Objective To assess the efficacy of early detection of breast cancer and the prognostic value of breast self-examination(BSE).Methods Randomized controlled trials(RCTs)involving BSE were included the present meta-analysis based on their qualities.The pooled analysis was performed with RevMany 4.2.8.Results Three RCTs were identified and then they were included the present metaanalysis.In women who conducted a BSE.the rate of biopsy fora lump in breast was 1.27%in the first 5 years,2.47%in more than 5 years but less than or equal to 10 years,and 2.50%in more than 10 years, respectively,all of which were significantly higher than in those who could not conduct a BSE(P<0.05) There was no significant difierence in the rate of final diagnosis and the mortality for breast cancer between the two populations in any follow-up time(P>0.05).Conclusion The rate of biopsy for a lump in breast in women could be increased by a BSE.which should not have been discarded from the early detection of breast cancer completely despite it is not helpful in increasing the rate of final diagnosis and decreasing the mortality for breast cancer.

Objective To establish the analytical method for the fingerprint of the volatile components in the root tuber of Pseudostellaria heterophylla by GC-MS and provide the basis for quality assessment of the crude drug.Methods The volatile components in the root tuber of P.heterophylla from different habitats were analyzed and the chromatographic fingerprints were established by GC-MS.The common peaks were determined and the fuzzy cluster was selected to compare the results.Results There were 12 main characteristic components in the volatile components in the root tuber of P.heterophylla.GC-MS Fingerprint of 12 common peaks was established preliminarily.Conclusion The method is reliable and accurate,and can be used for quality control of the root tuber of P.heterophylla.with favourable reproducibility.

Nitrous oxide/oxygen is one of the inhaled anesthetics that receives attention by scholars at home and abroad for its unique characteristics of excellence comparing with intravenous sedation analgesia which is more commonly used. In addition, the nurses who are the main body personnels of the pain management have certain differences in the implementation of the nitrous oxide/oxygen sedation analgesia both at home and abroad. In this paper, the nitrous oxide/oxygen analgesia and sedation and its nursing implications were reviewed from the physical and chemical properties, pharmacokinetic characteristics, excellent properties, mechanism of action and clinical application, then development directions of management in the future are put forwarded so as to provide theoretical evidences and practical guidelines for domestic medical staffs cooperating to implement the technology.

[Objective] To analyse medication rule for depression,and explore the mechanism and treatment features.[Method] On the basis of dealing 235 formulae with net technical,make analysis on drugs type,use frequency,nature and compatibility.[Result] The drugs can be divided into disease(1)and sign(2)differentiation medications,most drugs of 2 are Qi--and Yang-notifying;the natures are mainly sweet,bitter and warm,belonging to 5 organs.Notifying Qi and Yang,soothing the nerves are the main therapy for depression.[Conclusion] Depression belongs to deficient cold disease,deficient Yang Qi;not being able to rise is the mechanism;notifying Qi and warming Yang is the key basis for it.

