Background and purpose:Breast cancer is a rare disease in women aged less than 25.Furthermore,there were fewer studies reporting the outcomes of this cohort and the knowledge regarding its biological characteristics and clinical features were limited. The aim of this retrospective study was to examine and audit the experience of our institution in treating the extremely young patients with breast cancer,to focus on the clinical presentation and pathological fi ndings,and to identify the prognostic factors which might be helpful in identifying those patients with a worse prognosis. Methods:From Jan 1980 to Dec 2005,there were 54 breast carcinoma patients in women aged 25 years or less treated in our hospital.We retrospectively analyzed their clinical,histological and treatment variables as well as 5-year overall survival(OS) and 5-year disease-free survival(DFS) . Results:There were 0.48% of all breast cancer cases who occurred in age of 25 or less in our institute in the period. We found 77.8% to be invasive ductal carcinoma and none of the patients had any family history of breast cancer or ovarian cancer. Clinically,68.5% were stage Ⅰ or Ⅱ,53.7% had lymph node metastasis. 79.6% were classifi ed as T1 or T2. Regarding the biological features,the frequencies of positive ER and PR were low(29.6%,36.0%,respectively) ,and the frequency of positive c-erbB2(22.2%) was higher. Lymphovascular invasion occurred in eight patients. Thirty-eight patients received adjuvant chemotherapy. 26 patients in this study died of breast cancer. The 5-year DFS and OS were 54.3% and 55.5%,respectively. In lymph node-positive patients,chemotherapy improved their 5-year OS signifi cantly(P=0.007) . The patients who might have a worse prognosis were usually with diagnostic delay more than 3 months(P=0.019) ,higherclinical stage(P=0.000) ,larger tumor size(P=0.007) ,lymph node-positive(P=0.000) and lymphovascular invasion(P=0.011) . Multivariate’ analysis revealed that both diagnostic delay more than 3 months and lymph node-positive were the independent prognostic factors(P=0.034,P=0.027,respectively) . Conclusion:Breast cancer is a rare condition in women aged 25 or less. Invasive breast cancer occurring at this subgroup has more aggressive biological behaviors. Diagnostic delay of more than 3 months and lymph node metastasis are considered adverse prognostic factors in the current study. The general principles of managing adolescents and very young women with breast cancer are no different to those applying to older women in current study,but development of tailored treatment for this population is still crucial.

Objective To study the clinical significance of plasma(1→3)-β-D-Oaten measurement in invasive fungal infections.Methods The levels of plasma(1→3)-β-D-glucan were measured bymicrobiology kinetic rapid reader MB-80 and GKT-5M set dymmic fungus detecting kit in 14 patients proven to suffer from invasive fungal infection and 13 healthIy voluntary persons.And the difference between them was compared.Results In 14 patients with invasive fungal infection,8 patients had fungal infection of lower respiratory tract and lung,6 patients had fungemia.There were 11 patients infected by monilia(1 patient combined infection),2 patients infected by aspergillus,and 2 patients infected by pneumocystis(1 Datient clinical diagnosis without aetiology proof).The levels of plasma(1→3)-β-D-slucan in invasive fungal infections patients were(105.02±82.22)ng/L,which were higherthan thosein healthy persons[(6.65±1.01)ng/L)J,P＜0.01.Conclusion The levels of plasma(1→3)-β-D-glucanisan ia an important index in diagnosis of invasive fungal infections.

Adolescent ; Bone Neoplasms ; complications ; Humans ; Male ; Osteoma, Osteoid ; complications ; Scapula ; pathology ; Shoulder Joint ; pathology ; Synovitis ; complications

Objective To investigate the effects of baicalin on morphine-induced behavioral sensitization.Methods Locomotor activity was measured for 2h after administration with baicalin in mice.Hyperlocomotion induced by acute morphine (10 mg· kg-1,ip) and behavioral sensitization induced by repeated morphine were established.The level of dopamine of ventral tegmental area(VTA) and prefrontal cortex(PFC) in mice was tested by ELISA assay.Results Baiealin inhibited significantly both locomotor activity in mice (control (1095.8 ± 174.5) times,baicalin (899.6± 187.2),(724.2± 221.4),(609.1 ± 154.6) times ; P＜ 0.01) and hyperlocomotion induced by acute morphine(model (1518.2± 185.8) times,baicalin (1385.4±224.2),(1205.1 ± 174.6),(1100.3±235.1) times ; P＜0.01).Similar inhibition was also seen in the development and expression of morphine-induced behavioral sensitization(model(2096.2±304.6) times,baicalin (2004.2 ± 218.5),(1998.7-± 224.3),(1836.1 ± 233.5) times,P＜ 0.05 ; model (2124.2 ± 189.6) times,baicalin (1922.2± 314.7),(1524.1±289.2),(1477.4± 219.3) times,P＜0.01).Baicalin inhibited dopamine release in VTA and PFC of morphine-sensitized mice(model(457.6± 92.1,589.2 ±102.5) μg · L-1,baicalin(391.1±56.8) μg · L-1,(448.6± 99.3) μg · L-1; (324.5±66.2) μg · L-1,(368.7±45.9) μg · L 1 ; (234.3± 52.6) μg · L-1,(305.3±84.1) μg · L-1 ; P＜0.01,P＜0.01).Conclusion Baicalin inhibits the development and the expression of morphine-induced behavioral sensitization in mice,and this effect is related to the inhibition of dopamine release in VTA and PFC of mice.

