Objective To compare the effect of postoperative single or twin-tube suction drainage after breast cancer surgery.Methods This study was a retrospective review of 148 patients undergoing surgical treatment using the silica gel pipe joint negative pressure ball drainage for breast cancer from February 2013 to December 2014.The twin-tube group was with 88 patients and single-tube group was with 60 patients,and the effect was compared between two groups.Results The incidence of seroma was 18.3％(11/60) and 15.9％(14/ 88) in single-tube group and twin-tube group.The seroma puncture frequency,total drainage volume were (7.48±2.85) times,(300.25±112.37) ml in single-tube group and (4.99±1.89) times,(500.73±96.68) ml in twintube group,and there were significant differences (t=6.097,8.321,P=0.013,0.046).There were no significant differences in drainage time,hospital stay and effusion quantity between two groups(t=1.239,2.018,2.098,P ＞ 0.05).Conclusions It suggests that single tube could be use postoperative drainage instead of two tubes.

Preciseness of intraocular pressure measurement should be emphasized because intraocular pressure is the most important clinical index, which is the easiest one to control as well in glaucoma management. Ocular hypertension and glaucoma including primary open angle glaucoma, normal tension glaucoma and chronic angle closure glaucoma have their own clinical characters and special relationships with intraocular pressure respectively. In this article, on the basis of intraocular pressure, the recent important multicentre clinical research of the world is reviewed and clinical diagnosis and management in ocular hypertension and several common types of glaucoma are discussed.

Although the filtering surgery for glaucoma is the most effective therapy of lowering intraocular pressure,it has risks and complications.To bring its superiority into full play and avoid the risks and complications,we should recognize correctly the type of glaucoma and know accurately the patient's condition.In this article,we discussed the appropriate timing for surgery and other factors that could affect the surgical decisions for patients with primary glaucoma.

[Objective] To emphasize the importance of early prevention and treatment, this article discusses on the theory and application of preventive treatment of disease from traditional Chinese medicine in prevention and treatment of carotid atherosclerosis in patients with diabetes. [Methods] With de-tailed research into related study of risk factors affecting carotid atherosclerosis in type 2 diabetic patients from recent years, comprehensive summary of tra-ditional risk factors and risk factors of the latest findings were demonstrated. The prevention and treatment of carotid atherosclerosis in type 2 diabetes mel itus was discussed in two aspects by theory of“preventive treatment of disease. [Result] In diabetic patients without carotid atherosclerosis, early and timely intervention can prevent the occurrence and development of the diabetes vascular lesions; In diabetic patients with carotid atherosclerosis, active treatment can reduce the incidence of stroke, myocardial infarction and other critical care. [Conclusion] In patients with type 2 diabetes, risk factors affect-ing carotid atherosclerosis should be control ed and intervened early, which can effectively reduce the occurrence and development of the diabetes vascular lesions to improve the quality of life, but early diagnosis technology and indicators need to be further researched.

Objective The study aimed to evaluate the incidence rate and risk factors of early post-mastectomy pain syndrome (EPMPS) after surgery for breast cancer.Methods A retrospective study was carried out in 231 female patients with breast cancer who appeared EPMPS after surgery in the First Hospital of China Medical University from September 2012 to September 2014.They were followed-up for 3 months.Results Among 231 female patients with breast cancer,41.1％ (95/231) suffered from EPMPS.The incidence of EPMPS in women of 40-59 years old was 66.3％ (63/95),significantly higher than other age groups,RR=l.83,P＜0.05.Those who were submitted to axillary lymph node dissection and those without preservation of intercostobrachial nerve had shown a significantly increased risk of EPMPS compared with those with sentinel lymph node biopsy plus no surgery and preservation of intercostobrachial nerve patients (81 cases vs.14 cases,41 cases vs.18 cases,x2=19.921,P＜0.01;x2=11.045,P＜0.05).Conclusions The frequency of EPMPS in the middle-age women is high and possible explanations are unclear.Surgery of axilla affects the incidence of EPMPS,reassurance is key to coping with EPMPS in nursing and rehabilitation.

In coloreetal cancer,there are multiple abnormally expressed microRNA (miRNA),suggesting that the miRNA may be involved in tumor development process.Recently,more and more evidence shows that miRNA are more stable in the blood,compared with mRNA,which makes circulating miRNA are helpful to become the non-invasive tumor marker for the diagnosis,treatment and prognosis evaluation in coloreetal cancer.

OBJECTIVETo explore a safe and effective scheme of analgesic for labor.

METHODSEighty-four primiparas without contraindication of vaginal delivery were divided into an observation group and a control group, 42 cases in each one. In the observation group, the acupoint injection was given at Zusanli (ST 36) combined with electroacupuncture (EA) at Hegu (LI 4) and Sanyinjiao (SP 6) till the cervical opening at the end of first stage labor. In the control group, the routine respiratory instruction was applied. In 5 min, 10 min and 60 min of acupuncture (the same time points in the control group) as well as at the end of the first and second stage labor, the analgesic effect was assessed for the primiparas of the two groups. The labor stages, adverse reactions, postpartum hemorrhage, postpartum urine retention, newborn asphyxia rate and usage rate of oxytocin were compared between the two groups.

