Objective To explore the value of breast-duct endoscopy-assisted epidural catheter-guided tumor localization in the resection of intraductal lesions.Methods A total of 45 cases of breast-duct endoscopy-confirmed intraductal tumor were enrolled in this study.After the depth and location of the tumor was determined,the endoscope was withdrawn and an epidural catheter was inserted into the duct with discharge at a same level to support the duct and guide the resection of the tumor.Then,the skin covering the nipple and areola were cut radially,and the diseased duct was resected under the guidance of a epidural catheter.Results The ductoscopy showed intraductal papilloma in 41 cases,multiple intraductal papillomas in 2,and papillomatosis in 2.In the 41 patients with papilloma,the diagnosis was confirmed pathologically after the operation in 39 cases(95%),while in the 2 patients with multiple papillomas and the 2 with papillomatosis,the identical rate was both 50%(1/2).The misdiagnosed cases included 2 patients with epithelial hyperplasia,1 with multiple intraductal papillomas complicated with atypical ductal hyperplasia and severe focal hyperplasia,and 1 patient with breast cancer.In all the cases,the shape of the breast and nipple were normal after the operation.Conclusion Breast-duct endoscopy-assisted epidural catheter-guided tumor localization is worth being widely used for resection of intraductal lesions in local hospitals,for its precise localization,simple procedure,and good cosmetic outcomes.

Objective To investigate the expression levels and significance of interferon-γ(IFN-γ),interleukin (IL)-10 mRNA in peritoneal fluid mononuclear cells (PFMC) in patients with endometriosis (EM).Methods A total of 55 patients with EM diagnosed histopathologically after operation were enrolled as EM group,and 52 patients without EM were enrolled as control group.The PFMC were isolated,and the expression levels of IFN-γ and IL-10 mRNA were determined by TaqMan real-time reverse transcriptase-polymerase chain reaction (RT-PCR).Results It was found that IFN-γ mRNA expression level was significantly decreased in EM group compared with that in control group (P＜0.05),while IL-10 mRNA expression level was significantly increased in EM group compared with that in control group (P＜0.05).The ratio of IFN-γ/ IL-10 was significantly lower in EM group than that in control group (P＜0.05).The ratio of IFN-γIL-10 was significantly higher in patients with stage Ⅰ-Ⅱ than that in patients with stage Ⅲ-Ⅳ (P＜0.05).Conclusion The imbalance of IFN-γ/ IL-10 in PFMC is associated with the pathogenesis of EM.

Objective To investigate the risk factors for leukoaraiosis. Methods 204 cases of inpatients were registered. The severity of leukoaraiosis was as the dependent variable, the possible risk factors were as independent variables, unconditional logistic regression was analyzed with SAS 9.2 software, significant level α=0.10. Results 5 factors, that were carotid stenosis, age, low density lipoprotein cholesterol,apolipoprotein B and apolipoprotein A, were included, in which the former 4 were risk factors (OR>1, P<0.05), the latter was protection factor (OR=0.715, P=0.0993). Conclusion The vascular risk factors contribute to formation of leukoaraiosis, and carotid stenosis relate to leukoaraiosis.

Objective To investigate and analyze the requirement for health education during and after hospitalizadon of patients with cerebral apoplexy.Methods 150 sober patients with cerebral apoplexy from department of neurology were investigated by questionnaires and the results were analyzed. Results The education content that most patients wanted to understand during hospitalization was treatment method and limbs activity(83.6%and 82.2%);The health education style that they prefered was to communicate directly with doctors and nurses(74.0%);The education content after hospitalization that most patients required was self-nursing knowledge.clinical manifestation and first aid when relapse(90.4%,87.7%and 87.7%).The health education style that they most needed after hospitalization Was that Some reference books would he recommended to them (56.2%).The time choice for health education was consultation whenever they had problems.Conclusion Medical workers should supply selective education and instruction according to the health education requirement and style at different stages of patients with cerebral apoplexy.

OBJECTIVE:To promote the development of pharmacists' clinical thinking ability.METHODS:By analyzing the differences between physicians and pharmacists in clinical thinking together with our practical experience,we expounded the key points of pharmacists' clinical thinking,i.e.critical thinking,comprehensive thinking,evidence-based thinking,patient-cored thinking and creative thinking.RESULTS & CONCLUSION:The clinical thinking that is in line with pharmacists' characteristics should be developed with clinical pharmaceutical practice as the core and it can be achieved by enhancing pharmacists' ability to detect and solve the drug related problems.

0.05). NDP had lower reaction rate, vomiting (15.62%) occurred in NDP group, compared to that which occurred in DDP group (46.88%), with a significant difference between the two groups (P

Objective:To investigate the clinical efficacy and safety of antiplatelet combined with anticoagulation therapy for restenosis prophylaxis after stent placement in diabetic patients with leg atherosclerosis obliterans(LASO). Methods:83 diabetic LASO patients with stent placement were collected and randomly divided into the treatment group(42 cases)and the control group (41 cases)with 49 sick limbs in each. The control group was treated with clopidogrel(75mg,for 1 year)plus bayaspirin(100 mg),while the treatment group was treated with low molecular heparin(withdrawal when INR = 2. 0- 3. 0)plus warfarin(for 6 months)additionally. All cases were followed up for 12 months and the efficacy and safety were compared and evaluated. Results:After therapy,there were no differences in FPG,GHbA1C,TC and LDL-C at each time point between the two groups(P >0. 05). Compared with that in the control group,MLD in the treatment group was improved obviously(P < 0. 05)in the 12th month after the surgery,while restenosis rate and level of D-D in plasma were declined significantly(P < 0. 05). And there was no difference in bleeding rate between the two groups(P > 0. 05). Conclusion:Compared with antiplatelet therapy,antiplatelet combined with anticoagulation therapy for restenosis prophylaxis after stent placement in diabetic LASO patients is more effective and safer,which is worthy of clinical promotion.

Objective: To develop a method for determination of chlorgenic acid in Shuangyin Solution.Methods: HPLC with Hypersil-ODS column (4.6?250mm,5?m) was used. The mobile phase was acetonitrile-water-acetic acid glacial (10∶110∶3). The detective wavelength was 328nm.Results: The linear range was from 0.0568 ～0.2840mg/mL. The average recovery was 100.16%.Conclusion: The method is simple, rapid and accurate. It can be used to determine chlorgenic acid in Shuangyin Solution.