Objective To analyze the clinical results and risk factors according to cause-specific survival and local recurrence rates for the patients with Ⅰ-Ⅱstage breast cancer after breast conservative therapy(BCT).Methods During Jun.1988 to Jun.2005,304 patients with Ⅰ-Ⅱstage breast cancer in the General Hospital of PLA underwent lumpectomy,axillary lymph node dissection and definitive irradiation.All patients received adjuvant chemotherapy.The patients with positive estrogen hormone receptors received orally tamoxifen administration.The median follow up was 8.1 years.Results For all the patients,the total 5-year survival rate,cause-specific survival rate and local recurrence-free survival rate were 92.58%,93.46% and 86.26%,respectively.And the total 10-year overall survival rate,cause-specific survival rate and local recurrence-free survival rate were 85.29%,88.27% and 77.75%,respectively.The 5-year and 10-year local recurrence rates were 5.5% and 11.7%,respectively.The univariate and mutivariate analyses revealed that the age(4)were the risk factors according to cause-specific survival rates.The age(

Objective To investigate the preparation of the internal quality controls for urinary retinal binding protein(RBP)de-tected by the latex enhanced immunoturbidimetry assay and its performance evaluation.Methods The urine specimens from the pa-tients with nephropathy and healthy people with physical examination were collected,centrifuged by 3 500 r/min for removing sedi-ment,urinary RBP levels were adjusted to the low value for healthy population and the high value for the patients with nephropa-thy;then conducted the anticorrosion,packed and stored at -20 ℃.By using the urinary RBP commodity kits,the latex enhanced immunoturbidimetry was adopted to detect urinary RBP,the intra-batch and inter-batch precisions were detected respectively.Then the high and low values of self-prepared controls were detected once per day for consecutive 5 months.The data were processed by using the SPSS13.0 software.Then the performance of self-prepared urinary RBP quality control was evaluated.Results The intra-batch imprecision of 2 levels of urinary RBP controls was less than 5% and the inter-batch imprecision was less than 6%;the stable period by storage at -20 ℃ was at least 5 months,the imprecision had no statistical difference within 5 months(P >0.05).Conclu-sion The high and low levels of self-prepared urinary RBP quality controls can meet the operating requirements of internal quality controls.

Objective When detecting the blood C peptide by chemiluminescence method,used had confronted the lack of qual-ity control.This paper examines the feasibility of self-made C peptide quality control as indoor quality control products. Methods From the serum of diabetic patients and health examination,C peptide low values(concentration around the 1.20 ng/ml)and high value(concentration around the 12.0 ng/ml)were collected,excluding hemolysis,jaundice and tallow ser-um,preventing bacterial contamination,hepatitis B surface antigen,hepatitis C virus,human immunodeficiency virus indica-tors are negative;then these serum was mixed respectively,embalmed,packaged,-20 DEG preserved.The performance e-valuation of the C peptide mixed serum was carried out using SIEMENS’s C peptide reagent kit.Results Low value,high value of two levels of serum C peptide quality control in batch imprecision respectively were 4.46% and 4.15% respective-ly.Day not precision respectively were 6.00%,5.56%,-20 DEG saved stability for at least 6 months (P>0.05).Com-pared with six months by analysis of variance,F value of the low and high values were 0.665,0.602,P values were 0.471, 0.568 and the difference was not statistically significant (P>0.05),but the difference among bottles was no significant. Conclusion Two levels value of the C peptide in self-made preserved at -20 DEG can meet the requirements of internal quality control products.

Objective To investigate the effects of Liraglutide on plasma FGF-21 level in patients with type 2 diabetes mellitus (T2DM). Methods Enzyme linked immunosorbent assay (ELISA) was used to measure plasma FGF-21 level in patients with T2DM and normal controls (NGT). Relationship between plasma FGF-21level and BMI, WHR, HOMA-IR, HOMA-IS, FFA was analyzed. After Liraglutide treatment, plasma FGF-21level was observed in patients with T2DM. Results Fasting plasma FGF-21 level was higher in T2DM patients than that in normal control group ( 1.81 ±0.32 vs. 1.32 ±0.09 μg/L, P ＜0.01 ). After Liraglutide treatment, WHR, BMI, FPG, 2hPBG, HbA1c and FFA in T2DM patients significantly decreased ( P ＜0.05 or P ＜0. 01 ),HOMA-IS remarkably increased (P ＜ 0. 01 ), and FGF-21 had no change. Conclusion Liraglutide and FGF-21may have different roles in insulin resistance.

Objective To investigate the effects of perioperative intraperitoneal chemotherapy with 5-fluorouracil (5-FU) sustained release agent on the local recurrence and survival rates of patients with advanced gastric cancer. Methods The clinical data of 100 patients with advanced gastric cancer who had been admitted to our hospital from January 2002 to December 2004 were retrospectively analyzed. All patients were divided into treatment group and control group. Only patients in the treatment group were implanted with 5-FU sustained release agent (800 mg) in abdominal cavity after D2 gastrectomy. All patients accepted chemotherapy according to the FOLFOX regimen. Results The 3-year survival rate and 3-year disease free survival rate were 45% and 28% for treatment group, which were significantly higher than 32% and 16% for control group. Conclusions Intraperi-toneal implantation of 5-FU sustained release agent during operation can decrease local recurrence rate and improve the 3-year survival rate of patients with advanced gastric cancer after radical gastrectomy.

