Objective To explore a salvaging and nursing pathway of gas gangrene following trauma during seismic disaster.Methods The contingency plan of prevention was invocated to physically and psychologically salvage and nurse 18 sufferers having gas gangrene following trauma. Results The illness state of 18 sufferers were all effectively controlled and straightened up.The psychic trauma were pacified and no cross infections took place.Condusions Contingency plan of prevention from gas gangrene directs medical staff how to salvage gas gangrene after disaster,ensure the unblock green life passage for salvaging of patients with gas gangrene.

Objective To analyze the main causes of sources of stress for nurses in cardiovascular department. Methods We selected 110 nurses from three class-one hospitals in Chengdu and divided them into the nurses in cardiovascular department (the research group) and nurses in other departments (the control group). We compared the two groups in the following aspects: family, society, interpersonal relationship, work nature and work strength, continuing education and professional demand. In view of the high spirit stress existed in nurses in cardiovascular department, some corresponding stress-relief strategies were adopted. Results Two groups were statistically different in social, interpersonal relationship, work nature and work strength, continuing education and professional demand. While in the aspect of family, no difference was seen. Conclusions nurses in cardiovascular department had high spirit stress in social, interpersonal relationship, work nature and work strength, continuing education and professional demand. To analyze sources of stress and stress-relief strategy for them could improve physical and psychological health of them and thus enhance nursing quality.

Objective To assess the value of fiberoptic ductoscopy (FDS) in the diagnosis of nipple discharge.Methods Clinical records of 800 patients with nipple discharge undergoing FDS from October 1998 to July 2003 were retrospectively reviewed. Results Diagnoses established by FDS were pathologically confirmed in 92 2% of patients with papilloma (202/219), in 86 7% of patients with papillomatosis (13/15), and in 95 2% of patients with breast cancer (40/42). The total diagnostic accordance rate was 92 0% (266/289). Conclusions FDS in the diagnosis of nipple discharge is sensitive and of great clinical significance.

Objective To investigate the pathology of nonpalpable breast lesions(NPBL),and evaluate the diagnostic value of ultrasound-guided mammotome(MMT)biopsy.Methods Between January 2005 and December 2007,254 patients with NPBL(328 lesions)diagnosed by ultrasonography received ultrasound-guided MMT biopsy.Among the patients,176 were diagnosed as having no breast mass or calcification by mammography.Results Of the 328 lesions,269(82.0%)were fibroadenomas,34 were(10.4%)cysts,3(0.9%)were intraductal papillomas,19(5.8%)were adenosis,and 3(0.9%)were early breast cancers.Among the 254 cases,251(98.8%)were benign without positives findings during follow-up.These patients received simple MMT,and 239(95.2%)of them were satisfied with the cosmetic outcome.The other 3(1.2%)patients who had malignancies were treated with modified mastectomy;none of them had residual tumors.The underestimate rate for NPBL was 0 in our cases.Of the 251 benign patients who received only MMT biopsy,239(95.2%)have satisfactory cosmetic results.Conclusions As an effective,minimally invasive,and rapid diagnostic technique for NPBL,ultrasound-guided MMT biopsy is an optimal tool for "one-step" operation.By using the method,underestimate risk can be decreased.

Objective To assess the accuracy of histological type and molecular subtype observed in preoperative 11-gauge vacuum-assisted core needle biopsy(VACNB) specimens in breast cancer.Methods Patients diagnosed by preoperative 1 l-gauge VACNB and received subsequent open excisional biopsy (OEB) from Mar 1 st 2014 to Mar 31 st 2015 were included.Kappa testing was used to test the concordance rate of histological type,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor 2(Her-2),Ki-67 and molecular subgroups between VACNB and paired OEB specimens.ER,PgR,Her-2,and Ki-67 were determined by immunohistochemistry (IHC).Patients with Her-2 IHC (+ +) were further examined by FISH.Molecular subtypes were classified as follows:LuminalA,LuminalB,Triple Negative,and Her-2 positive.Results There were 36 patients analyzed(32 of them had invasive breast cancer).Between VACNB and paired OEB specimens,concordance rate of histological type,ER,PR,Her-2,Ki-67 and molecular group were 94.4％ (κ =0.934),96.9％ (κ =0.904),87.5％ (κ =0.710),100％ (κ =1.000),84.4％ (κ =0.570),78.1％ (κ =0.621).No significant difference was detected in the expression of ER,PR and Ki-67 between VACNB and OEB specimens according to paired t-test results.Concordance rate of each molecular subtype between VACNB and OEB specimens were 100％ for Her-2 positive subtype,94.1％ for LuminalB subtype,50％ for LuminalA,and 33.3％ for TNBC.When the threshold for ER/PR positivity was upgraded from ≥1％ to ≥10％ and Ki-67 cutoff value to≥20％,the concordance rate for ER,PR,Ki-67 and molecular subtype reached to 100％,93.8％,87.5％,81.3％.Conclusions 11 G vacuum-assisted core needle biopsy was accurate in determining histological type and molecular subtype in breast cancer.

