Objective To investigate the effects of different treatments on elderly patients with breast cancer, and to analyze the factors that affect the treatment effect.MethodsA retrospective analysis was used to analysis the clinical data of elderly patients with breast cancer treated in our hospital from March 2012 to October 2013 were selected as the study object and according to the treatment methods, which were divided into three groups (A, B, C, which a group by breast modified radical surgery combined with intravenous chemotherapy and endocrine therapy, group B with breast modified radical mastectomy+endocrine therapy, group C with breast mass resection and endocrine therapy.The differences of survival rate of 1 groups after three years, 2 years and 3 years were observed, and the difference of survival rate of patients with different clinical pathological characteristics after 3 years was compared.The factors influencing the survival rate of patients after operation were analyzed.ResultsThere was no significant difference in survival rate between the three groups after 1 years, 2 years and 3 years;High differentiation, lymph node metastasis, depth of invasion, T1+T2, TNM stage I+II, immune group of non Yin in the elderly patients with breast cancer of the 3 year survival rate was higher, while patients of different age and diameter of the tumor patients and 3 years survival rate had no significant difference;Will the elderly breast cancer patients age, differentiation degree, tumor size, lymph node metastasis, depth of invasion, clinical stage, immune group of three yin as independent variables, will survival in patients with multi factors logistic regression analysis was used.Statistical analysis available, lymph node metastasis, infiltration depth and the three Yin of the immune group were the risk factors affecting the treatment effect of patients, their OR values were 4.412, 5.138 and 4.085.ConclusionDifferent treatment methods have no significant effect on the survival rate of elderly patients with breast cancer, and lymph node metastasis, depth of invasion and the three Yin of the immune group are the factors that affect the treatment effect.

Objective To prove the application of bilingual teaching in the child health care curriculum. MethodsEnglish dubbing and Chinese subtitling DVD coursewares of child growth and development were played to medical interns.The interns were asked to do questionnaires to examine feasibility and effectiveness. Results In 8-year program medical students,77.8% of them and 64.8% of the 5-year nutrition professional students could understand the contents of more than 90%.If there was no Chinese subtitles,the ratio were only 5.6% and 6.4%.Most students preferred English subtitles and dubbing,and endorsed the model of bilingual teaching. Conclusion DVD coursewares with Chinese subtitles and English dubbing can be widely used in the teaching of child health care.

Objective To investigate the expression and distribution of Kv1.6 in rat hippocampus after status epilepticus (SE) induced by lithium and pilocarpine to explore the relationship between Kv1.6 and epileptogenesis.Methods Forty-eight healthy male Sprague-Dawley rats were randomly divided into experiment group and control group.The rats in each group were randomly assigned into 6-hour,1-day,2-day and 3-day subgroups (n =6).Electroencephalography (EEG) of rats in both groups were recorded to show the electrical activity of the rat brains.Nissel staining was performed to investigate the pathological changes,and immunohistochemistry and Western blotting were applied to analyze the expression and distribution of Kv1.6.Results (1) The EEG of rats in control group showed α wave with uniform amplitude,while the EEG in rats subjected to pilocarpine injection showed slow waves and spike waves with irregular amplitude and rhythm.Sustained spike waves were observed during SE.(2) Nissl staining showed that 6 hours after SE,the neural morphology of hippocampi in experiment group was as the same to that in control group.There was no change in neuronal morphology and numbers.However,1 day after SE,the structure of hippocampi was discrete and the number of neurons was decreased.Two and 3 days after SE,the number of neurons in hippocampi decreased further.Swelling and deformation of neurons were seen.Nissl bodies emerged,decreased or even disappeared.(3) There was no statistically significant difference in the expression of Kv1.6 in CA3 and CA1 areas between experiment group and control group 6 hours after SE (all P＞0.05).One day,2 days and 3 days post SE,the expression of Kv1.6 in CA3 area (0.117 ±0.040,0.135 ±0.029,0.112 ±0.050) decreased obviously compared to control group (0.192±0.054,0.201 ± 0.062,0.184 ±0.042;t---3.861,3.745,5.579,all P ＜0.05);and the expression of Kv1.6 in CA1 area (0.114 ± 0.02,0.082 ± 0.031,0.106 ± 0.043) decreased significantly compared to control group (0.165±0.036,0.187 ±0.025,0.172 ±0.052;t=3.221,6.360,3.645,all P＜0.05).The expression of Kv1.6 did not show statistically significant difference in DG area between experiment group and control group at all time points examined (P ＞ 0.05).The Western blotting showed the same trend.Conclusion The decreased expression of Kv1.6 may play a role in the epileptogenesis.

