Objective To investigate the clinical pathologic characteristics and prognosis of bilateral breast cancer, and to determine whether clinical factors is related to p53 gene mutation.Methods Archival material was reviewed from 48 cases of bilateral breast cancar.The clinical and pathological features of bilateral breast cancer were compared and summarized.Immunohistochemical stains for P53 were performed on 33 cases of bilateral breast cancer, 141 cases of unilateral breast cancer were also examined as control.Results The five-year survival rate for bilateral breast cancer patients was 70.5％.The median age when bilatereral breast cancer first dignosed was 47.5 (range from 27 to 69).The median time interval between the first and the subsequent breast cancer diagnosis was 9.5 months.Invasive ductal breast carcinoma was the main pathologic type of bilateral breast cancer.88.5％ of bilateral breast cancer would have the same estrogen receptor (ER) status and 81.8％ would have the same human epidermal growth hormone receptor 2 (HER2) status between the first and secondary primary tumors.Mutation p53 was more common among the bilateral breast cancer patients compared with the unilateral breast cancer patients (45.5％ vs.26.2％, x2 =4.711 ,P =0.030).There was no difference on the overall survival between bilateral breast cancer with p53 (+) and p53 (-)(x2 =0.434,P =0.510).Conclusion The main pathologic type of bilateral breast cancer is invasive ductal breast carcinoma, there is a good match of the ER and HER2 status between the first breast cancer and the contralateral one.Bilateral breast cancer patients have a similar overall survial with the unilateral breast cancer.p53 mutation is more common among bilateral breast cancer patients than those with unilateral breast cancer.

Women diagnosed with breast cancer have a significantly higher risk of developing contralateral breast carcinoma.When the dignosis ofbilateral breast cancer (BBC)is established,the challenges for the doctors are to determine contralateral breast carcinoma is metastasis or primary lesions.The pathological type,receptor status,biological behavior and the prognosis of bilateral breast cancer are the issues have to be considered.On the other hand,we discuss which type of breast cancer trend to be bilateral breast cancer,thus more effective follow-up and preventive procedures would be applied on this part of patients to improve their quality of life and the curative rate.

[Objective] To develop an HPLC method for the determination of berberine hydrochloride in GuZheNing liniment.[Methods]The chromatographic system consisted of Dimonsil C18 column and mobile phase of acetonitrile—50mmol?L-1 sodium dihydrogen phosphate(adjusted PH to 2.5 with H3PO4)(25∶75).The flow rate was 1.0 mL?min-1,and the detective wavelength was at 348 nm.[Results]The calibration curve was linear in the range of 0.106～0.530 ?g(n=5).The method was proved to be repeatable with RSD 0.7%(n=6).4 batches of sample were analyzed and the Berberine Hydrochloride contents were 19.11,18.81,18.83,18.92mg/100mg,respectively.[Conclusion]The method is selective,simple and accurate,and could be used for the quality control of this preparation.

[Objective]To develop an HPLC method for the determination of berberine hydrochloride in GuZheNing liniment.[Methods]The chromatographic system consisted of Dimonsil C18 column and mobile phase of acetonitrile-50mmol?L-1 sodium dihydrogen phosphate(adjusted PH to 2.5 with H3PO4)(25:75).The flow rate was 1.0 mL?min-1,and the detective wavelength was at 348 nm.[Results]The calibration curve was linear in the range of 0.106～0.530 ?g(n=5).The method was proved to be repeatable with RSD 0.7%(n=6).4 batches of sample were analyzed and the Berberine Hydrochloride contents were 19.11,18.81,18.83,18.92mg/100mg,respectively.[Conclusion]The method is selective,simple and accurate,and could be used for the quality control of this preparation.

Objective To investigate the relationship between the brachial‐ankle pulse wave velocity (baPWV) with the ca‐rotid arterial intima‐media thickness(IMT) and carotid artery plaque in the patients with type 2 diabetes mellitus(T2DM) and to analyze the related risk factors causing atherosclerosis .Methods A total of 426 patients with T2DM were collected and conduct the records of baPWV ,carotid artery ultrasound ,biochemical index detection andrelated risk factors record .The correlation between baPWV with carotid arterial IMT was analyzed .The patients were divided into the abnormal group and normal group according to the baPWV results .The carotid artery IMT ,carotid artery plaque and related risk factors were compared between the two groups . Results The DM duration ,systolic blood pressure ,diastolic blood pressure ,pulse pressure ,low density lipoprotein cholesterol (LDL‐C) ,number of atherosclerosis risk factors had statistically significant differences between the two groups (P< 0 .05 ,P<0 .01);while the age ,waist circumference ,BMI ,uric acid ,HDL‐C ,TG ,TC ,glycosylated hemoglobin had no statistically significant differences between the two groups(P>0 .05) .The detection rate of plaque by carotid artery ultrasound had no statistically signifi‐cant difference between the two groups(P>0 .05);but the statistically significant difference was found in the number of plaque be‐tween the two groups(P<0 .01) ,the abnormal group was obviously more than the normal group;the normal IMT ratio had statisti‐cally significant difference between the two groups(P<0 .05) ,the normal group was obviously higher than the abnormal group .The IMT value had statistical difference between the two groups(P<0 .01) ,which in the abnormal group was significantly thickened compared with the normal group .The analysis of correlation between baPWV and IMT showed that IMT was positively correlated with baPWV(r=0 .228 ,P<0 .05) .Conclusion T2DM patients with reduced arterial elasticity could complicated with the obvious thickening of carotid arterial IMT and increase of plaque number .Combining baPWV with carotid arterial ultrasound examination can better conduct the arteriosclerosis evaluation .

