Objective To elucidate the differences between invasive micropapillary carcinoma (IMPC) and invasive ductal carcinoma(IDC),and explore the clinicopathological and immunohistochemistry characteristics of invasive micropapillary carcinoma of the breast.Methods Invasive micropapillary carcinoma was identified in 51 patients by retrospective review of database from October 2004 to November 2007.Data were compared with 102 patients identified as invasive ductal carcinoma available in this hospital during the same period.Results Significant differences were observed in mammilla invasion,lymphatic vessel invasion,positivity of lymph node,lymph node metastatic level,extranodal extension,estrogen receptor,progestin receptor,triple negative between the two groups; while there was no significant differences between the two groups as to amenorrhea status,lesion laterality,number of metastatic lymph nodes,human epidermal growth factor receptor-2,local recurrence and distant organ metastasis.The median follow-up time of the invasive micropapillary carcinoma group were 46 months ( 16 - 75 months),and the 3-year overall survival and disease free survival was 90.2％ and 84.3％,respectively.Conclusions Invasive micropapillary carcinoma is a unique subtype of breast cancer which manifests an aggressive behavior tending to involve lymph node and extranodal soft tissues.Invasive micropapillary carcinoma of the breast had high expression of hormonal receptors,and triple negative breast cancer is less common in this type of breast cancer.

Objective To use phage display for generating surrogate peptides of candida albicans mycelial-phase protein as mimic antigen to develop an enzyme-linked immunosorbent assay (ELISA) assay for detection of candida albicans antibodies.Methods A monoclonal antibody against candida albicans mycelial-phase protein P47, was used in this study for selecting immunoreactive peptides, mimotopes, from a 12 mer phage library.The peptides were characterized immunologically and used for coating antigen in ELISA to detect antibodies against candida albicans in the patients' serum.Results The sensitivity, specificity and replication of the ELISA assay was good enough for clinical use. The antibody was positive in all of 10 samples of patients with confirmed systemic candida albicans infection and the results were same to those obtained with the purified mycelial-phase protein P47; The positive rates in patients receiving immunosuppressive drug cyclosporin A are 33% and the healthy 2% respectively.Conclusion The surrogate peptides from a 12 mer phage library can be used in ELISA for detecting the antibodies of candida albicans P47.

Objective :To study influence of health management mode on poor living habits and incidence rate of relat—ed complications in aged patients with coronary heart disease (CHD).Methods : Medical data of 259 aged CHD pa—tients in our hospital from Jan 2013 to Dec 2016 were collected .Health management mode was performed in our hospital since Jan 2015 ,therefore ,according to treatment time ,patients were divided into CHD control group (n＝114) and health management group (n＝ 140 ) ,both groups were intervened for continuous six months .Scores of self—rated abilities for health practices scale (SRAHP ) and Seattle angina questionnaire (SAQ ) ,levels of fasting blood glucose (FBG) ,blood pressure and blood lipids before and after intervention ,incidence of complications and mortality during follow—up were measured and assessed between two groups .Results :Compared with before interven—tion ,after six—month intervention , there were significant rise in each item score and total scores of SRAHP and SAQ ,and significant reductions in levels of FBG ,SBP ,DBP ,TC and TG in two groups , P＝0. 001 all.Compared with CHD control group after six—month intervention ,there were significant rise in each item score and total score of SRAHP [(82. 95 ± 18.24) scores vs .(91.91 ± 20.23) scores] ,each item score and total score of SAQ [(64. 90 ± 14. 29) scores vs .(72. 15 ± 15.87) scores] ,and significant reductions in levels of FBG [(5.51 ± 1.21) mmol／L vs. (5. 14 ± 1. 13)mmol／L] ,SBP[(121.07 ± 14.52) mmHg vs.(116. 72 ± 14. 01) mmHg] ,DBP [(80. 23 ± 9.63) mmHg vs.(77. 62 ± 9.31)mmHg] ,TC[(4. 31 ± 0.65)mmol／L vs.(4. 11 ± 0. 61) mmol／L] and TG[(1.45 ± 0. 21) mmol／L vs.(1. 39 ± 0.21)mmol／L] in health management group , P＜0. 05 or ＜0. 01. During follow—up ,incidence rates of recurrent angina pectoris (21.4% vs.35.3%) ,heart failure (2. 1% vs.7.6%) and myocardial infarction (3. 6%vs.10. 1%) in health management group were significantly lower than those of CHD control group , P＜0.05 all. Conclusion :Health management mode can enhance health behavior ,correct poor living habits ,stabilize blood glu—cose ,blood lipid and blood pressure ,and reduce incidence rate of related complications in aged CHD patients .

