Objective To explore the preoperative misdiagnosis in the breast cancer and the methods to improve the diagnostic accordance rate. Methods The preoperative diagnosis and results of 358 cases with breast cancer has been analysized retrospectively in the recent ten years. Results Total Cases with present diagnostic technique diagnosed befor operation was 176 only;the accordance rate was less than 50%.With aspiration biopsy and molybdenum palladium roentgenograph,the rate was 25%(79 cases).The actual preoperative accordance rate was less than 10%(32 cases).It is said approximately 90% cases were postoperatively diagnosed. Conclusion The present excision biopsy not only has made many patients lost the chance of chemotherapy preoperation, but also interferenced the application of new therapic methods in the clinical practice.Infrared spectroscopy and ultrasonography have been commonly used in the clinical practice.With the low diagnostic accordance rate,they were applied only for screening.With simplity and high diagnostic accor dance rate,aspiration biopsy and molybdenum pall adium roentgenograph should be enrolled extensively in the clinical practice. The puncture and specimen fixing technique also should be improved.

Objective To find an effective operational approach that can mostly reduce heat and other injury to Calot's triangle when separating and anatomizing it at LC operation.Method We abandoned traditional hot separating method by electric coagulation hook which can cause hot injury easily and cold separating method simply by elastic separating plier which can cause errhysis and illegibility of operational field.We applied sucting and scraping cold separating method mainly by suction apparatus which can keep operational field clear and avoid hot injury.Result 52 cases with different cholecyst disease (including cholecystolithiasis,cholecyst polyp,acute cholecystitis with edema and acute cholecystitis with partly gangrene) were adopted by this method and achieved satisfacted effect.Conclusion Sucting and scraping cold separating method are easily operated and can mostly keep separated tube skeletonized.It can avoid hot and other injury in operation,keep operational field clear by less errhysis.To acute cholecystitis with edema it has more advantage and are worth to adopting.

Objective To investigate and compare the clinical efficacy of mifepristone alone and combined with Gongliuxiao capsule in the treatment of uterine fibroids.Methods 106 patients with uterine fibroids in Harrison International Peace Hospital from December 2012 to December 2013 were selected.The patients were randomly divided into control group and experimental group(n=53).The former were treated with mifepristone alone while the later were treated with the combination of mifepristone and Gongliuxiao capsule.All the patients were given 2 courses of treatment with 12 weeks for a course.The menstrual phase,volume of menstruation,uterus and the volorne of uterine fibroids before and after the treatment,and the clinical efficacy of both groups were evaluated.All the results were recorded and compared. Results The menstrual phase,volume of menstruation,uterus and uterine fibroids of both groups after the treatment were significantly less than those before treatment (P <0.05 ).And the total effective rate of experimental group was 92.45%,which was significantly higher than 73.58% of control group.Both groups had some mild adverse reactions,which didn’t affect the treatment.Conclusion The combination of mifepristone and Gongliuxiao capsule has a great efficacy in the treatment of uterine fibroids.Compared with the use of mifepristone alone,the combination treatment is much more effective.

Objective To investigate the common pathogenic bacteria distribution and drug resistance in children with lower respiratory tract infection,which guide how to use antibiotics and decrease the progress of drug resistance.Methods Nine hundred and ninety-seven cases of lower respiartory tract infection were analyzed retrospectively in the Department of Pediatrics of the First Hospital of Lanzhou University from Jan.2008to Dec.2010.The sputum samples were collected for routine bacterial cultivation.The antibiotic sentivity test were used for pathgen.Results The phelm cultivition amount is 997,bred and separated 498 bacteria of 425samples,the check rate is 42.73％.There were 151 Gram Positive Bacteria,which had a rate of 30.32％,and 321 Gram Negative Bacteria,which had a rate of 64.46％,and 26 fungi whose rate is 5.62％.The main bacteria was changed during the three years.There were significant differences in detection rate of pseudomonas aeruginosa(PA) and haemophilus parainfluenzae(HPI) during the three years.PA was declining while HPI was rising.There were no significant differences in detection rate of streptococcus pneumoniae( SP),staphylococcus aureus ( SA),escherichia coli( E.coli ),klebsiella pneumoniae ( K.pn ),haemophilus influenzae ( HI ) and fungi.There were no significant differences in detection rate of PA between different age groups.With the increasing of age,the detection rate of SP,HI and HPI trended to rise,whereas the detection rate of SA,E.coli and K.pn trended todecline.The resistance phenotype of SA,E.coli and HPI in detection rate had significant difference in each year.SP and SA were most sensitive to linezolid and vancomycin.Ecoli and K.pn were most sensitive to carbapenems.HI and HPI were relatively sensitive to common antibiotics.Conclution In the past three years,the main pathogen in children with lower respiartory tract infection were Gram Negative Bacteria.Among the bacteria,SP and Ecoli was the most,followed by SA,HI,K.pn,and HPI.These bacteria had signifeicant difference in dectection rate between different age groups.SP and SA were most sensitive to vancomnycin and linezolid.E.coli and K.pn were most sensitive to carbapenems.HI and HPI were relatively sensitive to common antibiotics.So clinical doctors should use antibiotics based on the microorganism cultivation and sensitivity test m order to decrease the drugresistance strain.

