Objective To explore the value of preoperative diagnosis for breast cancer patients in different locating ways. Methods The tissues were gotten by core needle biopsy from 146 breast cancer patients through different locating ways,and were taken for histopathological examinations and were compared with postoperative pathologic results. Results Seventy-four cases were biopsied with ultrasound-guide (ultrasound-guide group), and 72 cases with free-hand (free-hand group), without serious complications.Compared with postoperative pathologic results,the false negative rate in ultrasound-guide group was 5.41%(4/74);the false negative rate in free-hand group was 18.06% (13/72). The accuracy of the ultrasound-guided biopsy was higher than that in free-hand (U = 13.63,P ＜ 0.01 ). Conclusions Preoperative ultrasoundguided biopsy and postoperative pathologic examination has no significant difference, with high consistency.The study provides a good basis for selection for clinical work,so as to the more effective guide for the comprehensive treatment of breast cancer patients.

Objective To understand the quality of life and self-efficacy of Parkinson patients and explore the relationship between them. Methods A cross-sectional study was conducted on 155 Parkinson patients. The instruments included a self-designed general information questionnarie, the 39-item Parkinson's disease questionnaire (PDQ-39) and self-efficacy scale for chronic patients. Results The total score of the quality of life was 26.12 ± 16.31.The total score of self-efficacy was 5.46 ± 1.87, and the scores of symptom management and disease management were 5.23 ± 1.98 and 5.94 ± 1.96. The quality of life was positively correlated with self-efficacy (r=0.800, P < 0.01). Conclusions Parkinson patients' overall the quality of life and self-efficacy remain a low level, and the quality of life was closely correlated with self-efficacy. The score of patients' self-efficacy was higer, the quality of life was better. Medical and nursing personnel can through strengthening patients' self-efficacy, optimizating of the patient' s health behavior, and improving negative emotion and attitude, so as to improve their quality of life.

Objective:To evaluate the efficacy and safety of dl-3-butylphthalide ( NBP) injection and soft capsules in the treat-ment of acute middle cerebral artery infarction. Methods:Sixty-one patients with acute cerebral infarction in the left middle cerebral artery in 72 hours of onset of ischemic stroke with score of 5-25 according to the national institutes of health stroke scale ( NIHSS) were randomly divided into the observation group (n=31) and the control group (n=30). The control group was treated with the routine treatment, while the observation group was sequentially treated with NBP injection and soft capsules additionally. The treatment course was 90 days. Before the treatment, the NIHSS score was evaluated in both groups to compare the neurologic impairment degree. After the treatment, the daily living skills assessment was performed by Barthel index ( BI) and modified Rankin score ( mRS) , and the ad-verse reactions were recorded. Results:Before the treatment, the NIHSS score in the two groups had no statistical significance ( P>0. 05). After the treatment, the BI in the observation group and the control group was (88. 55 ± 16. 74) and (70. 67 ± 26. 18), and mRS was (1. 87 ± 1. 02) and (2. 53 ± 1. 40), respectively, suggesting the observation group had more favorable outcome than the con-trol group (P≤0. 05). The incidence of adverse reactions had no significant difference between the groups. Conclusion: dl-3-Bu-tylphthalide sequential therapy should be regarded as an effective and safe method for acute cerebral infarction, which can improve the daily living skills and 90-day outcome of patients.

Objective To evaluate the clinical value of fiberoptic ductoscopy in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia. Methods From November 2005 to March 2008, fiberoptic ductoscopy were performed in 120 women with nipple discharge. The duct of 95 cases as non-malignant lesion were insufflated and perfusioned with entamycin and dexamethasone. Results Ninty-five of 120 cases were non-malignant disease,which contained one side 81 and two sides 14; the discharge was bloody,ivory, stramineous in 21, 17, 57 patinents, respectively; and the dignosis were 17 mammary duct ectasia, 53 galactophoritis, and 25 mammary duct ectasia with galactophoritis. Of the 95 cases, hich were intradutal insufflated and perfusioned with gentamycin and dexamethasone, the nipple discharge were decreased or disappeared in 81 cases, the effective rate was 85.3%. Conclusion Fiberoptic ductoscopy is a convenient,safe, accurate method in diagnosis and treatment of patients with galactophoritis or mammary duct ectasia.

OBJECTIVETo tentatively establish a diagnosis and treatment mode for effectively controlling the progress of cerebral microlesions (CM) and preventing the incidence of cerebral infarction (CI) by comparing different intervention modes for treating CM.

