Objective: Breast conserving surgery has been proved to be a safe strategy and widely applied to the treatment of early breast cancer.The aim of this work is to evaluate the operational techniques and effect of conservative surgery for breast cancer.Methods: We analyzed the clinical data of 20 patients with breast cancer that underwent conservative surgery from January 2004 to December 2007.All the tumors were found to be solitary,less than 3 cm in diameter,and treated by postoperative chemotherapy and radiotherapy.All the patients were followed for 5 to 52(mean 28) months.Results: During the follow-up,2 cases experienced local recurrence and received modified radical mastectomy.All the 20 patients remained alive up to the present study.Conclusion: The principle of specific procedures for specific cases counts quite a lot for satisfactory prognosis and outcomes of breast conservative surgery.

Objective:To study the effect of a three-in-one counseling model on mental health of medical students Method: A three-in-one counseling model composed of mental health education, group counseling and individual counseling was applied to 150 freshmen of a medical school (study group) Other 150 freshmen were collected as control The intervention lasted for 1 year The effect was assessed with EPQ, SCL-90, GWB (gross well being), SCCS (self-consistency and congruence scale), SAD (social avoidance and distress scale) and LESU (life events scale of undergraduates) at the baseline, in the middle and at the end of the study Result: After intervention, the study group had lower score in psychoticism of EPQ (46 3?7 5) than control group (50 7?11 9), and higher score in flexibility (48 9?5 6) than control (46 8?5 9) The total score and many subscores of SCL-90 decreased in study group While the scores of social avoidance and distress increased in control group Conclusion: The three-in-one counseling model has effect on balancing personality, reducing psychosomatic symptoms, facilitating self consistency and improving social interaction of medical students

A design scheme of a tele-screening system for diabetic retinopathy (DR) has been proposed, especially the communication subsystem. The scheme uses serial communication module consisting of ARM 7 microcontroller and relays to connect remote computer and fundus camera, and also uses C++ programming language based on MFC to design the communication software consisting of therapy and diagnostic information module, video/audio surveillance module and fundus camera control module. The scheme possesses universal property in some remote medical treatment systems which are similar to the system.
Computers ; Diabetic Retinopathy ; diagnosis ; Humans ; Programming Languages ; Telemedicine ; instrumentation

Objective To investigate the influence of low bilirubin level on hepatic stellate cells (HSCs) in vitro. Methods HSCs were isolated and cultured from the liver of SD rats. The effect of bilirubin in different concentration on reactive oxygen in HSCs was determined by DCFH-DA kit. The proliferation of HSCs was tested by CCK-8 test kit.Smoothmuscle α-actin (α-SMA) expression of HSCs was tested by Western blot.The apoptosis of HSCs was tested by flow cytometry.The fibrosis-related genes were tested by PCR. Results HSCs were isolated and cultured successfully.Bilirubin in low concentration (0,1,10,20 mg/L) inhibited the generation of the reactive oxygen.Proliferation and α-SMA expression of HSCs was inhibited by bilirubin (0.624 ± 0.092,0.536 ± 0.127,0.407 ± 0.033,0.399 ± 0.022,F =13.454,P ＜0.05 ; 339 ± 2,336 ± 10,246 ± 7,242 ± 5,3.7 ± 0.3,F =191.107,P ＜ 0.05 ) and the apoptosis of HSCs was promoted by bilirubin(2.69 ±0.07％,2.95 ±0.10％,4.41 ±0.22％,4.91 ±0.86％,F =34.731,P ＜0.05 ).Bilirubin in low concentration changed the expression of fibrosis-related genes in HSCs.The ratio of TIMP-1mRNA/MMP-2mRNA decreased (54 ± 2,65 ± 2,47 ± 2,44 ± 2,F =73.400,P ＜ 0.05).Conclusions Bilirubin in low concentration inhibits the proliferation and activation of hepatic stellate cells,orobablv bv a mechanism in which bilirubin promoted antioxidative function.