Objective To explore the effect of task-driven teaching methodology based on the action research on cardiopulmonary resuscitation training. Methods The 80 nurses recruited in 2011 were assigned in the control, receiving routine training while another 80 nurses recruited in 2012 were in the study group, where task-driven teaching methodology was used based on the action research. The two groups were compared in terms of results of theoretical and operational examinations. Result The study group was significantly better than the control group in the scores of theoretical and operational examinations ( P < 0 . 05 ) . Conclusion The task-driven teaching methodology based on the action research not only increases the examination results, but also improves the effect of teaching.

Objective:To study the effect and safety of transradial percutaneous coronary intervention (PCI).Meth-ods:Clinical data of 306 patients,who received PCI in our hospital from Mar 2012 to Jan 2014,were retrospectively analyzed,including radial group (n=153),and femoral group (n=153).Therapeutic effect,time and postoperative complications etc.were compared between two groups.Results:A total of 151 cases completed PCI successfully in radial group,the success rate was 98.7%;a total of 150 cases completed PCI successfully in femoral group,the suc-cess rate was 98.0%,there was no significant difference in success rate of operation between two groups,P >0.05. Compared with femoral group,there were significant reductions in hospitalization time [(8.0±3.5)d vs.(3.5± 1.7)d],treatment cost [(3.74±2.06) × 104 yuan vs.(2.61 ± 1.4) × 104 yuan],P <0.01 both,in incidence rates of postoperative coronary occlusion (3.92% vs.0%),arrhythmia (11.76% vs.1.31%),vascular spasm (6.54% vs.1.96%)and hematoma (7.19% vs.0.65%)etc.in radial group,P < 0.05 or < 0.01. Conclusion:Transradial PCI possesses better effect than that of transfemoral ,and it can reduce hospitalization time,cost and postoperative complications,which is worth extending.

OBJECTIVE To strengthen the hospital infection control to realize the potency feeling among malignant tumor patients under the conduct of psychological nurses and other medical staff.METHODS The related hospital infection control system and the psychological countermeasure of nursing were formulated,we used two groups of comparisons methods around implements,counting and analyzing the effect of the hospital infection control among malignant tumor patients.RESULTS The psychologically healthy instruction enabled the patient positively to coordinate the treatment,the ratio of hospital infection from the original 21.33% dropped to 15.41%,and make the certain dynamic function to the self-realization of the patients' potency feeling.CONCLUSIONS The hospital infection control is an essential and important link to the nursing of the malignant tumor patients;the psychologically healthy instruction is an effective way to promote the self-realization of patients potency feelings.

Objective: To explore influence of long-term oral valsartan-angiotensin II type 1 receptor blocker on ventricular arrhythmia after myocardial infarction (MI) in rabbits and its possible mechanism. Methods: A total of 24 New Zealand rabbits were randomly divided into sham operation group (n=8), MI group (n=8) and valsartan group (n=8) according to number table. Sham operation group only received thoracotomy without ligation of anterior descending branch of left coronary artery (LAD), while MI group and valsartan group received ligation of anterior descending branch of LAD. Valsartan group received valsartan gavage (10 mg•kg-1•d-1) since the second day after operation, three groups all were fed for 12 weeks. Mono active potential (MAP) of left ventricular myocardial cells of subendocardial myocardium（inner layer myocardium）, subepicardial myocardium（outer layer myocardium）and middle layer myocardium were recorded before MI and 12 weeks after MI, and times of provocative malignant arrhythmias were recorded on 12 weeks after MI in three groups. Results: 1. Ventricular tachycardia or fibrillation (VT/ VF) episodes were markedly decreased in VAL group than that in MI group on 12 weeks after MI [(3.1±0.8) vs. (12.7±1.5), P＜0.05]; 2. After MI 12 w, the action potential duration to 90% repolarization (APD90) of three-layer ventricular myocytes in MI group was prolonged than that before MI [（259.2±22.1）ms,（288.0±25.8）ms,（244.6±22.6）ms vs.（230.1±23.2）ms,（244.2±23.4）ms,（229.0±21.7）ms, P＜0.05 or＜0.01]；but there were no significant difference in APD90 of three layers ventricular myocytes between before and after MI in valsartan group (P>0.05 all); Compared with sham operation group and valsartan group, there was significant prolonged in transmural dispersion of repolarization (TDR) [(18.8±6.2) vs. (23.9±7.7) vs. (37.2±10.2), P<0.05 or＜0.01] in MI group; There was no significant difference in TDR between valsartan group and sham operation group (P>0.05). Conclusions: Long-term oral valsartan can significantly reduce malignant ventricular arrhythmia incidence in rabbits after MI, which may be related to improving TDR in rabbits after MI.