Objective To evaluate the effects of nursing intervention on the beliefs and behavior of early detection of breast cancer. Methods Four communities in Shanghai were selected by convenient sampling process. Then these four communities were randomly assigned to intervention group and control group. One hundred and eighty women who met the criteria of this study were selected from each group by convenient sampling process.Altogether 739 women were recruited. In intervention group,a one-year nursing intervention guided by health belief model was implemented,such as health education seminars,telephone follow in the third,sixth,and ninth months,and flyers of breast health care in the sixth month. Control group only received conventional education. Results After intervention women became aware of breast cancer (B=0.210,P＜0.01),perceived more benefits from attending early breast cancer detection (B=0.105,P＜0.01),and less difficulties in attending the activities of early detection of breast cancer (B=-0.086,P＜0.05). The number of women who performed breast self-examination once per month increased and more women received clinical breast examination (OR=3.0946) and mammogram after intervention (OR=2.746). Conclusion The nursing intervention,guided by health belief model,is helpful to improve women's beliefs and behaviors of breast cancer detection.

Purpose:To study the clinic characteristic, diagnosis and therapy of hereditary nonpolypoid colorectal cancer.Methods:We analysed the diagnosis, therapy and follow up of hereditary nonpolypoid colorectal cancer in 32 cases from 11 families by studying the tumour site, pathologic results. Results:There were 43 cancer patients having 61 tumours in 11 families, and 32 cases were intestinal cancer with 39 tumours. In these 32 cases, there were 12 hereditary nonpolypoid colorectal cancer (37.5), and 5 cases were intestinal cancer (15.6). We examined the patients and their direct relatives and found 28 people had various cancer, of which 20 cases without any complaint. Conclusions:Hereditary nonpolypoid colorectal cancer is a dominant hereditary disease, with the characteristic of early flare up,prone to upper colon. They are always non contemporary polygeneous cancer or contemporary polygeneous cancer, and prone to take place outside of colon. So it is important not only for patients to be treated and followed up but also for their relatives to be instructed and followed up. We must study the disease history in details. [

Objective To develop the clinical application of tandem mass spectrometry in earlystage diagnosis of patients with growth retardation.Methods Tandem mass spectrometry was used to quantitatively detect blood amino acids and acyl carnitine in 155 cases of children with growth retardation.The tandem mass spectrometry results,clinical symptoms,and treatment tracking results were analyzed.Results Ten patients with inborn metabolic absence of amino acids and acyl carnitine were confirmed including four cases of methylmalonic acidemia,one case of propionic acidemia,one case of medium-chain acyl-coenzyme A dehydrogenase deficiency,one case of ornithine transcarbamylase deficiency,and three cases of phenylketonuria.Conclusions Tandem mass spectrometry was helpful for some patients in etiologic diagnosis and therapeutic effect assessment of cerebral developmental retardation.

Thirty four patients with decompensated cirrhosis received umbilical blood stem cell transplantation via hepatic artery from December 2008 to August 2009. The symptoms and biochemical testing results were observed before and after stem cell transplantation. One month after the transplantation,appetite was improved in 32 patients ( 94% ), physical capacity improved in 29 patients ( 85% ) and the abdominal distention relieved in 28 patients (82%). Abdominal B-ultrasonography showed that ascites decreased in 15 cases(60% ), and disappeared in 9 cases(36% ). Six month later the mean serum albumin levels were increased from ( 30. 9 ± 0. 6) g/L to ( 35.5 ± 2. 5 ) g/L( P ＞ 0. 05 );alanine aminotransferase levels decreased from (57 ±7) U/L to (46 ± 10) U/L(P ＞0. 05);total bilirubin decreased from (47 ±5 )μmol/L to (25 ±4) μmol/L(P =0. 017);prothrombin time decreased from ( 17.9 ±0. 7) s to ( 16. 4 ±1.3) s (P ＞ 0. 05 ). Hemophagocytic syndrome developed in one case but no severe adverse reactions occurred. The results indicate that umbilical blood stem cell transplantation may improve liver function in various degrees with safety for patients with liver cirrhosis.

