Objective:To compare the characteristics of pruritus after epidural and subarchoid morphine for postoperative analgesia. Method: One hundred and twenty patients after hysterectomy were randomly allocated to receiving subarchoid morphine 0.5mg(group Ⅰ,n=60)or epidural morphine 2 mg(group Ⅱ,n=60),respectively. The pruritus incidence, pruritus scale, time and site of occurrence were observed in both groups. Result: In group Ⅰ, the pruritus incidence of 87%,27% of pruritus scale being more than 2 and total pruritus scale being 8 (0-18) were significantly higher than those[31%, 12% and 6(0-14)] in group Ⅱ (P

Objective To develop a stable and quick method to determine the urea in swimming pool water.Methods On the conditions of strong acid and calefaction,urea can react on antipyrine and diacetyl monoxime and become yellow which can be determined by colorimetric analysis in 450 nm with the ALLIANCE FUTURA continuous flow injection auto analysis system.Results Determined by this method,the linear range was 0.5-4.0 mg/L,the regression equation was y=0.077 5x+0.021 9,the correlative coefficient r=0.999,the detection limit was 0.07 mg/L.With residual chlorine of 0.3 and 3.0 mg/L,the recovery rates were 98.8%-104.0% and did not disturb the determination.The results determined by the present method were the same as those by the method in GB/T 18204.29-2000(Wilcoxon Signed Ranks Test:Z=0.051,P=0.959).Conclusion Determination of the urea in swimming pool water with continuous flow injection auto analysis,the sensitivity,accuracy and limit of determination can meet to the requirement,moreover,the analysis speed is faster,less reagent will be needed,the present method can be generalized in the laboratory that has the conditions.

Objective By investigating the departments of ECG and the staff in China,to study the current ECG status and thus provide references for training ECG workers,improving the work environment and stabilizing the ECG professional team.Methods One hundred and twenty four domestie grass-root hospitals were investigated through real-name questionnaire surveys.The data was collected and analyzed.Results Among the 124 investigated hospitals,the educational background description is:(1) The ECG workers in provincial or municipal hospitals had mainly been entitled with Bachelor's degree or above accounting for 72.7％ of whole ECG workers;the ECG workers in the county or township hospitals were entitled with college degree or below,accounting for 85.7％ of whole ECG workers.The difference between the two kind of workers was significant(P＜0.01).(2) The proportion of ECG workers owning senior professional titles in provincial or municipal hospitals and county or township hospitals were both low,which were 12.2％ and 3.6％,and the former one was significantly higher than the later(P＜0.01).(3) The proportion of hospitals which established dependent department of ECG was low;the percentage of provincial or municipal hospitals was 23.4％,which was significantly higher than that of county or township hospitals (3.3％,P＜0.05).(4) The provincial or municipal hospitals were well equipped and also conducted various of inspection projects in comparison to county or township hospitals.Conclusions The grass-root ECG staff in China has no satisfying education background and professional titles;ECG department belonging varies and the special inspection projects are insufficient and the economic benefit was low.So this study suggest that the competent departments take measures in improving ECG personnel enthusiasm,improving the working environment,and ensuring the healthy and orderly development of ECG profession.

Objective To compare the diagnostic value of digital breast tomosynthesis (DBT) versus digital mammography (DM) in the evaluation mass like lesions in dense breasts. Methods Eight hundred and fifty eight patients, who had DBT and DM, with breast diseases confirmed by pathology were retrospectively reviewed. The breast density and the imaging features were classified according to the standard of American College of Radiology(2013) and breast imaging reporting and data system (BI?RADS) scores. Six hundred and thirty one patients with mass lesions in dense breasts were chosen to included. All 631 patients had DM of both breasts and DBT of affected breast prior to mastectomy. Pathological results were used as the golden standard. Detection rate and diagnostic accuracy of masses, sensitivity and specificity of diagnosis, false negative and recall rates, the margins and spicules and BI?RADS category were calculated. The detection rate and diagnostic accuracy, the margins and spicules of masses were compared with Chi?square test, the BI?RADS scores were analyzed with rank test. Results With DBT, average detection rate increased from 77.3%(488/631) to 84.3% (532/631), average diagnostic accuracy rate increased from 73.4%(463/631) to 82.3%(519/631),with statistical significant difference between groups (c2=27.191,36.890,P<0.01).Sensitivity for DBT and DM were 68.1%(205/301) and 58.8%(177/301), respectively. Specificity for DBT and DM were 95.2%(314/330)and 86.7%(286/330), respectively. Recall rate for DBT and DM were 3.6%(23/631)and 9.8%(62/631), respectively. One hundred and seventy two cases and 75 cases with circumscribed masses of benign cases were detected by DBT and DM, respectively. One hundred and eighty-two cases and 115 cases with spiculated masses of malignant cases were detected by DBT and DM, respectively, with statistical significant difference between groups (c2=70.471 and 21.707, P<0.01). Of 330 malignant cases, the numbers of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 19,4,8,13,52,93,141, respectively, the numbers on DBT images were 3,1,7,5,52,83,179, respectively, with statistical significant difference(Z=-2.235,P=0.025). Of 301 benign cases, the number of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 43,10,60,117,58,11,2, respectively, the number on DBT images were 20,4,64,150,55,7,1, respectively, with no statistical significant difference between groups(Z=-1.846,P=0.065). Conclusion DBT significantly improves the detection of mass?like lesions in dense breasts, display of mass margin and architectural distortion of surrounding tissue.