Objective To investigate the value of endoscopic retrograde appendicitis therapy ( ERAT) in the diagnosis and treatment of atypical acute appendicitis. Methods All the 48 patients suspected of atypical acute appendicitis in Jiangsu Province Hospital from January 2015 to December 2016 were randomly divided into ERAT group and conservative treatment group according to the treatment method. The final appendectomy rate of the two groups was analyzed. Results Only 17 of the 24 patients in the ERAT group received endoscopic treatment because of complex conditions or personal wishes, and 16 cases were diagnosed as acute appendicitis. Surgical resection was performed in 5 cases because of recurrence of the disease after ERAT, and the appendectomy rate was 31. 2％ ( 5/16 ) . In the conservative treatment group, all 24 patients were treated with antibiotics. Twenty of them underwent surgical resection with appendectomy rate of 83. 3％ ( 20/24) , and 1 of them had appendiceal perforation. The appendectomy rate of the ERAT group was significantly lower than that of the conservative treatment group (χ2=11. 111, P<0. 05) . Conclusion ERAT has a high diagnostic and therapeutic value for atypical acute appendicitis.

Objective To compare the incidences of skin ecchymosis,skin induration and pain degree occurring after subcutaneous injection of low molecular weight heparin between two injection methods in order to determine the optimal subcutaneous injection method and provide the basis for standardizing the nursing process.Methods A total of 123 patients,who received subcutaneous injection of low molecular weight heparin during the period from March 2016 to September 2016 at authors' department,were enrolled in this study.Self-contrast method was used to compare the results.Each patient received low molecular weight heparin with two different subcutaneous injection methods.On the left abdomen,used as the experimental side,slow injection of heparin,lasting for 10 s,was conducted,then,after the needle stayed there for 10s the needle was pulled out,and no compression was applied on the injection site.On the right abdomen,used as the control side,slow injection of heparin,lasting for 10 s,was carried out,and the needle was pulled out immediately after the injection was finished,then compression was applied on the injection site for 3 min.Two hours and 12 hours after injection,visual analogue scale (VAS) was used to assess the degree of pain at injection site,and the incidences of skin ecchymosis and subcutaneous induration on the experimental side and the control side were documented.Results Two-hour and 12-hour VAS pain scores of the experimental group were (0.88±0.66) and (0.34±0.47) respectively,which were significantly lower than (2.02±0.65) and (1.19±0.63) of the control group (P＜0.05).The incidence of skin ecchymosis in the experimental group was 10.5％,which was strikingly lower than 23.5％ in the control group (t=2.736,P＜ 0.05).The incidence of subcutaneous induration in the experimental group was 0.04％,which was remarkably lower than 15.4％ in the control group (t=2.946,P＜0.05).Conclusion Slow injection of low molecular weight heparin,lasting for 10 s with needle staying for 10 s,and no use of compression after the needle is pulled out can decrease the incidence of skin ecchymosis and subcutaneous induration,and this injection method can reduce the pain degree as well.

Objective:The aim of this study was to explore the associations of muscle size and density with handgrip strength(HGS)and the Timed Up and Go(TUG)test.Methods:Totally 301 participants living in the Xinjiekou community near Beijing Jishuitan Hospital were recruited for CT imaging of the hip and a 1-cm slice of the mid-thigh.The cross-sectional area and density of the gluteus maximus and the mid-thigh muscles were estimated by the Osirix viewer based on CT images.HGS and TUG were also performed in these subjects.Logistic regression analysis was used to evaluate the correlations of muscle density and size with TUG and grip strength.Results:In women, after adjustment for age and BMI, the density of the gluteus maximus was negatively correlated with TUG( P trend=0.0366), while the size of the gluteus maximus and the mid-thigh muscles was not correlated with TUG.In men, the density or size of these muscles was not correlated with TUG.After adjustment for age and BMI, the density of the gluteus maximus was positively correlated with grip strength( P trend=0.0334)and the size of the mid-thigh muscles was also positively correlated with grip strength( P trend=0.0155)in men, but they were not correlated with grip strength in women. Conclusions:There were sex differences in the relationship between muscle size or density and grip strength or timed up and go.The density of the gluteus maximus is associated with muscle strength and physical performance while the size of the mid-thigh muscles is correlated with muscle strength.

