Objective To investigate the expression of vascular endothelial cell growth factor-C (VEGF-C) and its receptor--vascular endothelial cell growth factor receptor-3 (VEGFR-3) in breast cancer tissue and its correlation with metastasis of lymphonodi axillares.Methods Fifty-eight cases of breast cancer samples and 10 cases of tumor adjacent non-carcinomatous tissue were measured by immunohistochemical staining for expression of VEGF-C and VEGFR-3. Their expression rates were compared between axillary lymph node metastasis and non-metastasis groups.Results The positive rates of VEGF-C and VEGFR-3 as well as the number of VEGFR-3 positive vessels were significantly higher than those in lymph node non-metastasis group (87.5% vs 55.9%; 83.3% vs 38.2%; 8.54±2.54 vs 4.73±2.46, respectively).Conclusion The high expression of VEGF-C and VEGFR-3 as well as the increase in the number of VEGFR-3 positive vessels are related to lymph node metastasis of human breast cancer. VEGF-C/VEGFR-3 system may be a new specific target which contributes to blockage of lymphatic metastasis in breast cancer.

Purpose:To study the expression of Ki-67 antigen in normal mucosae,benign and malignant neoplasms of colorectum and its clinical significance. Methods:33 cases of carcinomas,13 cases of benign neoplasms and 13 cases of normal mucosae of colorectum were collected. Ki-67 antigen was detected using flow cytometry.Results:The Ki-67 antigen positive fraction of normal mucosae,benign and malignant neoplasms of colorectum were 2.65%?1.51%,6.38%?2.51%,18.52%?8.53% respectivly, there being significant difference between the groups(P0.05). Conclusions:Ki-67 antigen expression is a valuable marker to distinguish the normal mucosae,benign and malignant neoplasms of colorectum. Ki-67 antigen expression has no relation with tumor size,type of histopathology,Dukes stage,location,length of illness history,age,sex of the colorectal carcinoma patients.

Objective To investigate and analyze the clinical efficacy of psychological intervention in the treatment of uterine atony postpartum hemorrhage and its influence on the quality of life. Methods 100 cases of uterine atony postpartum hemorrhage were selected in our hospital from March 2015 to September 2016.The subjects were randomly divided into the control group and the experimental group, 50 cases in each group. The patients in the control group were treated with oxytocin, and the experimental group was treated with Xinmu Pei combined with psychological intervention.The treatment effect and quality of life total score were compared between two groups. Results After the corresponding treatment, the effective rate of the experimental group was 92.0％, which was significantly higher than that of the control group(72.0％), the difference was statistically significant (P<0.05). The total score of quality of life in the experimental group was (75.2±11.2) points, significantly higher than that of the control group (64.2±9.3), the difference was statistically significant (P<0.05). Conclusion The clinical effect of psychological intervention of hemabate in treatment of postpartum hemorrhage maternal, can improve the therapeutic effect to a great extent, improve the quality of life of patients, with further clinical promotion and application significance.

BACKGROUND:Studies have shown that ankle-foot orthosis can increase the feedback on the input information from receptors in the skin of the foot and leg to improve the ankle joint position sense, and promote brain function reorganization.
OBJECTIVE:To systematical y evaluate the effect of ankle-foot orthosis on the improvement of walking in hemiplegic patients.
METHODS:The Chinese Biomedical Literature Database, CNKI, WanFang Data and VIP database were searched for reports of randomized control ed trials of ankle-foot orthosis to improve walking ability in hemiplegic patients, from the date of establishment of each database to June 2013. The randomized control ed trials which met the criteria were included for the Meta-analysis.
RESULTS AND CONCLUSION:A total of 9 randomized control ed trials involving 456 patients were included. Meta-analysis showed that, compared with conventional treatment and drug therapy, ankle foot orthosis via the continuous treatment shows certain advantages to improve lower extremity motor function in hemiplegic patients, life skil s and 10-meter maximum walking speed. Due to a limited number of included documents, the remaining indicators such as walking speed, stride difference and balance function were only for appropriate descriptive analysis. The results suggested that, by improving abnormal gait, walking speed, stride frequency, gait cycle, space asymmetry, ankle muscle spasms and balancing, the ankle-foot orthosis could achieve the goal of improving walking function. Ankle-foot orthoses could not be confirmed to exert the role in the fol owing indicators, including time asymmetry, double support phase prolongation and stride length. This evidence shows that ankle-foot orthoses in hemiplegic patients may promote recovery of motor function of the lower limbs and activities of daily living to a certain extent, but the more high-quality, multi-center randomized control ed trials with large samples are necessary.

