For the near-infrared (NIR) spectral analysis of the concentration of blood glucose, the calibration accuracy can be affected because of the existing of outlier samples. In this research, a Monte-Carlo cross validation (MCCV) method is constructed for eliminating outlier samples. The human blood plasma experiment in vitro and the human body experiment in vivo were introduced to evaluate the MCCV method for its application effect in NIR spectral analysis of blood glucose. And the uninformative sample elimination method based on modified uninformative variable elimination (MUVE-USE) was employed in this study for the comparison with MCCV. The results indicated that, like the MUVE-USE method, the outlier samples elimination method based on MCCV could be used to eliminate the outlier samples which came from gross errors (such as bad sample) or system errors (such as baseline drift). In addition, the outlier samples from the random errors of uncertain causes which affect model accuracy can be eliminated simultaneously by MCCV. The elimination of multiple outlier samples is beneficial to the improvement of prediction accuracy of calibration model.
Blood Glucose ; analysis ; Calibration ; Humans ; Models, Theoretical ; Monte Carlo Method ; Spectroscopy, Near-Infrared ; methods

OBJECTIVETo investigate the clinicopathological features and prognosis of primary squamous cell carcinoma of the breast and to improve the diagnosis, treatment and prognosis of this disease.

METHODSThe clinicopathological data of 22 patients with primary squamous cell carcinoma of the breast treated in our hospital between January 1985 and January 2011 were retrospectively reviewed. The correlation between age, tumor size, axillary node status, treatment modality and prognosis was statistically analyzed.

RESULTSAll the 22 patients were female and their median age was 56 years.The average tumor diameter was 3.6 cm.The diagnosis was confirmed by histopathology. The positive rates of expression of ER, PR and HER-2 of the breast cancers were 9. 1%, 9. 1% and 33. 3%, respectively. In follow-up visits, recurrence or metastasis was found in 5 patients and they all died of it. The median overall survival of the 22 patients was 60 months and their overall 5-year survival rate was 73.6%. Univariate analysis showed that the tumor maximum diameter (P = 0.024) and axillary lymph node status (P = 0.022) were impact factors, while menopause, chemotherapy and radiotherapy were not. Cox multivariate analysis showed that the tumor size (P = 0.021) and axillary lymph node status (P = 0.037) were independent prognostic factors for primary squamous cell carcinoma of the breast.

CONCLUSIONSPrimary squamous cell carcinoma of the breast is a rare entity and lack of specific clinical features. Axillary node status is an independent prognostic factor.

Analysis of Variance ; Axilla ; Breast Neoplasms ; metabolism ; mortality ; pathology ; Carcinoma, Squamous Cell ; metabolism ; mortality ; pathology ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Survival Rate ; Tumor Burden

Autosomal recessive polycystic kidney disease (ARPKD) had a low incidence, and mainly in neonates or infants. It is caused by mutations of the polycystic kidney and hepatic disease 1 gene (PKHD1). The pathogenesis of ARPKD is still not clear. The principal of treatment is focused on the control of complications and slow down the progression. In this article, the research advances in the pathogenesis and treatment of ARPKD was reviewed.

Objective To evaluate the effect of nitroglycerin (NTG)-induced hypotension on cognitive function after endoscopic sinus surgery performed under isoflurane anesthesia in elderly patients.Methods Forty ASAⅠ or Ⅱ patients aged 65-85 yr weighing 40-75 ks undergoing endoscopic nasal sinus surgery for chronic sinusitis under isoflurane anesthesia were randomly divided into 2 groups(n=20 each):control group(group C) and controlled hypotension group(group H).Anesthesia was maintained with isoflurane inhalation in both groups.In group H controlled hypotension was induced and maintained with continuous iv infusion of NTG at function was assessed 1 day before(baseline)and at 6,12,24 and 72h after surgery using Minimental State examination (MMSE) and scored.Results The MMSE scores were significantly decreased after surgery from 6h to 24h in both groups and were significantly lower in group H than in group C.There was no significant difference in MMSE scores between the 2 groups at 72h after surgery.The incidence of cognitive deficit was significantly higher in group H(55%) than in group C(25%).Conclusion Controlled hypotension induced by NTG may aggravate transient cognitive deficit after isoflurane anesthesia in elderly patients.

Hepatitis B is a serious hazard to human health.This paper describes the current clinical use of several nucleoside antiviral drugs combination,and introduces the candidate drugs which are able to effectively inhibit the hepatitis B virus replication in vivo and in vitro in two years,which provides reference for the research and development of new anti-HBV drugs.

Objective　To analyze the CT features and diagnostic valuation of endometriosis. Methods 　The CT features in 26 cases with endometriosis confirmed by operation and pathology were retrospectively studied. Results　The endometriosis deposited in the overly （n=16）,wall of bladder （n=2）,uterus （n=5）,and Vagina （n=3）.On CT,the lesion could appear as a round or oval or irregular,Cystic or solid or mixed mass,with unclear margin,and certain adhesion to surrounding sssstructures.There were some small cysts within the mass.On enhanced CT,the cystic margin and solid part of the mass could be enhanced. Conclusion　CT features with clinical information,it is possible to diagnosis endometriosis.

