rates of NSSI in the last year were significantly higher in adolescents who had been exposed to suicidal behaviors than those who had not (P<0.05). Results from the multivariate logistic regressions showed that exposure to suicide death (OR=1.91, 95%CI: 1.22-3.01) or to suicidal behaviors of relatives (OR=1.79, 95%CI: 1.02-3.12) were both significantly associated with the increased risk of NSSI.@*Conclusions@#Experiences related to exposure to suicide-death or suicidal behaviors of relatives were associated with increased risk of NSSI in adolescents. After the suicide events, psychological counseling and health education programs set for high-risk groups were helpful in promoting physical and mental health and preventing the attempt of self-injury in teenagers.
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The parameters of illumination conditions include duration,illumination intensity,color temperature and so on.Different combinations of these conditions have different effects on human beings at the visual and psychological level and are related to occurrence or prevention of psychological diseases.Extension of illumination time and phase change of circadian rhythm increase the risk of bipolar disorder;changes in daytime,night or all-day illumination intensity have psychological effects,especially exposure to light at night increases risk of depression;inaddition,changes in color temperature of light also have psychological effects.This paper reviewed the effects of different illumination conditions on visual psychology.
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Objective To investigate the effect of maternal age,gestational weeks,numbers of previous spontaneous abortion and embryo gender on chromosomal abnormalities.Methods Bacs on Beads (BoBs) technology was used to detect the chromosome aneuploidy of 245 pregnant women with spontaneous abortion or stillbirth in Jinan Maternity and Child Care Hospital from January 2015 to December 2017 and to analyze the types of their chromosome abnormalities.Comparative analysis between different groups was carried out using Chi-square test.Results Karyotypes of all cases (n=245) were obtained using BoBs.Among them,113 had chromosome abnormalities (46.1%),including 66 autosomal aneuploidy (58.4%),26 sex chromosome aneuploidy (23.0%),seven autosomal partial trisomy (6.2%),five autosomal partial monomer (4.4%),seven triploid (6.2%),one complex triploid (0.9%) and one double trisomy (0.9%).Pregnant women aged over 35 had a higher incidence of chromosome abnormality than those under 35 [61.0% (36/59) vs 41.4% (77/186),x2=8.003,P<0.05].The incidence of chromosome abnormality of women aborted in the first-trimester was also higher than those aborted in the second-trimester [48.5% (99/204) vs 34.2% (14/41),x2=4.634,P<0.05].Moreover,male embryos were more likely to have chromosome abnormality than female ones [57.6% (49/85) vs 40.0%(64/160),x2=6.483,P<0.05)].However,there was no significant difference between gravidas with different times of spontaneous abortion (0,1 or ≥ 2,P>0.05).Conclusions Chromosome abnormality is a major cause of spontaneous abortion,particularly in embryos with chromosome aneuploidy,partial trisomy,partial monomer and triploid.Advanced maternal age may increase the risk of chromosome abnormalities in pregnancies complicated with spontaneous abortion or stillbirth.
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Objective To explore the application of "quality control specialized management" model in ultrasound department for medical quality management and effect evaluation.Methods The "quality control specialized management" model was applied for medical quality management in ultrasound department.We explored the changes of clinical and patients' satisfaction before and after the implementation of the model by taking the measures of quality control management by special responsible person,improving patient visit process,strengthening professional training to improve doctors' ability,strengthening humanistic literacy,and improving service attitude.Before and after implementation,clinical satisfaction and patients' satisfaction were evaluated.The comparison of clinical satisfaction before and after the implementation of "quality control specialized management" and the comparison of patient satisfaction was conducted by x2 test.Results After the implementation of "quality control specialized management" model,the clinical satisfaction score was (95.5 ± 0.3) points,which was significantly higher than that before the model was applied [(90.1± 1.5) points;t=7.541,P < 0.01);the patients' satisfaction score was (95.8±0.3) points,which was also significantly higher than that before the model was applied [(92.8±0.7) points;t=5.230,P < 0.01).Conclusion The "quality control specialized management" model can improve clinical and patients' satisfaction effectively,representing an effective way to guarantee and improve the quality of ultrasound medical services.
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A femal patient with 16 loss and the residual bone height of 4 mm at posterior maxilla was treated by"two steps"sinus evaluation via transcrestal approach with the add of endoscope to enable the operation to be performed visibly. Platelet rich fibrin was used to insulate the osteotome and Schneiderian membrane to decrease the risk of membrane perforation, the dental abutment was simultaneously implanted, 3 months after operation uper part for 16 dental implant was restore.
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Objective To evaluate the efficacy and safety of etoposide capsule on metastatic breast cancer. Methods Forty-five advanced breast cancer patients treated with oral etoposide during Feb.1,2012 and Oct.31, 2016 in our department were enrolled in our study,with their general data,median number of treatment lines, treatment effect,common adverse reaction collected. Such indexes of objective response rate,rate of clinical benefit,disease control rate,progression free survival time were anlayzed. Results All patients received median five lines of etoposide capsule therapy. The objective response rate(ORR,CR + PR)was 6.7% and the clinical benefit rate(CBR,CR+PR+SD≥6.0 months)was 26.7% and the disease control rate(DCR,CR+PR+SD) was 68.9%.The median progression free survival time(PFS)was 4.0 months(95% CI:2.3~5.6).The main toxic-ities were grade 1-2 neutropenia(37.8%),grade 3-4 neutropenia(6.7%).Conclusion Etoposide capsule could be an option with efficacy and safety for metastatic breast cancer.