Objective To highlight the role of physician's experience in physical examination for the early diagnosis of breast cancer.Methods Data of physical examination of mammary glands in 1785 female were analyzed and compare with the uhrasonography and mammngraphy results.Results Of the 31 breast cancers confirmed by pathologic examination after operation,2 cases were bilateral breast cancers and 1 was nonpalpable.9 of 41 cases which suspected by inspection were confirmed as breast cancers.The significant difference was found comparing with control group by X2 test (X2=100.5,P＜0.05).The 34 breast cancers were found in 2089 focus in palpation and there were 6 minimal cancers (diameter≤1.0 cm) among them.Some cancers were found in special location with no malignant clinical manifestation.The rate of missed diagnosis of ultrasonography and rnammography is 16.1% and 19.4%,respectively.Conclusions Physical examination plays an important role in the early detection of breast cancer and physician's experience is a major determinant for avoiding misdiagnosis.

OBJECTIVE To determine the extra-lengh of stay and the economic loss for nosocomial infections of group A rotavirus in children′s hospital. METHODS We performed a 1∶1 case-control study to determine the cost of nosocomial rotavirus infection. Data of hospitalized cases were collected from Jan 1 2007 to Dec 31 2007. RESULTS The average medical expenses in case and control group were 7589 yuan and 5319 yuan,the average increased cost per case was 2269 yuan,the expenses for medicine,treatment,laboratory test and bed accounted for 47.42%,19.96%,17.10% and 9.03%,respectively (P

Objective To study the chemical constituents of Paeonia veitchii. Methods Isolation and purification were carried out on repeated silica gel column chromatography. The structures of the compounds were identified by physico-chemical properties and spectral analyses. Results Nine compounds were isolated and identified as paeoniflorin (Ⅰ), hydroxypaeoniflorin (Ⅱ), benzoylpaeoniflorin (Ⅲ), benzoylhydroxypaeoniflorin (Ⅳ), albiflorin (Ⅴ), paeonisothujone (Ⅵ), mudanpinoic acid A (Ⅶ), 2-hydroxybenzyl alcohol (Ⅷ), bis (2-hydroxybenzyl) ether (Ⅸ). Conclusion Compound Ⅸ is obtained from natural products for the first time. Compounds Ⅳ, Ⅵ-Ⅸ are isolated from this plant for the first time.

Yunnan Strain Information System has been developed by using the Programming Lan guage and Database Engine It includes information of over 10,000 strains that are stored in Yunnan University Institute of Microbiology Strain Library The S ystem makes a convenience for management of Strain Library and supply i mportant information for study these

Objective To study whether there is correlation among the VEEG, head B ultrasound examination and NBNA score in evaluation of encephalopathy in premature infants. Methods One hundred cases of premature and low birth weight infants in our hospital from January 2012 to August 2013 admitted to NICU, were graded by video electroencephalogram, head B ultrasound examination and NBNA score to analyze the result of them in the assessment results encephalopathy in premature infants. Results In the treatment process, consistent with the EEG, head B ultrasound examination and NBNA score changes the presence of data results,with statistical significance. Conclusion There is a good correlation between VEEG,head B ultrasound examination and NBNA score.

Objective To investigate the clinical significance of the gray head B ultrasound quantitative determination on early detection for preterm low birth weight infants with cerebral white matter damage. Methods From 2013 January to August 2014 in the NICU department of our hospital, 100 cases of preterm and low birth weight infants were ran-domly divided into the treatment group and the control group. After birth 72 hours, the value of cerebral white matter was measured by head B ultrasound combined with medical image analysis software. The cases, whose early values of cerebral white matter were above 130, were treated with early brain nerve nutrition and rehabilitation. The develop-ment of nerve growth was followed up in 3 months and 6 months after birth, respectively. Results The NBNA score of premature and low birth weight infants was significantly higher than that of the control group. By the follow-up investi-gation in 3 months and 6 months after birth, the nerve growth of the treatment group was significantly better than that of the control group. Conclusion The head B ultrasound gray-scale quantitative analysis has important guiding signifi-cance for early diagnosis of premature and low birth weight infants with cerebral white matter injury,and it can help to judge the prognosis and guide early clinical treatment.