Objective To compare the diagnostic criteria of metabolic syndrome(MS) developed by the International Diabetes Federation(IDF) in 2005,the 3th Report of National Cholesterol Education Program-Adult Treatment Panel Ⅲ(NCEP-ATP Ⅲ) in 2005,and the Chinese Diabetes Society(CDS) in 2004.Methors A total of 1039 adults aged 23 to 62 year-old were enrolled in this epidemiological investigation to assess the prevalence of MS by above three definitions.Results The MS prevalence rate was 14.8%,14.2% and 10.7% in ATPⅢ,IDF,and CDS,respectively.The diagnoses agreement of IDF with ATPⅢ was stronger(Kappa=0.912) than IDF with CDS(Kappa=0.466) and ATPⅢ with CDS (Kappa=0.504).CDS definition found 5.7% of non-MS individuals had risk factor accumulation.Those defined by ATPⅢ and IDF criteria were presented with central obesity + ypertriglyceridemia + abnormal blood pressure and central obesity + hypertriglyceridemia + low hish-density lipoprotein hyperlipidemia.However,those defined by CDS criterion were commonly presented with obesity + hypertriglyceridemia + abnormal blood pressure or obesity + hypertriglyceridemia + hyperglycemia.Conclusions The agreement of IDF and ATPⅢ definition was relatively stronger.For better screening sensitivity,those three criteria,or CDS and IDF criteria,or CDS and ATPⅢ criteria should be used together.

Objective To explore and clarify the clinical features and management of patients with Castleman disease.Methods The clinicopathological features and therapeutic method of 65 patients with Castleman disease admitted to our hospital continuously from 2005 to 2012 were analyzed retrospectively.The mean follow-up time for the entire series was 40 (15-71) months.Results In contrast to Localized Castleman disease(LCD),Multicentric Castleman disease (MCD) patients were relatively older and exhibit various symptoms and abnormal laboratory tests.We found 44 tumor in LCD group.LCD ones,most of which were hyaline vascular (33/42,78.6％),were more likely originated in retroperitoneum,enterocoelia(10/44,22.7％) or mediastinum(10/44,22.7％).The initial treatment for LCD patients was complete surgical resection and all patients are current alive with no evidence of recurrence.MCD ones always accompanied by fever(9/23,39.1％),anemia(9/23,39.1％)and splenomegaly,and most of MCD patients were plasmacytic variants(14/23,60.9％) or mixed cellular variants (5/23,21.7％).We found 66 tumor in MCD group and they were more likely originated in neck (16/66,24.2％) and groin area (12/66,18.2％).Surgery combined with CHOP-like chemotherapy or CHOP-like chemotherapy alone was the mainstream treatment for MCD ones.21 patients achieved complete remission or partial remission,and only 2 patients died of lung infection.Whether patients could tolerate long-term chemotherapy or not was an important prognostic factor.Conclusions LCD patients had no typical clinical symptoms and could be cured by surgery.Most of MCD patients always had a good prognosis after receiving CHOP-like chemotherapy.

Objective To explore the correlation of S100 protein with the prognosis of patients with primary retroperitoneal liposarcoma. Methods Analyzed the clinical data about 108 patients with primary retroperitoneal liposarcoma managed with surgery from January 2009 to June 2014. All patients were followed up. Patients were divided into S100-positive group(58 patients) and S100-negative group (50 patients) according to the immunohistochemical staining results. The overall survival time and all clinical data between two group were compared. Results All patients with primary retroperitoneal liposarcoma received radical surgical resection for the first time. The overall 5-year recurrence rate were 88.9%(96/108), and the median recurrence time was 32.7 months. The 1-year, 2-year, and 5-year recurrence rates of the S100- positive group were 25.9% (15/58), 53.4% (31/58), 96.6% (56/58), respectively, and the median recurrence time were 26.2 mouths. The 1-year, 2-year, and 5-year recurrence rates of the S100-negative group were 10.0%(5/50), 36%(18/50), 80.0%(40/50) and the median recurrence time were 40.0 mouths. Log-rank test showed that S100 protein expression was significantly associated with postoperative recurrence rates (c2=9.931, P=0.002) and survival time (c2=4.571, P = 0.033). The difference between gender, age, removal of the joint organs and tumor size showed no statistical significance on disease special survival (P>0.05). Cox regression analysis showed that S100 protein expression (OR=1.582, 95%CI:1.005-2.491) and histologic subtype (OR=1.531, 95%CI: 1.254-1.870) were independent risk factors of the prognosis of primary retroperitoneal liposarcoma patients. Conclusions S100 protein played a critical role in retroperitoneal liposarcoma carcinogenesis and its expression may be used as a potential survival predictor in patients with primary retroperitoneal liposarcoma.

Objective To investigate the value of spiral CT in therapy observation during and after radiofrequency ablation (RFA) for lung or liver tumors. Methods Spiral CT-guided RFA were performed in 35 patients (38 lesions) with lung or liver tumors. CT value of lesions during operation and the changes of lesions after operation were observed. Results Thirty-eight lesions were accurately located under spiral CT. The position of the electrode and the expension of claw-like thin needle electrode could be observed directly. CT value of lesions decreased and some gasification foci in some lesions were observed after RAF therapy. One month after RFA, tumor volume decreased, and the tumors present as slightly low-density mass on contrast-enhanced CT. The total effective rate of RFA was 85.71% (30/35). Conclusion Spiral CT is able to accurately guide RFA treatment for lung or liver tumors and evaluate the efficacy of therapy.

Objective To investigate the status of clinical nursing teaching in the department of infection.Method To investigated the teachers and nursing students in the department of infection with a self-designed questionnaire.Results The evaluation from students to the teachers are:overall satisfaction score is(4?90±0?04),the lowest points are the advanced nursing of common diseases and the teaching attitude.While the evaluations from teachers are:overall satisfaction score is(4?45+0?04),the lowest are communication with patients and their families,conducting basic nursing operation and familiarity of common drugs.Conclusions To enhance teaching quality of clinical nursing teaching in the department of infection,it is efficient by improving the quality of teachers and their teaching methods,consolidating students’knowledge,and exercising their skills?