Breast cancer is the most common cancer in women. Compared with older patients, young breast cancer has unique clinicopathological characteristics, with lower detective rate and worse prognosis. Multidisciplinary individual-based therapy is of great significance in maximizing therapeutic benefits, as well as minimizing their side effects. Today more and more young patients are eager to reserve reproductive functions at the same time. This article reviews the progress on screen?ing and diagnostic measures, comprehensive treatments, and reproductive endocrine problems brought by therapies in early young breast cancer.

9.0 mmol/L, and well controlled group if FPG0.05). However, in each group, the incidence rate of different algesic severity decreased with the increasing algesic severity. Conclusion EIP will occur in DM patients within a week after RCT. Well controlling of the blood glucose can reduce the incidence rate of EIP.

Objective To evaluate the etiology, pathogenesis, clinical manifestation, imaging features, treatments and factors related to prognosis of acute spinal spontaneous hematoma.Methods The clinical data of 38 patients with acute spinal hematoma treated in our hospital from 2011 till now were analyzed retrospectively.Duration of follow-up was 6 months.The factors influencing the prognosis were analyzed.Results Acute epidural hematomas (n=29) were much more common than subdural (n=5), subarachnoid (n=1) and intramedullary (n=3).Most hematomas were located in the cervical and thoracic vertebra regions.The etiology of acute spinal spontaneous hematoma was unknown in most patients.Twenty-nine patients were dealt with surgical intervention and 9 patients were treated conservatively.After 6-month follow up, recovery rate measured by JOA score in patients of spinal injury ASIA level A and B was (51.26 ±38.97), and level C, D and E was (80.33 ±25.83), P<0.05.Recovery rate in patients with hematoma discovered in less then 24 hours treated with surgical decompression was (64.79 ±36.10), and that in those with hematoma present over 24 hours was (34.54 ±30.17), P<0.05.Conclusions Acute spinal hematoma always caused by unknown etiology, and usually manifests itself in a sudden onset of pain and neurological deficits.The early diagnosis mainly depends on MRI.Patients presenting with severe neurologic dysfunction or showing signs of progressive deficit should have immediate surgical intervention. The status of neurological deficits before surgery and the length of interval between onset and surgical intervention are associated with recovery.

Objective:To evaluate the curative efficacy of tacrolimus (FK506)combined with corticosteroids in the treatment of idiopathic membranous nephropathy (IMN ), and to analyze the response of anti-M-type phospholipase A2 receptor (PLA2R)antibody to the treatment.Methods:Sixty-one adult IMN patients were divided into FK506 group (FK506 combined with corticosteroids,n = 24)and CTX group (cyclophosphomide combined with corticosteroids,n=37)according to their willing to the acceptance of different immunosuppressives. The remission rates of the patients at 4,8,12 and 24 weeks after treatment in two groups were analyzed.The ELISA method was used for the detection of serum anti-PLA2R antibodies of the patients before and after treatment.The antibody level changes were observed and the difference of remission rates was compared between the antibody positive patients and the negative patients in FK506 group.Results:The total remission rates of the patients in FK506 and CTX groups 24 weeks after treatment were 91.7% and 64.9% respectively and the total remission rate of the patients in FK506 group was significantly higher than that in CTX group (P < 0.05).The total remission rates at 8,12,24 week after treatment and the partial remission rates at 12 and 24 weeks in FK506 group were significantly higher than those in CTX group (P <0.05).The anti-PLA2R antibody positive rates in FK506 group and CTX group were 75.0% and 70.3%,respectively;the negative conversion rate of anti-PLA2R antibody at 24 weeks after treatment in two groups were 61.6% and 57.7%,respectively;there were no significant differences between two groups (P >0.05).The total remission rates of the antibody positive patients and negative patients at baseline in FK506 group 24 weeks after treatment were 88.9% and 100.0%,respectively;there was no significant difference (P > 0.05).Except the characteristic side effects of corticosteroids,the patients in FK506 group presented no hyperglycemia,tubulointerstitial damage,hepatic lesion or neurotoxicity. But the patients in CTX group showed mild hepatic lesion or gastrointestinal symptoms.Conclusion:The remission rate of FK506 combined with corticosteroids is higher than that of CTX combined with corticosteroids in the treatment of IMN patients.FK506 treatment has relatively rapid effect and less side effects as well.The negative conversion of serum anti-PLA2R antibody follows the remission after treatment;however,the negative conversion rate has no significant difference between FK506 group and CTX group.The remission rate of IMN patients treated with FK56 combined with hormone has no relationship with the baseline anti-PLA2R antibody.

