Objective To discuss the advantages and disadvantages of the mammography and ultrasound examination for breast cancer diagnosis.Methods Totally 84 breast cancer patients enrolled in our study.All of the patients underwent mammography before surgery,and 69 of them received both mammography and ultrasound examination.The data were studied retrospectively.Results 84 foci were found totally on mammography and were all diagnosed above ACR BIRAD grade 4 by X-ray.Two of the 13 cases smaller than 2 cm in diameter were diagnosed as grade 3 by ultrasound.Eleven cases with microcalcification were diagnosed as grade 2（1case）and 3（1case）by ultrasound.Only 1 of the 6 cases shown as distortion was diagnosed as 5 by ultrasound.Conclusion X-ray has the superiority to ultrasound for distortion and microcalcification.For the mass smaller than 2 cm in diameter,both of X-ray and ultrasound may underestimate.

Objective:To clone and express the full length cDNA of human CD38. Methods:The full length cDNA of the human CD38 antigen was amplified from total RNA of Daudi cell by RT-PCR, and it was inserted into pGEM-T. The validity on the sequences was confirmed by automatic DNA sequencing. Inserting the valid CD38 gene into pcDNA3.1(+) plasmid to obtain recombinant mammalian expression vector pcDNA3.1(+)/CD38Z; Using lipofectin gene transfer technique system, recombinant expression vector containing CD38 gene was transfected into COS7 cells. The expression of CD38 molecules on the surface of COS7 cells was detected by FACS and immunohistochemical technique. Results:DNA sequencing showed that the cloned full length cDNA sequence was identical with reported. The result of FACS and immunohistochemical technique indicated that CD38 molecules were expressed on the surface of COS7 cells. Conclusion:The full length cDNA of human CD38 is obtained, recombinant mammalian expression vector pcDNA3.1(+)/CD38Z is successfully constructed, and the CD38 molecules is expressed on the surface of COS7 cells,this may facilitate studies on the biochemistry and function of CD38 antigen.

Objective To evaluate the protective effect of sinomenine (SIN) on renal ischemia/reperfusion (I/R) in mice. Methods In the experiment one, 12 C57BL/6 mice were randomly divided into 2 groups: SIN group (mice were injected with 200 mg/kg SIN by tail vein) and control group (mice were injected with equal volume of saline). Six and 24 hs later, the serum was collected and the contents of alanine aminotransferase (ALT) and creatinine (SCr) were determined. In the experiment two, C57BL/6 mice were randomly divided into 3 groups: sham-operated (SO) group, SIN group (mice were injected with 200 mg/kg sinomenine just before ischemia induction) and saline group (mice were injected with equal volume of saline at the same time). At the 6th h after reperfusion, the sera and renal samples subject to IR injury were collected. The SCr and BUN levels in serum were determined and renal histological changes were also examined. The apoptosis of renal tubular epithelial cells was measured by using terminal deoxynucleotidyl transferase mediated dUTP nick end labeling assay. The infiltration of F4/80 positive macrophages was measured by using immunohistochemistry and that of neutrophils with myeloperoxidase (MPO) kits. The mRNA expression of tumor necrosis factor (TNF)-α, chemokine CXC ligand (CXCL)-10, intercellular adhesion molecule (ICAM)-1 and IL-17 was detected by using real-time reverse transcription PCR. The activation of transcription factor NF-κB was measured by using Western blotting. Results In the experiment one, there was no significant difference in ALT and SCr between the two groups at 6 or 24 h. In the experiment two,levels of SCr and BUN were lower in SIN group (P＜0. 05 or P＜0. 01 ), histological damage was milder (P＜0. 01 ), and apoptosis rate of renal tubular epithelial cells apoptosis was lower than in saline group (P＜0. 05). The infiltration of macrophages, neutrophils and the mRNA expression of TNF-α, CXCL-10, ICAM-1 and IL-17 in the renal tissue in SIN group were reduced as compared with saline group (P＜0. 05 or P＜0. 01 ). The activation of NF-κB in SIN group was significantly downregulated as compared with saline group. Conclusion SIN can ameliorate the renal IR injury without hepatic or renal toxicity, which is associated with inhibition of acute inflammatory response induced by reperfusion.

Objective This study investigates the epithelial-mesenchymal transition effects exerted on human liver cancer cells HepG2 by THP-1 derived macrophages.The roles of tumor-associated macrophages (TAMs) on liver cancer progression and its mechanisms were explored.Methods HepG2 cells were cultured with THP-1 derived macrophages to mimic the microenvironment of liver cancer.After the culture treatment,morphological changes of the liver cancer cells were observed.Decreased E-cadherin expression is a hallmark of epithelial-mesenchymal transition (EMT),and the Ecadherin protein variations in the HepG2 cells were detected by immunofluorescence (IF) and Westernblot.FlowCytomix was carried out to screen the cytokines in the supernanants of THP-1 cells and THP-1 derived macrophages.Results After culture with macrophages,HepG2 cells revealed a morphological change.These cells lacked epithelial morphology and became a spindle-like mesenchymal cell phenotype.Additionally,the E-cadherin protein expression was reduced dramatically as measured by IF and Western-blot.IL-8 and IL-1β expression in the supernatants were increased 40 and 20 times,respectively,after THP-1 cells were activated to macrophages (P＜0.01).TNF-α expression was increased 8 times (P =0.056).Conclusion THP-1 derived macrophages could induce EMT effects on HepG2 cells,which may relate to the increased secretion of IL-1β,IL-8 and TNF-α.

