Pregnancy associated breast cancer (PABC) has many special characteristics,such as the clinical manifestation,pathology,diagnosis,treatment and prognosis.Due to the delay of diagnosis,the survival rate is low and the prognosis is poor.Early diagnosis and comprehensive individualized treatment with operation,radiotherapy and chemotherapy are needed to improve the prognosis of patients and prolong the survival period.

This paper analyzes the characteristics of the follow-up quality survey and evaluation of medical graduate students in China.It raises that the follow-up quality survey of graduate students in medical schools should be institutionalized,standardized and normalized; the survey and evaluation should be conducted through close cooperation with the relevant departments and training units; comparative studies on graduates of different years should be conducted; and the indicator system and survey content should value the characteristics of times,training units and subjects; Finally,specific technical issues such as when and to whom the evaluation and survey should be conducted,survey arrangements,evaluation methods,the diversity of participants and determination of results are discussed and suggestions are put forward.

Objective To evaluate the level situation of clinical doctors graduating from mil-itary medical university within a certain period, understand their career development, and explore and analyze the problems and deficiencies in doctoral education and training to provide reference for deep-ening the reform of clinical disciplines doctoral education. Methods Stratified random samples of 9 Hospitals were selected and the established evaluation index system of clinical discipline quality tracking and investigation questionnaire was used to evaluate doctoral quality. Evaluation was surveyed by self rating and other rating combination. Quality evaluation system contains 4 first level indicators such as the military and political quality, clinical, teaching and research level, the development po-tential as well as 15 second-level indexes. The scores of self-assessment and other evaluation were compared by Pearson rank correlation analysis. The corresponding indicator scores of different doctorate types were compared using the test of variance and the subject research and published papers were analyzed by χ2 inspection. Results The comprehensive score of graduated doctors is excellent, with self-evaluation score (92.72±7.06) and other evaluation score (93.61±8.05). Correlation coefficient is 0.33(P=0.04); The academic doctors have done better in publishing papers(χ2=5.97, P=0.01) and undertaking subject research(χ2=6.08, P=0.00), but poorer in clinical work compared with the doctors of professional degree. The assessed groups are inadequate in publishing high level papers and in un-dertaking research projects and doctors of different degree types have different cognition of the ele-ments of improving the quality. Conclusions Cultivating the doctors' clinical ability and innovation ability are the cores of deepening the reform of clinical doctoral education. We should focus on inno-vation ability , value the cultivation of the clinical professional doctoral degree and explore various joint evaluation systems to attain the goal of enhancing the education quality of doctors.

Radiotherapy after breast conserving surgery for breast cancer is an important part of comprehensive therapy,and breast conserving surgery combined with radiotherapy for early stage breast cancer has been widely recognized.Modern radiotherapy techniques including three-dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) have obtained reasonable application in breast conserving therapy.Radiation reaction and cosmetic result are important factors to evaluate radiotherapy after breast conserving surgery.Radiation reactions and cosmetic results of different radiotheraies are different and each has its own characteristics.

0.05).Side effects of group D were greater than other groups(? 2, P

Objective To explore the related factors influencing the condensate infection level in order to provide a reference for ventilator pipe care and reducing condensate infections.Methods A total of 80 patients using ventilator in ICU of the First Hospital of Liaoning Medical University was chosen as the research object,and the related factors influencing the condensate infection using correlation and regression analysis method were explored,and the regression model was estabhshed as well.Results Condensate infection were correlated with pipe length (r=0.837,P＜0.01),temperature difference between ward and gas in the pipe (r=0.875,P＜0.01),exhaled gas humidity (r=0.793,P＜0.01) and ventilation (r=0.932,P＜0.01),but the pipe length could not enter the regression equation (t=-0.09,P＞0.05),and the regression equation was y=-168.08 +9.96x1 (temperature difference) +0.33x2 (exhaled gas humidity) +20.98x3 (ventilation).Conclusions Pipe length,temperature difference between ward and gas in the pipe,exhaled gas humidity and ventilation were the influencing factors,and medical personnel can control the infection of condensate considering the influencing factors.

