Objective To investigate the surgical treatment of male gynecomastia. Methods The clinical data of 116 cases(156 sites) of male gynecomastia were treated by using micro incision of areola with tumescent anesthesia in the past 4 years were reviewed. Results In this series, 50 to 150 grams mammary gland tissue were resected from the breast. There were no severe postoperative complications,such as nipple or areola necrosis and apparent scar . Follow up was done for 12 to 36 months, the scars were obscure, and the configuration of the breasts were good. Conclusions The operation for male hynecomastia via micro incision of areola with tumescent anesthesia is a good, reliable and convenient technique. It is easily performed with milder injury,less bleeding, and quick recovery.

The integrated courses in pathophysiology have been implemented for clinical medicine in Nanfang Medical University with experimental contrast method since 2006 to compare the advantages of the teaching effect of the integrated courses with traditional learning in pathophysiology with the questionnaire. The results have showed that the students on the integrated track are more positive in the knowledge learning,problem analysis and solving as well as the subsequent clinical knowledge learning.

CXCR4, a receptor for stromal cell-derived factor-1 (SDF-1, also know as CXCL12) and a member of the chemokine receptor family, has been shown to play an important role in the proliferation, migration, invasion and metastasis of breast cancer cells. CXCR4 expression is an early event in breast cancer development and may serve as a biomarker for early detection and diagnosis of breast cancer. Expression of CXCR4 has been demonstrated to correlate with metastasis and poor prognosis in breast cancer. Inhibition of CXCR4 expression may be a potential target of breast cancer treatment.

Objective To study the effects of hypothermia therapy on coagulopathy in neonates with hypoxic-ischemic encephalopathy(HIE) of different degrees.Methods Twenty-five newborns with HIE were divided into 2 groups (moderate HIE group and severe HIE group) by amplitude integrated electroencephalogram(aEEG).The platelet (PLT) count,activated partial thromboplastin time (APTT),prothrombin time(PT),thrombin time(TT),fibrinogen (Fbg) and international normalized ratio (INR) were measured before hypothermia therapy and those after 24 hours,48 hours,72 hours after hypothermia therapy were collected.The hematological parameters of 2 groups were analyzed by repeated measurement analysis of variance.Results The APTT(t=2.239,P<0.05)and PT(t=2.453,P<0.05) of severe HIE group were significantly longer than those of moderate HIE group and significantly different.PLT,PT,APTT and Fbg(all P>0.05)showed no statistically significant difference between 2 groups after hypothermia therapy.The differences in INR(F=12.470,P<0.05),TT(F=8.275,P<0.01)between 2 groups were significant.Fbg at diffe-rent time points showed no significant difference (P>0.05) between 2 groups.The differences in PLT(F=32.420,P<0.01),PT(F=9.377,P<0.01),APTT(F=15.420,P<0.01),TT(F=7.326,P<0.01)and INR(F=12.699,P<0.01)at different time points were significant between 2 groups.The degree of brain injury and time had no interactive effects in PLT,INR and Fbg(all P>0.05).But the degree of brain injury and time had interactive effects in PT(F=3.374,P<0.05),APTT(F=4.227,P<0.05)and TT(F=3.585,P<0.05).It indicated that the change trend in PT,APTT and TT were different between 2 groups.The increase range of PT,APTT and TT of severe HIE group was higher than moderate HIE group after hypothermia therapy for 24 hours.The percentages of severe HIE group who received transfusion with blood product were higher than those of moderate HIE group(P>0.05).Conclusion The coagulopathy function is worse in neonates with severe HIE in hypothermia therapy which may aggravate the hemorrhage risk.And the effect of hypothermia on neonates with moderate HIE is less evident.So hierarchical intervention on coagulopathy in neonates with HIE during hypothermia should be adopted to relieve the hemorrhage risk.