Objective To investigate the construction of outpatient quality care services and the needs of patient for outpatient service,and to explore the relevance of the two projects.Methods A total of 152 cases of outpatient department registered nurse of Beijing Union Hospital and 281 cases of hospitalized patients on May,2017 were selected,and then developed the Content Questionnaire on Quality Nursing Work of Outpatient Nurse and the Questionnaire on Outpatient Needs Status to carry out investigation.Results This kind of hospital patients with college or university in 216 cases(76.9%,216/281),personal monthly income of 5.0-10.0 thousand accounted for 44.8%(126/281);outpatient nurses aged ≥46 in 83 cases(54.6%,83/152),the working time≥20 years in 120 cases(78.9%,120/152),college degree or above in 137 cases(90.1%,137/152),97 nurses(63.8%,97/152)in charge.The clinic nursing work relates to the rate of above 85%for disease treatment and consultation,health education,guidance service,self-service system services,on-site inspection,consulting room environment,and the cost of nurses working hours and the most frequent content for the on-site inspection and diagnosis of diseases,counseling,health education,medical order service.The order of patients' needs from high to low was disease and consultation,health education,guidance service,order service,on-site inspection,self-service system,registration service,waiting environment and consulting room environment.There was no correlation between the patient's needs and the rate of nursing,the length of work,and the frequency of work(P＞0.05).There were significant differences in the demand for health education on each department(F =3.047,P ＜0.05),education level,medical order service and on-site inspections have significant difference on demand(F=3.809,3.409,P＜0.05),family income,sources of patients were not statistically significant in the comparison(P＞0.05).The outpatient quality care services had lower improved demand(≤26%),and the first six item that needed to improve are disease and medical consultation,self-service system,treatment order service,waiting environment,health education,guidance services.Conclusions In view of the characteristics of outpatient medical staff and patients in large general hospitals,we will improve the quality of outpatient service and meet the needs of patient outpatient service,which will help to deepen the medical reform and improve the quality of medical service.

Objective To analyze the expression of miR-4524a-3p in peripheral blood mononuclear cells(PBMCs)and major immune cell subsets of patients with systemic lupus erythematosus(SLE),and evaluate its clinical application.Methods Peripheral blood samples were collected from SLE patients and healthy controls,followed by isolation of PBMCs,CD3+T lymphocytes,CD19+B lymphocytes,and CD14+monocytes using human peripheral blood lymphocyte isolation solution(Ficoll)and immunomagnetic bead cell sorting.The expression level of miR-4524a-3p was quantified using fluorescence quantitative PCR.Pearson's linear correlation analysis was per-formed to assess the relationship between miR-4524a-3p expression and the disease activity score in SLE patients(SLEDAI).Additionally,the diagnostic efficacy of miR-4524a-3p for SLE was evaluated by constructing a receiver operating characteristic curve(ROC).Results The expression of miR-4524a-3p was significantly decreased in PBMCs(P<0.05),CD3+T cells(P<0.001),and CD14+monocytes(P<0.001)from patients with SLE compared to healthy controls.Furthermore,it exhibited a negative correlation with SLEDAI score(r=-0.406,P<0.01).Notably,the expression level of miR-4524a-3p was significantly lower in patients with moderate or severe active stage than those in mild and inactive stages(P<0.01).In addition,the SLE subgroup with lupus nephritis and joint involvement displayed lower levels of miR-4524a-3p compared to the subgroup without such manifestations(P<0.01).Importantly,ROC analysis demonstrated that miR-4524a-3p holds promising diagnostic value for SLE.Conclusion The expression of miR-4524a-3p was significantly diminished in CD3+T cells and CD14+monocytes derived from patients with SLE,exhibiting a close association with disease activity and demonstrating potential clinical diagnostic value for SLE.

Objective To investigate the medication and compatibility patterns of traditional Chinese medicine(TCM)compound patents in the treatment of epilepsy through data mining research.Methods Data on TCM compound patents for treating epilepsy were retrieved from the China National Intellectual Property Administration's patent publication website.Descriptive analysis,association rule analysis,and cluster analysis were conducted using softwares such as Excel,Origin 2021,R 4.3.1 and Cytoscape 3.9.1,and the relevant topological property values were calculated to construct the core complex network.Results A total of 346 TCM compound patents for treating epilepsy were included,involving 738 different herbs.The top 5 frequently used herbs were Acorus tatarinowii,Gastrodia elata,Buthus martensii,Eupolyphaga seu steleophaga,and Uncaria rhynchophylla.The predominant drug category was liver-soothing and wind-extinguishing drugs.Cluster analysis identified two major categories of drug combinations,and the core combination in the co-occurrence network was Rhizoma acori tatarinowii-Scorpio-Gastrodiae rhizoma-Bombyx batryticatus-Uncariae ramulus cum uncis.A total of 23 association rules were obtained.Conclusion This study reveals the primary characteristics of treating epilepsy,which mainly focus on therapeutic directions such as soothing the liver and suppressing wind,calming wind to arrest convulsions,and calming the mind to tranquilize the spirit.It incorporates individualized dialectical diagnostic and treatment strategies,such as promoting blood circulation and resolving stasis,invigorating the spleen,and transforming phlegm.This discovery aims to provide reference and reference value for the clinical treatment of epilepsy in traditional Chinese medicine.