AIM: To detect CD23 mRNA expression in B-cell lymphoma. METHODS: 20 pathological diagnostic conformed B-cell lymphoma samples were selected. Surface CD23 protein expression was examined by SP-immunohistochemistry and CD23 mRNA was detected by in situ hybridization with digotoxin labeled CD23 DNA probe.RESULTS: The positive rates of both surface CD23 protein and CD23 mRNA expression in B-cell lymphoma samples were more than 90%. CONCLUSIONS: The high expression of CD23 was showed in B-cell lymphoma both in mRNA and in protein levels. The results of this study was useful for understanding the molecular mechanism of B-cell lymphoma and for clinical diagnosis and treatment of the disease.

Objective:To evaluate the clinical significance of expression of proliferation cell nuclear antigen(PCNA),P16 and P27genes in adenoid cystic carcinoma of salivary glands.Methods:The expressions of PCNA,P16and P27were detected by immunohistochemical staining (SP)in 55 patients with adenoid cystic carcinoma of salivary glands.Results:The higher and lower expressions of PCNA were 45.5%(19/55) and 65.5%(35/55) respectively;of P16 were 45.5%(25/55) and 54.5%(30/55)respectively.And the positive and negative expressions of P27 were 34.5%(19/55) and 65.5%(36/55),respectively.The correlation of expression of PCNA gene with local recurrence and tumor site showed significant (P=0.0317,P=0.0186);but the expression of P16was no any significant correlation in all of the variables.The expression of P27 was significant on the regional lymph node metastaisis (P=0.0083).When higher expression of P16was 45.5%(25/55),the P27positive expression was 56.0%(14/25),which showed a significant positive correlation (P=0.0025).Conclusion:In adenoid cystic carcinoma of salivary glands,the PCNA gene should be one of the biological target predicting local recurrence,and P27gene should be one of the biological target justifying regional lymph node metastasis.

Objective To detect the regional genomic instability of B16 cells treated with 60Co γ-rays by a green fluorescence protein (GFP)-based genomic instability reporting system.Methods Three groups were employed as non-transfection group,vector control group and transfection group.The GFP-marked reporter construct pCMV-EGFP2XhoI for regional genomic instability was successfully transfected into B16 cells using liposome.B16 cells were selected by screening of G418 with a series of concentrations and limiting dilution cultures to yield a single colony.B16 cells with the genomic instability report system were then irradiated by 60Co γ-rays at doses of 0,2 and 4 Gy.The regional genomic instability of B16 cellswas quantified by counting the number of cells with GFP expression.Results B-16 cell strain steadilyexpressing the GFP-based genomic instability reporting system was established successfully.GFP-positiveB16 cells were observed at 1 d after irradiation with 60Co γ-rays at doses of 2 and 4 Gy.Positive correlations between fluorescence intensity and dose and fluorescence intensity and time were also observed.The positive expression rate of GFP followed the increased of dose (F =36.55,36.76,P ＜ 0.05) and time (t =-3.27,-3.16,-4.26,-6.11,-7.17,P ＜ 0.05),and differences between groups were significant.The positive expression rate of GFP increased significantly at 3 d,and maximum expression was observed at 5 d(2.46 ± 0.24 and 3.82 ± 0.35).The level was tending towards stability.Spontaneous GFP expression at a ratio of 1/600 000 was observed in 0 Gy group after 2 weeks of culture.Conclusions The regional genomic instability of B16 cells induced by 60Co γ-rays can be detected using a GFP-labelled genomic instability reporter system.

