Objective: To investigate the diagnostic value of automatic breast volume system (ABVS) for breast carcinoma in clinical practice so as to use these reliable data to provide imaging reference for further therapy. Methods: 300 patients with suspected breast cancer were selected and the postoperative pathological examinations were chosen as the golden standard to implement screening. At the same time, 2 radiologists were selected to carry out the grading diagnoses of breast imaging reporting and data system (BI-RADS) so as to observe the consistency between diagnoses of ABVS and pathological results. Results: 210 patients were diagnosed as breast tumor by the post-operative pathological examination, and these patients included 89 malignant tumor (29.67%, 89/300). In these malignant cases, there were 42 cases were infiltrative ductal carcinoma, and its rate was 47.19% (42/89). Besides, there were 121 cases were benign tumor (40.33%), and the rate of patients with fibrosum adenoma (78 cases) was the highest in the 121 cases (64.46%, 78/121). And the diagnostic consistency of them was preferably (K=0.724). The sensitivity and specificity of ABVS in diagnosing breast carcinoma were 92.86% and 85.56%, respectively. Its positive predictive value and negative predictive value were 93.75% and 83.70%, respectively. And the Youden index was 0.78. Conclusion: ABVS has relatively high sensitivity and specificity, and the screening test has good authenticity and reproducibility. Therefore, it can provide a reliable basis for clinical diagnosis and treatment.

This paper summarizes the nursing care of a child with hand,food and mouth disease complicating multiple organ failure,such as use of ice-blanket and strategies of vessel protection. As a result,the child recovered well and was discharged after rehabilitation.

Objective To establish a scientific, objective and practical evaluation scale for thoracic close drainage system. Methods Based on the evidence-based practice and related documents, the indicators of efficiency for thoracic close drainage system were identified tentatively. Then Delphi method was used and 23 experts were investigated and consulted by two rounds. Results The index of experts activity was 92% and 100% in the first and second round of Delphi consultation, respectively. The scale comprised 50 indicators in 3 dimensions, the experts' authority coefficient was 0.987. Conclusions The reliability and authority of the scale are acceptable and it can be used to evaluate the efficiency of thoracic close drainage system.

Objective To assess the effect and safety of applying Diver CE thrombus-aspirating device during direct percutaneous coronary intervention(PCI)in pations with ST-segment elevation myocardial infarction(STEMI). Methods Select 46 patients with STEMI who underwent direct PCI between July,2006 and June,2007 in Fushun Central Hospital. Dividing these patients into thrombus-aspirating group and direct PCI group,comparing the difference in chest pain relieving.magnitude of ST-segment declining in 2h,TIMI flow grade 3,the maximum value of CK and CK-MB,EF and MACE outcome(death、myocardial infarction and targert vessel revascularization).Results The percent of chest pain relieving、magnitude of ST-segment declining 、TIMI flow grade 3、the maximum value of CK and CK-MB,and EF in thrombus-aspirating group are piror to the direct PCI group(P0.05).Conclusion applying Diver CE thrombus-aspirating device during PCI can obviously reduce thrombus in coronaty artery and distal embolization,improve myocardial reperfusion more effectively.

Objective To dynamic monitoring the changes of serum cortisol,adrenocorticotropic hormone (ACTH) in children with sepsis and servere sepsis,and to assess it's relationship with clinical features.Methods Thirty children with sepsis were enrolled in this study from Sep 2010 to Jan 2011 in our hospital,and were divided into severe sepsis group (n =10) and sepsis group (n =20).The serum cortisol and ACTH were analysed in acute and recovery period respectively in both two groups,and compared with 10 non-sepsis children as control group.Results In the acute period,the level of serum cortisol in severe sepsis group [ (33.97 ±6.83) μg/ml ] was significantly higher than those in sepsis group [ (26.30 ± 10.43) μg/ml]and control group [ ( 19.06 ± 6.91 ) μg/ml ] ( P ＜ 0.01 ) ; the level of serum ACTH in severe sepsis group [ (25.47 ± 9.41 ) pg/ml ] was significantly higher than those in sepsis group [ ( 15.52 ± 5.85 ) pg/ml ] and control group [ (9.16 ± 3.02 ) pg/ml ] ( P ＜ 0.01 ).Conclusion Stress response exists in the early period of sepsis,and the levels of serum cortisol and ACTH are increased significantly.The levels of serum cortisol and ACTH are positive correlation with the severity of diseases,and they could be used as serious index and a marker for evaluating prognosis in children with sepsis.