Objective To investigate the pathogenesis,diagnosis,treatment and prognosis of aort-oesophageal fistula(AEF).Methods Retropective analysis was performed on 6 patients presenting with AEF between January 2002 and December 2014,and relative literature was reviewed on its pathogenesis,di-agnosis,prognosis and treatment.Results Five men and 1 woman with a mean age of 49 (range,27-71 years)were recruited to the study.One case of AEF was caused by esophageal foreign body,2 cases were caused by aneurysm while the other 3 patients presented AEF after aortic surgery.All 6 patients showed he-matemesis,among whom 3 presented sentinel hemorrhage,1 presented exsanguination after sentinel hemor-rhage,2 presented sudden exsanguination.Among 4 patients with sentinel hemorrhage,2 accompanied with chest pain,1 with dysphagia and 1 with fever.Two patients had a history of hypertension.Diagnostic rate was nearly 100% by gastroscopy or CT/CTA.Four patients died from hemorrhagic shock and 2 patients re-covered from surgery.Conclusion AEF should be seriously considered for patients with a history of hyper-tension,aortic disease or esophageal foreign body presenting sentinel hemorrhage,chest pain,dysphagia,fa-tal exsanguination followed by symptom-free interval.Prompt examinations and aggressive surgery are of great significance for survival.

Objective To report the clinical,myopathological and genetic features of a patient with distal myopathy caused by caveolin-3 (CAV3) deficiency.Methods The patient was a 27-year-old female.She had an onset symptom of asymmetric lower extremities weakness.The proximal limb-girdle muscles were involved subsequently.Clinical data of this patient were collected.The leg muscle magnetic resonance imaging (MRI) and an open biopsy of left tibialis anterior muscle were performed.In addition to histological,enzyme histochemical staining and ultrastructural examination,immunohistochemical staining with antibody against CAV3 was done.CAV3 gene was analyzed in the patient and her parents.Results Tl-weighted enhanced skeletal muscle MRI of the lower limbs showed the abnormal signal in distal and proximal muscles.Muscle biopsy showed moderate dystrophic changes and immunostaining for CAV3 showed reduced plasmalemma in the muscle fibers.Gene analysis disclosed a heterozygous c.136G ＞ A (p.Ala46Thr)mutation in the CAV3 gene,and the patient's parents did not have this mutation.Conclusions We report a distal myopathy case caused by c.136G ＞ A (p.Ala46Thr) mutation in the CAV3 gene,who had an onset symptom of asymmetric lower extremities weakness.The proximal limb-girdal muscles were also involved.This would help clinical doctors to know more about this rare myopathy.

BACKGROUND:Calcaneus is a kind of irregular bone, with complicated three-dimensional structure. Calcaneus is often measured with X-ray plain film, while spiral CT three-dimensional imaging is a potent technology for anatomic measurement and has good application prospect. However, little is known about it. OBJECTIVE:To measure calcaneal anatomic data in Chinese peoples with spiral CT three-dimensional reconstruction and to explore its clinical significance.
METHODS:Calcaneal spiral CT three-dimensional reconstruction in 100 Chinese adults (including 50 males and 50 females) were performed. The length, width, height of calcaneus, and Bohler’s and Gissane’s angles were measured after reconstruction, and compared with the data of westerners.
RESULTS AND CONCLUSION:The mean length, width and height of the Chinese calcaneus were respectively (74.60±5.06) mm, (29.71±2.93) mm and (45.23±4.46) mm in male group, and (71.48±5.36) mm, (26.65±3.01) mm and (42.23±4.49) mm in female group. There were no significant differences between male group and female group in al the above parameters (P>0.05). There was no significant difference in the Gissane’s angle between the two groups (123.3±8.5° versus 122.7±8.9°;P>0.05). The Bohler’s angle in male group (35.98±4.34)° was significantly lower than that in female group (38.81±4.43)° (P<0.05). The length, width and height of Chinese calcaneus were significantly lower than those of westerners (P<0.05). The Bohler’s angle and Gissane’s angle in Chinese adults showed no statistical significance compared with the westerners (P>0.05). Experimental findings indicate that, the length, width and height of Chinese calcaneus in female were lower than that in male, but Bohler’s angle is significantly higher than that in male, there was no significant difference in Gissane’s angle between males and females. Compared with the data of westerners, the length, width and height of Chinese adult calcaneus are significantly decreased, and no difference is found in Bohler’s angle and Gissane’s angle.