Objective To explore the clinical characteristics and treatment of paroxysmal supraventricular tachycardia (PSVT) in children. Methods The clinical data of 67 children with PSVT were analyzed retrospectively, and the therapeutic effects of different treatments were compared. Results The clinical manifestations of infants were paleness, shortness of breath, irritability and sweating, and children showed chest tightness, palpitations, abdominal discomfort and fatigue. The curative effect of electric cardioversion, transesophageal atrial pacing, physical therapy, and drug therapy was statistically different (P<0.05), The different cardioversion rates of them were observed for the treatment of paroxysmal supraventricular tachycardia. The cardioversion rate of transesophageal atrial pacing, was the highest, and the rate of physical therapy was the lowest. There was no significant difference in the cardioversion rate between propafenone, digoxin and amiodarone. Conclusion The clinical manifestations of PSVT in infants are atypical and easily to be ignored. There are many methods for treatment of PSVT. The vagus nerve can be stimulated first, and, if no response, either drugs or electric cardioversion and transesophageal atrial pacing can be used. The cardioversion rate of transesophageal atrial pacing is higher. The drug effectiveness for the treatment of PSVT depends on many factors, and our choice of medication varies from person to person.

Female ; Humans ; Integrative Medicine ; Polycystic Ovary Syndrome ; therapy

Objective To investigate the clinical efficacy and side reaction of tandospimne citrate capsules on treating patients with depression after stroke.Methods Seventy-eight patients who were diagnosed as anxiety and depression after stroke were taken as our subjects.They were randomly divided into control group (n =40) and treatment group (n =38).Patients in the control group were given conventional therapy for cerebral vascular disease and psychological treatment,while in the treatment group were given the same treatment besides tandospimne citrate capsules of 10 mg per times,3 times/d oral,and course of both two groups for 4 weeks.The patients of two groups were scored according to Hamilton Depression Scale(HAMD) at the time of pre-treatment and post-treatment.And the the clinical efficacy and side reaction were observed and compared.Results (1) HAMD scores of treatment group in 2,4 weeks after treatment had significantly lower than that before treatment ((8.09±2.21) vs.(6.31 ±2.28) vs.(11.98 ±2.17),P ＜0.05).HAMD scores of control group in the treatment at 2week was as same as that in 4 weeks((10.57 ±2.53) vs.(8.91 ±2.31)).There was statistically significant difference in two groups in 2,4 weeks after treatment in terms of HAMD scores(P ＞0.05).The total effective rate of control group was 31.6％ (12/38),and 92.5％ (37/40) in treatment group,and the difference was significant(x2 =63.69,P ＜ 0.01).In the course of treatment in the two groups,there were no obvious adverse reactions.Conclusion Tandospirone citrate capsules show the clinical curative effect in the treatment of anxiety and depression after stroke,and no obvious adverse reactions.