METHODSUsing a prospective, nonrandomized, controlled trial, 408 subjects with multiple CM were assigned to the Chinese medical pharmacy intervention group (Group A, 100 case), the aspirin intervention group (Group B, 104 cases), the negative control group (Group C, 100 cases), and the non-intervention group (Group D, 104 cases). No intervention was given to those in Group D. Patients in the other 3 groups were intervened by life style and routine therapies of vasculogenic risk factors. Those in Group A took Guizhi Fuling Pill (GFP) and earthworm powder additionally. Those in Group B took aspirin additionally. They were routinely followed-up. The CM, the changes of vasculogenic risk factors, and the incidence rate of CI were compared among the 4 groups.

RESULTSThe total effective rate of CM was 66.67% in Group A, obviously higher than that of Group B (52.32%), Group C (42.86%), and Group D (37.04%), respectively. It was obviously higher in Group B than in Group D, showing statistical difference (P <0.01, P <0.05). After treatment, the serum levels of LDL-C, TC, and TG were obviously lower in Group A than in Group B (P <0.05); the serum levels of LDL-C and TC were obviously lower in Group A than in Group C (P <0.01); the systolic pressure was obviously lower in Group A than in Group D (P <0.05). The systolic pressure and the serum TC level were obviously lower in Group C than in Group D (P <0.05). The incidence rate of CI was 2.17% (2/92 cases) in Group A, obviously lower than that of Group C (11.36% ,10/88 cases) and Group D (14.44%, 13/90 cases), showing statistical difference (P <0.05). But there was no statistical difference between Group A and Group B (6.74% ,6/89 cases) (P >0.05).

CONCLUSIONSGFP combined earthworm powder could treat CM, control vasculogenic risk factors, and finally prevent the incidence of CI. Standard Chinese medical intervention mode showed the optimal effects in treating CM and preventing the incidence of CI, and perhaps it could be spread clinically.

Adult ; Aged ; Aged, 80 and over ; Aspirin ; therapeutic use ; Brain ; pathology ; Cerebral Infarction ; drug therapy ; pathology ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Prospective Studies ; Risk Factors ; Treatment Outcome

OBJECTIVETo study the expression of Rho/Rho kinase of cardiac muscle in heart failure rats caused by pressure overload and the effects of fasudil on heart failure.

METHODSThe heart failure models were successfully induced by coarctation of ascending aorta after 20 weeks in this study. Thirty female Wistar operated rats were divided randomly into three groups (n = 10) for 4 week treatment. (1) Sham operation group: normal saline, 0.1 ml, i.p,Bid. (2) Heart failure group: normal saline, 0.1 ml,i.p,Bid. (3) Fasudil group: fasudil 5 mg/kg, i.p, Bid. The hemodynamic parameters, the ratio of LV weight to body weight, the expressions of RhoA and Rho kinase mRNA, and the concentration of calcium ion same as [Ca(2+)](i) were investigated in the three groups.

RESULTSHemodynamic parameters were significantly changed in heart failure group than those in sham operation group, such as left ventricular diastolic end pressure increased [(13.00 +/- 0.30) mm Hg vs (3.78 +/- 0.31) mm Hg, P < 0.01], left ventricular systolic pressure decreased [(97.20 +/- 7.21) mm Hg vs (129.45 +/- 7.52) mm Hg, P < 0.01]. Those results could be significantly changed by use of fasudil, P < 0.01. The ratio of LV weight to body weight was significantly increased in heart failure group than that in sham operation group [(4.77 +/- 0.08) mg/g vs (2.51 +/- 0.12) mg/g, P < 0.01]. Fasudil could significantly decrease the ratio of LV weight to body weight compared with that in heart failure group [(4.05 +/- 0.08) mg/g vs (4.77 +/- 0.08) mg/g, P < 0.01]. Cardiac muscle RhoA, Rho kinase mRNA level and [Ca(2+)](i) were higher in heart failure group than those in sham operation group [Ca(2+)](i) (475.93 +/- 28.22) nmol/L vs (79.25 +/- 3.33) nmol/L, P < 0.01. Compared with those in heart failure group, the expressions of RhoA, Rho kinase mRNA level decreased significantly, P < 0.01, and the levels of cardiomyocyte [Ca(2+)](i) had no change in fasudil group [(462.78 +/- 16.72) nmol/L vs (475.93 +/- 28.22) nmol/L, P > 0.05].