RESULTSIn the observation group, in 5 min, 10 min and 60 min of acupuncture as well as at the end of the first and second stages, the visual analogue scale (VAS) was lower apparently as compared with the control group at the corresponding time points (all P < 0.05). The differences in the time limit in the active period, the second and third stages were not significant between the two groups (all P > 0.05). The incidence of adverse reactions and the usage rate of oxytocin were lower than those in the control group [2.4% (1/42) vs 31.0% (13/42); 2.4% (1/42) vs 23.8% (10/42), both P < 0.05]. The differences in postpartum hemorrhage, postpartum urine retention and newborn asphyxia rate were not significant between the two groups (all P > 0.05).

CONCLUSIONThe combination of acupoint injection and EA is the effective analgesic scheme for labor. This scheme effectively alleviates labor pain and has no maternal and child complications.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Analgesics ; administration & dosage ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Labor Pain ; drug therapy ; therapy ; Labor, Obstetric ; Pregnancy ; Young Adult

Objective To observe the location of the watershed zones of the choroidal blood supply relative to the optic disc in glaucoma by indocyanine green angiography, and to investigate the mechanisms in the development of glaucomatous neuropathy. Method Simultaneous ICGA and FFA were performed on 31 eyes of 31 patients with glaucoma (17 of POAG, 14 of NTG) and 37 eyes of 37 control subjects. The watershed zones were classified into three types according to their location relative to the optic disc: by type Ⅰ, no watershed zone around the optic disc; type Ⅱ, the optic disc surrounded partially by watershed zone; type Ⅲ, the optic disc surrounded completely by watershed zone. Each of the watershed zone types was scored (i.e., type Ⅰ=1, type Ⅱ=2, type Ⅲ=3). Results In 87.1% of the glaucomatous eyes, the watershed zones included or partially included the optic disc. However, the figure in the control group was 56.8%. The glaucoma group had a higher score of watershed zone type than the control group. Conclusions The mechanisms in the development of glaucomatous neuropathy are correlative to the choroidal blood supply around the optic disc.

Objective:To discuss the application effect of quality management of quality control circle (QCC) for reducing re-washing rate of suction aspirator tip in the quality management of medical instrument of hospital.Methods: Through established QCC group to designate one topic, to investigate its current situation and to protocol project plan of quality management. The qualified rate of first washing of 904 suction aspirator tips was analyzed before control management of QCC was implemented, and then series of QCC methods including fishbone diagram were applied to analyze and confirm main factors. The protocol countermeasure, depend on above information, achieved improvement for washing quality of 856 suction aspirator tips after the quality management of QCC was implemented in practice. The re-washing rates of washing quality of suction aspirator tip between before and after QCC was applied were compared.Results: The qualified rate of first washing of 904 suction aspirator tips before the quality management of QCC was implemented was 65.7%, while it was 97.6% for 856 suction aspirator tips after quality management of QCC was implemented. The washing qualified rate of suction aspirator tip after quality management of QCC was applied was significantly higher than that before it was applied (x2=8.429,P<0.05), and the result has achieved the aim that continuous improved quality.Conclusion: The application of quality management of QCC can decrease re-washing rate of suction aspirator tip, and contribute to decrease cost, to increase work efficiency, to strengthen the attention and degree of involvement of staff for work quality. Therefore, the management can fully exert potential of member of quality management of QCC, and enhance washing quality of suction aspirator tips.

Objective To study clinical manifestations,laboratory variables,imaging features and therapies of refractory Mycoplasma pneumoniae pneumonia (RMPP).Methods The retrospective analysis of clinical data was conducted in 45 children with RMPP and 74 children with Mycoplasma pneumoniae pneumonia (MPP)admitted to department of pediatrics.The general data,clinical manifestations,laboratory variables,imaging features and therapies were compared between two groups.Results As compared to MPP,the age(6.14 ±3.35)y,febrile days(9.49 ± 5.28)d,the hospitalized days(11.45 ±3.42)d were significantly higher than that of MPP group (P <0.001);RMPP had higher rations of unilateral pulmonary infiltration[41(91.11%)],large consolidation shadows[35(77.78%)], pulmonary[21(46.67%)]and extrapulmonary complications[24(51.33%)](P <0.05);CRP,ESR,LDH and IgM were increased,the difference was statistically significant (P <0.01);Thirty -seven cases(82%)of RMPP had to add ceftriaxone sodium,thirty -two cases(71.7%)of RMPP had to add glucocorticoid,,Bronchofiberoscope lavages were used in six cases of RMPP.Only one case of RMPP occured sequela.Conclusion The older children,the per-sistent high fever,large consolidation shadows of pulmonary,pulmonary and extrapulmonary complications,high level of serum CRP,ESR,LDH and IgM are the clinical related factors of RMPP.The combination of cephalosporins and (or)glucocorticoid might consider for the cases who have no effect with macrolides.The effect is sure for RMPP with Bronchofiberoscope lavages.