Objective To explore the application value in primary hospitals using conventional ultrasound and ultrasonic elastography in the diagnosis and surgery of breast cancer both in the diagnosis of joint.Methods One hundred and sixteen patients with breast disease confirmed by surgical pathology were studied retrospectively .All the patients were examined by acoustic elastogra-phy and conventional ultrasonography before surgery.Results Pathological results of 116cases were:74 malignanies and 42 benigni-ties.①Preoperative routine ultrasonography in diagnosis of benign breast lesions in 41 cases, 65 cases of malignant lesions.Ultra-sonography showed that benign lesions were round or oval, smooth edge, no obvious signs of malignant microcalcifications, breast cancer spiculation (87.84%, 65/74), intralesional calcification (62.16%, 46/74).With the pathology of routine preoperative ul-trasound diagnosis coincidence rate was 91.38%(106/116).②Ultrasonic elastography in diagnosis of breast benign lesions in 39 ca-ses, 66 cases of malignant lesions, benign lesions of ultrasound elastography score of 1-2 (92.86%, 39/42); malignant lesions of ultrasound elastography score of 3-5 (89.19%, 66/74);and the pathology of preoperative ultrasound elastography diagnosis coinci-dence rate was 90.51% (105/116).③Preoperative ultrasound elastography and conventional ultrasound diagnosis of 42 cases of be-nign lesions, 68 cases of malignant lesions, and pathological diagnosis coincidence rate was 94.82% (110/116).Conclusion Ul-trasound elastography and conventional ultrasound examination can improve the resection of benign and malignant breast lesions diag-nosis in primary hospital diagnosis, as an effective method for the detection of breast cancer before operation .

ObjectiveTo evaluate the efficacy of etanercept in the treatment of active ankylosing spondylitis ( AS) with enthesitis and explore an easy and accurate scoring method.MethodsWe designed this 12-week double-blind,placebo-controlled,randomized clinical study in active AS patients.The first part was a 6-week placebo-controlled period that patients received etanercept or placebo,followed by a 6-week open-label period that all patients received etanercept. At week 0,2,4,6,8,10,12,the scores of enthesitis were recorded.The primary efficacy endpoint was the Mander Index in the two groups. We compared the Maastricht AS Enthesis Score ( MASFS) index,Spondyloarthritis Research Consortium of Canada ( SPARCC) index,Berlin index and San Francisco index with the Mander Index. Results A total of 127 patients were included with 92 in the etanercept group and 35 in the placebo group.In etanercept group there were 25,41,47 patients without enthesitis at week 2,4,6 separately. At week 12,more than 70％ patients' enthesitis in two groups turned negative.The primary endpoint,as the Mander Index at week 6,was achieved by 0(0,2) score in the etanercept group compared with 1 (0,3) score in the placebo group (P =0.0286). Among the four Indexes.the San Francisco Index was the one most COrrelated with the Mander Index.Conclusion Etanercept can improve the symptoms of enthesitis fast and significantly. In clinics,the San Francisco Index is easier to operate and more accurate for assessment.

China ; Cleft Lip ; etiology ; therapy ; Cleft Palate ; etiology ; therapy ; Humans

Objective To explore the distribution and genotypes of plasmid-mediated quionlone resistance (PMQR)genes and intI1 integrase genes in Enterobacteriaceae isolates.Methods The PMQR genes and intI1 integrase genes were identified by polymerase chain reaction in the nonduplicate strains of E.coli (80),E.cloacae (18)and K.pneunoniae (27).The positive PCR products were subj ect to DNA sequencing analysis.The gene-positive strains were tested by conj ugation experiment.The minimum inhibitory concentrations (MICs)of donor,recipient strains and transconj ugants were tested by agar dilution method with quinolones and other antimicrobial agents.Results Sixteen (12.8%)of the 125 Enterobacteriaceae isolates were qnr gene positive,including 8 qnrS1 positive and 8 qnrB6 positive.Furthermore,the aac(6′)-Ib-cr gene was identified in 15 (12.0%) strains.Twenty PMQR-positive isolates harbored intI1 integrase gene.The conjugation experiments were successful in 12 of the 26 PMQR-positive isolates and 7 of the 20 intI1-positive isolates.The MICs of quinolones and other antimicrobial agents against the transconj ugants were higher than the MIC values against recipient strains.Conclusions The PMQR genes are prevalent in Enterobacteriaceae isolates.The PMQR-positive isolates can co-harbor integrase genes.These resistance genes have the feature of horizontal transfer,to which close attention should be paid.