Based on analyzing image edge cloning theory and algorithms, a marginal clone algorithm is proposed with a combination of edge connectivity and noise removal algorithm. Simulation results show that the edge image detected by the algorithm has solved problems of traditional edge discontinuities and tsereve noise. Moreover, it has better edge recognition performance.
Algorithms ; Humans ; Image Enhancement ; methods ; Retinal Vessels

Objective To explore the prevalence,subtype,distribution characteristics and risk factors of IBS met ROME Ⅲ criteria in local adult residents of Shanghai Songjiang area.Methods With multi-stage,stratified cluster random sampling method,from April to May in 2010,residents of45 shanghai Songjiang communities were interviewed by questionnaire survey.IBS diagnosis was based on Rome Ⅲ criteria,and the subtypes were according to Bristol stool scale.Self-rating anxiety scale (SAS),self-rating depression scale (SDS) and Athens insomnia scale (AIS) were also simultaneously finished. Results There were 7648 individuals who completed the survey with qualified questionnaires; the efficient rate was 90％. The sample size accounted about 1.62％ of total population in Shanghai Songjiang area.Total 970 patients were detected,who met the Rome Ⅲ criteria,of those 492 males and 478 females.The adjusted prevalence of IBS was 13.1％,13.8％ in males and 12.7％ in females.The ratio of male to female was 1 ∶ 0.92.There was no significant difference in detection rate between males and females (P＞0.05).The prevalence was highest in the 18 to 29 years age group (18.2％,P=0.000).IBS unsubtyped (IBS-U) was the most common type in patients who met the Rome Ⅲ criteria (45.3 ％),IBS with diarrhea (IBS-D) type was more common in male (27.0％) and IBS with constipation (IBS-C) was more common in female (19.5％).The IBS prevalence of obesity group (x2 =4.046,P=0.044),higher education group (x2=31.210,P=0.000),mental group (x2 =8.409,P =0.015),unmarried group(x2 =26.933,P =0.000) and no abdominal surgery history group(x2 =5.894,P=0.015) was higher than that of control group.The risk of IBS prevalence in those who had the history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics increased by 5.105,3.388,2.949 and 2.811 times respectively(P=0.000).Multivariate analysis indicated that the risk of IBS prevalence was increased by 1.69 times if took more spicy food,however high-protein diet was a protective factor (OR=0.900,P=0.000).Anxiety (OR=2.452,P=0.000) and insomnia (OR=1.923,P=0.000) were also risk factors of IBS.Conclusion IBS is a common and frequently occurring disease in Shanghai Songjiang community.The history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics,intake of more spicy food,anxiety and insomnia may be risk factors of IBS.

Objective To investigates the efficacy and tolerability of second line treatment with S-1 plus thalidomide in patients with advanced pancreatic cancer.Methods Sixty patients hospitalized in Department of Oncology of Cangzhou Central Hospital from July 2010 to October 2012 were included in this study.All the patients were diagnosed as having pancreatic carcinoma.The patients were randomly divided into two groups,one group was treated with S-1 alone,and the other group was treated with S-1 plus thalidomide.Then the efficacy and toxicity of two groups was evaluated.Results The disease control rates were 36.7％ and 46.7％ in the S-1 alone group and the S-1 plus thalidomide group,and the difference between the two groups was not statistically significant (P =0.31).The progression free survival (PFS) was 2.9 months and 3.3 months,and the difference between the two groups was statistically significant (P ＜ 0.05),the Karnofsky score,pain,sleep and weight improvement rate was 63.3％,46.7％,66.7％ and 53.3％ in combination group,which were significantly better than those in control group (30.0％,13.3％,30.0％ and 20.0％),and the difference between the two groups was statistically significant (P ＜ 0.05).The major adverse events were nausea,vomiting,fatigue and drowsiness,mainly of grades Ⅰ ～ Ⅱ.Conclusions S-1 plus thalidomide as second line treatment of pancreatic cancer can prolong the PSF of patients with advanced pancreatic cancer with excellent safety,and patients' quality of life is also improved.

