Each woman of childbearing age has the right to enjoy reproduction, including cancer patients. Breast cancer is the most common malignant tumor in women. Many factors led to the significant increase of young patients with fertility problems, and the majority of doctors neglected their reproductive requirements in clinical work. Given the comprehensive treatment, almost every young patient suffers from fertility decline and even loss. Patients who chose to get pregnant also harbor a variety of concerns. This paper reviews the effects of comprehensive treatment on fertility, preservation strategies, pregnancy and prognosis, optimal time for pregnancy, and other aspects and provides guidance for young breast cancer patients in their reproduction choices.

ObjectiveTo explore the effect of endoscopic sinus surgery combined with mitomycin in nasal inverted papilloma (NIP). MethodThe clinical data of 75 patients with NIP was retrospectively analyzed and divided into treatment group (endoscopic sinus surgery combined with mitomycin treatment, 38 cases) and control group (endoscopic sinus surgery treatment, 37 cases) by random digits table. Results There was no complication in treatment group, the symptoms disappeared after treatment, good recovery and surgery epithelization was found after follow-up, 1 case of grade Ⅲ recurred at 3 months after treatment and followed up for 5 years without recurrence. In control group, 37 cases of conventional dressing endoscopic treatment, recurrence within 1 year in 3 cases, 4 cases of recurrence in the second year, 5 cases of reoperation cured, 2 cases of malignant transformation. The efficacy was no statistically significant between two groups( X2 =9.86,P ＜ 0.05). ConclusionEndoscopic sinus surgery combined with mitomycin in treatment of NIP, intraoperative and postoperative adjuvant therapy given to the local mitomycin, inhibit their growth and development, can inhibit the NIP recurrence and improve the cure rate.

Objective To assess the prevalence of hand hygiene compliance rates of health care workers (HCWs) at general hospitals in China in 2010-2012. Methods Literatures about hand hygiene compliance of HCWs from 2010 to 2012 were retrieved from China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI),Wan Fang database,VIP ,and PubMed database ,Comprehensive Meta Analysis V2 software and Stata 1 2 .0 software were adopted to conduct statistical analysis . Results Ninety literatures were selected with heterogeneity (Q= 48 118.32,P<0.01),random effect model was used. The overall hand hygiene compliance rate of HCWs was 47.83% (95% CI:43.27% -52.42% );When stratified by occupation group,the overall compliance rate of doctors,nur-ses,and unclassified HCWs was 40.36% (95% CI:35.42% -45.49% ),46.70% (95% CI:41.81% -51.65% ),and 40.72% (95% CI:27.75% -55.13% )respectively. According to subgroup analysis,there was no statistical difference in compliance rate between doctors and nurses(Q= 3.12,P>0.05);the compliance rate after patient contact was higher than before patient contact (54.33% [95% CI :44.76% -63.59% ]vs 20.21% [95% CI:14.12% -28.06% ])(Q= 32.59, P<0.01 );hand compliance rate from field observation was higher than from covert observation (70.91% [95% CI :70.71% - 71.10% ]vs 41.20% [95% CI:37.55% -44.94% ])(Q= 247.66,P<0.01).Conclusion The overall hand hygiene compliance rate of HCWs in 2010-2012 was low,in order to reduce the risk of healthcare-associated infec-tion,hand hygiene compliance of HCWs need to be increased .

