Ductal carcinoma in situ belongs to the early stage of breast cancer.The treatment of ductal carcinoma in situ is similar with that of the breast cancer.Because of the low mortality rate in patients with ductal carcinoma in situ,there was an excessive treatment in the treatment of ductal carcinoma in situ.So the key to the treatment of ductal carcinoma in situ was to improve the quality of life.The present study shows that the effect of conserving surgery with radiotherapy is same with mastectomy's in the treatment of breast ductal carcinoma in situ.Sentinel lymph node biopsy can also be used to evaluate the patient's axillary status.For patients with ductal carcinoma in situ with breast conserving surgery,radiotherapy and endocrine therapy can reduce the recurrence rate of ipsilateral breast cancer.Radiotherapy and endocrine therapy have also become the standard treatment for ductal carcinoma in situ.

Objective:This study aimed to investigate the role of mitochondrial fusion protein 2 (Mfn2) in chronic renal injury caused by cyclosporine A (CSA) and the possible mechanism.Methods:The model of chronic CSA nephropathy was established in rats. The rats were divided into solvent control group, CSA model group and normal control group. Serum creatinine and urinary protein levels were detected. The tubulointerstitial injury was observed by light microscopy. The changes of mitochondrial structure were observed by electron microscope, and the expression of Mfn2 was detected by Western blot.Results:The levels of serum creatinine and urinary protein in CSA model group at 2 and 4 weeks were significantly higher than those in control group and solvent group ( P<0.05). In CSA model group, tubulointerstitial injury was obvious, mitochondria swelling and deformation were found in tubular epithelial cells, and ridge disappeared. Compared with normal control group and solvent control group, the expression of Mfn2 in CSA model group was significantly decreased at 2 and 4 weeks ( P<0.05), and the expression of Mfn2 in CSA model group at 4 weeks was further decreased compared with 2 weeks ( P<0.05). Conclusions:Mfn2 may play an important role in the injury of tubular epithelial cells caused by cyclosporine.

Parkinson′s disease(PD),the second neurodegenerative disease in the world,is characterized by a combination of motor symptoms(rest tremor,bradykinesia,rigidity,postural instability,stooped posture and freezing of gait)and non-motor symp?toms(including psychiatric and cognitive disorders). The core neuropathological features of PD are the loss of dopaminergic neurons in the substantia nigra and the deposition of iron and cytoplasmic protein aggregates(Lewy bodies)inside neurons. Currently,clinical treatment for PD is symptomatic and there is no effective treatment to restore neuronal degeneration. In the PD therapy ,medication re?mains dominant. Anti-PD drugs are mainly based on the critical signal pathways or some specific targets which play a key role in the pathogenesis of PD to relieve the symptoms of PD. Research and development in novel drugs to prevent or treat PD have been a crucial subject,and some novel candidates are under development. In this paper,we summarize and analyze the anti-PD drugs,and make a brief discussion about its pharmacological targets.

Birth Weight ; Fetal Growth Retardation ; genetics ; Humans ; Molecular Biology

Objective To explore the therapeutic value of hemoperfusion combined with daytime high capacity hemofiltration in the treatment of severe acute pancreatitis.Methods The clinical data of 25 patients with severe acute pancreatitis treated by hemoperfusion combined with daytime high capacity hemofiltration(the observation group) were retrospectively analyzed,and compared with 30 severe acute pancreatitis patients without blood purification treatment(the control group).Results After the treatment,the biochemical indicator of the observation group was improved obviously compared with pre-treatment.Of the observation group,the hospital slaying time was shorter [(21.6±12.3) d vs(30.8±15.6) d],and the cure rate was higher(72％ vs 40％),and the death rate was lower (16％ vs 30％),compared with the control group(all P ＜ 0.05),but the treatment costs had no difference between the two groups.Conclusion Patients with severe acute pancreatitis on the basis of conventional treatment should conduct as early as possible hemoperfusion combined with daytime high capacity hemofiltration,and it could improve the success rate of the rescue and shorthen the length of hospital stay,and its curative effect was accurate.