Objective To evaluate clinical features,therapeutic effects and outcomes of patients with non-human immunodeficiency virus(HIV)-infected cryptococcal meningitis treated with fluconazole or fluconazole and flucytosine.Methods Twenty-four cases of non-HIV-infected cryptococcal meningitis(fluconazole with or without flucytosine as initial therapy)in Huashan Hospital,Fudan University from 1997 to 2007 were retrospectively reviewed.Clinical manifestations,therapeutic effects and outcomes of the patients were collected.Results Fluconazole was administered with median dosage of 400 mg/d,for a median duration of 20.5 days.After fluconazole initial therapy for 2 weeks,16.7% showed partial response,83.3% showed no response,and the overall response rate was 16.7%.After 10 weeks,33.3% showed partial response,29.2% showed complete response,16.7% showed no response,and the overall response rate was 62.5%.Mortality at week 10 was 20.8%.Twenty-two patients who failed to respond to initial therapy were switched to other antifungal drugs(amphotericin B,amphotericin B colloidal dispersion,itraconazole)or other fluconazole containing combined therapy.Eleven out of the 24 patients died during one-year follow-up,8 of whom died of eryptococcal meningitis,and 3 died of other diseases.Conclusions The initial therapy of fluconazole with or without flucytosine is inefficient,and most of the patients need other antifungal drugs because of initial therapy failure.Therefore,fluconazole might not be appropriate for initial therapy in non-HIV-infected cryptococcal meningitis.

With the development of various laboratory testing techniques such as serum calcium and parathyroid hormone (PTH) , a large number of asymptomatic or normocalcemic primary hyperparathyroidism (PHPT) can be diagnosed early. PHPT has become the third most common endocrine disease affecting human health. Currently, most PHPT, especially normocalcemic primary hyperparathyroidism, are not primary diseases and may be related to vitamin D deficiency/insufficiency and/or insufficient calcium supplementation. That is, the relative hypocalcemia caused by long-term vitamin D deficiency/insufficiency and/or insufficient calcium supplementation leads to parathyroid hyperfunction, stimulates parathyroid hyperplasia, and secretes excessive parathyroid hormone to compensate for the regulation of calcium and phosphorus balance. When it is in the initial reversible stage, it can be cured by internal medicine; if it progresses freely, long-term hypocalcemia stimulation will lead to excessive parathyroid hyperplasia and even tumor occurrence with the formation of so-called PHPT and parathyroidectomy has to be performed. Therefore, routine screening of bone mineral density, calcium, magnesium, phosphours, 25-hydroxyvitamin D, parathyroid hormone and other bone metabolism indicators in the physical examination of general population is beneficial to the prevention and treatment of bone metabolism diseases, urinary stones and hyperparathyroidism. At the same time, attention should be paid to identifying the stage of prehyperparathyroidism in which vitamin D deficiency/insufficiency and insufficient calcium supplementation will stimulate parathyroid hyperfunction. Active intervention on prehyperparathyroidism is an effective way to avoid the development of primary hyperparathyroidism.

Objective:To explore the main hindering factors of nutritional care for family caregivers of patients with digestive system neoplasms after surgery, so as to provide reference for nursing workers to improve the quality of nutritional care for family caregivers and formulate personalized intervention programs.Methods:From January to April 2021, the phenomenological research method was used to select 14 family caregivers of patients with digestive system neoplasms after surgery in the First Affiliated Hospital of Anhui Medical University for semi-structured interviews, and Colaizzi 7-step analysis method was used to analyze and collate the data.Results:The obstacles to nutritional care for family caregivers of patients with digestive system neoplasms after surgery extracted 4 themes and 9 sub-themes. The first theme was insufficient awareness of nutritional care, including caregivers' insufficient awareness of the importance of nutritional care and lack of awareness of nutritional risks related to assisted eating. The second theme was the lack of nutritional care ability, including lack of nutrition knowledge of caregivers, poor practical ability of caregivers and poor compliance and initiative of caregivers. The third theme was the difficulty in obtaining and using nutritional information, including limited access to information for caregivers and difficulties in using information for caregivers. The fourth theme was caregiver role barriers in nutritional care, including lack of social support and heavy family financial burden.Conclusions:Nursing workers can formulate individualized interventions for family caregivers' nutritional care barriers, promote the improvement of nutritional care quality of them and then improve patients' nutritional status and quality of life.