Objective To investigate the effects of methylthioadenosine phosphorylase (MTAP) on invasion and migration in breast cancer cells.Methods Human breast cancer cell line MCF-7 cells were treated with MTAPtargeted siRNA to diminish MTAP mRNA.MCF-7 cells proliferation was evaluated by cell counting kit-8,the analysis of cells invasion and migration was performed using Transwell chamber.The expressions of MTAP and matrix metalloproteinase 1 (MMP1) in cell extracts were detected by Western blotting.The experimental divided into blank contrd group,negative control group,MTAP-siRNA experimental group.Results The MCF-7 cells growth was promoted after knockdown the MTAP mRNA.MATP-siRNA experimental group 450 nm absorbance values at 24h,48 hand72 h of the control group were (112.3±11.9)％,(144.4±8.4)％,(169.3±9.4)％ respectively.Cell invasion analysis by Transwell chamber showed 570 nm absorbance values were 0.49 ± 0.06 (control),0.45 ± 0.07 (negative control) and 0.87 ± 0.07 (MTAP-siRNA) respectively.Cell migration analysis by Transwell chamber showed 570 nm absorbance values were 0.46 ± 0.06 (control),0.49 ± 0.08 (negative control)and 0.75 ± 0.07 (MTAP-siRNA) respectively.The expression of MMP1 in MCF-7 cells was upregulated after knockdown the MTAP mRNA.Conclusion The knockdown of MTAP in MCF-7 cell can increase the cells invasion and migration,and this may involve the the MMP1.

Objective To study HRCT appearances,clinic value and pathological fundament of the pulmonary honeycombing.Methods 60 patients including three groups with pulmonary honeycombing underwent HRCT scan.The comparative study of HRCT-pathology was done in 6 pulmonary postmortems with honeycombing.Results On HRCT images,honeycombing cysts were round-like with air inside,the cyst walls included remains of pulmonary inherent components and hyperplastic fibrotic tissue in pathology.The diameter of cysts was small,58 cases of them belonged to small group(90.6%).The distribution of lesions was mainly at lower(47cases,71.9%)and peripheral lung zone(52cases,81.3%),but there were differences in different type of the diseases.The cysts might become larger and it is impossible to recovery.Conclusion The honeycombing cysts appear as cystic cavities arranging as multiple layers,the cystic walls consist of different tissues in pathology,that are the manifestations of the end-stage of pulmonary fibrosis.HRCT appearances in different patients in three groups were different.

Objective To compare the sensitivity and diagnostic features of mammogram (MG) and magnetic resonance imaging (MRI) on diagnosis of breast ductal carcinoma in situ (DCIS) with or without microinvasion (DCIS-MI).Methods From Jan 2012 to Nov 2013,results of MG and MRI from 72 cases of DCIS or DCIS-MI were retrospectively analyzed.Results The sensitivity of MG was 52.8％ (38/72).The sensitivity of MRI was 87.5％ (63/72),among those 76.2％ (48/63)lesions presented as non-mass-like enhancement.Sensitivity of MRI was significantly higher in DCIS-MI than DCIS (84.6％ vs 100％,P =0.027).Logistic regression analysis showed calcifications was an independent factor influencing the sensitivity of MG (OR =23.785,P ＜ 0.001).Conclusions The sensitivity of MRI is higher than MG for the diagnosis of DCIS and DCIS-MI.

Objective To explore the diagnostic value of MRI special use of breast and uhrasonography in axillary lymph node metastasis of early breast cancer.Methods Clinical data of 136 Ⅰ-Ⅲ A breast cancer patients accepted MRI examination before surgery had been retrospectively studied,analysing diagnostic value of MRI and ultrasonography in axillary lymph node metastasis of early breast cancer.Results The sensitivity,specificity,and accuracy obtained by MRI were 83.3％,88.6％ and 86.3％.And these data of ultrasonography were 73.1％,76.7％ and 75.0％.The sensitivity,specificity,and accuracy obtained MRI were better than that of ultrasonography.The sensitivity,specificity,and accuracy of ≥ 50 years old patients were 70.0％,77.8％ and 75.0％.And ＜ 50 years old patients were 85.7％,92.3％ and 88.9％.The sensitivity,specificity,and accuracy of ＜ 50 years old patients were better than ≥ 50 years old patients.Conclusions The MRI special use of breast have an important value in axillary lymph node metastasis of early breast cancer,especially to gounger than 50 years old patients.It can provide a scientific basis of the clinical accurate treatment for early breast cancer patients.

Objective To investigate the role of the predictive prognostic value of BRCA1 screened by whole genome expression profiling in ductal carcinoma in situ.Methods Collected 4 cases of breast ductal carcinoma and 4 cases of breast invasive ductal carcinoma fresh samples from January 2014 to June 2014,and the difference of BRCA1 expression on whole genone expression profiling was analyzed by microarray comparative genomic hybridization.The expression of BRCA1 was detected by immunohistochemistry in 70 cases of ductal carcinoma in situ of the breast,and the prognosis of intraductal carcinoma was evaluated.Results BRCA1 gene differentially expressed in invasive ductal carcinoma and ductal carcinoma in situ by screening.The positive rate of BRCA1 protein in breast ductal carcinoma in 14.3％ (10/70),its expression had no significant relationship with age (P =0.959),menopause (P =0.959),tumor size (P =0.627),axillary lymph node status (P =1.000),HR status (P =0.958),HER-2 status (P =1.000),P53 expression (P =0.460).ductal carcinoma with micro-infiltration ratio in BRCA1 negative group was higher than BRCA1-positive group (P =0.043).The median follow-up of 47 months,Disease-free survival rate of all was 97.1％.Disease-free survival of BRCA1 negative group and BRCA1-positive group had no significant difference (96.7％ vs 100％,P =0.569),over all survival of BRCA1 negative and positive groups was 100％.Conclusions BRCA1 expression may not predict the prognosis of intraductal carcinoma,but ductal carcinoma in situ with microinvasion group ratio in BRCA1 negative was higher than ductal carcinoma in situ group,BRCA1 may take affect within ductal carcinoma infiltration process work.