Doctors'language can help the patients and hurt them as well just like their bis-toury.Warm words give the patients confidence,hope and energy to beat their disease.When doctors communicate with the patients,their words are not only the important tool but also a kind of art.This article displays five artistic characters of doctors'words such as morality,etiquette,emotion,preciseness and secrecy.

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The DNA structures could be altered or even damaged by exogeous or endogenous factors during cell proliferation. Failure of effective and timely repair will lead to cell cycle arrest or apoptosis. By taking the advantage of the quick proliferation of cancer cells, DNA damage induction, cell cycle arrest and apoptosis promotion have become important strategies for ant-cancer chemotherapy. Previous reports showed that an array of natural compounds inhibit cancer cell proliferation by inducing DNA damage, which have therapeutic potentials for anti-cancer drug research and development.
Animals ; Biological Products ; pharmacology ; therapeutic use ; DNA Damage ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Neoplasms ; drug therapy

Objective To evaluate the reliability of mannitol for fluid responsiveness test in the patients undergoing intracranial surgery.Methods Sixty-two ASA physical status Ⅰ or Ⅱ patients,aged 18-64 yr,with body mass index of 18-25 kg/m2,scheduled for elective intracranial surgery,were enrolled in the study.The patients were mechanically ventilated after induction of anesthesia.The radial artery and central vein were cannulated,and FloTracTM/VigileoTM system was connected for stroke volume variation monitoring.Before infusion of mannitol,effective circulating blood volume was confirmed according to stroke volume variation.20％ mannitol 250 ml was infused over 20 min starting from onset of craniotomy.The fluid responsiveness test was recorded at the end of mannitol infusion.Results The sensitivity of fluid responsiveness test was 43％,and the specificity of fluid responsiveness test was 44％.Conclusion Mannitol can not be used for fluid responsiveness test in the patients undergoing intracranial surgery.

Objective To investigate the effect of intensive lipid-lowering therapy on the imbalance between inflammatory and anti-inflammatory responses in patients with acute coronary syndrome (ACS).Methods Observed serum levels of hs-CRP and IL-IO in 82 patients with ACS, 17 patients with stable angina, and 22 controls. Forty-one patients with ACS were randomized to take either atorvastatin 10 mg/d (standard lipid-lowering therapy) or atorvastatin 40 mg/d (intensive lipid-lowering therapy) for one month in addition to their routine anti-anginal treatment. Serum levels of hs-CRP, blood lipids, IL-10 were investigat-ed.IL-10 was measured by ELISA. Results The level of hs-CRP in patients with ACS [(11.10 ± 14.30)mg/L] was higher than that in patients with stable angina [(2.47 ± 2.72) mg/L]and controls [(2.34 ± 4.22)mg/L] (P all < 0.05 ). The level of IL- 10 was lower in ACS patients [( 3.94 ± 1.91 ) ng/L] compared with those who had stable angina [(6.31 ± 4.26) ng/L] and controls [(7.76 ± 2.82) ng/L], Pan <0.05. The level of hs-CRP in patients with ACS was decreased and IL-10 was increased after one month treatment with atorvastatin (P < 0.05).The effect of atorvastatin 40 mg/d was more effective than that of atorvastatin 10 mg/d.Conclusions Patients with ACS have higher level of hs-CRP and lower level of IL-10 than those with sta-ble angina. This finding suggests that imbalance of inflammatory and anti-inflammatory responses is related with aggravation of atherosclerotic disease. Intensive lipid-lowering therapy is more effective than standard lipid-lowering therapy on ameliorating the imbalance.

Objective To investigate the clinicopathologic characteristics and prognosis of medullary breast carcinoma.Methods We conducted a retrospective analysis on clinical and pathologic data of 166 patients with medullary breast cancer.Results All the patients were female with a median age of 52 years old.The proportion of patients with stage Ⅰ,Ⅱ and Ⅲ disease was 16.9％,68.1％,15.0％,respectively.The Luminal,HER-2 overexpressing and triple-negative subtypes constituted 31.3％,8.4％,and 60.3％,respectively.There was significant difference in regional lymph node status of medullary breast cancer patients with different molecular types (x2 =18.248,P =0.003),but not in tumor size,TNM stage,histological grade,and expression of Ki67 (all P ＞ 0.05).Multivariate survival analysis indicated that TNM stage was an independent predictor in the prognosis of medullary breast cancer (HR =5.664,P =0.001).All the patients were followed up from 15 months to 145 months with a median follow-up time of 108 months.The 5-year survival rate was 91.5％ and the 10-year survival rate was 87.2％.Conclusions The prognosis of medullary breast cancer is favorable.Personalized treatment according to the TNM stage and histopathologic characteristics achieve a favorable prognosis.