Objective:To explore the main hindering factors of nutritional care for family caregivers of patients with digestive system neoplasms after surgery, so as to provide reference for nursing workers to improve the quality of nutritional care for family caregivers and formulate personalized intervention programs.Methods:From January to April 2021, the phenomenological research method was used to select 14 family caregivers of patients with digestive system neoplasms after surgery in the First Affiliated Hospital of Anhui Medical University for semi-structured interviews, and Colaizzi 7-step analysis method was used to analyze and collate the data.Results:The obstacles to nutritional care for family caregivers of patients with digestive system neoplasms after surgery extracted 4 themes and 9 sub-themes. The first theme was insufficient awareness of nutritional care, including caregivers' insufficient awareness of the importance of nutritional care and lack of awareness of nutritional risks related to assisted eating. The second theme was the lack of nutritional care ability, including lack of nutrition knowledge of caregivers, poor practical ability of caregivers and poor compliance and initiative of caregivers. The third theme was the difficulty in obtaining and using nutritional information, including limited access to information for caregivers and difficulties in using information for caregivers. The fourth theme was caregiver role barriers in nutritional care, including lack of social support and heavy family financial burden.Conclusions:Nursing workers can formulate individualized interventions for family caregivers' nutritional care barriers, promote the improvement of nutritional care quality of them and then improve patients' nutritional status and quality of life.

Objective:To translate the Glaucoma Symptom Scale (GSS) into Chinese, and to test its reliability and validity.Methods:Following the Brislin questionnaire translation principles, GSS was translated, back-translated and culturally adapted, and the Chinese version of GSS was formed. From January 2021 to June 2022, a total of 210 glaucoma patients in Ophthalmology Outpatient and Inpatient Department of Class Ⅲ Grade A hospitals in Hefei were enrolled as the research objects by the convenience sampling method. The items of the Chinese version of GSS were screened by correlation coefficient method, critical ratio method and Cronbach's α coefficient. The reliability of the Chinese version of GSS was tested using Cronbach's α coefficient, split-half reliability and test-retest reliability. The validity of the GSS was evaluated by content validity and construct validity. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive ability of the Chinese version of GSS, and to determine the sensitivity, specificity and the most appropriate critical value of GSS. Pearson correlation analysis was used to explore the correlation between the total score of GSS and the score of each item. A total of 210 questionnaires were distributed in this study, and 205 were effectively received, with an effective recovery rate of of 97.62% (205/210) .Results:A total of 2 common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 50.64%. With clinician's diagnosis as the gold standard, the area under the curve of the Chinese version of GSS was 0.916 (95% CI: 0.886-0.947, P<0.01). The optimal critical score of the scale was 73, and the sensitivity and specificity were 85.2% and 87.3%. The concordant Kappa value of the two diagnostic results was 0.749 ( P<0.01). The Cronbach's α coefficient, split-half reliability and test-retest reliability of the Chinese version of GSS were 0.812, 0.781 and 0.912, respectively. Conclusions:The Chinese version of the GSS has good reliability and validity, and is suitable for the screening of glaucoma patients in China.

OBJECTIVETo explore the clinicopathological characteristics, efficacy, and prognostic factors for patients with duodenum gastrointestinal stromal tumor(GIST).

METHODSClinicopathological and follow-up data of 80 patients with duodenum GIST in the Zhongshan Hospital from January 2000 to December 2013 were analyzed retrospectively.

RESULTSThere were 38 male and 42 female patients with a median age of 54 years. The major symptoms were upper alimentary tract hemorrhage and abdominal pain. Thirty-nine patients received local tumor excision, 18 patients underwent segmental duodenectomy, 23 patients were subjected to pancreaticoduodenectomy, all these operations were R0 resection. Thirty patients received imatinib treatment after operation, and 11 among them had metastasis relapse. Recurrence-free survival rates of 1-, 3-, and 5-years were 96.2%, 90.6%and 78.6% retrospectively. Overall survival rates of 1-, 3-, and 5-years were 100%, 98.3% and 96.1%. Multivariate Cox analysis showed tumor size >5 cm, mitotic count >5 mitosis/50 HPF and intermediate/high NIH risk classification were associated with an increased risk of recurrence. The significant difference was not detected between the limited resection group and pancreaticoduodenectomy group in OS and RFS.

CONCLUSIONSSurgery is still the main treatment for duodenum GIST. The surgical program is mainly determined by the location and size of tumor. Imatinib therapy should be used if necessary.

Abdominal Pain ; Benzamides ; Duodenal Neoplasms ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Humans ; Imatinib Mesylate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Pancreaticoduodenectomy ; Piperazines ; Prognosis ; Pyrimidines ; Retrospective Studies ; Survival Rate