Objective To evaluate the clinical value of breast localization needle placed via mammary ductoscopy in surgical treatment of patients with intraductal neoplasms. Methods In this study,76 patients with intraductal neoplasms diagnosized by mammary ductoscopy from January 2009 to March 2010 in the Second Affiliated Hospital of Soochow University were randomly divided into two groups.For methylene blue group,ducts with the lesion were marked by methylene blue injection before operation.For localization needle group,ducts were marked by localization needle placed via ductoscopy.The operative time,specimen weight,incision length and diagnostic coincidence rate were compared among the two groups. Results Compared to the methylene blue group,the localization needle group had a significantly shorter operative time (31 ± 8 min vs.42 ± 9 min),lighter specimen weight (1.51 ± 1.36 g vs.2.95 ± 2.07 g),and shorter incision (23.2 ± 7.8 mm vs.34.4 ± 7.1 mm).All the breast cancer cases dianosised by mammary ductoscopy were confirmed by postoperative pathology,but the localization needle group had a higher diagnostic coincidence rate than the methylene blue group (94.7% vs. 76.3%). Conclusion Localization needle under mammary ductoscopy is a reliable technique for localizing intraductal neolasms.The surgical excision guided by localization needle is accurate and less traumatic,and should be a routine method marking the tumor involved duct before operation.

Objective The incidence rate of complication during central venous catheterization through internal jugular vein (IJV) and subclavian vein (SV) puncture. Methods Clinical controlled trials about IJV and SV puncture were collected and related literatures were screened according to the criteria of inclusion. The literatures underwent Meta analysis and subsequent analysis of sensitivity. Results A total of 18 literatures were included. Meta analysis indicated that statistical difference existed in the related infection rate [RR=1.74, 95%CI (1.32, 2.30)] and arterial puncture [RR=3.19, 95%CI (1.70, 5.99)], but not in the one-time-puncture success rate [RR=1.06, 95%CI (0.90, 1.24)] between IJV and SV puncture. Conclusions The rate of related infection and arterial puncture was higher by IJV than by SV puncture. But we could not confirm if any difference existed in the one-time-puncture success rate between the two methods. The results still needs evaluation by high-quality randomly controlled experiments.

Objective: To study changes of ultrastructure of atrial endothelial cells during acute atrial fibrillation (AF) in canines, and explore the possible mechanism of AF left atrial thrombosis. Methods: A total of 16 healthy adult mongrel canines were randomly and equally divided into blank control group (only received thoracotomy without pacing) and rapid atrial pacing (RAP) group (established acute AF model). Myocardial tissue of left and right appendage were taken from two groups and received hematoxylin eosin (HE) staining, then myocardial cell morphological changes was observed under ordinary light microscope; morphological changes of appendage endothelial cells was observed under electron microscope. Results: (1) Paroxysmal AF was successfully induced in all canines of RAP group; (2) There were no significant difference in morphology of appendage and endocardial tissue under ordinary light microscope between two groups; 3. Under transmission electron microscope, endothelium cell of appendage tissue presented defect of different extent, and some shedding in RAP group; while endothelial cell layer was complete with absence of necrosis and shedding in blank control group. Compared with blank control group, there was significant rise in endothelial cell incompleteness (12.5% vs. 75.0%) in RAP group, P=0.041. Conclusion: When acute atrial fibrillation occurs, endothelial cell ultrastructure has already changed, which may be related to thrombosis adhered to wall during atrial fibrillation.

Objective This study aims to examine expression of Caveolin -1 in non smoking cell lung cancer(NSCLC)and to discusses the relationship between expression of Caveolin -1 and the Epidermal growth factor receptor mutations .Methods Immunohistochemical staining was used to determine the Caveolin -1 ex-pression and ARMS-qPCR was used to measure EGFR mutations in 40 cases of lung cancer tissue .The clinical pathological characteristics and correlations in patients were analyzed .Results The expression of Caveolin -1 in human lung cancer was significantly lower than that in normal lung tissue ,and negatively correlated with EGFR mutations ,which was statistically significant .Conclusion Caveolin -1 expression is negatively correlated with EGFR mutations in non-small cell lung cancer and related to the histologic type .Caveolin-1 may be a molecu-lar target for diagnosis and judgment of NSCLC .

Objective To investigate the level and influencing factors of PICC catheter patients' willingness to participate in patient safety. Methods A total of 198 PICC catheter patients were sampled from the targeted hospital by convenience sampling,and investigated by the Patient Participate Patient Safety Willingness and Behavior Scale ( PSWBS). Results The PSWBS score of PICC catheter patients was 3.73 ± 0.52 , including initiative willingness 4.13 ± 0.54, initiative tendency 3.82 ± 0.49, attention for technique level 3.70 ± 0.50, attention for environmental safety 3.27 ± 0.48. Among these factors, age(F=14.75, P<0.01), education degree(F=9.588, P<0.01), occupation(25.070, P<0.01), residence(t=8.570, P<0.01)and complications(t=8.880, P<0.01)were the influencing facts with statistical difference (P<0.05) . Conclusions Most of the patients have a high willingness to participate in patient safety , the distribution of impact factors have certain characteristics. Clinical nurses should take targeted nursing measures according to these different characteristics.