The technique of nipple-areola complex (NAC)-sparing mastectomy (NSM) facilitates the breast reconstruction due to preserving the skin and NAC of breast in the treatment of breast cancer. Key issues still remain controversial in NSM, in terms of the role of radiotherapy combined with NSM and sequence of radiotherapy and NSM, which arise from the consideration of the oncology safety. Some investigations addressed that post-NSM external beam irradiation and intra-operative radiotherapy (IORT) combined with NSM could reduce the local recurrence rate. Based on the appropriate patient selection and good quality of surgery, radiotherapy would be applied in different strategies of combination with NSM according to the risk of local recurrence of the cancer.

As the products of modern science,the effects of video games on children and adolescents drew the attention of psychologists.Anderson and Bushman proposed the General Aggressive Model,which could explain both the development of aggressive behavior and the difference of individual vulnerability to the effects of violent video games,and they advocated the effects,including short-term effects and long-term effects.Many researches about the relation of violent video games and aggression reported five consistent results:exposure to violent video games increased aggressive behavior,cognition,affect and physiological arousal,and decreased helping behavior.The positive intervention of parents can decrease negative effects of video games.

OBJECTIVE:To facilitate Chinese pharmaceutical industry's understanding and application of the new "Patent Law".METHODS:The amendment of the "Patent Law" related to 3 aspects of medicine,i.e.specifying regulations on the information disclosure in the utilization of genetic resources,adding the clause of forced permission for the patent drugs for the purpose of public health,and introducing the Bolar exception clause was analyzed using law hermeneutic.RESULTS & CONCLUSIONS:The medicine-related amendment of the new "Patent Law" generally reflects an international tendency of restricting pharmaceutical patents so as to maintain public interests,which is in line with the status quo of low technological level of pharmaceutical industry in China.

Bone remains the predominant site of metastasis in advanced breast cancer. Bone metastases dramatically decrease the quality of life. Moreover, pathologic fractures and other skeletal-related events (SREs) caused by bone metastases could result in higher mortality risk in patients with breast cancer. Palliative radiotherapy is a crucial element in bone metastases treatment. The present review discusses the emerging evidence in bone metastases of breast cancer, focusing on optimized radiotherapy strategies and multidisciplinary management.

Clinical practice of anesthesia is an important phase for interns to be professional physicians.In order to improve teaching quality of anesthesiology,we should attach great importance to following three aspects:stressing medical ethics and standardize medication,inspiring activity of the students,reinforcing self-construction of the teachers.Mutual action between teaching and learn-ing can only bring about the improvement of teaching quality in anesthesiology.

Sentinel lymph node biopsy has been the standard axillary intervention for breast cancer patients with clinical negative axillary lymph nodes.Complete axillary dissection could be omitted for patients with negative sentinel lymph nodes.While, the optimal axillary intervention for patients with 1-2 positive sentinel lymph nodes remained controversial.This review introduced the latest research results of the axillary management for early stage breast cancer patients with 1-2 positive sentinel lymph nodes.

Objective To know the influence factors of untimely inoculation of measles vaccine among children of Enping, so as to provide scientific evidence for infectious diseases control. Method Cluster sampling was used and children from 2 towns of Enping were surveyed for their status of measles immunization and other information related to the immunization. Results The results indicated that the coverage rate of measles vaccine (MV) was 92.03%, and the untimely coverage rate was 36.20%. There were no statistical difference between local children and migrant children , urban children and rural children , as well as male children and female children. The results of multi-variate Logistic analysis suggested that the main factors that could decrease the untimely coverage rate of MV were inoculation appointment (OR = 0.415), vaccination health education (OR=0.385), guardians′ education (OR = 0.393) and guardians′ EPI knowledge (OR=0.472). The main factors that could increase the untimely coverage rate of MV were children′s suffering from diseases (OR=2.376) and egg allergy (OR=2.476). Conclusion Greater attention should be paid on measles immunization among children of Enping, which should be noticed and dealt with by proper authorities.

Objective To know the sleeping quality of clinical nurses in Urumqi, and analyze the influencing factors, put forward the corresponding countermeasures for different factors to improves the sleeping quality. Methods Randomly selected 407 nurses in clinical departments as the research objects in Urumqi top three hospitals, using the Pittsburgh sleep quality index scale (PSQI) and general situation questionnaire to investigate, and then analyzed the results of the survey. Results The incidence rate of sleeping disorders in emergency nurses was the highest (80.00%), followed by pediatric, intensive department, internal medicine, surgical department, operating room, outpatient and others was the lowest (39.02%). Gender (t=-2.015, P =0.045), age (F=8.509, P =0.000), establishment(F=3.609, P =0.013) were the influence factors of PSQI scores. Only the difference of the scores of hypnotic drugs between different ethnic groups was significant, P<0.05, while the others had no significant difference, P>0.05. Conclusions Poor sleeping quality of nurses existed in every department, its sleeping quality status, department, gender, age and establishment have certain correlation, interventions should be strengthened, to improve the overall level of sleeping.

Objective To analyze treatment of tubal interstitial pregnancy with Guizhi Fuling pill assisted with methotrexate and mifepristone.Methods 90 cases tubal interstitial pregnancy patients from January 2015 to June 2016 were grouped by admission order and each group with 45 cases.Methotrexate and mifepristone therapy were given the control group,Guizhi Fuling pill assisted with methotrexate and mifepristone were given the observation group.Treatment success rate,β-HCG negative time,mass disappearance time,length of hospitalization and adverse reactions were compared.Results (After treatment,treatment success rate of observation group was 91.11％and 80.49％of tubal smooth,witch all higher than control group with(88.89％,77.50％),but the difference was not statistically significant.(For the treatment of two groups of patients with success,β-HCG negative time,mass disappearance time and length of hospitalization of observation group were(13.05±1.08,24.09±1.43,15.37±0.82)days,shorter than control group with(17.39±1.50,27.43±2.19,18.85±1.)days(P<0.05).③ During treatment,adverse reactions of observation group was 11.11％,lower than control group with 26.67％(P<0.05).Conclusion Guizhi Fuling pill assisted with methotrexate and mifepristone can shorten treatment time and reduce side effects for tubal interstitial pregnancy patients.

Objective To investigate the effect of hydroxyl starch (HES 200/0 5) infusion on blood rheology during operation Methods Forty adult ASA Ⅰ Ⅱ patients (male 28, female 12) scheduled for elective operation on spine (26 patients) and lower extremities (14 patients) were enrolled in this study The age ranged from 18 56 yr and weight from 40 85kg Preoperative heart, lung, liver and kidney function tests, blood routine exam, bleeding and coagulation time were all normal No patients had any history of abnormal bleeding The patients were randomly divided into two equal groups: control group(C) receiving lactated Ringer solution 1 000ml during operation and HES group receiving 6% HES 1 000ml No patient received any plasma or whole blood during operation The patients were premedicated with intramuscular atropine 0 5mg and sodium luminal 0 1g The operations were all performed under continuous epidural block (1 6% lidocaine with adrenaline 1:200 000) BP,ECG,and SpO 2 were continuously monitored during operation Blood pressure was maintained with range and SpO 2 above 97% Venuos blood samples were taken before anesthesia , 30min and 4h after the fluid had been infused and 24h after operation for determination of blood viscosity, plasma viscosity, hematocrit(HCT) index of red blood cell (RBC) aggregation and deformation and index of fibrinogen Results Blood viscosity, Hct, index of RBC aggregation and fibrinogen decreased significantly (P