Objective To improve the knowledge of paediatric pulmonary arterial hypertension(PAH) and to elevate the level of early diagnosis and treatment.Methods The clinical data of 45 PAH patients admitted in Shanghai Children's Hospital from Jan.2006 to Dec.2012 were reviewed,including clinical manifestation,laboratory examination,diagnosis,treatment and prognosis.Results Of the 45 PAH patients,21 cases (46.7％) were male and 24 cases (53.3 ％) were female,with an average age of 2.5 years old.Among them idiopathic PAH was in 24 cases (53.3 ％) and secondary PAH was in 21 cases [including interstitial lung disease in 4 cases,upper airway obstruction in 3 cases,systemic lupus erythematosus in 3 cases,hepatic disease in 3 cases,including hepatic hemangioma 1 case,liver cirrhosis portal hypertension 1 case and autoimmune hepatic sarcoidosis 1 case,tachycardia induced cardiomyopathy in 2 cases,extensive pulmonary small artery stenosis in 2 cases,human immunodeficiency virus (HIV) infection in 1 case,hypothyroidism in 1 case,and familial PAH in 2 cases].Main clinical manifestations were anhelation after exercise (71.1％),fatigue (68.9％),cough (48.9％),chest tightness (26.7％),chest pain (33.3％),syncope (8.9％),et al.The most common physical signs were splitting of the second sound in pulmonary valve area (93.3％),followed by tricuspid murmur (77.8％),cyanosis (53.3％),hepatomegaly (42.2％),hydropericardium (28.9％),and oedema (11.1％),et al.Twenty-seven cases did cardiac catheterization,compared with idiopathic PAH and secondary PAH,pulmonary artery systolic pressure,mean pulmonary artery pressure,pulmonary capillary wedge pressure,pulmonary arteriolar resistance index had significant difference(P ＜ 0.05).Thirty-one cases' condition improved after treatment,11 cases without any improvement and 3 cases died during follow-up visit.Conclusions PAH is a rare disease with no specific symptom and can be easily misdiagnosed in children.Ultrasonic cardiogram and cardiac catheterization are helpful in diagnosis.Actively looking for the cause can improve the prognosis.

BACKGROUND: Looking for effective measures to ensure the survival of the implanted stem cells against ischemia-induced hypoxia becomes the major concern in the research of cell transplantation therapy for cerebral infarction.OBJECTIVE: To study the effects of human Persephin gene transfer on hypoxia-induced apoptosis of neural stem cells.DESTGN: A randomized controlled basic study on cells.SETTTNG: Department of Neurology, the Second Affiliated Hospital of Sun Yat-sen University.MATERTALS: This study was completed in the Lin Baixing Laboratory Center of the Second Affiliated Hospital of Sun Yat-sen University from July to December in 2006. Recombinant adenovirus pAdCMV persephin was constructed in our lab. C17.2 neural stem cells were kindly provided by Prof. Snyder, Harvard Medical University, USA. Trypsin and DMEM/F12 were purchased from Gibco Company (USA), fetal bovine serum (FBS) from Sijiqing Biological Engineering Materials Co. Ltd (Hangzhou, China); Poly-lysine from Sigma Company (USA), TUNEL assay kit and FuGENE kit from Roche Molecular Biochemicals Company (Swiss), and S-P immunohistochemical detection kit and DAB reaction kit from Mycine Biological Engineering Company (Fujian). Rat anti-human monoclonal Nestin antibody and rabbit anti-human polyclonal persephin antibody were manufactured by Santa Cruz Company (USA), and persephin anti-senseoligodeoxynucleotide (ODN) was synthesized by Shanghai Biological Engineering Company.METHODS: ① Interventions: C17.2 neural stem cells cultured in vitro were infected by recombinant adenovirus containing persephin gene, and they were divided into four groups: blank control group (Group A, in which the C17.2 neural stem cells were not treated with hypoxia), hypoxic group [Group B, in which the cells were cultured at 37 ℃ in anaerobic incubation containing N2 (0.95 in volume fraction) and CO2 (0.05 in volume fraction)], hypoxia + pAdCMV persephin infection group [Group C, where the cells were cultured under the conditions as in group B after pAdCMV persephin infection for 48 hours], and hypoxia + pAdCMV persephin infection + anti-sense persephin ODN group (Group D, where the cells were infected by pAdCMV persephin and anti-sense persephin ODN. ② Evaluation: The expression of Persephin protein was analyzed using Western blotting; Apoptotic index was detected with terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling (TUNEL) assay; The changes of apoptotic rate was determined with flow cytometry.MAIN OUTCOME MEASURES: Expression of Persephin protein; Apoptotic index; Apoptotic rate.RESULTS: ① Expression of Persephin protein: A specific band (relative molecular mass of 24 000) was detected by Western blotting in pAdCMV persephin infected cells, suggesting the successful expression of persephin gene.Interestingly, the cells infected with both pAdCMV persephin and anti-sense persephin ODN also showed the specific band of about 24 000, but with much less density, indicating that anti-sense persephin ODN could effectively inhibit the expression of pAdCMV persephin. However, this band was not presented in the blank control groups. ② Apoptotic index:The apoptotic index in group C was significantly lower than those in groups B and D (P＜0.01), but still higher than that of group A (P＜0.01), suggesting that persephin gene transfer could attenuate apoptosis to some extent. ③ Apoptotic rate: The apoptotic rate in groups B and D were obviously higher than that in group A (P ＜ 0.01), and it was lower in group C than in groups B and D (P＜0.01).CONCLUSION:Recombinant adenovirus can efficiently mediate Persephin gene transfer into C17.2 neural stem cells,resulting in high expression of the exogenous Persephin in vitro, which effectively reduces C17.2 neural stem cell apoptosis induced by hypoxia.

