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 and discuss if there are special syndromes,same disease but different syndromes and same syndrome but different diseases in the different gastric ulcer rat models.[Methods] Based on reports,we select fourmethods-stress,antifani,apoplon,and alcohol to make gastric ulcer model simultaneously,and set up the normal and control groups.Then we use the standardized and quantified four diagnostics and differentiation methods for mice,which are established to examine and appraise the above models in an objective,dynamic and quantified way.[Result] First,different mice models have different syndromes,such as in the water immersion model,damage to Qi blood Yin and Yang was slight and recovered quickly.The anti-fani model,with typical syndromes of cold in the stomach,is a compound model of Qi,blood,Yin and Yang deficiency;second,there exists syndrome evolution in the disease diversity stage in the same rat;moreover,significant syndrome difference exists for the same disease in different rat.For example,on the second day after the alcohol was given to the rats,there was Yin deficiency,or abundance of Qi,or deficiency in both Yin and Yang to the different individual.Thirdly,as for same syndrome but different disease,similar syndromes appear on the same stage in different diseases,as well as the similar syndrome appear on the different stage in different diseases.For instance,the anti-fani model and the apoplon model have similar syndromes of cold in the stomach,Qi deficiency,Yin and Yang deficiency.[Conclusion] There exist respective syndromes in different gastric ulcer mice models.We can infer that to put into practice"treating the same disease with different methods"and"treating different diseases with same method"will help improve the curative effect.

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 explore the prevalence of depression in diabetes foot ulcer patients , and to an-alyze the correlation between depression morbidity and various factors such as age , HbA1c level, and quality of life etc.Methods 73 diabetes foot ulcer patients admitted from Sep .2012 to Sep.2014 were enrolled.Depres-sion was assessed using the 9-item patient health questionnaire (PHQ-9).Data such as the age, sex, duration of diabetes and foot ulcer , HbA1C level, smoking were recorded .The severity of foot ulcer was evaluated by Wagner's classification.The quality of life was scored by short form(SF-36)health survey questionnaire.Results The morbidity of depression in diabetes foot ulcer patients was 49.3%in total and 17.8% in the moderate to severe depression group .The prevalence in patients with HbA 1c≥7.0%was significantly higher than that in pa-tients with HbA1c<7.0%(66% vs 35%,P<0.01).Higher occurance of HbA1c≥7.0% was found in the moderate to severe depression group compared to that in the mild depression group .The prevalence of depression was 39.1%in grade 1 in wagner classification , 48.6% in grade 2 to 3 in wagner classification and 69.2% in grade 4 to 5 in wagner classification , showing the two was positively correlated .When duration of foot ulcer lasted more than 6 months, the morbidity of depression(58.1%)was significantly increased(P<0.05).The quality of life was significantly declined in patients with depression by SF-36 questionnaire ( P<0.05 ) .No association was found between the depression morbidity and the age , duration of diabetes , amount of complications or smoking (P>0.05).Conclusions This study shows a high prevalence of depression symptom in diabetes foot ulcer pa -tients.Depression is associated with HbA1c level, the extent and duration of foot ulcer .

Objective To compare the efficacy of and adverse reactions to a fractional micro-plasma radio-frequency technology versus fractional ultrapulsed CO2 laser in the treatment of atrophic acne scars.Methods Twenty-one patients with atrophic acne scars were enrolled in this study.Half of each subject's face was treated with micro-plasma,and the other half with fractional ultrapulsed CO2 laser,for one session.Treatments were randomly administered in a split-face manner.The efficacy and adverse effects were evaluated 6 months after the treatment by using the following outcome parameters:ECCA grading scale (échelle d' évaluation clinique des cicatrices d'acné),degrees of post-treatment pain and edema,time taken for crusting and durations of inflammatory erythema,patients' subjective rating of improvement in scar by using a quartile grading scale.A non-parametric rank test was conducted to compare the efficacy and adverse effects between the two treatments.A scar model was established on both ears of a New Zealand big ear rabbit,and treated with the CO2 laser and micro-plasma respectively,immediately followed by the resection of scar tissue for the observation of histological changes.Results A decrease of ECCAscore was observed in 90.5％ (19/21) of the patients after micro-plasma treatment,and in 86.7％ (18/21) after CO2 laser treatment; no significant difference was observed in the response rate (P ＞ 0.05).In detail,ECCA score decreased by 31.5％ (from 50.71 to 34.76 ) after micro-plasma treatment,compared to 29.9％ (from 53.57 to 38.10) after CO2 laser treatmet.Mild edema was observed after micro-plasma treatment,with the duration of erythema and crusting being 13.95 days and 6.95 days,respectively,compared to 45.81 days and 10.10 days respectively,after CO2 laser treatment.Pigmentation occurred in none of the patients after micro-plasma treatment,but in 19％ after CO2 laser treatment.Animal experiment showed that microscopic ablation zones were broad and shallow after micro-plasma treatment,but narrow and deep after CO2 laser treatment.Conclusions Fractional micro-plasma and CO2 laser are both effective for the treatment of atrophic acne scars,but the former seems to have less side effects with a lower incidence of pigmentation.

