Objective To compare the effects of breast conservative therapy and radical mastectomy in treatment of patients with early stage breast cancer.Methods 76 patients with early breast cancer,informed consent by themselves and their families were divided into breast conservative therapy group(BCT group,2 1 cases)and breast radical group(RT group,55 cases),and BCT group was conducted breast conserving surgery,and RT group Was given radical surgery of breast cancer.The two groups were all given conventional postoperative chemotherapy and endocrine therapy.Then the therapeutic effects and complications were observed and compared.Following up for 1 to 6 years,the recurrence was compared.Results All patients were cured.In BCT group,5 cases of subcutaneous fluid,2 cases offat liquefaction of incision,1 ease of wound infection,1 case of upper limb edema,and in RT group,8 cases of subcu-taneous fluid occurred,5 cases of wound fat liquefaction,2 cases of wound infection,3 cases of upper limb edema,and the difference of complication rate between the two groups had no significant difference(P＞0.05).The scores of quality life of BCT group were significantly higher than those of RT group(t=3.42,3.18,4.07,3.09,2.87,3.26,all P＜0.05).All patients were regularly followed up for 1 to 6 years,local recurrence rate and survival rate of BCT group Was 4.8%(1/21)and 95.2%(20/21),and those of RT group Was 3.6%(2/55)and 96.4%(53/55),and the difference of local recurrence rate and survival rate between the two groups had no statistical significance(all P＞0.05).Conclusion Breast conserving surgery for early breast cancer was safe and feasible without increasing the relapse rate,and could get a good quality of life.

[Objective]To discuss the effect of post-natal depression on vaginal bleeding and lactation.[Methods]A retrospective analysis of 100 cases with complete information,including 66 cases of the control group,34 cases of post-natal depression,record the post-natal vaginal bleeding and lactation situation.[Results]The post-natal depression group 24h amount of vaginal bleeding after childbirth and lactation period was significantly higher than control group,while the volume of lactation was significantly lower than control group(P

Objective:To investigate the incidence of anxiety and depression and explore the effects of psycho- logical intervention on anxiety and depression in geriatric patients with chronic heart failure (CHF).Methods:A to- tal of 190 geriatric inpatients were recruited.They were assessed with the self-rating anxiety scale (SAS) and the self- rating depression scale (SDS) before the psychological intervention.All subjects were divided into two groups (101 in case group and 89 in control group) randomly.The case group received relaxation therapy and basic psychological care lasting four weeks,while the control group only received basic psychological care.Relaxation therapies,including re- laxation training and music therapy,were offered to patients in case group one hour per day for four weeks.Then the changes of SAS score,SDS score,and length of hospital stay of patients in two groups after psychological intervention were observed.The re-hospitalization rate due to CHF after discharge was assessed at 6-month follow-up.Results:The SAS score,SDS score,age,gender,educational level,economic status,caregiver status,cardiac function-graded, free medical service,self-care ability,and course of CHF were balanced between two groups before psychological inter- vention.The incidence of depression and anxiety of geriatric patients in our hospital were higher than that of the general population (45.8% vs.5%,52.6% vs.5-10%,respectively).After psychological intervention,the SAS score and SDS score were reduced in both case and control groups;the reduced degree in case group was higher than that in control group,and there was significant difference between the two groups (P

Objective To investigate the potential factors that may be associated with clinical significant endoscopy findings (CSEF) and the characters of the appropriate patients for upper endoscopy.Methods Information of the out-patients was collected from the questionnaires that were performed before undergoing upper endoscopy from 26 September 2011 to 23 December 2011,including demographics characteristics,symptoms,gastroesophageal reflux disease questionnaire (Gerd Q) score,comorbidities,medication and purpose for upper endoscopy.The analyses were performed by Logistic regression to find the potential factors that were associated with CSEF.Results A total of 942 cases were enrolled.There were 471 (50.0％) patients with dyspepsia and reflux symptoms,300(31.8％)patients with dyspepsia and without reflux symptoms,and 86(9.1％)patients with reflux symptoms and without dyspepsia.Sum to 325 (34.5％) patients were diagnosed with CSEF,119(12.6％) with erosive esophagitis,28(3.0％) with Barrett esophagus,102 (10.8％)with peptic ulcers,66 (7.0％) with gastric dysplasia,and 13 (1.4％) with upper malignancy.Multivariate Logistic regression analysis showed that men (OR=1.677,95％CI:1.148 to 2.451),older age (OR=1.032,95％CI:1.021 to 1.044),alcohol intake (OR=1.761,95％CI:1.068 to 2.903),Gerd-Q score increase (OR=1.079,95％ CI:1.003 to 1.160),and presence of acid regurgitation (OR=1.659,95 ％CI:1.143 to 2.408) were significantly associated with increasing risk of diagnosis for CSEF,while taking proton pump inhibitors (OR=0.298,95％CI 0.109 to 0.818)was associated with lower possibility of detection.Conclusions Factors such as male,older age,alcohol intake,Gerd-Q score increase,presence of acid regurgitation and taking proton pump inhibitors,may have a certain significance for screening out patients and further improving the cost efficiency of gastroscopy.