Objective To explore the effects of low ligation of the inferior mesenteric artery (IMA) on the third station lymph node dissection in laparoscopic radical resection of rectal cancer (RC),and analyze the risk factors affecting the third station lymph node metastasis.Methods The retrospective cohort study was conducted.The clinical data of 380 RC patients who were admitted to Renji Hospital of Shanghai Jiaotong University School of Medicine from June 2014 to June 2016 were collected.Of 380 patients,177 with preservation of left colic artery (LCA) and 203 without preservation of LCA were respectively allocated into the low ligation group and high ligation group.All the patients received laparoscopic radical resection of RC based on the principle of total mesorectal excision (TME).Observation indicators:(1) intra-and post-operative recovery situations;(2) results of postoperative pathological examination;(3) follow-up and survival;(4) risk factors analysis affecting the third station lymph node metastasis.Follow-up using outpatient examination and telephone interview was performed to detect postoperative disease-free survival and tumor recurrence or metastasis up to May 31,2017.Measurement data with normal distribution were represented as x ± s,and comparisons between groups were evaluated with the t test.Comparisons of count data and ordinal data were respectively analyzed using the chisquare test and U test.The survival curve and survival rate were respectively drawn and analyzed using the KaplanMeier method,and the survival analysis was done by the Log-rank test.Results (1) Intra-and post-operative recovery situations:all the patients underwent successful surgery.The operation time,time to initial exsufflation and cases with anastomotic leakage were respectively (147.2±3.0) minutes,(72.8± 1.4)hours,20 in the low ligation group and (137.2±2.8) minutes,(76.6± 1.1) hours,38 in the high ligation group,with statistically significant differences between groups (t =2.463,2.073,x2 =4.025,P＜0.05).Volume of intraoperative blood loss,cases with temporary stoma,vascular injury (injury of inferior mesenteric vessels and presacral vein injury),urinary retention and duration of postoperative hospital stay were respectively (119±6)mL,25,29,24,(10.7± 0.5)days in the low ligation group and (108±5)mL,32,27,30,(9.6±0.4)days in the high ligation group,with no statistically significant difference between groups (t=1.524,x2 =0.235,0.716,1.115,t=1.780,P＞ 0.05).Of 58 patients with anastomotic leakage,31 received previously terminal loop ileostomy,13 received conservative treatment and 14 received postoperatively terminal loop ileostomy.Fifty-four patients with urinary retention received urethral catheterization.All the patients with complications were improved by treatment and then were discharged.(2) Results of postoperative pathological examination:number of lymph node dissected in the low ligation group and high ligation group was respectively 12.8±0.4 and 12.0±0.3;cases with depths of tumor invading to intestinal wall in stage pT1-T2 and pT3-T4,with tubular adenocarcinoma and non-tubular adenocarcinoma,with high-differentiated,moderate-differentiated and low-differentiated tumors,with lymph node metastasis in stage N0,N 1 and N2,with and without the third station lymph node metastasis,with TNM staging in stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ were respectively 53,124,150,27,81,63,33,73,66,38,16,161,17,54,93,13 in the low ligation group and 59,144,176,27,99,59,45,79,78,46,24,179,32,47,105,19 in the high ligation group,with no statistically significant difference in above indicators between groups (t =1.556,x2 =0.035,0.296,U=2.002,0.220,x2 =0.778,U=5.557,P＞0.05).(3) Follow-up and survival:338 of 380 patients were followed up for 6-36 months,with an average time of 28 months,including 164 in the low ligation group and 174 in the high ligation group.The 1-and 3-year disease-free survival rates and cases with postoperative tumor recurrence or metastasis were respectively 93.9％,76.4％,39 in the low ligation group and 94.8％,79.3％,36 in the high ligation group,with no statistically significant difference between groups (x2=0.861,P＞0.05).(4) Risk factors analysis affecting the third station lymph node metastasis:results of univariate analysis showed that tumor location and diameter,depth of tumor invading to intestinal wall and tumor histopathological type were related factors affecting the third station lymph node metastasis of RC patients (x2 =9.957,9.921,6.196,6.576,P＜0.05).Results of multivariate analysis showed that tumor diameter ＞ 5 cm and non-tubular adenocarcinoma were independent risk factors affecting the third station lymph node metastasis of RC patients (Odds ratio=2.561,2.296,95％ confidence interval:1.280-5.123,1.037-5.083,P＜0.05).Conclusions The low ligation of the IMA is safe and feasible in laparoscopic radical resection of RC,meanwhile,it has the same radical effect in lymph node dissection and doesn't affect the third station lymph node metastasis and shortterm disease-free survival compared with high ligation of the IMA.Tumor diameter ＞ 5 cm and non-tubular adenocarcinoma are independent risk factors affecting the third station lymph node metastasis of RC.