Purpose　To investigate the role of urokinase plasminogen activator (uPA),uPA receptor (uPAR),tissue type plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) in the invasiveness of human breast cancer cells.　Methods　Three human breast cancer cell lines with different invasive ability were taken as research targets.RT-PCR and milk plates methods were used to detect the expression of uPA system members and the PA activities,respectively.Modified Boyden's chamber model was employed to detect the invasive ability of cancer cell.　Results　MDA-MB-231 could express high level of uPA,uPAR,PAI-1 and low level of tPA.MDA-MB-435 could express lower level of uPA and hight level of tPA,but no PAI-1 and uPAR were detected.MCF-7 could express lower level of uPAR and high level of PAI-1,but no uPA and tPA were detected.MDA-MB-231 cells showed the highest total PA and uPA activity.MDA-MB-435 cells also showed high total PA activity,but almost all the activity owed to tPA.MCF-7 showed almost no PA activity.Correlated with their PA activities,MDA-MB-231 was found the most invasive in vitro,followed by MDA-MB-435,and MCF-7 almost had no invasive ability.The antibodies against uPA and uPAR were significantly effective in reducing the matrigel invasiveness of MDA-MB-231 by approximately 83.1% and 43.9% respectively (P<0.05).　Conclusions　Co-expression of uPA,uPAR and PAI-1 in human breast cancer highly correlates with the invasiveness in vitro.

Objective To comprehensively grasp the grassroots medical institutions blood transfusion(blood) management present situation,put forward improvement strategy for the universality of existence weak link,the stand-ardized management of clinical blood transfusion to strengthen grass -roots medical institutions to provide necessary theoretical support.Methods 62 grassroots medical institutions blood transfusion(blood)in Yantai district were selected as the research subjects,to set the planning,layout,basic construction standards,related technology and equipment application aspects of quantitative evaluation,preliminary conclusions.Results By examination of 62 grassroots medical institutions transfusion quality management level both in terms of hardware and software facilities, emergency plan formulation,system file support informatization construction,staff education training,etc,found many problems,there was a certain gap between the existing department of blood transfusion standards.Conclusion The current grassroots medical institutions transfusion management is conditioned by the objective conditions,there are many problems,such as not improved,will cause a certain hidden trouble on the safety of clinical blood transfusion. Therefore,should combine their own reality,strengthen the quality of blood transfusion management system construc-tion,and give full play to the supervision and management of the hospital transfusion quality management committee. At the same time,the local administrative department of health also should formulate corresponding policies,ensure transfusion management level significantly increased.

Background Anti-VEGF drugs are generally applied in the treatment of ocular neovascular diseases.However,the therapy effect is unsatisfactory in some patients.Studing the effect of hypoxia-inducible factor-1 (HIF-1),a upstream regulatory gene of VEGF,and its limiting enzyme prolyl-4-hydroxylase domain proteins (PHDs) is of important clinical significance.Objective This study was to investigate the negtive regulation of exogeneous PHDs on HIF-1 pathway in human RPE cells.Methods pFLAG-PHD1,pFLAG-PHD2 and pFLAG-PHD3 plasmids were constructed by extracting RNA from Hela cell line and coloning PHD1,PHD2 and PHD3 using reverse transcription PCR with restriction enzyme.The plasmids were identified by gene sequencing.ARPE-19 cells were cultured at 21％ O2 (normoxia group),1％ O2 (hypoxia group),or in hypoxia-mimicking agents (CoCl2,anoxia group),respectively,and then were transfected with plasmids encoding FLAG-tagged PHD1,PHD2,PHD3 and pFLAGCMV2 transfected cells served as blank control.The expressional intensities of PHD1,PHD2 and PHD3 in the cells were detected and compared among different groups by using Western blot assay.The transcriptional activity of HIF-1 in the cells was evaluated with dual luciierase reporter assay.Results Western blot assay showed that PHD1,PHD2 and PHD3 all were expressed in ARPE-19 cells in the normoxia group,hypoxia group and anoxia group.The expression was strong in PHD2 protein and was weak in PHD3 protein,a statistically significant difference was found between PHD2 protein expression and PHD1 or PHD3 expressions (all at P＜0.05).Endogenous HIF-1 activity was elevated in pFLAG-CMX transfected cells in the hypoxia group and anoxia group than that in the normoxia group.Compared with pFLAG-CMX transfected cells,no obvious change was seen in the endogenous HIF-1 activity in the normoxia group,however,HIF-1 activity was declined in the hypoxia group and anoxia group after pFLAG-PHD1,pFLAG-PHD2 or pFLAG-PHD3 transfection.Under the same oxygen environment,HIF-1 activity was lower in the pFLAG-PHD2 transfected cells than that in the pFLAG-PHD1 or pFLAG-PHD3 transfected cells (both at P＜0.05).Conclusions PHDs play a negative regulation to HIF-1 activating pathway in human RPE cells,especially in hypoxia and anoxia cells.Among PHDs proteins,PHD2 presents the strongest inhibition on HIF-1 activating pathway.