Objective:To study the effects of LPS and TNF-? on the expression of SSeCKS and morphology as well as cytoskeleton of endothelial cell, so as to explore the role of SSeCKS in cell morphology changes.Methods:The cultured Bovine pulmonary artery endothelial cells(BPAEC) was induced by LPS, TNF-? and the expression of SSeCKS was detected by in situ hybridization,Western blot and immunohistology. Immunofluorescent staining method with confocal laser-scanning fluorescence microscope was used to observe the effects of LPS and TNF-? on the morphology of endothelial cells and the organisation of SSeCKS as well as cytoskeleton.Results:Firstly, we found that TNF-? could induce the expression of SSeCKS in a concentration and time dependent manner , meanwhile LPS had no effects on SSeCKS expression. Secondly, it was observed that LPS and TNF-? induced reorganization of F-actin and SSeCKS in endothelial cell. Thirdly,PKC inhibitor Ro-31-8220 reversed the effect of LPS,TNF-? on F-actin and SSeCKS in endothelial cells.Conclusion:The results demonstrate that TNF-? could induce endothelial cell to express SSeCKS; PKC plays a role in the reorganization of SSeCKS and F-actin in endothelial cells induced by LPS and TNF-?; the results suggest that the mechanism for reorganization of cytoskeleton induced by LPS, TNF-? be partially related to the SSeCKS of ECs.

AIM: To explore whether exogenous hydrogen sulfide (H2S) depresses high glucose (HG)-in-duced injury by modulating the Janus kinase/signal transducer and activator of transcription ( JAK/STAT) pathway in hu-man umbilical vein endothelial cells (HUVECs).METHODS:The protein levels of JAK2, STAT3 and cleaved caspase-3 were determined by Western blot.The cell viability was measured by CCK-8 assay.Mitochondrial membrane potential ( MMP) was detected by rhodamine 123 staining followed by photofluorography.The intracellular level of reactive oxygen species (ROS) was analyzed by DCFH-DA staining followed by photofluorography.The activity of superoxide dismutase (SOD) was also measured.RESULTS:Pretreatment of the HUVECs with 400 μmol/L NaHS (a donor of H2S) for 30 min prior to exposure to 40 mmol/L glucose ( HG) markedly attenuated HG-induced upregulation of the phosphorylation of JAK2 and STAT3.Pretreatment with 400μmol/L NaHS for 30 min or with 20μmol/L AG490 (inhibitor of the JAK/STAT pathway) for 30 min attenuated the injury of HUVECs induced by HG, as indicated by the increases in cell viability and SOD activity, and decreases in the protein level of cleaved caspase-3, ROS generation and dissipation of MMP.CONCLU-SION:Exogenous H2 S protects HUVECs against HG-induced injury by inhibiting JAK/STAT pathway.

Objective To explore the clinical effect of percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture.Methods 63 feet of 55 patients with calcaneal fractures were involved in this study.According to Sanders fracture classification including 38 feet of Sanders Ⅱ,18 feet of Sanders Ⅲ,7 feet of Sanders Ⅳ.There were 6 to 16 days interval between the injuries and the surgeries.The patients were treated by percutaneous osteoplasty with the SKy bone expander system.The standard of operation was the satisfaction of reduction and Bohler's and Gissane's angles under X-ray.Results All of 63 feet of 55 patients were followed up for average 22 months.According to the criterion of therapeutic effect,the results were as follows:excellent in 30 cases,good in 26 cases,fair in 7cases,and no poor case.The excellent and good rate was 88.9％.Conclusion Percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture,especially in reduction and fixation of Sanders type Ⅱ and Sanders type Ⅲ,can recover Bohler's and Gissane's angles,significantly shorten the duration of illness,and has fast recovery and can possess satisfactory curative effect,and it is worth popularizing.