Node negative breast cancer is a prevalent form of breast cancer .With the improvement of breast cancer screening and disease awareness ,the rates of node negative breast cancer are gradually increasing . Although node negative breast cancer patients have much lower recurrence rates as compared with node positive patients,node-negative breast cancer is unequal to a low risk disease .Thus,it is important for oncologist to esti-mate the risk factors of node negative disease ,to carry out risk assessment and to guide the best regimen for these patients.In current review ,we discuss the value of traditional prognostic factors and new prognostic factors ,such as the urokinase -type plasminogen activator/plasminogen activator inhibitor 1,oncotype DX,MammaPrint and tumor associated macrophages ,on the predictive and treatment decisions in node negative breast cancer .

Objective To explore the significances of expression of tumor associated macrophages ( TAMs) and its correlation with microvessel density ( MVD) in triple negative breast cancer ( TNBC) .Methods Immunohistochemistry was used to detect TAMs and MVD expression in 108 TNBC tissues and to analyze the cor-relation between TAMs with clinicopathological features ,prognosis and MVD.Results The expression of TAMs was correlated with the tumor size,lymph node metastasis,histological grade,TNM stage and MVD,but had no statistically significant association with age .TAMs was correlated with 5 year disease free survival ( DFS) and over-all survival( OS);MVD was correlated with 5 year DFS, while no correlation with OS .Univariate and multivariate analyses showed that TAMs was an independent unfavorable prognostic factor for patients with TNBC .Conclusion High infiltration of TAMs indicated poor survival rate for patients with TNBC .The infiltration of TAMs was a new,important risk factor for TNBC recurrence .TAMs were closely related to MVD ,by promoting tumor angiogen-esis,thereby promoting TNBC growth ,invasion and metastasis ,and further affect the prognosis of patients with TN-BC.

Objective To evaluate the value of occlusion of congenital heart disease(CHD) combined with pulmonary artery hypertension (PH) by color Doppler echocardiography. Methods Experimental transcatheter closure was performed in 209 patients suffering from CHD with PH, which included 86 cases of atrial septal defect(ASD), 17 cases of ventricular septal defect(VSD) and 106 cases of patent ductus arteriosus(PDA). All patients were occluded experimentally in order to determin whether or not to be the dynamia type of PH. During the process, whether pulmonary arterial systolic pressure(PASP) was stepped down and the degraded degree were detected by echocardiography. Results After 209 cases were done trial occlusion from half an hour to an hour,PASP of 136 cases of lihgt PH patients dropped to normal; in 46 cases of midrange PH patients,PASP of 30 cases dropped to normal,PASP of 16 cases dropped to light; in 17 cases of sever PASP patients,PASP of 9 cases dropped to midrange,PASP of 6 cases stepped down over 30 mmHg,whieh those patients were occluded permanently. PASP failed to respond in 2 cases sever PH after the procedure,implied resistant PH, the permanent transcatheter closure was not recommended and the device was removed. Conclusions PASP can be estimated by color Doppler echocardiography before,during and after occlusion,which could judge reversibility of PH.

Objective To explore the relationship between general self-efficacy sense and psycho-logical health of nursing staff. Methods 230 healthy nursing staff were investigated with self-rating de-pression scale, serf-rating anxiety scale and general serf-efficacy scale. Correlation analysis and t test were adopted to analyze the data. Results There was a negative correlation between the scores of general self-efficacy scale and the scores of self-rating anxiety and depression scale. Moreover, the scores of anxi-ety and depression of nursing staff with higher self-efficacy were higher than those with lower self-effica-cy. Conclusions Self-efficacy sense has positive effects on the level of psychological health of nursing staff. The higher self-efficacy sense will help maintain higher psychological health state.

