Objective To study the application effect of ENCOR vacuum-assisted breast minimally invasive polypectomy system in the diagnosis and treatment of breast tumors. Methods Totally 86 breast cancer patients treated in the General Hospital of Yangmei Group from January 2017 to October 2017 were randomly divided into study group and control group,with 43 cases in each group. The study group was treated with ENCOR vacuum-assisted minimally invasive rotational atherectomy system,while the control group was treated by traditional breast excision. The operative conditions, postoperative complications and postoperative recurrence were observed and compared between the two groups. Results The intraoperative bleeding volume,operation time,scar length and postoperative recovery time in the study group were (5.1 ±1.2)mL,(15.9 ±3.5)min,(0.3 ±0.1)cm,(2.7 ±0.4)d,respectively, which in the control group were (12.7 ±2.3)mL,(26.8 ±4.6)min,(3.2 ±1.1)cm and (5.1 ±0.8)d,respectively, the differences between the two groups were statistically significant ( t=15. 579,14. 297,14. 108,13. 597,all P<0. 05). The total incidence rate of postoperative complications in the study group was 11. 63％,which was significantly lower than 30. 23％ in the control group (χ2 =5. 187,P<0. 05). During the follow-up of 12 months,in the study group,2 patients (4. 65％) had residual tumor,1 patient (2. 33％) developed recurrence; in the control group, 3 patients (6. 98％) had residual tumor,2 patients (4. 65％) developed recurrence. There was no statistically significant difference between the two groups (χ2 =1. 013,P >0. 05). Conclusion ENCOR vacuum - assisted breast minimally invasive revolving system in the treatment of breast tiny tumors has advantages of less trauma and pain,rapid recovery,etc,it is safe and effective.

BACKGROUND:Studies have shown that the application of electrical stimulation of peripheral nerve fibers can recover partial muscle functions due to the loss of central nervous control.
OBJECTIVE:To verify the feasibility of selective nerve excitatory effectively used the symmetric biphasic pulses under the bipolar electrodes stimulation of 1 mm.
METHODS:Eight adult Wistar rats were selected to expose the sciatic nerves after anesthesia and then the electrodes were placed on the sciatic nerves careful y to establish the model of selective nerve stimulation. Experimental electrode was homemade Cuff bipolar electrode, and the electrode stimulators were Grass S88
stimulator and AWG2005 arbitrary waveform signal generator. The two-way dual-electrode stimulation was used. The distance between two electrodes was 1 mm, and the stimulation waveform was symmetric biphasic pulse
with the width of 0.2 ms. The output pulse amplitude, pulse width and delay could be adjusted. The stimulation
intensity was adjusted, and the law of nerve excitability was detected under two-way dual-electrode stimulation, in order to achieve selective nerve excitability, and the feasibility of two-way dual-electrode stimulation to achieve
selective nerve excitatory was verified with“col ision”method.
RESULTS AND CONCLUSION:The change of nerve action potential was amplified by P511 amplifier and then linked into oscil oscope for displaying, and dual-electrode stimulation waveform was the symmetric biphasic pulse with the width of 0.2 ms. With the increasing of stimulus amplitude, we achieved the selective nerve excitatory. The results indicate the selective nerve excitatory can be achieved with the closed (1 mm) dual-electrode symmetric pulse, and the feasibility and effectiveness of this method can be verified with“col ision”principle.

Objective To explore the influence of the clinical pathway to control on hospital stay and medical expenses of pediatric rotavirus enteritis.Methods 245 infants with IRE were randomly assigned into two groups,109 in research group,136 in control group.All were treated with conventional therapy,for research group with clinical pathway.136 patients with previous medical routine therapy patients in the control group were compared.Compared two sets of average day in hospital,cure rate and cost,expenses for medicine and checking expenses proportion.Results The results shwed that the observation group of children's average hospital stay was lower than the control group,the cure rate higher than that in the control group,each time of total cost,expenses for medicine,each day medicine reducing( P ＜ 0.05 ).Checking expenses proportion was increased ( P ＜ 0.05),as to therapeutic effect,there was significant difference between two groups( P ＜ 0.05 ).Both expenses of drug ratio and ratio of the average daily expenses of drug are reduced.Conclusion Clinical pathway is applied in pediatric rotavirus enteritis can improve recovery rate,reduce hospitalization time and lower hospitalization fees and expenses,charges,medicine and inspection charge proportion.And can improve health education effect and patient satisfaction.