Objective To improve the ingestion protocol of esophageal capsule endoscopy in right lateral supine (RLS) position. Methods A total of 53 patients were randomized into RLS group and improvement group. The time of passing the esophagus, visual range and clarity of esophagus and z-line, and comfort of the procedure were compared between the two groups. Results The time of capsule passing the esophagus in improvement group was significantly longer than that in RLS group [ 202 (20-480) s vs.63 (8-210) s, P ＜ 0. 001 ) ]. The range of visualization in esophagus (2. 69 ± 0. 21 ) and Z-line (2. 54 ±0. 22) in improvement group was significantly larger than that in RLS group (2. 55 ± 0. 23 and 2. 40 ± 0. 24,respectively, P =0. 019 and P =0. 037, respectively). No significant difference was detected in clarity of esophagus or Z-line between 2 groups (P ＞0. 05). Two patients (7.7%) in RLS group had transient cough due to frequent water drinking, while no cough was observed in improvement group. Conclusion Compared with the ingestion protocol of esophageal capsule endoscopy in right lateral supine position, the improved ingestion protocol shows larger range of visualization, better safety and the same definition.

Objective To investigate the clinical characteristics of the patients with portal hypertension secondary to primary myelofibrosis (PH-PMF). Methods The clinical data of patients with PH-PMF retrieved from Peking University Third Hospital were collected and analyzed. Results A total of 6 from illness onset to definite diagnosis was 24 months. The symptoms related to portal hypertension included bloating, abdominal mass, hematemesis and melena. The signs related to portal hypertension included splenomegaly ( moderate or severe in all patients), hepatomegaly ( mild or moderate in most of patients),shifting dullness positive and varices in abdominal wall. Only a small portion of patients had jaundice, liver palms and spider angioma. The indexes related to liver functions were normal or only mild abnormal in most cases. The average diameters of portal vein and splenic vein were ( 16. 0 ±3.2) mm and ( 11.0 ±3.4) mm,respectively. Thrombosis of portal vein or splenic vein was found in 2 cases. Liver biopsy revealed extramedullary hemopoiesis in one patient. In addition to medicine therapy related to portal hypertension in 5 patients with PH-PMF, 1 patient received splenectomy and another received endoscopic variceal ligation.Conclusions The patients with PH-PMF were clinically rare and easy to be misdiagnosed. The main keys to differentiate PH-PMF from cirrhosis included marked splenomegaly, mild or moderate hepatomegaly, good liver functions, lack of liver palms or spider angioma and extramedullary hemopoiesis showed in liver biopsy samples.

Objective To study the diagnostic value of color Doppler ultrasonography in hematoma of soft tissues, and compare the images of different period of hematoma. Method Analyzed and compared the size,shape and sonographic characteristic of 46 cases with hematoma. Results The images of hematoma were round or oval in shape, more than 2.0 cm in trans-diameter, and were isoechoic or hypocchoic in the early stage, then anoechoic areas increased with hyperechoic septum and irregular hypoechoic, with posterior enhancement and hyperechoic boundary. A part of muscle fibres raptured and were occupied by the hematoma if the muscle tore. Conclusion Color Doppler ultrasonography can be the first choice and reliable imaging method to diagnose hematoma of soft tissues.

Vitamin D deficiency is a global public health problem.Vitamin D is well known for its classic role in the maintenance of bone mineral density.In addition,vitamin D is also closely related to many infectious diseases.This article describes the physiology of vitamin D and methodology for 25-hydroxyvitamin D or 25(OH) D.The factors that influence vitamin D levels in children and the relationship between vitamin D deficiency in children and infectious diseases are introduced.

Objective:To assess the effect and mechanism of ClassⅢ malocclusions treatment with Frankel-Ⅲ appliance and reverse Twin-block appliance. Methods:Twenty subjects of ClassⅢ malocclusion were included in this study(9 males,11 females). Among them, 10 subjects were randomly selected for treatment with reverse Twin-block appliance (T group) and 10 subjects for Frankel-Ⅲ appliance (F group). All patients were treated all the day for total of 4-11 months. The cephalometric records of these subjects were examined before and after treatment. The acquired data were processed with SPSS 10.0. Results: The results showed a mandible receded backward in both groups. Both group could accelerate the development of the maxillary bone. But the Frankel-Ⅲ was more effective. F group had significant effects of uprighting upper frontal teeth and flaring lower teeth. the average treatment time was 6.5 months in reverse twin-block appliance therapy group and 9 months in Frankel-Ⅲ appliance group. Conclusion: Both reverse Twin-block appliance and Frankel-Ⅲ appliance can treat angle classⅢ malocclusions effectively. The effects of maxillary changes of Frankel-Ⅲ appliance is better than reverse Twin-Block. Treatment period is shorter in T group than in F group.

Treatment options are limited for triple negative breast cancer (TNBC)since endocrinother-apy and targeted therapy that aims directly at human epidermal growth factor receptor-2 (HER-2)are ineffec-tive.As such,in addition to surgical treatment,the mainstay of treatment of TNBC is systemic cytotoxic chemo-therapy.The targeted therapy of TNBC is becoming a research hotspot because of traditional chemotherapy cura-tive effect is not good enough.A large number of clinical trials have found that patients with TNBC can get ben-efits from targeted molecular strategies including poly-adenosine diphosphate glucose pyrophospheralase-ribose polymerase-1 (PARP-1 )inhibitor and epidermal growth factor receptor (EGFR)inhibitor.