Objective To evaluate the diagnostic efficiency of multi-parameter magnetic resonance imaging of routine MRI,including dynamic contrast-enhanced MRI(DCE-MRI)and diffusion weighed imaging(DWI)in diagnosis of breast cancer.Methods The results of routine MRI (morphology,boundary and,edge and Internal enhancement),DCE-MRI (1,2,3 minutes early enhanced rate and TIC curve)and DWI (b=500,800 s/mm2 )were analyzed in 43 cases of malignant breast lesions and 54 benign lesions,with pathology results asthe gold standard,the sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value had been respectively gained,and Logistic regression analysis were used for statistical analysis.Results The specificity of edge (burr sign) was 96.3%,the sensitivity and specificity of TIC curve,ADC values (b=500,800 s/mm2 )were respectively 97.67%,83.33%,81.4%, 90.74%,88.37%,92.59%.Edge (burr sign)and ADC values (b=800 s/mm2 )had a statistic difference in the diagnosis of benign and malignant lesions (P<0.05),TIC curve had a significant statistic difference (P<0.01).Conclusion Edge (burr sign),TIC curve,ADC values (b=800 s/mm2 )had excellent diagnostic efficiency in the diagnosis of benign and malignant lesions.

Objective To investigate the effects of dopamine combined with norepinephrine on blood lactate and inflammatory factors in elderly patients with severe septic shock.Methods 120 elderly patients with severe septic shock were randomly divided into control group and observation group,60 cases in each group.The control group was treated with dopamine.The observation group was treated with norepinephrine on the basis of the control group at the same time.The treatment was evaluated 48 h after treatment.The changes of heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),blood lactate(Lac),urine output,central venous oxygen saturation(SC-VO2),tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP),serum calcitonin(PCT),cardiac function index(CI),peripheral vascular resistance index(SVRI)and extravascular lung water index(ELVWI)were observed before and after treatment for 48h.Results After treatment,the HR of the patients of the two groups decreased,there was no significant difference between before and after treatment in the control group(t=1.551,P=0.062),HR of the observation group were significantly lower than those of the control group and before treatment,the differences were statistically significant(t=15.847,14.960,all P=0.00).The MAP of the control group and the observation group after treatment were higher than those of before treatment(t=32.949,44.344,all P=0.00),and CVP were higher than before treatment(t=12.620,18.959,all P=0.00),urine volume increased significantly compared with before treatment(t=83.213,94.562,all P=0.00),and SC-VO2 were higher than those of before treatment(t=36.589,42.899,all P=0.00),Lac were lower than before treatment(t=15.653,24.016,all P=0.00).The improve degree of HR,MAP,CVP,Lac,urine volume,SC-VO2 of the observation group were higher than those of the control group(t=14.960,15.267,4.857,7.022,20.395,5.704,all P=0.00).The TNF-α levels of the control group and the observation group were lower than those of before treatment(t=13.300,33.004,all P=0.00),the CRP decreased significantly compared with before treatment(t=24.759,24.756,all P=0.00),the PCT were lower than those of before treatment(t=15.235,26.693,all P=0.00),the TNF-α,CRP and PCT of the observation group were decreased more significantly compared with the control group(t=17.470,6.079,10.550,all P=0.00).The CI of the control group and the observation group was higher than before treatment(t=16.050,34.124,all P=0.00),the SVRI were higher than those of before treatment(t=60.357,68.434,all P=0.00),the ELVWI were lower than those of before treatment(t=4.523,8.013,all P=0.00),the CI,SVRI,ELVWI of the observation group were improved more significantly than those of the control group(t=13.176,12.483,2.100,all P=0.00).Conclusion Dopamine combined with norepinephrine can improve the vital signs of patients with severe septic shock,reduce the concentration of lactate in blood,improve the level of inflammatory factors,and heart index.However,due to the subjective factors such as the size of the subject,the lack of research,the future study can increase the sample size to demonstrate the above speculation.

Objectives To explore the effect of type A personality and type D personality on coronary heart disease (CHD) ,and the influence of the two kinds of personality factors with the risk factors of CHD. Methods 123 CHD patients and 116 healthy subjects were randomly chosen to answer the questionnaire of general situation and type A behavior questionnaire(TABQ) and type D personality scale(DS14) and assay the fasting glucose ( GLU ), total cholesterol ( TC ) and triglycerides ( TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) ,very low density lipoprotein (VLDL). Results ( 1 )The detection rate of type A personality were respectively 66.7% in CHD group and 40.5% in control group,while type D personality were respectively 39.8% in CHD group and 22.4% in control group (P ＜ 0. 05 ). ( 2 ) There were significant differences in total TABPQ,TH, CH , SI, NA scores between the two groups(P＜ 0.05 ). (3)Coronary heart disease had correlated with gender,history of hypertension, HDL, LDL, GLU and negative affectivity. Conclusion Negative affectivity plays an important role in CHD.