Objective To investigate the prognostic value of CD44V6, MMP-9, p57kip2 and hCG in diagnosis differential diagnosis and malignant transformation of hydatidiform mole. Methods The expressions of CD44V6 MMP-9 and p57kip2 was detected by SP method and the serum hCG was detected with CLIA method in 55 cases of hydatidiform mole, 20 cases of abortion villi and 10 cases of normal villi, and the value of CD44V6, MMP-9, p57kip2 and hCG in diagnosis differential diagnosis and malignant transformation of hydatidiform mole was analyzed. Results There were 9 cases malignant transforming hydatidiform mole and 44 cases of non-malignant transforming hydatidiform mole(20 cases of complete hydatidiform mole, 26 cases of partial hydatidiform mole). The expression of CD44V6 MMP-9 and p57kip2 of malignant transforming mole was significantly higher than that of non-malignant transforming group (77.8 % vs 30.4 %, 77.8 % vs 34.8 %, 11.1 % vs 58.7 %) (P <0.05) and the expression difference of p57kip2 in complete mole and partial mole group (5.0 % vs 100.0 %) was statistically significant (P <0.05). HCG remained positive in 4 cases of hydatidiform mole and dropping and then rised in 5 cases. The sensitivity of p57kip2 in the diagnosis of partial hydatidiform mole was 100.0 %, the specificity was 95.0 %, the negative prediction was 100.0 %. The sensitivity of CD44V6 in the diagnosis of malignant hydatidiform mole was 77.8 %, specificity was 69.6 %, negative prediction was 94.1 %;The sensitivity of MMP-9 was 77.8 %, specificity was 65.2 %, negative prediction was 93.8 %. The sensitivity of the two combined detection (CD44V6 and MMP-9) was 88.9 %, negative prediction was 96.3 %. The sensitivity of combined detection (CD44V6, MMP-9 and hCG) was higher than any of them. Conclusion p57kip2 is an important marker in differential diagnosis of hydatidiform mole. CD44V6, MMP-9 play important roles in the process of transformation of hydatidiform mole. The combined detection of CD44V6, MMP-9, p57kip2 and hCG can help to diagnosis and differential diagnosis and predict biological behaviors and prognosis of hydatidiform mole.

Objective To explore the change of perioperative serum alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) in patients with primary liver cancer undertaken transcatbeter arterial chemoembolization (TACE).Methods One hundred and two patients with primary liver cancer were performed with TACE treatment.The levels of AFP and CEA after treatment 3 d,1 week,3 weeks were detected and compared.Results The levels of AFP after treatment 3 d and 1 week were higher than that before treatment,but there was no significant difference [(549 ±30),(530 ±30) μg/L vs. (527 ±40) μg/L] (P ＞ 0.05).After treatment 3 weeks,the levels of AFP significantly decreased than that before treatment [ (351 ± 20) μ g/L vs.(527 ± 40) μ g/L ] (P ＜ 0.05 ).The levels of CEA after treatment 3 d,1 week,3 weeks were significantly lower than that before treatment [(410 ± 15),(350 ± 20),(200 ± 10) μg/L vs.(570 ±22) μ g/L] (P ＜0.05).After treatment 3 weeks,the levels of AFP and CEA achieved normal.Conclusions TACE in treatment for primary liver cancer can achieve better therapeutic effect,significantly improve the symptoms,decrease the levels of AFP and CEA.To control the indication and contraindication,perform TACE in time can decrease mortality,improve prognosis,and is valuable in clinic.

Objective To summarize the clinical characters,diagnosis and surgical treatment of primary hyperparathyoidism (PHPT).Methods The diagnosis,treatment and efficacy of 35 cases of PHPT were retrospectively reviewed.Results PHPT presented a variety of clinical manifestations,and occoured to different age groups without significant gender differences.All the 35 cases had elevated blood calcium and PTH.All patients underwent preoperative ultrasonography and 99Tcm-MIB imaging,and the positive rates were 68.6％ and 97.1％ respectively.34 patients received surgical treatment,among whom 30 cases had parathyroid adenoma,1 case had parathyroid hyperplasia and 3 cases had parathyroid carcinoma.Through operation,31 cases were cured,2 cases improved,and 1 case of parathyroid carcinoma suffered from lung metastasls.Conclusions PHPT can be diagnosed according to co-elevated serum calcium and PTH.Ultrasonography combined with 99Tcm-MIB imaging should be recommend for preoperative localization.The main cause of PHPT is solitary parathyroid adenoma.PTPT can be cured by surgery.Minimally invasive parathyroidectomy with accurate location is an efficient surgical strategy,and the prognosis is favorable.

Objective To investigate the causes and treatment measures of an outbreak of Norwegian scabies oc-curred in a hospital.Methods In May 2013,an outbreak of Norwegian scabies among health care workers(HCWs) occurred because of the misdiagnosis of a patient with Norwegian scabies,epidemiological investigation was carried out by healthcare-associated infection(HAI)control department,medical intervention and disinfection and isolation measures were performed.Results A total of 27 HCWs and patients’relatives developed Norwegian scabies.After active medical treatment,patients’condition improved;all appliances used by patients were cleaned and disinfected after being wrapped and sealed with plastic bags for one week.Epidemic trend of infection was under control and no new case was found.Conclusion With highly contagious,Norwegian scabies can be spread in local area,it is neces-sary to improve HCWs’diagnostic ability to this disease and take effective measures to prevent the epidemic once HAI occur.