Objective Aiming at the characteristics of the course of acupuncture and massage,to discuss the application of Situational heuristic teaching.Methods 60 undergraduate students in Grade Four of Jiangxi University of Traditional Chinese Medicine (clinical practice) were even divided into 2 groups,that was situational teaching group (the experimental group) and the traditional teaching group (control group).The students in the experimental group received basic theory course of 30 hours,60 hours in the course of situational teaching.The clinical cases of teaching were carefully designed according to the simulated hospital scene in each chapter,including large cases,acupuncture and massage therapy program,which were conducted between teachers and students through interactive and positive research and other forms.In the control group the teachers taught the content to students in class for full 90 hours in accordance with the requirements of the teaching syllabus.Taking objective theoretical examination,subjective questionnaire survey,and subjective clinical return visit questionnaire scores as indicators the difference of the two kinds of teaching methods were compared and statistical analysis was carried out by SPSS 19.0 software,chi square test and t test.Results By comparison of objective theoretical examination results of two groups of subjects,the number of good students in the experimental group was 10,and the number of outstanding students was 7,with an average of (80.63 ± 1.35) points.In the control group,the number of good students was 9,the number of outstanding students was 6,with the average score of (80.54 ± 1.32),and the average score of the objective theory test scores were not statistically significant (P＞0.05).The learning satisfaction of the students in the experimental group was (3.91 ± 0.29).Students in the experimental group thought situation heuristic teaching was conducive to professional development (3.23 ± 0.39),to improving the learning quality (3.68 ± 0.72),clinical thinking culture (4.11 ± 0.24),clinical ability (3.72 ± 0.27),clinical physician-patient communication skills (3.28 ± 0.79),basic clinical skills (3.48 ± 0.42) points,with teaching satisfaction (4.19 ± 0.25),which were all higher than the control group,and the difference was statistically significant (P＜0.05).Conclusion Situational heuristic teaching method is better than the traditional teaching method in stimulating students' learning enthusiasm,innovation ability,cultivating professional interest and cultivating students' clinical practice ability.The teaching practice of teachers should give full play to the advantages of the method and improve the teaching effect,which is worthy of further research and promotion.

Objective To determine the medium-long term functional outcome of arthroscopic repair of type II SLAP lesions with two loops.Methods According to retrospective study,29 cases patients with arthroscopic repairs of isolated type II SLAP lesions were collected from March 2011 to June 2013,the mean patient age at the time of surgery was 31.8 years(range17 to 47 years).All patients with ground anchor suture,and through double loop knot technology to fix SLAP injury.Visual analogue scale(VAS),Kerlan-Jobe Orthopaedic Clinic(KJOC),Roche Shouder function Score(ROWE) were used to determine the function of shoulder joint.The shoulderjoint range of motion before treatment and post treatment were recorded,shoulder joint mobility was recorded,satisfaction survey was done,compared the preoperative and postoperative data to evaluate its clinical effect.Results All patients were available for follow-up of 2.7-5.2 years.Overall,functional outcome was improved from baseline compared with final follow-up for VAS scores((4.3±1.2) points vs.(1.5±0.8) points,t=5.435,P<0.05),KJOC scores((72.1±4.9) points vs.(92.8±5.4) points,t=5.921,P<0.01),and ROWE scores((54.1±12.4) points vs.(84.3±10.2) points,t=7.326,P<0.01).Only a minority of patients feel pain when they did srenuous exercise.According to satisfaction investigation of patients,patient satisfaction was reported in 89.7%,3 cases had not good results,they could not return to previous level of play,including 2 cases were athletes,1 case was not athlete.Conclusion There is no more persistent pain and dysfunction after surgery,a good or excellent medium-long term functional outcome can be anticipated after arthroscopic repair of type II SLAP lesions with two loops.

Objective To investigate and summarize the clinical and high-resolution computed tomography(HRCT) characteristics of invasive pulmonary fungal infections(IPFIs)in children.Methods Clinical and HRCT data of 35 cases with IPFIs admitted in our hospital between March 2007 and July 2015 were retrospectively analyzed.The clinical and HRCT characteristics were summarized.Results Thirty-five patients consisted of 23 boys and 12 girls with mean age of(3.2±1.9) years.Host factors included acute leukemia (n=12),primary immunodeficiency disease (n=4),congenital heart disease (n=2),cerebral palsy (n=2),severe influenza A infection (H1N1) (n=2),ichthyosis (n=1),acquired immunodeficiency syndrome(n=1),systemic lupus erythematous (n=1),tubercular meningitis(n=1),mechanical ventilation(n=2).All patients were treated with broad-spectrum antibiotic,ranking by descending order:third-generation cephalosporins (28 cases),carbapenems(19 cases)and vancomycin (18 cases).Seventeen cases were treated with corticosteroids systemically and 12 cases with acute leukemia took antineoplastic medicine.The symptoms of IPFIs were intermittent or persistent fever,cough and rales.HRCT results:nodules (n=25,71.4％),subpleural patchy opacities (n=24,68.6％),mass (＞3cm) (n=4,11.4％),halo sign (n=27,77.1％),cavities (n=8,22.9％),air crescent sign (n=4,11.4％),miliary nodules (n=2,5.7％),pleural effusion (n=14,40％).Conclusion There are certain specific characteristics of IPFIs in children in clinical and HRCT aspects.The possible diagnosis of IPFIs can be made based on clinical and HRCT features.

