Objective To investigate the effects of different surgical procedures on clinical outcomes and quality of life(QOL)in patients with breast cancer.Methods The clinical data of 93 patients with breast cancer were retrospectively reviewed.According to the different surgical methods,they were divided into two groups:breast conserving surgery(BCS)group(n =42)and modified radical mastectomy(MRM)group(n =51).Clinical outcomes and QOL score between the two groups were compared.Results Compared with MRM group,the incidence rate of complication in BCS group was significantly lower in subcutaneous exudate[7.1%(3 /42)vs.25.5%(13 /51),χ2 =5.443,P =0.020]and upper limb swelling[14.3%(6 /42)vs.37.3%(19 /51),χ2 =5.443,P =0.020].In the aspect of QOL score,BCS group showed significantly higher score in emotional well -being [(23.14 ±2.71)points vs.(19.98 ±2.69)points,t =5.606,P =0.000],functional well -being[(24.61 ±2.72)points vs.(23.18 ± 2.99)points,t =2.372,P =0.020]and total score of QOL[(116.42 ±12.439)points vs.(111.18 ±10.75)points, t =2.147,P =0.034].BCS group showed significantly lower score in self -rating anxiety scale test[(47.89 ±8.32) points vs.(52.46 ±7.38)points,t =2.767,P =0.007].Conclusion Compared with MRM,BCS can effectively decrease the incidence rate of complications and increase the QOL in breast cancer patients.

Objective To investigate clinical effects of neoadjuvant chemotherapy of TAC scheme in breast cancer.Methods 82 patients with locally advanced breast cancer receiving neoadjuvant TAC chemotherapy program were retrospectively analyzed.The total efficiency,toxicity,and recent surgical cases were evaluated.Results There were 21 cases of CR in 82 cases with breast cancer,accounting for 25.6％,47 PR(57.3 ％),14 SD(17.1％),so the clinical total effective rate was 82.9％.The major toxic reactions was bone marrow suppression and neutropenia occurrence rate was 81.7％.Other adverse effects include gastrointestinal symptoms and liver dysfunction,and alopecia.All patients after symptomatic treatment can be tolerated.Conclusion TAC program neoadjuvant chemotherapy for locally advanced breast cancer patients can improve the cure rate,increase breast-conserving opportunities.

This paper introduces the feature of binocular indirect ophthalmoscope and its application in ophthalmologic examination and operation. Compared with direct ophthalmoscope, binocular indirect ophthalmoscope has many special advantages owing to its unique illumination system and principle of formation of image. Most of ocular fundus diseases can be diagnosed correctly by binocular indirect ophthalmoscope. The view is that the inspection technique of binocular indirect ophthalmoscope is the most convenient and predominant in fundus examination, ophthalmology operation and treatment until now, and is of value in use.

Objective To construct the plasmid pSilencer4.1/HtrA1 and stably transfect human trophoblastic cell line HPT-8.Methods We detected the expression of HtrA1 in cell line HPT-8 with immunohistochemical SABC,constructed the plasmid pSilencer4.1/HtrA1,transfected human trophoblastic cell line HPT-8 with plasmid pSilencer4.1/HtrA1 and negative plasmid pSilencer4.1, and observed the cell expression after transfection. Results About 90% of cellular cytoplasm of HPT-8 was dyed brown while the nucleus was negatively stained. Selective concentration of G418 was 200 μg/mL for HPT-8 to be transfected pSilencer4.1/HtrA1.With RT-PCR and Western blot methods,the expression of HPT-8 transfected plasmid Psilence4.1/HtrA1 was significantly downregulated compared with that of cells with negative plasmid and normal cells (P < 0.05 ).There was no significant difference in absorbance value between blank plasmid group and HPT-8 group (P >0.05).Conclusion We successfully constructed stable trophoblastic cell line HPT-8/ pSilencer4.1-HtrA1 with silenced expression of HtrA1,which lays foundation for further research.

Objective: To study the cognitive function of patients with myasthenia gravis.Methods: Cognitive function of 35 patients with general myasthenia gravis and 31 patients with Eye-Muscles myasthenia gravis,and 35 control subjects was examined with cognitive measures of Recall of Auditory Verbal Learning Test,Symbol Digit Modalities Test,Trail Making Test,Logic Memory Test,Stroop Color Words Test(A、B 、C),Verbal fluency Test and Boston Naming Test.Results: MG patients performed worse than the control subjects on several cognitive measures.Conclusion: There is disorder of cognitive function in the patients with myasthenia gravis,revealing that there may exist deficiency in the central neuroal system of the patients with myasthenia gravis.

Objective To explore the therapeutic effects of nimodipine and magnesium sulfate on severe pregnancy induced hypertension (PIH) as well as the effect on plasma endotheline (ET) and serum nitric oxide (NO), in order to provide theoretical foundation for clinical treatment. Methods Forty two patients with severe PIH, being divided into 2 groups at random, were treated with nimodipine or magnesium sulfate. The changes of blood pressure, arteriole of eyeground, urine protein, ET, NO and clinical symptoms were observed respectively before and after the treatment, and the pregnancy outcomes were compared. Results (1) After the treatment of nimodipine, the serum NO of patients increased significantly from (51.72?14.64)?mol/L to (67.56?14.77)?mol/L ( P 0.05). (2) The nimodipine group took shorter time (0.5 h) to lower the blood pressure notably than the magnesium sulfate group (2 h).(3) As for the disappearing of subjective symptoms , nimodipine group (1.7? 1.3) h was quicker than magnesium sulfate group (3.4?1.7) h. Conclusions Compared with magnesium sulfate, nimodipine was better in improving and protecting the function of endotheline cells, dilating cerebral blood vessels, depressing blood pressure strongly and persistently, reducing subjective symptoms of patients and had no other side effects except increasing heart rate.