Objective To investigate acute cell damage and delayed inhibition effects by pulsed electric fields(PEFs)with different frequencies on human ovarian carcinoma cell line SKOV3 in vitro and in subcutaneous transplanted tumor of human SKOV3 in BALB/c nude mice,and evaluate the potential use of relatively higher frequency PEFs to reduce unpleasant sensations without decreasing therapeutic effects in clinical electrochemotherapy.Methods Firstly,SKOV3 cell suspension were exposed to PEFs with gradient increasing frequencies(1,60,1 000,5 000 Hz)and voltages(50,100,150,200,250,300,350,400 V),respectively.MTT assay was used to determine the acute cell damage.Then PEFs with gradient increasing frequencies(1,60,1 000,5 000 Hz)and fixed voltage (250 V)were applied to the subcutaneously transplanted tumor,in vivo antitumor assay was used to observe the delayed inhibition effect;histological changes were observed by light and electron microscope. Results The 1 Hz PEFs has similar cytotoxic effects with 5 kHz,and no significant difference of delayed tumor inhibition effect on subcutaneous transplanted tumor among all groups exposed to different frequencies of PEFs(P＞0.05).Histological observation showed acute damage in all exposed groups.and only in 5 kHz group was induced apoptotic effect observed.Conclusions PEFs with relatively higher frequency can achieve similar tumor killing effect with the low frequency PEFs,and it can also induce apoptosis.Relatively higher frequency PEFs show therapeutic potentials for reducing unpleasant sensations in clinical electrical treatment of tumor.

Objective:To explore the curative effect of acupuncture combined with huanglian wendan decoction on the mild cognitive impairment after stroke.Methods:100 patients with mild cognitive impairment after stroke were enrolled in our hospital from June 2013 to August 2016 and randomly divided into two groups.The control group (n=50) accepted nimodipine,and the study group (n=50)accepted huanglian wendan decoction combined with acupuncture treatment based on the control group.The MMSE and MSSS scores were evaluated and compared,and the improvement of cognitive dysfunction and nervous dysfunction,quality of life were compared and analyzed.Results:After treatment,the MMSE,ADL scores of patients were remarkably decreased compared with those before treatment (P＜0.05),and the decreasing degree of study group was significantly higher than those of the control group (P＜0.05).The MSSS,MBI scores of both groups were significantly increased compared with those before treatment (P＜0.05),and the increasing degree of study group was significantly higher than those of the control group (P＜0.05).The effective rates of improvement in cognitive dysfunction and nervous dysfunction,quality of life of study group were significantly higher than those of the control group (P＜0.05).Conclusions:Huanglian wendan decoction combined with acupuncture treatment was effective for the mild cognitive impairment after stroke and could improve the quality of life.

Objective To explore the relationship between H.pylori (HP) infection and the functional dyspepsia (FD) by 4-lead electrogastrography (EGG). Methods The data of the gastric electrical activity of 163 children with FD, includ-ing 103 children with HP infection (group A), 60 without HP infection (group B) and 22 healthy controls (group C) were mea-sured by 4-lead EGG, which included normal slow wave percentage (N%), bradygastria percentage (B%), tachygastria per-centage (T%) and motilin uneven rhythm percentage (A%). EGG frequency and power examination included the main fre-quency (DF), the main power (DP) and postprandial/pre-prandial gastric electrical main power ratio (P/R). EGG data was compared between three groups. Results There was significant difference in pre-prandial and postprandial percentage of different slow wave frequency between group A and group B. There were no significant differences in pre-prandial and post-prandial changes of DF and DP between group A and group B. There was no significant difference in the pre-prandial and postprandial percentage change of different slow wave frequencies in 84 HP negative patients. But the significant change was found in pre-prandial and postprandial change of DF, DP and P/R. Conclusion The eradication of HP improved the gas-tric electrical activity and relieved the postprandial symptom in children with functional dyspepsia under HP infection.