Objective To investigate the correlation of M-type phospholipase A2 receptor (PLA2R) genetic polymorphism in two single nucleotide polymorphisms (SNPs) with idiopathic membranous nephropathy (IMN) of Chinese Han population in Northeast China.Methods A total of 327 individuals were enrolled in the study including 95 adult patients with biopsy-proved IMN (IMN group) followed up for (25.4±11.6) months and 232 healthy people identified by healthy examination in China-Japan Union Hospital of Jilin University (HC group).Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the genotype and allele frequency of rs35771982 and rs3828323 site in PLA2R gene.The x2 test was performed to compare the distribution difference of allelic frequency and genotype frequency of the two sites in PLA2R gene between two groups.Unconditional Logistic regression analysis was used to determine the risk factor of IMN.Results IMN and HC group were matched in male predominance and body mass index (BMI).Patients with IMN were older than the healthy controls and had higher Scr,serum total cholesterol (TC),24-hour urine protein level and lower serum albumin (Alb) level,lower estimated glomerular filtration rate (eGFR) than the healthy controls (all P ＜ 0.01).The CC genotype frequency and the C allele frequency at SNP rs35771982 site of PLA2R gene in IMN group were significantly higher than those in HC group (x2=13.658,P=0.001;x2=15.315,P=9.10× 10-5),whereas there was no distribution difference of genotype and allele frequency at rs3828323 site between two groups (x2=2.844,P =0.241; x2 =2.959,P=0.085).The CC genotype at rs35771982 site in patients with IMN was not related to,age,gender,BMI,blood pressure and several laboratory indexes such as Alb,TC,Scr,eGFR and 24-hour urine protein level (all P ＞ 0.05).Unconditional Logistic regression analysis revealed that the genotype at rs35771982,age,TC,Scr and eGFR were correlated with IMN occurrence.The CC genotype at rs35771982 was the risk factor of IMN (OR =4.408,95％CI 1.488-13.058).Conclusions The CC genotype and C allele at rs35771982 site in PLA2R may be associated with the susceptibility to IMN,whereas the correlation between gene polymorphism at rs3828323 site and IMN is not demonstrated.The CC genotype at rs35771982 is the independent risk factor of IMN in Chinese Han population in Northeast China.

Background and purpose:Along with the development of diagnosis and treatment technology, the disease free survival and overall survival of breast cancer have been extended. In order to improve the quality of life after mastectomy, more and more breast reconstructions were applied in breast cancer patients. We retrospectively reviewed 118 cases of free abdominal lfaps for breast reconstruction performed in Fudan University Shanghai Cancer Center. Clinical outcomes, reconstructive techniques and experiences are discussed. Methods:From November, 2006 to June, 2013, we used free abdominal lfaps to perform 118 cases of breast reconstruction on 117 female patients after mastectomy. We observed the surgery, complications and safety of this technic. Results:We performed 118 cases of lfaps based on deep inferior epigastric vessels. The average operation time was 7.72 h. The average time of ischemia was 78.74min. The average anastomosis time was 60.83min. The average number of perforators included in the lfap was 3. The internal thoracic vessels were preferred recipient vessels. Ten cases of vessel crisis occurred and 6 of them were venous thrombosis and 4 cases were venous kink. Seven of them were salvaged, and the other 3 failed, the success rate was 97.46%. Postoperative infection rate was 7.00%. Abdominal bulge occurred in 3.50%of patients. None of the patients developed abdominal hernia. The median interval between surgery and the ifrst cycle of adjuvant chemotherapy was 19 days. The median follow-up time was 12 months. One case of distant metastasis, but no local recurrence was observed. Conclusion: Although free abdominal flap breast reconstruction requires complicated microsurgical techniques, and the learning curve does exist, free abdominal lfap breast reconstruction has a high success rate with oncological safety and few complications.

The demand for diagnosis and therapy of diseases should be higher in the era of precision medicine.The superparamagnetic iron oxide nanoparticles (SPION) is used in diagnosis,therapy,and monitor of diseases due to its good superparamagnetism,which has always been paid more attention in molecular imaging.The research progresses of SPION in precision medicine were reviewed in this article.