Objective To detect the changes of soluble αB-crystallin in X-ray irradiated rat lens,and to explore the potential role of αB-crystallin in the pathogenesis of radiation-induced cataract.Methods The radiation cataract model was established with the accelerator linear in male Sprague-Dawley(SD)rats.The rats were divided into normal control group,experimental control group and X-irradiated group(the doses were 5,15,and 25 Gy,respectively).The rats were killed at 3 morlths post-irradiation,and the lenses were carefully isolated and homogenized.The protein changes of αB-crystallin in lens supernatant were measured by Western blotting.Results Typical radiation-induced cataract was observed in 15 and 25 Gy groups,while the lenses of the normal control group,experimental control group and the 5 Gy irradiation group remained transparent.The αB-crystallin protein level was significandy decreased in a dose-dependent manner(5 Gy group:0.871±0.085;15 Gy group:0.643±0.096;25 Gy group:0.338±0.160;F=40.764,P＜0.05).Conclusions The decreased expression of the molecular chaperone αB-crystallin in X-irradiated rat lens indicates its important role in the pathogenesis of irradiation cataract.

Objective To investigate the clinical characteristics of Takayasu's arteritis (TA) with pulmonary hypertension (PAH) in order to improve the diagnosis and treatment earlier. Methods Twelve out of 191 patients with TA registered in Peking Union Medical College Hospital from 1987 to 2007 were diagnosed as PAH, the clinical data of 12 patients were analyzed. Results Ten patients were females. The range of age were from 14 to 47 years old, the average age was (27±10) years old. Eleven patients had the clinical manifestations or/and signs of pulmonary artery involvement. Seven patients presented with short breath after exercise or hemoptysis as the first manifestation, four patients with fatigue, four patients with intermittent claudication or pain or numbness of extremities, three patients with dizziness. Seven patients belonged to type Ⅰ+Ⅳ, one patient to type Ⅱ+Ⅳ, three patients to type Ⅲ+Ⅳ, one patient to type Ⅴ. Elevated ESR/CRP was found in ten patients. All patients took the glucocorticoid and DMARDs, stent implantation in pulmonary artery was done in one patient, Bentall was operated in another patient.The symptoms of all patients improved except one patient died for low cardiac output after operation. Conclusion PAH is one of the severe complications in late stage of TA, and other arteries are usually involved too. Because it is difficult to observe PAH in TA patients in early stage, CTA or pulmonary angiography and UCG should be taken in early stage. The stent implantation or dilating the artery should be considered aa a treatment, but at on the same time, glucocorticoid and DMARDs should be taken to avoid the relapse.

BACKGROUND:Treatment methods of pterygium mainly include pterygium excision,pterygium excision combined with local application of mitomycin,pterygium excision combined with conjunctival flap transfusion and pterygium excision combined with autologous corneal limbus stem cell transplantation.Dry eye commonly occurred in many patients following pterygium excision.OBJECTIVE:To evaluate the effects of stem cell transplantation of limbus cornea and simple excision of pterygium on tear film stability.METHODS:Eighty patients(eighty eyes)with pterygium were involved in this clinical experiment.All patients were randomly divided into 2 groups:Group A accepted simple excision of pterygium in 40 patients with 40 eyes under a 10-fold microscope,and Group B accepted excision of pterygium with stem cell transplantation of limbus cornea in 40 patients with 40 eyes under a 10-fold microscope,in which a free transplantation of the superotemporal limbus stem with an adjacent piece of conjunctiva was transplanted in the excision area.Slit-lamp examination,tear film break-up time and questionnaire on dry eye were performed before operation,at one week post-operation,and at three months post-operation.RESULTS AND CONCLUSION:In both groups,following surgery,some patients affected dryness,foreign body sensation,burning sensation.These symptoms were more in the group A compared with group B(P ＜ 0.05).Implant was red 1 week following surgery in the group B,and confluence was found,without infection or rejection.The tear film break-up time was prolonged in the group B compared with the group A at 1 week following surgery,and no significant difference was determined at 3 months.Results indicated that compared with simple excision of pterygium,combined excision of pterygium with stem cell transplantation of limbus cornea obtained better outcomes,and could decrease the manifestations of dry eye and maintain better tear film stability in patients with pterygium.