Objective To identify the relationship between the clinical characteristics and prognostic factors in sequentially occurring primary cancers of the breast and ovarian.Methods Clinical and pathological data of 44 cases of successive primary cancers of the breast and ovarian in each single patient diagnosed in Tianjin Medical University Cancer Institute and Hospital from 2000 to 2013 were retrospectively analyzed.Results The median overall survival of all patients with double primary cancers of breast and ovarian was 264 months.3-year overall survival rate was 95.3％ and 5-year overall survival rate was 83.0％ respectively.32 patients were first diagnosed with breast cancer and 12 patients firstly suffered from ovarian cancer.The interval between breast cancer and ovarian cancer was 1-240 months (median 60 months).The staging of ovarian cancer (P =0.005) is the main prognostic factor.In patients firstly diagnosed breast cancer,age (P =0.025) and chemotherapy(P =0.010) were mainly associated with the interval between breast cancer and ovarian cancer.Age when first cancer diagnosed,tumor size of the breast and staging of ovarian cancer were mainly prognostic factors.Age when breast cancer diagnosed and chemotherapy were factors impacting the interval of breast cancer and ovarian cancer.Conclusions For patients with sequentially diagnosed primary cancers of the breast and ovarian cancer,late stage ovarian cancer predicts a poor prognosis.The interval in patients aged 50 and below suffering from secondary cancer is long.Proper chemotherapy for breast cancer seems to delay the occuring of ovarian cancer.

Objective:To improve the recognition, appropriate diagnosis, and treatment of breast cancer in women aged 25 years or less through their clinicopathological features, diagnosis, treatment, and prognosis. Methods:The clinicopathological data from 77 patients with breast cancer treated in our hospital between January 1995 and January 2010 were retrospectively reviewed. The correla-tion between age, lactation, tumor size, axillary node status, surgical approach, pathological stage, indicators of immunohistochemistry treatment modality, and prognosis was analyzed using statistical software. Results:All patients were female, and their average age was 22.94 ± 1.94 years. The diagnosis depended on pathological examination. In the follow-up visits, recurrence or metastasis was found in 27 patients, of which 18 died . The median overall survival was 39 months, and the median progression-free survival was 36 months. The 3 year overall survival rates of stagesⅠ,Ⅱ,Ⅲ, andⅣwere 100%, 92.44%, 59.97%, and 0, respectively. The 5 year overall sur-vival rates of the four stages were 100%, 86.84%, 59.97%, and 0, respectively. Univariate factor analysis showed that tumor size, axil-lary lymph node status, surgical approach, pathological stage, and estrogen receptor were impact factors, whereas lactation, progester-one receptor, human epidermal growth factor receptor-2, p53, molecular subtyping, chemotherapy, and radiotherapy were not. Cox mul-tivariate analysis showed that axillary lymph node status was an independent prognostic factor for breast cancer in women aged 25 years or less. Conclusion:Breast cancer in young women is rare and has unique characteristics in biological behaviors, diagnosis, prognosis, and other factors. Axillary lymph node status was an independent prognostic factor. The crucial factors in the treatment were diagnosis and on time and early-stage treatment.

Adjuvant treatment, which includes chemotherapy and endocrine therapy, for early breast cancer may impair bone den-sity, resulting in bone loss. The third generation bisphosphonate-zoledronic is an anti-resorptive agent that inhibits osteoclast-mediated bone resorption. This drug can be mainly used in the treatment of hypercalcemia caused by bone metastases of the cancer. The Zome-ta-Femara Adjuvant Synergy Trial revealed that immediate zoledronic acid and endocrine therapy not only prevents bone loss, but also reduces recurrence. The Austrian Breast and Colorectal Cancer Study Group-12 (ABCSG-12) also confirmed that zoledronic acid, when combined with endocrine therapy, could reduce the risk of cancer disease progression and death. Moreover, preclinical studies and clini-cal trials have demonstrated the synergistic antitumor effects of chemotherapy and zoledronic acid. Neo-adjuvant zoledronic acid to re-duce recurrence trials showed that the addition of zoledronic acid to adjuvant chemotherapy significantly reduced the risk of disease pro-gression and death in postmenopausal women more than five years postmenopause at the beginning of the study or over 60 years of age at the baseline. The ABCSG-12 subgroup analysis based on age (≤40 years or>40 years) also showed that zoledronic acid can signifi-cantly improve the prognosis in women who were over 40 years at the study entry. These results suggest that zoledronic acid administra-tion in patients with lowered estrogen levels (naturally or as a consequence of adjuvant treatment) easily exerts anti-tumor effects. How-ever, the optimal dose and duration of zoledronic acid requires further studies. More clinical trials should be performed to provide suffi-cient evidence to support the effectiveness of zoledronic acid in the treatment of early breast cancer.

Objective To explore the application of 2010 edition cardiopulmonary resuscitation clinical nursing teaching pathway combined with OSCE mode in teaching and assessment,and improve clinical emergency response capabilities.Methods 99 target school undergraduate nursing students were selected as research objects,and were randomly divided into the traditional group (50 students) and the combination group(49 students).The traditional group adopted the traditional CPR teaching and assessment methods,the combination group took the 2010 version of CPR pathway and OSCE clinical nursing teaching mo de.The mastery of CPR was compared between two groups.Results The mastery of cardiopulmonary resuscitation skills of the combination group was significantly better than that of the traditional group.Conclusions Implementation of the combination of 2010 version of the CPR and the OSCE clinical nursing teaching pathway mode can effectively promote the mastery of CPR skills by students,effectively improve the first-aid skills and adaptability of students.