Objective To evaluate the impacts of health self-management club on hypertensive patients who lived in Gushan town of Fuzhou.Methods Thirty-three community hypertensive patients who partitipated in health self-management club during July and October 2010 were enrolled in this investigation.Control and awareness of high blood pressure and patients' health condition were compared before and after the intervention.Results Normal blood pressure (systolic pressure ＜ 140 mm Hg (1 mm Hg =0.133 kPa),diastolic pressure ＜90 mm Hg) was found in 19 patients after intervention ((19/31 vs 16/33),x2 =1.058,P ＞ 0.05).Meanwhile,awearness rate of normal blood pressure and mediciation order-guided drug taking was increased to 27/33 and 26/31,respectively (x2 vales were 0.047 and 1.242,respectively ; both P ＞ 0.05).Other information inluding annual blood pressure measurement in ＞ 35 years old populations was well known by more participants (x2 vales were 10.810,4.280,4.039,14.249,10.573and 14.539,respectively; all P＜ 0.05).Since intervention,blood pressure was measured at least once a month in all the subjects,and 28/31 patients measured blood pressure weekly (x2 =11.532,P ＜ 0.05).Health condition of the patients were significantly improved after intervention (Z =-2.034,P ＜ 0.05).Conclusions Community health education could raise patients' awareness of hypertension and improve their health condition.Health self-management club may be feasible to hypertensive patients living at rural-urban fringe.

Objective: To investigate the application of conventional ultrasound and 16-slice CT examination in clinical diagnosis of hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia. Methods: To choose 94 cases patients were receiving treatment in our hospital who were diagnosed as hepatic focal lesion through percutaneous biopsy of hepatocyte or histopathological examination of postoperation, and then take conventional ultrasound and 16-slice CT, respectively, to detect them. To compare and analyze the two methods in series of indicator, such as accuracy, the number of lesion size and the imageology character. Results: Conventional ultrasound diagnosis of benign tumor lesions was consistent with spiral CT results, and the difference was not statistical significance (x2=0.5556, P>0.05). The accuracy of spiral CT for hepatic carcinoma was higher than that of conventional ultrasound, and the difference was significant (x2=8.1987, P<0.05). The consistent rate of the spiral CT group with real result for micro-miniature carcinoma (the diameter less than 1 cm) was higher than that of conventional ultrasound group, and their difference was significant (x2=14.4028, P<0.05). The disappear and persist time of hepatic carcinoma patients were longer than that of non-hepatic carcinoma patients, and the difference between them was significant (t=9.7531, P<0.05). Conclusion: It is higher accuracy that 16-spiral CT can diagnose malignancy lesions in earlier stage.

Objective:To study the long-term stability of 6MV photon beam on TrueBeam, which is a new linear accelerator introduced by Varian Medical System. Methods:QA BeamChecker Plus (QABC+, Standard Imaging Inc., Middleton, USA) was used to measure 6MV X-ray on TrueBeam linac as daily quality assurance (Daily QA). Dosimetric parameter, including output Constancy, flatness and symmetry, were employed to evaluate the dose delivery stability of TrueBeam linac. Results: Daily QA results of 18 months showed the dose output delta was (0.0%±0.7%), only once out of tolerance of 2%. The constancy of Flatness was excellent with the delta of (0.1%±0.1%). The symmetric of axial and transverse varied within 1%. Conclusion:The output constancy of TrueBeam with 6MV is very stable, as well as flatness and symmetry. It’s stable and reliable to implement Truebeam linear accelerator in clinical.