CONCLUSIONSThese results indicated that heart failure was probably related to activating of RhoA, Rho kinase. Fasudil may contribute to the observed beneficial effects on heart failure such as the decrease of RhoA, Rho kinase mRNA expression and not increase of [Ca(2+)](i) level. Rho/Rho kinase may be a novel, potent signaling of heart failure.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine ; analogs & derivatives ; pharmacology ; Animals ; Female ; Heart Failure ; metabolism ; physiopathology ; Myocardium ; metabolism ; Protein Kinase Inhibitors ; pharmacology ; Rats ; Rats, Wistar ; rho-Associated Kinases ; metabolism

Objective To analyze the association between β2-AK 27 locus genetic polymorphisms and asthma, and the protective effect in airway hyperreactivity. Methods The allel polymerase chain reaction were used to determine β2-AR 27 locus genetic polymorphisms in 149 patients with cough variant asthma who have the airway hyperreactivity. To observe these people for two years in order to know the proportion of changed to typical asthma. And compare with 90 people in healthy group. Results (1) The distribution frequency of β2-AR 27 locus genetic polymorphisms is major in heterozygote (57 % ) , and the Glu/Glu homozygote has the least ( 20% ) , (2) There was a significant decrease in the frequency of Glu/Glu genotype in asthmatics compared with healthy group(9% VS 20% ) ,OR = 0.4(P<0.05) ,95% CI (0.2 ～0. 9) ,but there was no significant difference in the allele frequency of asthmatics compared with healthy group,(3)The frequency of Glu/Glu genotype in severe asthma was lower than stable asthma group(P<0. 05). Conclusion These results suggesteded that β2-AR 27 locus genetic polymorphisms is correlated with asthma,and the Glu27 could have the protective effect to the airway.

Objective To explore the value of clinical application of high intensity focused uitrasound (HIFU)supplementary treatment evaluated and instructed by immediate contrast-enhanced uitrasound for Drimary hepatic carcinoma.Methods Fifty-five cases(68 lesions)of hepatocellular carcinoma(HCC)were randomized into 2 groups,30 cases(38 lesions)in group A and 25 cases(30 lesions)in group B.Patients of group A were examined by contrast-enhanced ultrasound before and after therapy in 10 minutes.The lesions of incomplete deactivation were treated by HIFU in time.The treatment security and the therapeutic effects were observed by the clinical symptom,serum AFP and imaging appearance.The long-term therapeutic effects were judged by follow-up survival rate.Results Nineteen lesions in group A were found incomplete deactivation and run supplementary treatment in time.No serious complication was identified.The AFP descending rate was 86.7%(26/30)in group A,64.0%(16/25)in group B,respectively(P＜0.05),and the lesions complete necrosis rate was 97.3%(37/38),60.0%(1 8/30),respectively(P＜0.05).Half year survival rate was 100%in group A,90.0%ih grouD B(P＜0.05),and 1 year survival rate was 76.0%,68.0%,respectively(P＜0.05).Conclusions HIFU supplementary treatment evaluated and instructed by immediate contrast-enhanced ultrasound for primary hepatic carcinoma can help to destroy the lesions completely,alleviate the symptom,reduce recurrence,improve life quality,lengthen the lifcrime,and has the better clinical practice value.

Autopsy ; China ; epidemiology ; Congenital Abnormalities ; epidemiology ; etiology ; mortality ; Folic Acid ; adverse effects ; Humans ; Infant, Newborn ; Survival Rate ; Ultrasonography, Prenatal ; adverse effects

Objective To explore the effect of multi-disciplinary team (MDT) combined with bundle management on prevention and control of multidrug-resistant organism (MDRO) infection in the intensive care unit(ICU).Methods Patients who were admitted to the ICU in a tertiary first-class hospital from January 2013 to December 2015 were studied,MDT combined with bundle management has been applied in the prevention and control of MDRO infection in ICU since January 2014,continuous quality improvement program was performed one year later,isolation of MDROs from specimens of ICU patients before implementation(in the year of 2013),after implementation(in the year of 2014),and after continuous quality improvement(in the year of 2015) was compared.Results The infection rates of MDROs in ICU patients before implementation,after implementation,and after continuous quality improvement were 26.55％ (154/580),17.13％ (117/683),and 12.01％ (77/641) respectively,showing a downward trend,with a significant difference (x2 =44.030,P＜0.001);the total isolation rates of MDROs in ICU patients were 64.44％(154/239),63.59％(117/184),and 43.26％ (77/178) respectively,showing a downward trend,with a significant difference (x2 =22.284,P＜0.001).The main MDROs in ICU were multidrug-resistant (MDR) and pandrug resistant(PDR) Acinetobacterbaumannii (44.54％).Conclusion MDT combined with bundle management can decrease MDRO infection rate and isolation rate in ICU.