With the progress of science technology,the 3D technology has raised comprehensive attention for its application value in medical field,especially in the orthopedic field.It has been mainly used before complicated orthopedic surgeries,and several studies have focused on 3D duplicated materials used in the treatment of bone defect.However,there are seldom studies about the 3 D technology used during surgeries,such as whether it is possible to 3D print internal fixation materials of bone fracture (the materials have biodegradability and excellent biomechanical characteristics),which can not only promote the healing of fracture,but also reduce the pain of second surgery for the patient.This paper reviews and summarizes the exploration of foreign and domestic scholars about the application value of 3 D printing technology used in complicated bone fracture,and proposes a forecast to the developing trend of the technology used in future orthopedic surgeries.

Objective To study the burden of dementia patients' caregivers and related influencing elements.Methods A survey was carried out in 152 dementia patients' caregivers after studying the prevalence of dementia in Gushan town using self-designed questionnaires.Results Among the 152 earegivers,65.13% received primary school education or below.And those taking care of disabled dementia patients,taking care of patients with higher ADL scores,attending on without professional helper,having insufficient knowledge,reluctant to give care,and spending much time on it got higher burden score.Conclusions Among caregivers of dementia patients,females are more than males;sons,daughters and spouse are the primary caregivers.Their education level is low,and the caregivers don't have enough knowledge on dementia care and can't give enough service to the senile dementia patients.

Objective: To establish the quality standard for Yangyinjiangtang Tablet. (Radix Astragali, Cortex Moutan, Rhizoma Polygoni Cuspidati, Radix Puerariae, etc.). Methods: Radix Astragali, Radix Puerareiae, Cortex Moutan and Rhizoma Polygoni Cuspidatiwere by TLC. Puerarin was determined by HPLC. Results: Radix Astragali, Radix Puerareiae, Cortex Moutan and Rhizoma Polygoni Cuspidati could be detected by TLC. Puerarin showed a good linear relationship at a range of 10.0～60.0 ?g, r=0.9996. The average recovery was 99.6%, and RSD was 1.52%, respectively. Conclusion: The method established is simple, feasible and reproducible. This study provided a method for the quality control of Yangyinjiangtang Tablets.

O bjective To introducetheosteotomyofacetabularmedialwallas a techniqueto facilitateanatomicalimplantationand securefitofacetabularcupsfordysplastichips. Methods Eighteen hipreplacementswereperformedwithuseofan osteotomyofacetabularmedialwalltostabilizethecups in 17 dysplasticpatients. The patientswere aged from35-70 years, withan averageof51.4 year. Among all thedysplastichips,4 were oftypeⅠ,7 oftypeⅡ,4 oftypeⅢ,and 3 oftypeⅣ accordingtotheCrowe criteria. A Ranawat trianglewas drawn on theX-ray film, and a supposedoptimalrotatingcenterwas located.Bothofthehorizontaland verticaldistancesbetweenfemoralhead and supposedrotatingcenterwas decreasedsignificantlyafteroperation.Results With medialwallosteotomy,alltheacetabularcomponents wereplacedinthetrueacetabulum.The diametersoftheimplantedcupswere44-56 mm withan averageof 50.78 mm . Medialbony wallwas preservedwithan averagethicknessof9.5 mm . The horizontaldistance was 21.09 mm (12-40 mm )preoperativelyand 3.73 mm (-3-10.1 mm )postoperatively,therewas statistical difference(t=7.95,P

Objective To investigate major causes of chronic diseases and death from 2004 to 2006 in Gang Za district of Nan Tong city. Methods According to ICD-10, the data of diseases were coded and classified. Mortalities were accounted. Results The crude mortality of the whole crowd was for 754.26 / 100 000, and standardized mortality was for 419.47 / 100 000. The crude mortalities of chronic diseases (malignant tumor, cerebrovascular disease, respiratory system, cardiac disease and endocrine system disease) were for 208.97 / 100 000, 151.79 / 100 000, 114.17 / 100 000, 101.38 / 100 000, 16.55 / 100 000, and standardized mortalities were for 77.73/ 100 000, 56.14 / 100 000, 50.28 / 100 000, 9.19 / 100 000. The percent of death was 78.60%. The standardized mortalities of malignant tumor, cerebrovascular disease and endocrine system disease were in the up trend. Conclusions It is clear that malignant tumor, cerebrovascular disease,respiratory system, cardiac disease were the most important causes of death. Health education and effective prevention should be strengthened in order to reduce the mortality of chronic diseases.

OBJECTIVE: To establish and improve the quality management system of drug dismounting and subpackage in hospital.METHODS: The status quo and problem of drug dismounting and subpackage were analyzed,and improvement approaches were put forward.RESULTS: The quality management system of drug dismounting and subpackage was established and improved by enhancing personnel quality,dismounting environment,material management as well as process control.CONCLUSION: The quality management system of drug dismounting and subpackage can effectively guarantee the quality of dismounted drug and is worthy of spreading.