Objective:To analyze the skin microbiota diversity in patients with pemphigus vulgaris (PV) using 16S rDNA sequencing.Methods:Ten patients with PV and 10 healthy controls were collected from the Department of Dermatology, the Third People′s Hospital of Hangzhou. Skin swabs were collected from perilesional skin (PV group) and contralateral non-lesional skin (PVn group) of the patients with PV, as well as from the corresponding body sites of the healthy controls (normal control group) . The 16S rDNA amplicon sequencing technology was used for gene sequencing and classification in all microbiota samples, and Usearch software for data cluster analysis to obtain operational taxonomic units (OTUs) and assess species abundance at the phylum, class, order, family and genus levels. Observed species index, Shannon index and Simpson index were used to estimate α diversity, and principal coordinate analysis (PCoA) was performed to analyze β diversity. Linear discriminant analysis effect size (LEfSe) analysis was conducted to identify differentially abundant species in each group. PICRUSt software was used for gene function prediction. Wilcoxon rank sum test was used as nonparametric test for comparisons between 2 groups, and Kruskal Waills test as nonparametric test for comparisons among 3 groups.Results:There were 2 002, 1 869, 1 751, 1 611 and 1 120 OTUs at phylum, class, order, family and genus levels respectively. Cluster analysis showed that skin microbiome in the 3 groups mainly consisted of Firmicutes, Actinobacteria, Bacteroidetes and Proteobacteria at the phylum level. At the genus level, Staphylococcus was the most abundant in the PV group and PVn group, and Corynebacterium was the most abundant in the normal control group. The observed species index, Shannon index and Simpson index all significantly differed among the 3 groups (all P< 0.05) , and the Shannon index and Simpson index were significantly lower in the PV group (3.24±1.30, 0.70±0.19, respectively) than in the normal control group ( P< 0.05) . PCoA analysis showed no significant difference in β diversity among the 3 groups ( P=0.054) . Rank sum test showed that the abundance of 32 species significantly differed among the 3 groups ( P< 0.05) . Among them, high relative abundance was observed in the class Bacilli enriched in the PV group, as well as the genera Micrococcus and Brevundimonas enriched in the normal control group. According to the disease duration, the patients with PV were divided into long-course PV group with disease duration of ≥ 3 months, and short-course PV group with disease duration of < 3 months. Clostridiales, Oscillibacter, Sphingomonas were enriched in the long-course PV group, and Gammaproteobacteria was enriched in the short-course PV group. Gene function prediction analysis showed that the genes related to infectious diseases were enriched in the pemphigus group. Conclusion:The 16S rDNA-based microbiota profiling suggested differences in the diversity and composition of skin microbiota between patients with PV and healthy individuals.

Objecfive To investigate the effects of endotoxin on nuclear factor-κB p65(NF-κB p65)mRNA expression and ahtosteron secretion in rat hepatic stellate cells(HSCs).Methods Cultured rat HSCs(HSC-T6)were divided into endotoxin-treated group and control group.Cells in endotoxin-treated group were exposure to 1 mg/ml.endotoxin.Aldosteron secretions of HSCs were determined by radioimmunoassay,and NF-κB p65 mRNA expressions of HSCs were detected by one-step RT-PCR.Results At 6,12,24 and 48 h,aldosteron secretions in endotoxin-treated group were significantly hisher than those in the control group(t=3.063,4.577,6.847 and 9.317,P<0.05),and the expressions of NF-κB p65 mRNA in endotoxin-treated group were also higher than those in control group(t=5.155,6.095,7.875 and 9.313,P<0.01).Aldosteron secretions and NF-κB p65 mRNA expressions in HSCs displayed a positive correlation(r=0.886,P<0.01).Conclusion Endotoxin can up-regulate the aldosteron secretion and NF-κB p65 mRNA expression in rat HSCs,which may be one of the mechanisms of liver fibrosis induced by endotoxin.