ObjectiveTo collect and analyze patients' evaluation of basic medical services in Tianjin community health service institutions and to suggest improvements.MethodsA total of 15 community health service centers and 15 community health service stations in six urban districts of Tianjin were selected by stratified sampling and 300 randomly intercepted patients were surveyed by questionnaire.ResultsApproximately half ( 157/300, 52. 3％ ) the patients selected community health service institution as their first choice to seek medical attention. The most important reason for this, with 89.2％ patients responding yes, was that the community health service institution was close to home and very convenient.One quarter (79/300, 25.3％ ) of the patients regularly consulted the same doctor and 17.7％ (53/300)seldom went to see a doctor. The proportion of patients expressing a high degree of satisfaction to service standards and health professionals was 78. 7％, of which satisfaction with physicians' explanation about the patients' illness ranked highest at 83. 7％ (251/300). Patients' confidence level of doctors' diagnosis,physical examination, and auxiliary examination was 92. 0％. Moreover, most (87. 0％ ) patients reported that doctors communicate well with them; 85.0％ (255/300) patients received health instruction from doctors during visits, and 82. 0％ patients reported that doctors pay attention to protecting patients' privacy.The overall satisfaction of patients to environmental facilities and process management of community health service institutions was 73.6％. On the other hand, patient satisfaction with medicine types, service price,instrumentation and equipment, and environment were all lower than the average satisfaction. Conclusions Patients were basically satisfied with medical service in community health service institutions. Three main problem areas were identified: patients' use of community health services is deficient, medical service ability is partially lacking, and the service feature of general practitioners (GPs) is not obvious. Improvements of basic medical service ability in the community, cultivation of GPs, and basic medicine regulation are advocated.

Objective To analyze the clinical characteristics and coagulation parameters of the infants with placental abruption . Methods Analysis was made on clinical and laboratory indexes of the hospitalized children of the NICU of Bayi Clinical Medical College of South Medical University ,enrolled from August 2012 to January 2013 ,including 60 infants with placental abruption as observation group and 60 infants without placental abruption as the control group .Results From clinical manifestations and lab date ,significant differences were found in gestational age ,polyembryony ,premature rupture of membrane ,birth weight ,intrauterine growth retardation ,motherhood gestational hypertension ,mother gestational diabetes mellitus ,asphyxia ,APTT ,D-dimer on admis-sion between the observation group and control group (P<0 .05) .Conclusion Placental abruption is the result of placental insuffi-ciency ,which may cause coagulation disorder and thus show the pathological state of high condensation in infants .

Background and purpose: It has been reported that activation of Notch1 could strongly inhibit proliferation of HPV (human papilloma virus)-positive HeLa cells by down-regulation of the E6 and E7 genes. The aim of this paper was to investigate the role of the Notch signaling pathway in growth arrest of EC109 cells in vitro and the molecular mechanism. Methods: EC109 cell lines, a well differentiated human ESCC (esophageal squamous cell carcinoma) cell line with HPV18-positive, was used in the study. Exogenous intracellular domain of Notch1(ICN) was transfected into cultured EC109 cells by lipofectamine transfection, the proliferation of the transfected cells was measured by an MTT assay. Cell cycle distribution was analyzed by flow cytometry. Human papilloma virus type 18 (HPV18) E6/E7 mRNA expression was detected by RT-PCR, and p53 protein expression was detected by Western blot.Results: Activation of Notchl signaling resulted in inhibition of EC109 cell proliferation with the induction of G_2/ M arrest. There was a significant difference in terms of the percentage of G_2/M phase cells among the ICN-transfected group (42.57±1.57)% and the non-transfected group (1.88±0.66)% or the empty plasmid transfected group (1.99±1.02)% (P<0.01). Down modulation of HPV18 E6/E7 gene expression and upregulation of p53 expression was (2.15±0.23) in ICN-transfected group higher than non- transfected group (0.45±0.07) and empty plasmid transfected group (0.46±0.02) (P<0.01). Conclusion: Repression of HPV18 E6/E7 expression by Notch1 signaling results in growth suppression of HPV18-positive EC109 cells with concomitant activation of p53-mediated pathways.