Objective To explore the practicality and feasibility and evaluation of the team based learning method (TBL) combined with the clinical pathway leaning method (CP) in clinical teaching of department of gynecology and obstetrics. Methods Toltally 40 clinical specialist interns selected for the study were randomly divided into two groups (each 20) respectively, using TBL com-bined with CP teaching method and traditional teaching method, and to make analysis and comparisons on the above two teaching methods. Differences were compared with t testing. Meanwhile, a question-naire survey was carried out among students of TBL combined with CP teaching group for qualitative analysis of the implementation effect of TBL combined with CP pedagogy. (Qualitative analysis is the medical students' evaluation of teaching effect, without further statistical processing). Results The professional test results of TBL combined with CP teaching team were superior to the traditional teach-ing group [(83.95 ±7.63) vs. (72.00 ±5.26)] and the difference was significant by paired t tests and analysis (t=5.063,P<0.05). The knowledge contest results of TBL combined with CP teaching team were superior to the traditional teaching group(90 vs. 85,95 vs. 75,85 vs. 70). TBL combined with CP method has been recognized by 90% medical students and they think that most of their quality has been further improved. Conclusions TBL combined with CP method for the clinical teaching of de-partment of gynecology and obstetrics is practical and feasible, and should be widely applied.

BACKGROUND:Severely curved root canal preparation is the difficulty during clinical root canal preparation, and improper preparation may induce complications such as stage, root canal offset and apical open, which affect the quality of root canal preparation and apical closure. Therefore, it is important to choose a root canal preparation instrument which has the best cutting and forming ability. OBJECTIVE: To compare the shaping ability of Mtwo nickel-titanium rotary instruments, K3 nickel-titanium rotary instruments and stainless steel K-files for the preparation of curved root canals. METHODS:A total of 30 severely curved root canals of freshly extracted human maxilary molars were randomly divided into three groups, with 10 canals in each group. The canals were prepared by Mtwo instruments, K3 instruments and K-files, respectively. The instrument’s tip location in pre- and post-instrumentation radiographs of the three groups was recorded; the changes of root curvature, working length and working time in the three groups were measured and compared. RESULTS AND CONCLUSION:The root curvature showed no significant difference in the three groups before preparation (P> 0.05). The changes of root curvature after root preparation in Mtwo instrument and K3 instrument groups were significantly less than that in K-files group (P < 0.01), and no significant difference was found between Mtwo instrument group and K3 instrument group (P > 0.05). The root canal preparation time in the three groups showed significant differences (P < 0.01), which was the shortest in Mtwo instrument group and the longest in K-files group. The changes of working length after root preparation in the three groups showed no significant difference (P > 0.05). Mtwo nickel-titanium rotary instruments and K3 nickel-titanium rotary instruments are have high efficacy and strong shaping ability in preparing curved root canals.

Objective To study the effect of transcranial ultrasound (US) on arterial recanalization in acute ischemic stroke patients.Methods Patients with acute middle cerebral artery (MCA) main stem occlusion after 6 h were randomized into a target group receiving low-frequency,pulse-wave mode,transcranial US for 30 min or a control group.All were treated with intravenous urokinase for thrombolysis.Transcranial doppler sonography (TCD) was used to document vascular occlusion and confirm recanalization at 2 h and 24 h after treatment,and the patients were evaluated using the National Institutes of Health Stroke Scale ( NIHSS).Results Recanilization (complete or partial) after 2 hours was significantly higher in the US group (44.4％) compared with the control group ( 10.5％ ).Recanalization had occurred in 50％ of the US group 24 hours after treatment compared with 15.7％ of the controls.At 2 h after treatment,33.3％ of the US group and 5.5％ of the controls had improved at least 4 points on the NIHSS assessment.After 24 hours the figures were 44.4％ and 10.5％.After 3 months,11 subjects from US group (61.1％ ) had a modified Rankin score ≤2 compared with 4 subjects (21％) from the control group.Conclusions In acute ischemic stroke,transcranial US has positive effects on recanalization and neural function.