Objective : To study the effect of leucine rich repeat kinase 2 ( LRRK2) on pain sensitivity in neuro- pathic pain (NP) rats and explore its possible mechanism． Methods : 48 SD rats were randomly divided into four groups : sham surgery (Sham) ，model，LRRK2 inhibitor(MLi-2) ，and LRRK2 inhibitor + p38 mitogen activated pro- tein kinase (MAPK) agonist (MLi-2 + Anisomycin) ，with 12 rats in each group．The NP rat model was induced by chronic constriction injury ( CCI) of the sciatic nerve．Intrathecal injection of MLi-2 ( 1 mg / kg，10 μl) or Anisomy- cin (20 μmol / L，10 μl) was started from the 8 th day after surgery，once a day for 7 consecutive days．Pain sensi- tivity tests were conducted before surgery (day 0) and on postoperative days 7 and 14，respectively．The changes in mechanical withdrawal threshold (MWT) and paw withdraw thermal latency (PWTL) were analyzed in each group of rats．ELISA was used to detect the levels of interleukin-1 β (IL-1 β) ，IL-6 and tumor necrosis factor-α (TNF-α) in the dorsal horn of the rat spinal cord．Nissl staining was used to observe the pathological changes of neurons in rat spinal cord tissue．Immunofluorescence staining was used to observe the expression levels of ionized calcium-binding adapter molecule-1 (Iba-1) ，a marker of microglia in the spinal cord of rats ．Western blot was used to detect theprotein expression levels of LRRK2，p-p38 mitogen activated protein kinase (MAPK) ，p38 MAPK，and Iba-1 in the dorsal horn of the rat spinal cord. Results : Compared with the sham group，the model group showed a significant decrease in MWT and PWTL in the right hind limb of rats (P＜0. 01) ．The levels of IL-1，IL-6，and TNF in the spi- nal dorsal horn tissue，as well as the expression levels of LRRK2，Iba-1 proteins and p-p38 MAPK / p38 MAPK pro- tein ratio significantly increased (P＜0. 01) ．The proportion of Iba-1 positive cells in the spinal cord tissue signifi- cantly increased (P＜0. 01) ，while Nissl bodies were significantly reduced (P＜0. 01) ．Compared with the model group，the MLi-2 group showed a significant increase in MWT and PWTL in the right hind limb of rats (P＜0. 01) ， a significant increase in Nissl bodies (P＜0. 01) ，a significant decrease in the proportion of Iba-1 positive cells in the spinal cord tissue (P＜0. 01) ，and a significant decrease in the levels of IL-1，IL-6，and TNF and the expression levels of LRRK2，Iba-1 proteins and p-p38 MAPK / p38 MAPK protein ratio (P＜0. 01) ．However，Anisomychin in- tervention could activate the p38 MAPK signaling pathway and partially reverse the beneficial effects of MLi-2 on pain sensitivity and neuroinflammation in rats with neuropathic pain． Conclusion Inhibiting the expression of LRRK2 can alleviate pain sensitivity in NP rats induced by microglia activation mediated neuroinflammation，and its mechanism of action may be related to regulating the p38 MAPK signaling pathway.