Objective To identify the dose-volumetric parameters associated with acute bone marrow suppression in concurrent chemoradiotherapy for cervical cancer,and provide the reference standard for the radiotherapy planning.Methods In total,155 patients concurrently receiving chemoradiotherapy for cervical cancer were enrolled in this study.The pelvis was contoured for each patient in radiotherapy treatment planning system and divided into three subsites:lumbosacral spine,ilium,and lower pelvis.The pelvic dose volume parameters were analyzed using univariate analysis (Chi-Square and t test),and multivariate analysis (Logistic regression model).Dose volume parameters include V5,V10,V15,V20,V25,V30,V35,V40,V45,V50 and the average dose (D).Results The percentage of patients that developed acute bone marrow suppression (≥ grade 2) was 87.7％ (136/155).The univariate analysis revealed that pelvic V5,V10,V15,V,0,ilium V15,lower pelvis V15 of patients with acute bone marrow suppression (≥ grade 2) were significantly higher than those of ＜ grade 2 patients (t =-2.277,-2.142,-3.475,-2.018,-2.963,-2.741,P ＜0.05).Multiple regression analysis indicated that pelvic V15 was associated with acute bone marrow suppression (OR =1.728.P ＜ 0.05).The threshold of pelvic V15 was 88％ as determined by receiver operating curve (ROC).Conclusions The results show that Pelvic V15 is associated with acute bone marrow suppression in concurrent chemoradiotherapy for cervical cancer and is thus an independent risk factor.To better predict and control acute bone marrow suppression,pelvic V15 should be carefully controlled below 88％ in treatment planning to reduce the incidence of acute bone marrow suppression.

Objective To study the effect of tumor size on the expression of adrenal cholesterol homeostasis mole -cules in H22 hepatoma-bearing mice.Methods Two hundred and twenty mice were injected with H 22 hepatoma cells to their right armpit.On the 11th day after injection, the mice were sorted according to the tumor size .18 mice with large tumor (large tumor group) and 18 mice with small tumor (small tumor group) were sacrificed, and the tumors were weighed.A control group consisting of 18 normal Kunming mice was also included in this study .The plasma TC, TG and HDL-C were detected using total cholesterol , triglycerides or HDL-C assay kits , respectively .The mRNA expressions of Srb1, Ldlr, Npc1, Npc2, Stard3, Hmgcr, Lipe, Acat1, Abca1, Abcg1, Srebp-1c, Lxrα, Lxrβ, Rxrα, Apoa1 and Apoe were tested by real-time quantitative RT-PCR ( qRT-PCR ) , and Gapdh and β-actin were used for normalization .SRB1 and ApoA1 proteins were analyzed by Western blot .Results The tumor weight was significantly higher in the large tumor group than that in the small tumor group (P<0.05).Compared with the control group , the plasma HDL-C was significant-ly decreased in the two hepatoma groups (P<0.05).The expression levels of Srb1, Ldlr, Apoa1 mRNA and SRB1 protein were significantly increased in the large tumor group (P<0.05 for all).The ApoA1 protein level was significantly higher in the large tumor group than that in the small tumor group (P<0.05).The expressions of Acat1, Lipe, Abca1 and Abcg1 mRNA were significantly lower in the large tumor group than those in the small tumor group (P<0.05 for all).However, the expressions of Srebp-1c, Lxrαand RxrαmRNA were not significantly changed , then, Srebp-1c, Lxrβand RxrαmRNA expressions were significantly up-regulated in the small tumor group (P<0.05).The expressions of Hmgcr and Apoe mR-NA were not significantly different in the two groups .Conclusions In hepatoma-bearing mice , due to the adaptation to tumor-induced chronic stress response , the adrenal cortical cells can effectively utilize intracellular cholesterol to synthetize cortical hormones .