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 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.

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 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.

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.

BACKGROUND:Studies have shown that placement, needling point, angle and length of pedicle screws for thoracic vertebral fractures have been unified. Many studies concerned axial pul-out force and biomechanical behavior of a single screw, but few reports addressed the biomechanical behavior after the replacement with three kinds of screw connecting to rods. OBJECTIVE:To further observe and compare biomechanical behavior after three kinds of thoracic screw placement connecting rod using biomechanical testing, to understand the strength of thoracic pedicle screw replacement connecting rods, and the effects of its puling out on the stress of the bone surrounding the placement site. METHODS:The fresh frozen specimens of thoracic vertebra were divided into three groups at random: the pedicle fixation group, the transverse process-vertebral body fixation group, and modified rib transverse process fixation group. Thoracic pedicle screw system was inserted by the standard placement method in each group. The experiment was measured on the mechanical equipment. During puling out, the strength that bone bore was described with dynamic curve, folowed by statistical analysis. The difference in the gripping force on the thoracic vertebra among three kinds of screw placement method was compared. RESULTS AND CONCLUSION: Among three kinds of screw placement methods and among three kinds of screw placement methods on the injured vertebral body, the gripping force was significantly bigger in the pedicle fixation group than in the transverse process-vertebral body fixation group and modified rib transverse process fixation group (P < 0.01). No significant difference in the gripping force was detected between the transverse process-vertebral body fixation group and modified rib transverse process fixation group. Results verified that the stability of loading ability was apparently better in the pedicle fixation group compared with the transverse process-vertebral body fixation group and modified rib transverse process fixation group.

AIM: To study the effects of intrathymic inoculation of liver specific antigen (LSA) on hepatocyte apoptosis after liver allotransplantation. METHODS: Orthotopic liver transplantation was used in this study. Group Ⅰ: syngenic control (Wistar-to-Wistar); Group Ⅱ: acute rejection (SD-to-Wistar); Group Ⅲ: thymus inoculation of SD rat LSA day 7 before transplantation. The observation of general situation and survival time, hepatocyte apoptosis and LAT expression in liver transplants were used to analyze immune state of animals in different groups. RESULTS: The general situation of group Ⅰ was very well after transplantation. Recipients of groupⅡ lost body weight progressively and all died within day 9 to day 13 post transplantation. As for group Ⅲ, the general situation of recipients was remarkably better than that in group Ⅱ. The positive cells of apoptosis in group Ⅲ detected by TUNEL were not significantly different from that in group Ⅰ, but was significantly lower than that in group Ⅱ. LAT was detected at any time in group Ⅱ with peak expression at day 5 and day 7 post transplantation. In contrast, LAT was not detected in any other groups. CONCLUSION: Intrathymic inoculation of LSA protects hepatocytes from apoptosis after liver allotransplantation.

1.2 ng/ml on the third day as a threshold,the sensitivity,and specificity in predicting the prognosis of VAP were 81.0%,and 87.5%,respectively. CONCLUSIONS The results suggested that serum PCT be important for the diagnosis of VAP.PCT concentration over 1.2 ng/ml as a threshold is more sensitive and specific to distinguishing different outcomes.And the sensitivity and specificity of PCT are better than that of IL-6,IL-8.