The carotid plaque (CP) detachment can induce thrombosis, which may lead to cerebral vascular disease. In recent years,research of CP is mainly focused on qualitative and quantitative analysis of vulnerable plaque. Therefore, it is important to choose therapeutic method and opportunity according to the structure and stability of the plaque. This article reviews the progress in the diagnosis of plaque from the aspects of common ultrasound, contrast enhanced ultrasound, ultrasound real-time tissue elastography, intravascular unltrasound, digital subtraction angiography (DSA), comuted tomography angiography (CTA), magnetic resonance imaging (MRI) and optical coherence tomography (OCT). Common and all kinds of new ultrasonic technology can be used to evaluate the vulnerability of CP from different aspects.

AIM: To investigate the infection factors,diagnosis and treatment of endophthalmitis after intraocular foreign body injury.METHODS: Totally 256 cases with intraocular foreign bodies including the occurrence of endophthalmitis in 42 cases were analyzed retrospectively.RESULTS: The incidence of endophthalmitis after intraocular foreign body injury was 16.4%.Posterior segment foreign bodies and combined with traumatic cataract were the risk factors of endophthalmitis after intraocular foreign body injury (all P<0.05).Intravitreal injection of vancomycin hydrochloride and ceftazidime in the treatment of intraocular foreign body injury reduced the incidence of endophthalmitis (P<0.05).Types and sizes of intraocular foreign bodies,the time of extraction and the condition of wound had no significant effect on the incidence of endophthalmitis (all P>0.05).Vitrectomy was the main treatment of endophthalmitis.CONCLUSION: Posterior segment foreign bodies and combined with traumatic cataract were the risk factors of endophthalmitis after intraocular foreign body injury.It should be kept the integrity of the posterior capsule of lens in traumatic cataract surgery.Intravitreal injection of vancomycin and ceftazidime is recommended in emergency surgery.Vitrectomy should be performed as soon as possible when confirmed endophthalmitis.

[Objective]To establish a HPLC method or the determination of ginsenside Rg1 in Danqi tablet.[Method]HPLC conditions were as fellows:DiamonsiLTM C18 colum,a mobile phase of MeOH:H2O(48:52),and the wavelength at 280nm.[Results] There was a good linearity within the rang of 4.8ug～24.0ug of ginsenside Rg1.The average recover was 99.80%and RSD was 1.46%.[Conclusion]This method can be used for the quality control of Danqi tablet.

Cystadenoma, Papillary ; surgery ; Humans

Cytomegalovirus ; Cytomegalovirus Infections ; prevention & control ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; T-Lymphocytes, Cytotoxic ; virology ; Transplantation, Homologous

OBJECTIVE Approach the cause of esophageal perforation and the analysis of diagnosis, therapy and its outcome in this disease. METHODS We retrospectively review 11 patients of esophageal perforation between1997 and 2004 in our department. There were 9 cases were taken out foreign bodies from their esophageal, another 2 cases haven't been found any foreignbodies and 1 of 2 was caused by iatrogenic reasons. Perforation occurred in the cervical esophagus was 4, and in the thoracic esophagus was 7. Their symptoms were dysphagia or pain, retrosternal-pain, dyspnea, subcutaneous emphysema, fever, hematemesis or melena. RESULTS 7/11 cases visited the clinic during 24 hours after foreign-body occured, 4/11 cases visited after 24 hours and the last visited clinic on 27th day late. Dysphagia was the most common presenting symptom specially with pain in eating, noted in 9 cases (81.8 %); retrosternal-pain and fever were noted in 8 cases (72.7 %), subcutaneous emphysema in 5 (45.5 %), dyspnea in 2 (18.2 %), hematemesis and melena.in 1 (9.1 %). 5 cases were died and the common mortality was 45.45 % (5/11). The mortality in primary repair with surgery treatment was 66.7 % (2/3); the mortality in conservative management was 37.5 % (3/8). The mortality of the perforation in cervical esophagus was 25 % (1/4), in thoracic esophagus was 57.14 % (4/7). The mortality of the visit time in 24 hours was 28.57 % (2/7),and out of 24 hour was 75% (3/4). CONCLUSION Sophageal perforation is usually caused by foreign body or iatrogenic in ENT-Head&Neck surgery. The esophageal perforation will been cured that decided in early visiting, taking away of foreign-boby, the right choice of antibiotic, nutritional support, primary healthy statement of esophagus. We regard that should perform non-operational conservative therapy in the patients who resulted in esophageal perforation except abscess or remain causing by foreign body. And the high risks in mortality of the repairing in surgery should been noticed.