Objective To investigate the clinical outcome of post-traumatic tibial osteomyelitis treated by induced membrane technique combined with the antibiotic cement-coated locking plate.Methods A restrospective case series analysis was made on 71 cases of post-traumatic tibial osteomyelitis treated by induced membrane technique from September 2014 to September 2014.There were 55 males and 16 females, aged 18-60 years(mean, 37.4 years).Mean length of bone defect following debridement was 4.5 cm(range, 4-11 cm).Antibiotic cement-coated locking plates were used to provide the stability of the bone defects after one-stage debridement.Bone grafting and exchanging the plates with ntramedullary nails were done during the second-stage surgery.Parameters were monitored dynamically after operation to evaluate infection recurrence and bone healing, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), clinical features(sinus formation, redness and swelling, warmth and pain) and X-ray films of the involved limbs.Results All patients were followed up for 13-25 months (mean, 19.5 months).There was no sign of recurring infection and CRP and ESR were normal in all cases after the first stage surgery.However, four cases (6%) had recurrent infection with sinus exudates and their CRP and ESR were abnormal after the second stage surgery, and further treatments were carried out on these patients.Follow-up showed bony union in all patients within mean 5.5 months (range, 4-6 months).Conclusion Induced membrane technique with antibiotic cement-coated locking plates for treatment of post-traumatic tibial osteomyelitis can shorten bone healing time and decrease infection recurrent rate without obvious impact on osteogenic activity.

Objective To study the 18F-FDG PET/CT features of tuberculous and malignant diffuse peritoneal lesions and to discuss the diagnostic value of 18F-FDG PET/CT in diagnosing and differentiating the lesions. Methods The 18F-FDG PET/CT features of 72 patients with tuberculous peritonitis,28 primary serous papillary carcinoma of the peritoneum and 135 peritoneal metastases confirmed by clinic and/or histopathology, were retrospectively reviewed. The peritoneal thickening features of tuberculous and malignant peritoneal lesions were observed. The maximal standardized uptake value (SUVmax) of peritoneal lesions and ascites, ascites SUVmax/liver SUVmax (T/NT) were compared between tuberculous peritonitis and cancerous peritonitis. The ROC curve was used to analyze the diagnostic efficiency of T/NT, SUVmax of peritoneal lesions and ascites. Results The typical 18F-FDG PET/CT features of tuberculous peritonitis were uniformity thickening of parietal peritoneum, mesenteric and omental stain like changes, widely and even distribution of the peritoneal 18F-FDG, while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum, mesenteric and omental nodules and pie-shape changes, uneven distribution of the peritoneal 18F-FDG. The degree of 18F-FDG uptake was increased in all peritoneal lesions, and there was no significant difference between the tuberculous group (SUVmax=10.53±5.44) and the cancerous group (SUVmax=11.45±6.78, t=1.017, P>0.05). The 18F-FDG concentration in malignant ascites (SUVmax=1.88±0.65,T/NT=0.73± 0.18) was obvious higher than that of tuberculous ascites (SUVmax=1.67±0.69,T/NT=0.57±0.27, t=2.243 and 5.045,both P<0.05). The area under the ROC curve of T/NT, SUVmax of ascites, SUVmax of peritoneal lesions were 0.707, 0.593, 0.536, respectively. Conclusion The 18F-FDG PET/CT imaging can reflect the morphology and metabolic changes of peritoneal lesions. It is important to combine the SUVmax of ascites in order to improve the efficiency of diagnosing the diffuse peritoneal diseases.

Objective To investigate the clinical efficiency of kid foot soft tissue defect with reverse flap with cutaneous branch of fibular artery combine with sural nerve nutritional vessel axial. Methods From Feb. 2006 to Feb. 2009, according to the position and size of the soft tissue defects, the sural nerve nutritional vessel flap combine with the cutaneous branch of the peroneal artery were desingned and obtained to repair the 5 cases soft tissue defects of the foot. The flap size ranged from 8 cm × 7 cm to 18 cm × 10 cm. The vessel pedicle of cutaneous branches ranged from 1.7 cm to 3.0 cm. The distribution of the vessel pedicle of cutaneous branches ranged from 4.5 cm to 8.0 cm on the lateral malleolus. Results All flaps survived completely in 6 cases. The outline and function were satisfactory during 6-18 months follow-up. Among of 6 cases, the sural nerve were anastomosed with the acceptor sensory nerve in all cases. The skin sense were sat-isfactory after 1 year of operation and 2-point discrimination was 10-13 mm. Conclusion The blood supply of this flap is reliable without sacrifice of major arteries. Flap elevation is easy. It can reverse to a long dis-tance and can repair large skin defects. Especially this flap could have some sensory nerve. It is very useful in repairing kid foot large soft tissue defect.

Objective To study the stability of anticoagulant peptide Hirulog-S and its lyophilized product, and to provide data on the storage conditions and clinical applications.Methods RP-HPLC was used to determine the content and the related substances of Hirulog-S and its lyophilized powder with influence factor test, accelerated test and long-term storage test.Results Light, temperature and humidity had no significant effect on the stability of Hirulog-S and its lyophilized powder in the influence factor test.The content and related substances of Hirulog-S and its lyophilized powder did not significantly change in the accelerated test ( 40℃, RH75%) and 24-month long-term storage test at room temperature and 4℃.Conclusion Hirulog-S and its lyophilized product are very stable, even after being stored at room temperature for two years.