Objective:To investigate the association of body weight and body mass index (BMI) with bone mineral density (BMD) and osteoporotic risk in elderly men with type 2 diabetes mellitus (T2DM).Methods:210 elderly male patients with T2DM admitted to the Department of Endocrinology of the First Hospital of Changsha from June 2017 to May 2018 were selected as the research objects. The height, weight and bone mass index (BMI) were measured. BMDs of the left hip [including femoral neck (FN), greater trochanter (G.T.), intertrochanter (InTro), and total hip (TH)] and lumbar spine (LS) were measured in 210 elderly male patients with T2DM by dual-energy X-ray absorption method. Patients were divided into three groups according to BMI: the overweight group (24.0 kg/m 2≤BMI<28.0 kg/m 2), the obesity (BMI≥28.0 kg/m 2) group, and the normal group (18.5 kg/m 2≤BMI<24.0 kg/m 2). The influence of body weight and BMI on BMD and osteoporotic risk in these elderly men with T2DM was analyzed. Results:The BMDs in various sites of the hip of the overweight group and obesity group were higher compared with those in the normal weight group ( P<0.05). There was a positive correlation between weight and BMI with BMDs in various sites of the hip femoral neck (including FN, G. T., InTro, and TH) ( r=0.239-0.427, P<0.05). All patients were divided into different tertiles (T1-T3) stratified by weight and BMI respectively. The BMDs in various sites of the hip increased with tertiles stratified by weight ( P<0.05). The TH-BMD also increased with tertiles stratified by BMI ( P<0.05). The odd ratios ( OR) were calculated using T3 as the control group and T1 as the case group, using T2 as the control group and T1 as the case group, respectively. The osteoporotic risks of T1/T3, T1/T2 at FN stratified by weight were significantly increased by 4.50 times ( OR=4.50, 95% CI: 1.41-14.35) and 9.27 times ( OR=9.27, 95% CI: 2.03-42.30); The osteoporotic risks of T1/T3, T1/T2 at TH were significantly increased by 3.25 times ( OR=3.25, 95% CI: 1.10-9.59) and 8.50 times ( OR=8.50, 95% CI: 1.85-38.99). The osteoporotic risks of T1/T3, T1/T2 at FN stratified by BMI respectively were significantly increased by 4.13 times ( OR=4.13, 95% CI: 1.28-13.25) and 5.58 times ( OR=5.58, 95% CI: 1.53-20.42); while the osteoporotic risks of T1/T3, T1/T2 at TH stratified by BMI were not significantly increased ( P>0.05). There was no statistically significant difference in BMDs and the osteoporotic risks of the LS among T1, T2, and T3, regardless of stratified by weight or BMI ( P>0.05). Conclusions:For elderly males with T2DM, weight and BMI are important factors affecting BMDs in the hip, and also affecting the osteoporotic risks of the hip, especially that of FN. Osteoporotic risks of the FN decrease with the increase of weight and BMI within a certain range.

OBJECTIVETo study the chemical constituents from Corallodiscus kingianus.

METHODThe column chromatographic techniques were applied to isolate constituents. A combination of ESI-MS and NMR spectroscopy was used to identify structures.

RESULTSix compounds were isolated from the acetone extract of this plant, and the structures of them have been identified as castanopsol (1) , 3beta-hydroxy-9 (11), 12-oleanadien-28-oic acid (2), 2,3,7-trihydroxy-6-oxo-1,3,5 (10), 7-tetraene-24-nor-frie-delane-29-oic acid methylester (3), 3-epicyclomusalenol (4), palmitinic acid (5) and stearic acid (6).

CONCLUSIONCompounds 1-6 were isolated for the first time from Gesneriaceae.

AIM:To investigate whether early endothelial progenitor cells (early-EPCs) expressβ2-adrenergic receptor (β2 AR) in the chronic obstructive pulmonary disease ( COPD) patients and the effect of β2 AR expression on the migration of early-EPCs.METHODS:Venous blood samples (20 mL) were obtained from antecubital vein of COPD pa-tients or healthy controls .Peripheral blood mononuclear cells were isolated by standard Ficoll gradient centrifugation , and purified by CD34 positive selection cocktail .The mRNA expression of β2 AR in the early-EPCs was detected by RT-PCR. The protein levels of β2 AR were assessed by Western blotting and flow cytometry .Chemotaxis was studied by Transwell as-say.Cultured early-EPCs were treated with ICI118551, norpinephrine (NE) or monoclonal antibody of β2AR (mAb-β2 AR) for 24 h.The number of migratory cells was counted under a light microscope .RESULTS:The level of β2 AR ex-pression in the COPD patients was higher than that in the controls .The number of migratory early-EPCs to stromal cell-de-rived factor 1αwas significantly improved by ICI 118551 compared with other COPD groups .When early-EPCs from the COPD patients or the controls were treated with different concentrations of mAb-β2 AR for 24 h, the number of migratory early-EPCs from the COPD patients and the controls treated with NE at concentration of 100 nmol/L was significantly re-duced.However, a marked decrease in the number of migratory early-EPCs from the COPD patients treated with NE was observed compared with control group .Before treated with ICI118551 or NE for 24 h, the early-EPCs were co-incubated with mAb-β2 AR for 40 min, and the number of migratory early-EPCs was not significantly different between COPD group and control group .Genetic down-regulation of β2 AR promoted the migration of early-EPCs in COPD group .CONCLU-SION:The level of β2 AR expression in the COPD patients is increased compared with the controls .The down-regulation ofβ2 AR improves the migration of early-EPCs.