Objective: To investigate fusidic acid resistance in Staphylococcus aureus (S.aureus) strains and to analyze their molecular characteristics. Methods: A total of 1 333 strains of S. aureus isolated in the First Affiliated Hospital of Wenzhou Medical University from October 2013 to March 2016 were collected. Fusidic acid resistance in these strains was detected by K-B method. Minimum inhibitory concentrations (MIC) of fusidic acid were measured by agar dilution method. Resistance genes of fusB, fusC and fusD and S. aureus A protein-coding gene (spa) were detected by PCR. Strains that did not carry fusB, fusC or fusD were detected for mutations in fusA by sequencing. Housekeeping genes were detected by PCR and analyzed by multilocus sequence typing (MLST). Results: Among the 1 333 strains of S. aureus, 52 were resistant to fusidic acid, accounting for 3.90%. From 2013 to 2016, fusidic acid-resistant strains accounted for 5.3% (7/132), 3.5% (20/571), 4.1% (21/510) and 3.3% (4/120), respectively. The MIC values of fusidic acid against S. aureus were 2, 4, 8, 64 and >64 μg/ml, which inhibited the growth of 26.9% (14/52), 34.6% (18/52), 13.5% (7/52), 1.9% (1/52) and 23.1% (12/52) of strains, respectively. MLST revealed that there were 13 sequence types (STs), among which ST630 was the predominant type accounting for 50% (26/52), followed by ST5 accounting for 17.3% (9/52). There were 19 spa types, among which t4549 (11/52), t2460 (8/52), t377 (8/52) were the predominant types. Nine strains carried drug resistance genes accounting for 17.3% (9/52), including seven fusB-positive and two fusD-positive strains. No fusc-positive strains were detected. Mutations in fusA gene were detected in 11 strains (21.2%, 11/52) and the MIC values against them were all >64 μg/ml. The predominant type of the strains with fusA gene mutations was ST5-t2460. Conclusion Fusidic acid shows a good and relatively stable in vitro antibacterial activity against S. aureus. The mechanism of high resistance to fusidic acid is closely related to fusA gene mutation.

Objective:To identify the core genes related to the disease severity of respiratory syncytial virus (RSV) bronchiolitis in children using RNA sequencing (RNA-seq) and weighted gene co-expression network analysis (WGCNA), aiming to provide reference for predicting the condition of RSV infection.Methods:Twenty-two patients admitted to the Second Affiliated Hospital of Wenzhou Medical University with RSV bronchiolitis from October 1, 2019 to February 29, 2020 were enrolled as the case group. They were divided into three groups based on the severity of the disease: mild group, moderate group and severe group. Twenty-two healthy children were selected as the control group. Total RNA was extracted from whole blood leukocytes and analyzed by RNA-seq to compare the differentially expressed genes (DEGs) between children with RSV bronchiolitis and healthy children. The gene co-expression modules related to disease severity and biological indicators for disease severity assessment were identified.Results:The median age of the 22 patients (19 males and 3 females) was 3 months. The median age of the 22 healthy children (14 males and 8 females) was 4 months. There was no significant difference in age or gender between the two groups. There were 8 cases in the mild group, 7 cases in the moderate group and 7 cases in the severe group. Through significance analysis, 416 DEGs were found in the mild group, 586 in the moderate group and 846 in the severe group. According to WGCNA analysis, 10 co-expression modules were found, among which brown module ( r=0.62, P<0.001) was significantly correlated with disease severity. The protein-protein interaction network of DEGs in brown module was constructed and the top 30 core genes were selected according to the connectivity of gene nodes, among which the genes with high correlation were RBX1 and PSMA7. The expression of RBX1 and PSMA7 genes was up-regulated in the severe group, but their expression in the mild and moderate groups was not significantly different from that in the control group. Conclusions:RBX1 and PSMA7 genes might be biological predictors of disease severity in RSV bronchiolitis.