Cerebral Palsy ; physiopathology ; Child ; Child, Preschool ; Humans ; Infant ; Motor Activity ; Posture ; Walking

Objective To observe the influence of the sperm abnormalities on conventional invitro fertilization therapy outcome. Methods Sperm of 105 infertile husband's semen was analyzed. The patients were divided into three groups according to the sperm morphology observed Using Kruger 's criteria: normal sperm morphology group (sperm normal morphology ≥ 15 % ), mild sperm abnormalities group( sperm normal morphology 10%- 15%), middle sperm abnormalities group (sperm normal morphology 5 % - 10 % ). Fertilization rate, cleavage rate, good quality embryo rate, implantation rate, clinical pregnancy rate and abortion rates were compared to study the influence of the sperm abnormalities on conventional IVF outcome. Results ①Fertilization rate(79.4 % vs 78.3 % ), cleavage rate(104. 6% vs98. 6%), good quality embryo rate(58. 1% vs 53. 9%), implantation rate (31.7% vs 30. 8%), clinical pregnancy rate(48.1% vs 42. 3%)and abortion rates(13.0% vs 18. 2%)were not significantly different between normal sperm morphology group and mild sperm abnormalities group(P>0. 05). ②The fertilization rate (79.4% vs 63.9%), good quality embryo rate(58. 14% vs 48.23%), implantation rate (31.7% vs 16. 7%) and clinical pregnancy rate(48.1%vs24.0%) of the normal sperm morphology group were higher than middle sperm abnormalities group(P<0.05). The abortion rates(13.04% vs 28. 57%) and cleavage rates(104.6% vs 102.9%) were not significantly different(P>0. 05). ③The fertilization rate (78.3% vs 63.9%), good quality embryo rate (53. 9%vs 48. 2%) of the mild sperm morphology group were higher than middle sperm abnormalities group(P <0.05). Implantation rate (30.8% vs 16. 7%) , clinical pregnancy rate(42.3% vs 24.0%) , abortion rates(13. 0% vs 28. 6%) and cleavage rates(104.6% vs 102.9%) were not significantly different (P>0. 05). Conclusions There is a significant influence of middle sperm abnormalities on IVF fertilization rate, good quality embryo rate, implantation rate and clinical pregnancy rate. However, it could not be influenced on mild sperm abnormalities.

Objective:To evaluate the safety of cardiac catheterization intervention therapy and transthoracic small incision surgery in the occlusion bydomestic occluder under echocardiography guiding in patients with atrial septal defect (ASD).Methods:A total of 1 080 patients with ASD in the occlusion by domestic occluder were analyzed retrospectively,and the interventional treatment were performed in 734 cases through cardiac catheterization intervention therapy and 346 cases through transthoracic small incision surgery.The patients undergone cardiac catheterization intervention therapy were guided under the digital substraction angiography (DSA) and were monitored by transthoracic echocardiography (TTE) in the whole interventional process,and the efficacy was evaluated with TTE.The occlusion of transthoracic small incision surgery was guided under the transesophageal echocardiography (TEE),which was used to monitor the position of occluder and evaluate the efficacy immediately.Results:Two kinds of intervention in the occlusion by domestic occluder had achieved satisfactory results in patients with ASD.There was no statistically difference in the longest size of ASD between the 2 intervention methods,while there were statistically differences in the ratio between ASD longest diameter and atrial septal length,and the size of the occlusion,and the disparity between the size of the occluder and ASD longest diameter (D value),respectively (all P＜0.05).When the size of arithmetic mean of the ASD was ＜30 mm,the success rate of the 2 methods was both 100％.When the size of arithmetic mean of the ASD was ≥ 30 mm,the success rate was 100％ in the transthoracic small incision surgery and 50％ in the cardiac catheterization intervention therapy.Conclusion:Domestic occluder is safe.Compared with the imported one,its cost is lower.When the size of the defects is same,the occlusion is smaller in the transthoracic small incision surgery compared with that in the cardiac catheterization intervention therapy.When the size of arithmetic mean of the ASD is ≥ 30 mm,the success rate of the transthoracic small incision surgery is higher compared with the cardiac catheterization intervention therapy.When the cardiac catheterization intervention therapy fails,the transthoracic small incision surgery may be a better choice.