Objective To explore the improvement of cardiopulmonary resuscitation (CPR) efficiency by rescue team through the clinical access to pre-hospital care.Methods Mter establishment of clinical approaches to cardiac arrest,the training program of first line personnel of rescue teams in the Hangzhou Emergency Center was carried out with practice on simulated patients and scenario.A total of 45 eligible teams were randomly enrolled for study by observing the performance of some essential resuscitation techniques before and after training.Result The efficiency of resuscitation performed by rescue team for cardiac arrest was generally not good enough before training evidenced by the shortage of application of ECG monitoring,endotracheal intubations and establishing intravenous line which were only 8 (17.8％),5(11.1％),6 (13.3 ％),respectively,and the interruption time of chest compression during the first three minutes was (102.13 ± 13.68) seconds and the successfully artificial respiration ratios by assistant members was (0.37 ± 0.09),and ratios of ECG forensics and written inform consent were 8 (17.8％) and 6 (13.3％) respectively,CPR and forensics done simultaneously was only 2 (4.4％).The efficiency of rescue for cardiac arrest was obviously improved after training by the clinical approaches proved by the increase in application of ECG monitoring,endotracheal intubations,intravenous line set up reached to 45 (100％),43 (95.6％),43 (95.6％),respectively,and the interruption time of chest compression during the first three minutes was shorten to (69.7 ± 7.7) seconds and the successfully artificial respiration ratios done by assistant members was (0.57 ±0.12) after training.The ratios of on-site ECG forensics and written inform consent were 40 (88.9％) and 43 (95.6％),respectively,and CPR and evidence obtained simultaneously was up to 36 (80.0％).The efficiency of work done by teams was obviously improved and the risk of miserable events was controlled.Conclusions The clinical approaches to cardiac arrest in prehosptial care is the efficient strategy to rescue the patient with cardiac arrest and it is worthy to popularize at present.

Background:The efficacy of standard triple therapy for eradication of Helicobacter pylori(Hp)is decreasing in recent years,and bismuth-containing quadruple regimen becomes the first-line therapy for Hp infection. However,the application of bismuth has some limitations. Aims:To investigate the efficacy of proton pump inhibitor(PPI)-based standard triple therapy combined with teprenone for Hp eradication. Methods:A total of 155 Hp-infected chronic gastritis patients were enrolled from Jan. 2013 to Dec. 2014 at Aerospace Center Hospital,and were randomly assigned into standard triple therapy group,bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group. Patients in standard triple therapy group were given rabeprazole sodium 20 mg + amoxicillin and clavulanate potassium 914 mg +clarithromycin 500 mg bid for 10 days. Patients in bismuth-containing quadruple therapy group were given standard triple therapy combined with bismuth potassium citrate 0. 6 g bid for 10 days. Patients in teprenone-containing quadruple therapy group were given standard triple therapy combined with teprenone 50 mg bid for 10 days. Symptoms of patients were evaluated before and after eradication therapy. Four weeks after the end of therapy,13 C-urea breath test( UBT)was reexamined to assess the status of Hp infection. Results:One hundred and fifty-two patients completed the treatment course. By ITT analysis,the eradication rates of standard triple therapy group,bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were 69. 8%(37 / 53),86. 5% (45 / 52)and 88. 0% (44 / 50), respectively;by PP analysis,the eradication rates of the three groups were 71. 2%(37 / 52),88. 2% (45 / 51)and 89. 8%(44 / 49),respectively. Eradication rates analyzed by ITT and PP in bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were significantly higher than those in standard triple therapy group(P <0. 05),but no statistically significant difference was found between these two groups( P > 0. 05). Relieving rates of abdominal pain,abdominal distention and belching in bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were higher than those in standard triple therapy group,but statistically significant difference was only found in relieving of abdominal pain between teprenone-containing quadruple therapy group and standard triple therapy group(88. 9% vs. 70. 3% ,P < 0. 05). Adverse effects included transient and mild nausea,diarrhea and black stool, etc. Conclusions:Teprenone-containing quadruple regimen are effective for Hp eradication and symptoms relieving with no severe adverse effects,the efficacy is comparable with bismuth-containing quadruple regimen.

Objective:To investigate the role of soluble Fas ligand (sFasL) in the mechanism of immune escape and counterattack of colorectal cancer.Methods:ELISA was used to detect the level of sFasL in the sera of colorectal cancer patients and the supernatant of SW480. Transmission electron microscopy (TEM), flow cytometry (FCM) analysis and fluorescence microscopy were used to examine the apoptosis of Jurkat induced by the sera of colorectal cancer patients and the supernatant of SW480. The apoptosis was also studied after pretreatment of Jurkat by Fas blocking antibody ZB4. The supernatant of African green monkey cell line Vero was used as control.Results:The concentration of sFasL in sera of colorectal cancer patients was 12.21?1.14 ?g/L before treatment, the concentration decreased significantly after treatment(P