Objective To discuss the feasibility of percutaneous nephrolithotomy (PCNL) for treating upper urinary calculi under local anesthesia.Methods One thousand three hundred and sixty-three patients who suffered with upper urinary calculi were treated with PCNL, the puncture and tracts were created using local anesthesia and guided through ultrasound.Of the 1363 patients, 475 patients had complicated renal caluli, 520 patients had kidney pelvic calculi and 368 had upper uretere calculi.Results All of the patients successfully received PCNL under the local anesthesia.Of the 1363 patients five tracts were used in two patients, four tracts were used in four patients, three tracts were used in nine patients, double tracts were used in 25 patents and one tract was used in the remaining patients.The stone-free rate was 96.0% in the kidney pelvic calculi patients, 100.0% in the upper uretere calculi patients, and 90.1% in the complicated renal caluli patients.90.0% patients were find well throught the operation, 10.0% patients find a little pain and solved by another more 5 - 10 ml lidocaine local injection or 50 - 75 mg pethidine hydrochloride intramuscular injection.No case stop operation because of pain or position changed.All without any severe complications such as damaged of liver, spleen, thorax and intestine.Conclusion The PCNL handled under local anesthesia was simple safe and effective, deserved clinical popularizing use.

Objective To analyze the mammographic findings of triple-negative breast cancer [TNBC,which is estrogen receptor (ER) negative,progesterone receptor (PR) negative,and human epidermal growth factor receptor 2 ( HER2 ) negative ] and triple-positive breast cancer ( TPBC,which is ER positive,PR positive,and HER2 positive ),and to evaluate the relationship of immunohistochemologic receptor status and mammographic findings.MethodsThe immunohistochemistry results of 631 cases with breast cancers were reviewed,including 117 cases of TNBC and 44 cases of TPBC.All of the patients took mammography at initial diagnosis.We retrospectively evaluated the visibility,morphology,distribution and size of the lesion (masses and calcifications) and breast density on mammography of TNBC,and compared them with those of TPBC.The age onset and tumor sizes of TNBC and TPBC were compared by using Chi-square test and t test.ResultsThe visibility rate of TNBC and TPBC on mammography were 88.0％(103/117) and 90.9％ (40/44),and the difference between them was insignificant ( x2 =0.055,P ＞0.05).TNBC was more frequently associated with merely a mass (56/103) than TPBC (12/40) (x2 =6.860,P＜0.01 ),and the mean diameter of the mass of TNBC [ ( 2.6 ± 1.4 ) cm ] was larger than that of TPBC [(2.0 ± 0.6) cm](t =2.087,P ＜ 0.05). TNBC were less frequently associated with microcalcifications (37/103) than TPBC ( 24/40 ) ( x2 =7.423,P ＜ 0.01 ).Mammographic density and lesion visibility were similar between the two different immunophenotypes of breast cancers.The mean age of TNBC (52±9) was more than that of TPBC (48 ±8) (t =2.759,P ＜0.01).Infiltrating ductal carcinoma was the main pathologic type of both groups.Basal-like breast cancer accounted for 49％ (57/117 ) of TNBC while none happened in TPBC.ConclusionsTNBC shows merely a mass with indistinct margins,lager size and is less associated with microcalcifications.These mammographic features might be useful in diagnosing triple negative breast cancer.

Objective To compare transurethral enucleation of plasma chamber(TUERP)plasma and tran-surethral resection of the prostate(PKRP) treatment efficacy,security and the impact on sexual function.Methods 80 cases of BPH patients were randomly divided into two groups,TUERP and PKRP.Follow-up for 12 months,compared two groups maximum urinary flow rate(Qmax),residual urine volume(PVR),serum prostate-specific antigen(PSA) level,prostate volume(PV),international prostate symptom score(IPSS),quality of life score(QOL),the bladder prostate prominent(IPP)and other indicators and erectile dysfunction and retrograde ejaculation changing circum-stances were compared.Results In the weight of prostate surgery there were significant differences,in which removal of the weight of TUERP group significantly higher than PKRP group.After 12 months,32 cases of TUERP patients and 31 patients of PKRP group completed follow-up.After 1,3,6,12 months,Qmax,PVR,IPSS,QOL improved than that before surgery.Two groups were compared after a month,and there were significant differences in prostate volume,which TU/ERP group was significantly smaller than PKRP group.After3 months in the prostate volume and residual U-rine volume there were significant differences,both TUERP group Was significantly smaller than PKRP group.After 6 months and 12 months in the prostate volume,residual urine volume and there were significant differences in PSA,both TUERP group was significantly smaller than PKRP group.ED,and retrograde ejaculation occured after the rate of two between the two groups was no significant difference.Conclusion Transurethral enueleation of plasma chamber on sexual function in patients,but through the appropriate personalized treatment,sexual function in some patients was recoverable.