The authors first give a detailed account of the background against which humanistic medicine came into being and then expound the connotations of humanistic medicine. These include the following aspects. The first one is humanism and the humanistic spirit. The second one is humanistic medicine and the three implications it embodies. The authors argue that humanistic medicine, taken as the science of benevolence, ought to regard the patient as the unity of three aspects, physiological, psychological and social. The third one is medical humanity, viz. medical humanity is indispensable to the advancement from physiological medicine to humanistic medicine. As to what disciplines are involved in medical humanity, no final conclusion has yet been reached on this matter so far.

Objective To observe the effect of acupoint sticking plus cervical plexus block anesthesia on post-operative pain in patients undergone subtotal thyroidectomy.Method Sixty patients who were going to receive unilateral subtotal thyroidectomy were randomized into group A and group B, 30 cases in each group. Group A was intervened by acupoint sticking plus cervical plexus block anesthesia, while group B was by cervical plexus block anesthesia alone. The Visual Analogue Scale (VAS) scores under static and swallowing condition were recorded at 6 h, 12 h, 24 h, and 48 h after the operation. Tramadol hydrochloride tablets were given to help cease pain when static incision VAS>3, and the total dose and adverse reactions in 48 h after the operation were recorded.Result There were no significant differences in comparing the VAS scores at static and swallowing status between the two groups at 6 h, 12 h, 24 h, and 48 h after the operation (P>0.05). The total dose of Tramadol hydrochloride tablets used in 48 h after the operation was (110±55)mg in group A, versus (210±48)mg in group B, and the difference was statistically significant (P<0.05). There was a significant difference in comparing the occurrence rate of adverse events in 48 h after the operation between the two groups (P<0.05).Conclusion Acupoint sticking plus cervical plexus block anesthesia can effectively alleviate the pain after subtotal thyroidectomy, reduce the use of analgesics in 48 h after the operation, and lower the occurrence rate of post-operative adverse events.

Collective preparation for classes is a very effective teaching activity.It can maximize teaching effects,practically raise teacher's teaching enthusiasm for the course and improve teaching quality.Moderator of collective class preparation should be well familiar with the teaching program and content,dig into teaching material,look up for relative information,draw up standard original text then lead and organize whole preparation process for classes from the aspects of introducing teaching objective and content,analyzing teaching material,discussing the new content and progress,analyzing the relative excises,exploring the teaching methods and proposing the questions for discussion.

Objective To evaluate the association between air pollution and daily cardiovascular mortality in Beijing. Methods The daily death data, the meteorological data and the air pollution data from January 1 to December 31, 2003 were collected, the time-series analysis by generalized additive model was used, controlling for long-term trends, seasonal patterns and meteorological variables (temperature, humidity). Results An increase of 10 ?g/m3 of SO2, NO2 and PM10 corresponded to 0.4%(0.1%-0.8%), 1.3%(0.2%-2.4%)and 0.4%(0.2%-0.6%)increase of cardiovascular mortality respectively in Beijing. Conclusion The results of the present paper show that the current level of air pollution is a risk factor for cardiovascular mortality in Beijing.

The effect of CHIP [cis-dichloro-trans-dihydroxy-bis-isopropy-lamine platinum (Ⅳ)] on the biosynthesis of DNA, RNA, and pro-tein of Ehrilch ascites carcinoma ( EAC ) cells in vitro was studied. 3H-TdR, 3H-UR, 3H-Leu were used as precursors of cellular macro-molecules to study the effect of CHIP on the biosynthesis,with CDDP [cis-dichlorodiammineplatitinum (Ⅱ)] as a positive control. The experimental results showed that CHIP, similar to CDDP, inhibited the biosynthesis of DNA, RNA and protein, and has a strong antitumor activity. The inhibitory effect on DNA biosynthesis lasted 40 hours indicating that CHIP might induce permanent damage in DNA template and thus reduced the mitotic division of tumor cells. Furthermore, in contrast to the general view, the in vitro experimental results showed that CHIP, a tetravalent platinum coordination compound, exerted its antitumor activity directly in vitro.

Objective To establish the quality standard for Lithospermum anti-inflammatory tablets.Methods Houttuynia,diffusa and grass coral in the prescription were qualitative identified by Thin Layer Chromatography(TLC) method.Results TLC spot features clear and specific.Conclusion The established standard can be used for quality control of Lithospermum anti-inflammatory tablets.

The core of the ethical and legal issues in the treatment and recovery of patients with mental disorders is the balance between public security and individual interests. In the treatment and recovery of patients with mental disorders, it is imperative to adhere to the principles of respecting basic hmnan rights and respecting the freedom, dignity, equality and rights of the individual, protect the privacy of the patient, stick to the combination of hospital recovery and community recovery, and strictly define the boundary between willing treatment and unwilling treatment. The aim is to promote the recovery and return of patients to society. At the same time, it is necessary to put issues of mental hygiene in China on the demestic legislative agenda and set up a specialized multi-level legal system of mental hygiene.