Objective: To evaluate the clinical efficacy of 125I seed implantation combined with chemotherapy in the treatment of non-small cell lung carcinoma (NSCLC) and its complications. Methods: Combined treatment group (n = 42) received CT-guided interstitial 125I seed implantation (PD = 8-10 Gy/h), and three days later they were given TAX + DDP intravenous chemotherapy. Control group (n = 46) only received TAX + DDP chemotherapy. The dosage was selected based on the same reference standard as the treatment group. The therapeutic efficacy was observed two months later. The life quality of patients was evaluated by using EORTC QLQ-C30 table. Results: Both the technical success rate and follow-up rate were all 100%. In combined treatment group 4 patients achieved complete response (CR, 9.5%), 14 patients had partial response (PR, 33.3%), 20 patients with stable disease (SD, 47.6%) and 4 patients with progressed disease (PD, 9.5%). The total response rate (CR + PR) was 42.9%. In control group 1 patient achieved complete response (2.2%), 8 patients had partial response (17.4%), 22 patients with stable disease (47.8%) and 15 patients with progressed disease (32.6%). The total response rate (CR + PR) was 19.6%. The total response rate of the treatment group was significantly higher than control group. Conclusion: 125I seed implantation is synergistic with chemotherapy which is beneficial in reducing tumor load in a short period and increased the short β2-MG term therapeutic efficacy for NSCLC.

Objective To explore the efficacy and safety of low-dose ketamine for prevention of shivering during cesarean section under subarachnoid space and epidural anesthesia.Methods Ninety pregnant women who scheduled cesarean delivery under subarachnoid space and epidural anesthesia were randomized divided into three groups:control group (30 patients) low-dose ketamine group (30 patients) and high-dose ketamine group (30 patients).0.9％ sodium chloride,0.25 mg/kg(3 ml),and 0.50 mg/kg (3 ml) ketamine were given in three groups before operation.The incidence of shivering and adverse effect were recorded respectively before anesthesia,after anesthesia 15 min and 30 min and after operation 1 h.Results The level of mean arterial pressure (MAP) in control group after anesthesia 15 main and 30 min and after operation 1 h[(62 ± 10),(58 ± 8),(61 ± 11) mm Hg(1 mm Hg =0.133 kPa)] were significantly lower than those in high-dose ketamine group [(78 ± 12),(82 ± 8),(76 ± 11)mm Hg] and low-dose ketamine group [(72 ± 10),(76 ± 6),(80 ± 7) mm Hg],there was significant difference (P ＜ 0.05).There was no shivering need treat in low-dose ketamine group and high-dose ketamine group.The rate of hallucinations and nystagmus in low-dose ketamine group [0,6.7％ (2/30)] was significantly lower than that in high-dose ketamine group [20.0％ (6/30),50.0％ (15/30)],there was significant difference (P ＜ 0.05).Conclusion The pretreatment with low-dose ketamine on shivering during cesarean section under subarachnoid space and epidural anesthesia has better preventive effectiveness,0.25 mg/kg of ketamine is more effective than 0.50mg/kg.

Objective To investigate the infection rates of mycoplasma penetrans (Mpe),mycoplasma pneumoniae (Mp) and mycoplasma ferments (Mf) in patients with IgA nephropathy (IgAN),chronic kideny disease (CKD),and heathy people,to compare the difference of infection rate,and to analyze the association of mycoplasma infection and clinicopathological features in IgAN.Methods Blood samples were collected from 118 patients in IgAN group,90 patients in CKD group,and 89 cases in health control group.DNA of Mpe,Mp and Mf was detected in plasma by PCR.Positive cases were confirmed by Southern blot.According to mycoplasma infection,IgAN patients were divided into two groups,then analyzed the clinicopatholgical features.Results (1)Genus,Mpe,Mp,and Mf positive rates were 33.05％,16.1％,25.45 ％,and 8.47％ in IgAN group,respectively; 5.56％,2.22％,5.56％,and 2.22％ in CKD group,respectively; and 3.33 ％,1.11％,2.22％,and 0 in health group,respectively.Compared with CKD and health group,patients in IgAN group had a higher infection rate in Genus,Mpe,and Mp (P ＜ 0.05).In IgAN group,10 patients had three kinds of mycoplasmas infection at the same time,and positive rate was 8.47％ much higher than CKD group (positive rate was 2.22％) (P ＜ 0.05).(2) Based on mycoplasm detection results,IgAN patients were divided into two groups,overlapping infection group and mycoplasma negative group.In overlapping infection group,the mean age of onset was much younger than negative group.Compared with negative group,overlapping infection group had higher tonsillitis and urinary tract infection rate,more severe microscopic hematuria and tubulointerstitium lesion (P ＜ 0.05).Conclusions Patients with IgAN had higher infection rate of Genus,Mpe and Mp,compared with CKD patients and health people.Compared with mycoplasma negative group in IgAN patients,more severe microscopic hematuria and tubulointerstitium lesion in overlapping infection group,which suggested that infection of Mpe might have some possible connection with IgAN.

From both doctors and patients′different perspectives , this paper analyses the causes of conflict of doctor-patient communication , and from the subjective and the objective , the history and reality , individual and social aspects of light on the restricting factors for good doctor -patient communication , and puts forward strengthe-ning the consciousness of active , rule execution , achieving full coverage , explore ways to standard mode , rich di-verse ways and other countermeasures .