Objective:To investigate the anti-proliferation effect of carvacrol on human gastric cancer cell BGC-823 and explore the molecular mechanism. Methods:The proliferation of BGC-823 cells was evaluated by MTT assay. Flow cytometry was used to ana-lyze the cell apoptosis after exposed to carvacrol. Transwell assay was used to analyze the effect of carvacrol on cell metastasis. Quanti-tative realtime-PCR was used to detect the expression of MMP-9 and TIMP-1. The expression of caspase-9 and PARP,and the activa-tion of ERK and P38 were detected by Western blot. Results:The incubation with carvacrol resulted in a significant inhibition of BGC-823 cell proliferation. After the treatment with carvacrol,the apoptotic rate was significantly increased( 0 μmol · L-1 vs 10 μmol · L-1 ,P<0. 000 1;0 μmol·L-1 vs 20 μmol·L-1 ,P<0. 000 1;0 μmol·L-1 vs 40 μmol·L-1 ,P<0. 000 1;0 μmol·L-1 vs 80μmol·L-1 ,P<0. 000 1)and the invasion ability was decreased(0 μmol·L-1 vs 80 μmol·L-1 ,P<0. 000 1). The expression of caspase-9(0 μmol·L-1 vs 80 μmol·L-1,P<0. 000 1)and TIMP-1 was increased(P<0. 000 1),PRAP fragment occurred(P<0. 000 1)and P38 signaling pathway was activated in the carvacrol treated group,while the expression of MMP-9 activity of ERK signa-ling pathway was inhibited(P<0.000 1). Conclusion:Carvacrol can inhibit cell growth and invasion,and induce cell apoptosis, which is closely related to MAPK signaling pathway.

AIM: To investigate the expression of heat shock protein 60(HSP60) and Toll-like receptor 4 transduction system in mouse cardiac transplantation. METHODS: The mouse cervical heart transplantation model was established. The animals were divided into control group (the donor and recipient were all C57BL/6 mice) and experimental group (the donor was BALB/c mice and recipient was C57BL/6 mice). The heart and blood were collected for study at 3 d and 7 d. The pathological analysis of the hearts was performed. The levels of cytokines in the serum were determined using ELISA. The expression of HSP60, TLR4, MyD88 and NF-κB in the myocardium was determined by immunohistochemistry and Western blotting. RESULTS: The expression levels of HSP60, TLR4, MyD88 and NF-κB were higher in experimental group than those in control group. Severe rejection was observed in experimental group, whereas no distinct rejection in control group was found. The cytokines (TNF-α, IFN-γ, IL-12) increased significantly in experimental group as compared to those in control group. CONCLUSION: HSP60 increases significantly after heart transplantation, which may activate Toll-like receptor 4 transduction system in a MyD88-dependent pathway and promote allograft rejection. Regulation of HSP60 signal transduction may be a novel way for treating allograft rejection.

Objective: To study the expression and localization of apoptosis-related protein TFAR19 in TF-1 cells undergoing apoptosis. Methods: Using monoclonal antibody against TFAR19, the expression level and cell localization of TFAR19 were examined by fluorescence microscope, confocal laser scan microscope(CLSM) and flow cytometry. Simultaneously, we also analyzed the relationship of TFAR19 protein with phosphatidylserine (PS) externalization and cell nuclear DNA fragmentation. Results: The level of TFAR19 proteins expressed in TF-1 cells treated with GM-CSF withdrawal was significantly increased compared with normal TF-1 cells, then translocated rapidly from cytoplasm to the nucleus of cells. Appearance of TFAR19 in the nucleus of apoptotic cells preceded the detection of PS externalization and DNA fragmentation. Conclusion: Nuclear translocation of TFAR19 protein is one of the earliest events of cell apoptotic process. These data provided a new clue to further approach to the biological function of TFAR19 and study of cell apoptosis.