In this study,we analyzed the data of hemorrhagic fever with renal syndrome (HFRS) and host animals monitoring in Zhangzhou City,Fujian Province,China,2006-2015,in order to find out the epidemic situation and risk factors,and provide a scientific basis for the prevention and control strategy.A total of 171 HFRS cases,including 1 death,were reported in Zhangzhou in this decade.The incidence rate of 0.352/105 showed an upward trend (xtrend2 =58.60,P＜0.01).And 70 villages and towns in 11 counties have affected,accounting for 56.00％ of the counties in Zhangzhou City.The cases were mainly reported in some towns of Huaan,Nanjing and Zhaoan countries.The cases mainly occurred in countryside,which reported 142 cases.The cases in farmers accounted for the highest proportion (79.58 ％),and pig farming staff accounting for 23.01％ in farmer cases.Most cases were reported in municipal hospitals (86.55 ％).The common clinical manifestations of those cases were fever,nausea,vomiting,backache,headache,pain,oliguria or anuria,eyelid edema and so on,with 72.67％ of thrombocytopenia and of 83.09 ％ proteinuria positive.Compared with the proportion (80.49 ％) of mice in patients' house from 2006 to 2010,that (45.83％) from 2011 to 2015 decreased obviously;however,the proportion of mice or mice droppings in workplaces were rising from 60.98％ to 73.33％.Mean rodent density was 6.40％ and total infection rate in rats was 7.42％.The main kind of rats with virus infection was Rattus norvegicus,carrying Seoul virus Ⅱ.Results of this study indicate that Zhangzhou is one of the foci of HFRS rodent,and the epidemic is rising in recent years,the overall in the highly distributed,while some counties showed a rising trend year by year.Thus,monitoring and control efforts in prone areas should be increased,and to carry out clinics training of HFRS in primary health care institutions.

Objective: To investigate the relationship between metabolic parameters of primary lesion and clinicopathological features of patients with breast cancer. Methods: Clinical data of 78 patients with breast cancer undergone ¹⁸F-FDG PET/CT before surgery was retrospectively analyzed. SUVmax, SUVmean and metabolic tumor volume (MTV) of primary lesions were measured by horizontal, sagittal and coronal position volume section with a threshold of 40% SUVmax. TLG was calculated and the highest SUVmax among metastatic lymph nodes was measured. Results: SUVmax, SUVmean, MTV, TLG and the maximum diameter of 78 primary lesions were 6.64(1.85, 22.79), 3.88(1.30, 11.42), 13.36(1.66, 129.08)cm^3, 47.92(2.85, 443.28)g and 2.35(1.23, 9.80)cm, respectively. SUVmax of metastatic lymph node was 5.12(2.38, 14.32). There were statistically significant differences of primary lesion metabolic parameters (SUVmax, MTV, TLG) in different pathological stages, T stages, with or without lymph node invasion (all P<0.05). Only TLG of ER negative patients was higher than that of ER positive patients (P<0.05). TLG, MTV of PR negative patients were higher than that of PR positive patients (both P<0.05). No significant differences of metabolic parameters were found between HER-2 negative and positive patients (all P>0.05). SUVmax, MTV, TLG of primary lesion were positively associated with Ki-67 and the maximum diameter (all P<0.05), and the correlation coefficient of TLG was the highest. SUVmax, SUVmean, MTV and TLG were all positively associated with T stage (all P<0.05), and the correlation coefficient of TLG was the highest. None of the parameters had correlation with N stage(all P>0.05). Only TLG had positive correlation with clinical stage (P<0.05). SUVmax of metastatic lymph node was positively associated with metabolic parameters of primary lesion, T stage and clinical stage, respectively (all P<0.05). Conclusions ¹⁸F-FDG PET/CT metabolic parameters, especially TLG has the highest correlation with clinicopathological features of breast cancer. SUVmax of metastatic lymph node was positively associated with metabolic parameters of primary lesion and clinical stage.

Objective To evaluate the differences among five representative and useful Doppler parameters in the diagnosis of the three common types of renal artery stenosis (RAS). Methods Five Doppler parameters including renal peak systolic velocity (RPSV), renal-aortic ratio (RAR), renal-interlobar ratio (RIR),acceleration time (AT),and resistant index (RI) were measured in 221 patients before renal arteriography. Differences between the groups of patients with various clinical causes of RAS were analyzed by Chi-Squared test. One-way ANOVA or t test were used to compare the means between different groups.The optimal cutoff value was determined with the maximum sum of sensitivity and specificity. Results Of the 442 renal arteries (main and accessory renal arteries) demonstrated at arteriography,214 were normal or stenosed less than 50 %, 204 stenoses 50% - 99 %, and 24 occlusions. RIR, RAR and RI were significantly different between the atherosclerotic and non-atherosclerotic RAS groups (P ＜0.05), while RPSV and AT were not. The optimal cutoff values of RAR,RIR and RI for detecting RAS between the atherosclerotic and non-atherosclerotic groups were much different (2.5 versus 1.9, 5. 1 versus 6.5, 0.57 versus 0.50,respectively) ,but those of RPSV and AT were similar or the same (170 cm/s versus 200 cm/s,51 ms versus 51 ms,respectively). Conclusions In the case of RAS (diameter reduction≥50%),it is advised to establish separate cutoff values of RAR, RIR and RI according to atherosclerotic and non-atherosclerotic RAS, but the same cutoff value of RPSV and AT can be applied. RIR is a good Doppler parameter in the diagnosis of RAS,especially atherosclerotic and fibromuscular dysplasia RAS.