Objective To systematically analyze the current situation of case‐control studies published on Chinese nursing ac‐ademic journals and provide references for future researches .Methods All literatures related to case‐control studies published on Chinese nursing academic journals were retrieved from CNKI ,CBM ,Wangfang databases ,and VIP by computer .The literatures were analyzed by bibliometrics method .Results Totally 77 literatures published in 17 journals were retrieved .The number of liter‐atures revealed an increasing tendency .T he content of these literatures involved 11 nursing fields ,such as medicine nursing ,surgery nursing ,and fundamental nursing .29 .9% of studies were supported by research grants .On the other side ,authors were located in 18 provinces ,autonomous regions and municipalities .Meanwhile ,most of them were from developed regions and worked in medical institutions .Conclusion The method of case‐control studies have gradually gained recognition of Chinese nursing researchers . However ,the number of case‐control studies were still small .Nursing researchers should be encouraged to conduct case‐control studies actively and apply this kind of method in more extensive fields of nursing .

Objective To evaluate the reporting and methodological quality of randomized controlled trials (RCTs) related traditional Chinese medical nursing which published in key Chinese journals.Methods Electronic databases were searched for collecting RCTs related traditional Chinese medical nursing which published in key Chinese journals.The impact factors of all these journals ranked the first three in the Chinese S & T journal citation reports,2013.The CONSORT statement and Cochrane collaboration risk of bias tool were applied to evaluate the reporting and methodological quality respectively.Results A total of 135 articles were identified to meet the criteria.To the best of our knowledge,however,none of these articles have reported the 14 items in the CONSORT statement,either without the CONSORT flow diagram.According to the Cochrane Collaboration Risk of Bias Tool,17.0％(23/135) of these articles was confirmed to be high risk of bias,with the rest uncertain in the degree of bias.Conclusions The reporting and methodological quality of RCTs on traditional Chinese medical nursing were poor.It is urgent to improve the methodological and reporting quality of RCTs on traditional Chinese medical nursing researches.

Objective To investigate the status of the plague natural focus and assess the risk of plague in regions with large scale engineering construction project,in order to provide a basis for plague prevention and control.Methods The survey was carried out in 14 regions with large scale engineering construction project of 40 counties in Guizhou Province in 2000-2011,2-3 towns were selected in each county and 2-3 villages in each town,the plague hosts and flea vectors in the residential houses and outdoors were investigated,the sera of 5 animals were collected in each village.The capture rate of hosts and flea index were calculated.Then the samples were cultured and serological tested for plague.Results The density of rodents was 1.14％-3.87％ in the reservoir region' residential building of hydro power station (Tianshengqiao,Pingban,Silin,Guangzhao,Sanbanxi,Dongqing,Qianzhong,Shatuo) and Xingyi airport,and Rattus flavipestus was the dominant species.The density of rodents was 0.00％-0.84％ in the reservoir region of hydro power station (Hongjiadu,Yingzidu,Goupitan,Longtan) and Jinyang district; the total flea index in Yinzidu,Pingban,Longtan reservoir regions of hydro power stations were 3.16,2.00,1.06,3.47 and 1.99,respectively.A total of 21 rodent and flea samples from Tianshengqiao hydro power station were tested positive for F1 antigen of the plague.Three strains of Yersiniapestis were isolated.Nine rat filter paper blood samples and 7 sera of indicative animals were tested plague F1 antibody positive.Other regions with large scale engineering construction project were tested negative.Conclusions The reservoir region of Tianshengqiao hydro power station is endemic areas of the plague,where belong to high risk areas.The density of Rattus flavipestus is higher than the controlling standard of the country in the reservoir region of hydro power station (Pingban,Silin,Guangzhao,Sanbanxi,Dongqing,Qianzhong,Shatuo),where belong to potential risk areas.The plague prevention and monitoring should be continually strengthened to reduce the risk of plague.