Objective:In order to explore the impact of corona virus disease 2019(COVID-19)on the hospitalization of children with bronchiolitis and to improve clinicians′ understanding of the characteristics of bronchiolitis during the COVID-19 epidemic.Methods:This was a multicenter clinical study, and the data have been collected from 23 children′s medical centers in China.All the clinical data were retrospectively collected from children with bronchiolitis who were hospitalized at each study center from January 1, 2019 to December 31, 2021.The results included gender, age at hospitalization, length of stay, respiratory syncytial virus(RSV) test results, severity rating, ICU treatment, and the total number of children hospitalized with respiratory tract infection during the same period.The clinical data of children with bronchiolitis in 2019 before COVID-19 epidemic and in 2020、2021 during COVID-19 epidemic were statistically analyzed and compared.Results:According to a summary of data provided by 23 children′s medical centers, there were 4 909 cases of bronchiolitis in 2019, 2 654 cases in 2020, and 3 500 cases in 2021.Compared with 2019, the number of bronchiolitis cases decreased by 45.94% in 2020 and 28.70% in 2021.In 2019, 2020 and 2021, there were no significant differences in gender ratio, age, and duration of hospitalization.Compared with 2019, the ratio of bronchiolitis to the total number of hospitalizations for respiratory tract infection decreased significantly in 2020 and 2021( χ2=12.762, P<0.05; χ2=84.845, P<0.05).The proportion of moderate to severe bronchiolitis cases in both 2020 and 2021 was lower than that in 2019, and the difference was statistically significant ( χ2=4.054, P<0.05; χ2=8.109, P<0.05).There was no statistically significant difference in the proportion of bronchiolitis cases requiring ICU treatment between 2019, 2020, and 2021 ( χ2=1.914, P>0.05).In 2019, a total of 52.60%(2 582/4 909) of children with bronchiolitis underwent RSV pathogen testing, and among them, there were 708 cases with RSV positive, accounting for 28.00%.In 2020, 54.14%(1 437/2 654) of children with bronchiolitis underwent RSV pathogen testing, and there were 403 cases with RSV positive, accounting for 28.04%.In 2021, 66.80%(2 238/3 500) of children with bronchiolitis underwent RSV pathogen testing, and there were 935 cases with RSV positive, accounting for 41.78%.Compared with 2019 and 2020, the RSV positive rate in 2021 showed a significant increase( χ2=99.673, P<0.05; χ2=71.292, P<0.05). Conclusion:During the COVID-19 epidemic, the implementation of epidemic prevention and control measures reduced the hospitalization rate and severity of bronchiolitis, but did not reduce the positive rate of RSV detection.

Objective To investigate the role and mechanism of silent information regulator 1 (SIRT1)-NOD-like receptor protein 3 (NLRP3) axis in the effect of remifentanil against ischemia-reperfusion injury (IRI) in rat livers. Methods SD rats were randomly divided into sham operation group (sham group), IRI group, IRI+remifentanil pretreatment group (IRI+RPC group), IRI+SIRT1 inhibitor EX-527 group (IRI+EX-527 group) and IRI+RPC+EX-527 group, with 8 rats in each group. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), interleukin (IL)-1β and IL-18 of rats in each group were detected. The liver tissue pathology was observed. The apoptosis rate of hepatocytes in rats was detected. The expressions of SIRT1, NLRP3, cleaved cysteinyl aspartate specific proteinase-1 (Cleaved Caspase-1) and Gasdermin D (GSDMD) proteins in rat liver tissue were detected. Results Compared with the sham group, the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI group were increased, the serum ALT, AST, LDH, IL-1β, and IL-18 levels were increased, the relative expression of SIRT1 protein in liver tissue was decreased, and the relative expression of NLRP3, Cleaved Caspase-1, and GSDMD proteins were increased (all P<0.05). Compared with the IRI group, the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI+RPC group were decreased, the serum ALT, AST, LDH, IL-1β, and IL-18 levels were decreased, the relative expression of SIRT1 protein in liver tissue was increased, and the relative expression of NLRP3, Cleaved Caspase-1, and GSDMD proteins were decreased; the liver tissue pathological score and hepatocyte apoptosis rate of rats in the IRI+EX-527 group were increased, the ALT, AST, LDH, IL-1β, and IL-18 levels were increased, the relative expression of SIRT1 protein in liver tissue was decreased, and the relative expression of NLRP3, Cleaved Caspase-1, and GSDMD proteins were increased (all P<0.05). Compared with the IRI+RPC group, the liver tissue pathological score and hepatocyte apoptosis rate in the IRI+RPC+EX-527 group were increased, the levels of ALT, AST, LDH, IL-1β, and IL-18 were increased, the relative expression of SIRT1 protein in liver tissue was decreased, and the relative expression of NLRP3, Cleaved Caspase-1, and GSDMD proteins were increased (all P<0.05). Conclusions SIRT1 may participate in the regulation of remifentanil against rat liver IRI by inhibiting NLRP3 mediated cell pyroptosis.