Objective To examine the expression and clinical significance of E26 transformation specific-1 in premature rupture of fetal membranes. Methods Fetal membranes from 75 women in the following categories were analyzed for Ets-1 expression: preterm and term premature rupture of fetal membranes; 70 women (control group) with term cesarean sections and without complications. Ets-1 protein was localized with the use of immunohistochemical S-P method. Results Ets-1 protein was expressed in both the nucleus and cytoplasm of trophoblast of human fetal membranes, with more obvious expression in the nucleus. Ets-1 protein's expression was up-regulated in the trophoblast of fetal membranes with premature rupture, which differed significantly from the control group (P<0.05). Ets-1 protein's expression was up-regulated in the trophoblast of fetal membranes with preterm premature rupture, which did not differ significantly from the control group (P>0.05). Conclusion Ets-1 is expressed in human fetal membranes and its expression is up-regulated with premature rupture of fetal membranes, suggesting a role for Ets-1 in extracellular matrix remodeling of the membranes. This study provides an evidence to predict premature rupture of fetal membrances.

Objective To observe the value of dual source CT (DSCT) dual energy subtract method in diagnosis of lower extremity arterial occlusion. Methods Thirty-two patients with lower extremity arterial occlusive diseases underwent DSCT direct bone removal CT angiography (DE-BR-CTA) and digital subtraction angiography (DSA) within 2 weeks. Raw data were reconstructed with techniques including MIP and VR. Arterial visibility of DE-BR-CTA was analyzed by two experienced radiologists taking DSA as the standard. Results A total of 328 arterial segments were selected in 32 patients with lower extremity arterial occlusive diseases. The correlation between DSA and DE-BR-CTA was good. There was no significant difference in arterial visibility between DE-BR-CTA and DSA (P＞0.05). Compared with DSA, 12 of the segmental stenosis were overestimated and 6 were underestimated with DE-BR-CTA. When stenosis was over 10%, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of DE-BR-CTA was 94.51%, 96.15%, 93.02%, 92.59% and 96.39%, respectively. Conclusion DSCT energy subtraction angiography is an accurate diagnostic method and non-invasive imaging technology in the assessment of lower extremity arterial occlusive diseases. It may provide precious information for pre-surgery evaluation and screening the arterial diseases of the lower extremities.

Objective To evaluate the effect of automatic bone and plaque removal on image quality and grading of steno-occlusive lesions in patients undergoing dual energy CT angiography (DE-CTA) of body artery. Methods DE-CTA was performed in 23 patients with suspected body vascular disease. Separate datasets were calculated for each of the two tubes and used to generate automatically bone-subtracted images (ABS) as well as additional manual bone removes after plaque subtracted images (ABPS). In addition, a weighted average dataset from both dual energy acquisitions resembling routine 3D CT acquisition was used for automatic bone remove (ABR). Residual bone in the ABR dataset was removed manually (ABR-M). Operator time for bone removal was measured, while effectiveness of bone subtraction and the time needed of ABPS and ABR-M was assessed. Compared with MPR, ABR images and stenosis grading in plaque subtracted were assessed with two radiologists. Results The imaging quality of ABR was superior to that of ABS (P<0.05). The time needed of ABPS was (7.8±4.3) min, significantly lower than that of ABR-M (11.4 min±2.5 min, P<0.05). A total of 325 steno-occlusive lesions were assessed. The sensitivity, specificity of DE-CTA and traditional 3D CTA was 95.74%, 96.19% and 92.93%, 97.87%, respectively. Conclusion The imaging quality is good after automatic bone and plaque subtraction of DE-CTA. Automatic plaque subtraction for the first time provides a true CTA imaging which is easy to interpret and reduces the need for further post-processing. The diagnosis of vascular stenosis with DE-CTA is also accurate, and the time spent in post-processing is less than that of traditional 3D angiography.

Objective To investigate the optimal window level and center level settings in the diagnosis of costal cartilage fracture with 256-slice spiral CT through ROC analysis. Methods Thirty patients with suspected costal cartilage fractures underwent 256-slices chest spirals CT scaning. CT value of costal cartilage was measured by three experienced radiologists. The soft copy images of three kinds of window level and window width (-100 HU/1120 HU, 100 HU/1120 HU, 300 HU/1120 HU) were analyzed independently in PACS with dual-blind method, and the diagnosis results were taken ROC analysis with SPSS 16.0 software. The diagnostic accuracy of three physicians were evaluated and compared according to the area under the ROC curve (Az). Results A total of 8 patients of costal cartilage fractures were confirmed by CT diagnosis combined with clinical follow-up. The mean CT value of 30 patients was (98.78±32.86) HU. The area under the ROC curve with the window level and center level settings of (100 HU/1120 HU) were bigger than that of other window level and window width (P=0.045,P=0.002). Kappa identity test showed that there was a powerful conformability between the diagnostic results of three physicians. Conclusion 256-slice spiral CT is a good way for the diagnosis of costal cartilage fractures with suitable window level and center level settings.