Objective To study the infection condition of AmpC ? lactamases producing strains for reasonable use of antibiotics in clinic. Methods Adopting modified three dimensional extract test was adopted to detect enterobacteriaceae strains, and 12 antibiotics were determined by the antimicrobial disk diffusion susceptibility tests in specimen collected from 233 senile infectious patients. Results The total isolating rate of AmpC ? lactamases producing enterobacteriaceae strains in senile patients was 8 6%. The incidence of AmpC ? lactamases producing strains was found most often in E.cloacae. The AmpC ? lactamases producing strains were susceptive to imipenem and there the resistance rates to imipenem were 100 0%. The resistance rates to cefepime were 85%～100% to the third generation cephalosporins and aztreonam Conclusions The drug resistance of AmpC ? lactamases producing enterobacteriaceae is very serious. It is important to surveillance and control drug resistance of AmpC producing strains.

Objective To compare and analyze gene expression patterns in rat model of nonalcoholic fatty liver disease (NAFLD).Methods Twelve male Sprague-Dawley rats were randomly given either general diet (control group) or a high-fat diet (model group) for 4 weeks.The histopathologic changes of the liver were observed and gene expression patterns were analyzed and compared by cDNA mieroarray.Results Hepatocellular steatosis and inflammatory infiltration were observed in model group after high-fat diet for 4 weeks.Fifty-one differential genes were found in model group,20 of which were up-regulated (sterol regulatory element binding factor 1,stearoyl-coenzyme A desaturase 1 and Bcl 2 modifying factor)and 31 were down-regulated (peroxisomal enoyl coenzyme A hydratase 1,heat shock 70 protein 1A and ATPase inhibitory factor 1). The up-regulating genes were involved in lipogenesis and cell apoptosis,while down-regulated genes were involved in fatty acid oxidation, protein modification and energy metabolism.Conclusions The differential expression of genes may involve in the pathogenesis of NAFLD.

Objective To compare the consistency of 2 methods,RUCAM and CDS,for assessment of drug-induced liver injury and their sensitivity and specificity.Methods A total of 332 patients with drug-induced liver disease,who admitted to the first hospital of Zhejiang university from January 2000 to December 2006,were retrospectively evaluated.The data were collected from patients including clinical presentation,liver function,etc.The liver function and the outcome of the patients after treatment were also observed.The probability of the diagnosis was classified as definitive,probable,possible,unlikely,or excluded.The consistency,the specificity and sensitivity of two methos were evaluated with Spearman correlation analysis.Results Absolute agreement between the 2 scales was observed in 91 cases(27.41%),with disagreement of 1 level in 219 cases(65.96%),and of 2 levels in 22 cases(6.63%),which showed a positive correlateion(r=0.485,P=0.001).Absolute agreement between the 2 scales was observed in 12 cases of severe drug-induced liver disease(18.46%)(r=0.578,P=0.001)and in 79 cases of minor drug-induced liver disease(29.59%)(r=0.382,P=0.001).The specificity of CDS was 100%,and the sensitivity was 57%and 25%in diagnosis of severe and minor drug-induced liver disease,respectively.Conclusions The best correlation between the 2 scales was obtained for drug-induced liver injury.The RUCAM scale showed better sensitivity,especially in diagnosis of server drug-induced liver disease.