Objective To investigate the relationship between the single nucleotide polymorphism of aminoimidazole carbexamide ribonucleotide transformylase gene and the efficacy and toxicity of methotrexate treatment in rheumatoid arthritis. Methods Total of 359 patients with RA were divided into mono-therapy with MTX group, combination therapy with other DMARDs group and other DMARDs combination with no MTX treatment group. The clinical and laboratory measurements were evaluated before therapy and 12, 24 weeks after therapy. Efficacy (evaluated by ACR20) and side effects of the drugs were also assessed. Real-time fluorescent quantitative PCR was conducted to test ATIC 347C/G mutation in RA patients and 340 healthy controls. Results There was no statistical significant difference in 347 CC, CG, GG between RA patients and healthy controls. In the MTX mono-therapy group (n=107), 72% (n=77) there was no statistical significant difference in 347CC, CG, GG between patients with good response and patients without efficacy. 32.7%(n=35) of these patients experienced adverse drug reactions. The ATIC G allele carriers (22.4%) experienced a greater frequency of side effects than the CC carriers (OR=2.672, 95%CI, 1.27～5.59, P<0.05). In MTX combined with other DMARDs group (n=128) and other DMARDs combination without MTX group (n=90), the polymorphism in the ATIC gene was not associated with good clinical response and adverse events (P>0.05). Conclusion There is no statistical significant difference between RA and healthy controls in the ATIC347 gene. Polymorphism in the ATIC gene is not associated with clinical response to MTX treatment, but the ATIC347 G allele is associated with MTX toxicity. It maybe used to predict the adverse drug reactions of patients who take MTX.

OBJECTIVE:To systematically evaluate the efficacy and safety of modified infusion(2-4 h infusion or continuous 24 h infusion)versus traditional infusion(0.5-1 h infusion)of meropenem in the treatment of severe infectious,and to provide evi-dence-based reference for clinic treatment. METHODS:Retrieved from Medline,CJFD,VIP database and Wanfang database, modified infusion(test group)versus traditional infusion(control group)of meropenem in the treatment of severe infections were collected,and Mata-analysis was performed by using Rev Man 5.0 statistical software after extracting data and evaluating quality. RESULTS:A total of 13 studies were included,involving 1 012 patients. Results of Meta-analysis showed the effective rate [RR=1.25,95%CI(1.10,1.43),P<0.001] and bacterial eradication rate [RR=1.25,95%CI(1.05,1.48),P=0.01] in test groups were sig-nificantly higher than those of control group,and there were no significant differences in the mortality rate [RR=0.74,95%CI (0.46,1.18),P=0.21] and incidence of adverse reactions [RR=0.81,95%CI(0.48,1.39),P=0.45]. CONCLUSIONS:Compared with traditional infusion of meropenem,extended or continuous infusion can improve efficacy in the treatment of severe infections, with similar safety. Due to methodology limit of included studies,large-scale and high quality RCT are required for further valida-tion of the conclusions.