Objective To detect Helicobacter pylori (H.pylori) multiple antibodies of urease (Ure),cytotoxin associated gene A protein (CagA),vacuolating toxin A (VacA),heat shock protein 60 (Hap60) and nitroreductase ( RdxA),and disclose their relations with chronic gastritis,peptic ulcer and gastric cancer.Methods A volume (3 ml) of venous blood was taken from 300 patients of gastroduodenal disease diagnosed by endoscopy,to centrifuge and detect antibodies of Ure,CagA,VacA,Hsp60,RdxA by protein chip technique.Results The infective rates of H.pylori in chronic gastritis,peptic ulcer,and gastric cancer were 34.0％,58.0％,34.0％ ( P ＜ 0.01 ),respectively.In the H.pylori positive chronic gastritis,peptic ulcer and gastric cancer,the positive rates of CagA antibody were 54.9％,75.9％,64.7％ ( P =0.070) ; the positive rates of VacA antibody were 31.4％,22.4％,17.6％ ( P =0.412) ;and the positive rates of Hap60 antibody were 56.9％,48.3％,41.2％ ( P =0.466),respectively.The total positive rate of RdxA antibody was 4.0％ (5/126).Conclusions H.pylori infection and virulence factor CagA are closely related to peptic ulcer,while it did not show the exact correlation between VacA,Hsp60 and gastroduodenal disease.The level of RdxA antibody can not represent the level of H.pylori resistance to metronidazole.

Objective To summarize the incidence, diagnostic and therapeutic experience of hepatic sinusoidal obstruction syndrome (HSOS) after liver transplantation. Methods Clinical data of 4 patients with HSOS after liver transplantation were retrospectively analyzed. The incidence, clinical manifestations, imaging and pathological characteristics of HSOS after liver transplantation were collected, and the treatment methods and clinical outcomes of patients with HSOS were analyzed. Results The incidence of HSOS after liver transplantation was 0.8%(2/239), and the median time of onset was 4.5(1.7, 9.0) months after liver transplantation. The clinical manifestations of HSOS mainly included abdominal distension, ascites, hepatomegaly, increased bilirubin, and renal insufficiency in partial cases. Enhanced abdominal CT scan of 4 patients with HSOS showed uneven spot-like enhancement and the liver histopathological examination mainly showed the signs of hepatic sinusoidal dilatation complicated with congestion. Four patients were administered with an adjusted regime of immunosuppressant by replacing tacrolimus (Tac) with ciclosporin and adding anticoagulant therapy with warfarin. One patient received transjugular intrahepatic portosystemic shunt (TIPS). After treatment, the symptoms of 3 patients were completely relieved, and 1 patient died. One of the 3 surviving patients died from pulmonary infection and gastrointestinal bleeding. Conclusions HSOS is a rare and fatal complication after liver transplantation. Timely diagnosis and treatment can avoid the incidence of graft failure and improve clinical prognosis of the patients.

Mounting evidence indicates that oral health during pregnancy is associated with pregnancy outcomes and the oral health of the offspring. Pregnant women in China have a high prevalence of oral diseases, low attendance to oral health care, and an increased burden of untreated oral infectious diseases such as periodontitis and caries. A joint perinatal oral health program between obstetrics and stomatology may improve pregnant women's and their children's oral health outcomes. This paper briefly summarizes the current status of oral health care for pregnant women and the clinical practice in obstetrics and gynecology related to stomatology in China. It provides future perspectives on the potential role of obstetricians and gynecologists in promoting oral health care through developing an interdisciplinary care model.