Objective To explore the clinicopathological characteristics and prognosis of invasive micropapillary carcinoma of the breast (IMPC),and the distinction between IMPC and invasive ductal carcinoma of the breast (IDC).Methods From February 2004 to November 2013,195 IMPC patients and 420 IDC patients were analyzed retrospectively.Results There were significant differences in mammilla invasion,lymph vessel invasion,orange peel sign,soft tissue encroachment,neoadjuvant chemotherapy,radical mastcctomy,lymph node metastasis,clinical stages,tumor size,lymph node staging,estrogen receptor (ER),progestin receptor (PR),human epidermal growth factor receptor 2 (HER2),molecular subtyping,ratio of radiation,ratio of endocrine therapy,disease-free survival (DFS),overall survival (OS)between the two groups,all P ＜0.05.Patients with IMPC had lower 5-year DFS and OS rates (68.2％ and 73.8％,respectively) than IDC patients (85.7％ and 88.6％,respectively),all P ＜ 0.05.In IMPC patients with positive ER/PR,HER2-negative,smaller tumor volume,less lymph node metastasis,negative nipple invasion,negative lymphatic vessel tumor thrombus,negative orange peel change had higher 5-year DFS and OS rates than those with negative ER/PR,HER2 overexpression,larger tumor volume,more lymph node metastasis,positive nipple invasion,positive lymphatic vessel tumor thrombus,positive orange peel change,all P ＜ 0.05.Besides,the patients with pathologic stage Ⅰ had higher OS than those with stage Ⅲ (P ＜ 0.05).Cox regression analysis found that orange peel change,lymph vessel invasion and HER2 were the independent risk factors for the survival time of patients with IMPC.Conclusions IMPC patients have lower DFS and OS compared with IDC.

Objective To evaluate the effectiveness of Percu Twist (PT) tracheostomy comparing with that of operative tracheostomy(OT)in intensive care unit(ICU). Methods Related data were retrieved from CBM,CNKI,Wanfang Data,VIP,PubMed,EMBASE,CENTRAL,and Web of Science from the time of their establishment to May 15th 2014,and the data of randomized controlled trials(RCTs)concerning PT and OT were selected. The risk of bias assessment and data extraction were performed by two independent reviewers. Meta analysis was conducted using RevMan 5.2 software. Results A total of 12 RCTs were identified,and 893 patients in ICU were involved. The results of Meta-analysis showed that PT could significantly shorten the operation time〔mean difference (MD)=-15.11,95% confidence interval(95%CI)=-17.14 to -13.07,P<0.000 01〕,reduce the volume of blood loss(MD=-17.59,95%CI=-21.90 to-13.28,P<0.000 01),reduce the size of incision(MD=-2.20, 95%CI=-2.57 to -1.82,P<0.000 01),shor ten the time of healing(MD=-3.60,95%CI=-4.15 to -3.05, P<0.000 01),and reduce complications such as infection of the wound〔odds ratio(OR)=0.20,95%CI=0.10-0.44,P<0.000 1〕and cutaneous emphysema/mediastinal emphysema(OR=0.22,95%CI=0.10-0.47,P<0.000 1)compared with OT group. The funnel plot suggested that publication bias might be found among 12 researches. Conclusions PT was shown to be more effective than OT in ICU with lower incidence of complications. As number of RCT cases is still small with unsatis factory quality,further clinical use is warranted for a better assessment.

Objective To investigate the correlation between the human telomerase gene (hTERC) and the generation and progression of cervical cancer.Methods A total of 173 patients with abnormal results of cervical biopsy by colposcopy were selected,meanwhile the 40 normal cases were selected as control group.The expression of hTERC gene was detected by fluorescence in situ hybridization (FISH),and the relationship between the HPV infection and the positive rate of hTERC was analyzed.Results The positive rate of hTERC in the control group was 7.50％,which was respectively 15.79％,46.15％,68.63％,and 91.11％ in the CIN Ⅰ group,CIN Ⅱ group,CIN Ⅲ group,and cervical cancer group.The positive rate of the hTERC was significantly increased during the progression of cervical exfoliative cell lesions (P ＜ 0.05).The precancerous lesion and cancer rate in patients with high-risk HPV infection and positive hTERC was 100％,significantly higher than that of patients with high-risk HPV infection as well as positive hTERC and also non high-risk HPV infected patients (P ＜ 0.05).Conclusion hTERC gene amplification is involved in the development of cervical cancer,and increase with cervical lesions rising,and the positive expression of hTERC gene is valuable to the early diagnosis of cervical cancer.

Objective:To retrieve and analyze the relevant literatures on vancomycin added into bone cement to provide the evi-dence for the treatment of osteomyelitis and other orthopedic infections. Methods:Search strategy and criteria of inclusion and exclu-sion for literatures were designed. PubMed, SCI, Embase, CNKI, VIP and the other databases were searched, and the articles from the establishment date to February 2014 were statistically analyzed using bibliometric methods. The final included documents were sta-tistically analyzed in respect of the article type, year, contents, citation frequency and the maln contents of the study. Results:A total of 1 941 articles were searched, and 430 of them were in the final inclusion. The total number of the articles in every year was in an es-calating trend. The paper focused on the research and analysis of clinical studies, and there were 74 clinical studies among the includ-ed literatures, which accounted for 17. 2% of all the included literatures. The highest citation frequency was 97 for one literature. The research included the overall situation, year distribution, publishing country, research type analysis, corresponding author and their in-stitutions, journals, citation frequency, and the maln content of work and clinical studies on vancomycin added into bone cement. The analysis could provide reference for the clinical treatment of orthopedic diseases. Conclusion: The results of the analysis show that vancomycin added into bone cement in the treatment of chronic osteomyelitis is effective with high security, and the technology is ma-ture.