It has been shown that MR imaging of breast is superior to conventional mammography and ultrasonography on early diagnosis and cancer staging on breast cancer due to MRI’s high soft-tissue contrast and no radiation. The concept of multidisciplinary treatment of breast cancer has been increasingly accepted in clinical practice of breast cancer care. Investigation of breast MRI on cancer staging, selecting conservative therapy, detecting the primary malignant of patients presenting as axillary metastases, evaluating residual disease after neoadjuvant chemotherapy(NAC), predicting response in the early phase of treatment as well as monitoring recurrence during follow-up has been carried out along with its board clinical application. The advantages of breast MRI in mapping the disease accurately provide measures to select appropriate use of variable treatments.

Objective:To explore the expression and biological functions of miR-346 in nasopharyngeal carcinoma.Methods:63 cases nasopharyngeal carcinoma tissue and 34 cases nasopharyngeal non-cancer tissues were collected,the miR-346 expression were detected by Real-time PCR between nasopharyngeal carcinoma tissue and nasopharyngeal non-cancer tissues,6 strains of human nasopharyngeal carcinoma cell lines and 1 strain of normal nasopharyngeal epithelial cell immortalized NP69.Two cell lines with middle expression levels in human nasopharyngeal carcinoma cells lines were selected,and transfected into miR-346 inhibitor,the control group (NC group) were with negative control plasmid transfection,miR-346 expression in two groups were detected by Real-time PCR,the proliferation,apoptosis were detected by Brdu-ELISA and flow cytometry,the migration and invasion were detected by Transwell Chambers experiments.Results:Compared with the nasopharyngeal non-cancer tissues,the miR-346 expression in nasopharyngeal carcinoma tissues was significantly increased (P =0.000);compared with the normal nasopharyngeal epithelial cells NP69.the miR-346 expression in human nasopharyngeal carcinoma cell lines was significantly increased (P＜0.05).The CNE-1 and CNE-2 were chose,after the miR-346 inhibitor transfection,the miR-346 expression were significantly lower compared with NC group,the difference was statistically significant (P＜0.05).The proliferation of two kinds of nasopharyngeal carcinoma cell CNE-1 and CNE-2 were restrained after transfection,the difference showed statistically significant 3 days after transfection (P ＜ 0.05).The apoptosis increased significantly,and the migration cell numbers and invasion cell numbers decreased significantly compared with NC group,the differences were statistically significant (P＜0.05).Conclusion:miR-346 is overexpression in nasopharyngeal carcinoma,down-regu-lation of miR-346 inhibits the proliferation,migration,invasion,promotes the apoptosis,miR-346 may act as a oncogene and play an important role in the pathogenesis of nasopharyngeal carcinoma.

Objective:To investigate the expression and biological significance of MicroRNA-204 in nasopharyngeal carcinoma (NPC). Methods: qRT-PCR was applied to detect the relative expression of miR-204 in 43 paired nasopharyngeal carcinoma in comparison to the normal nasal mucosa tissues. Pearson chi-square test was used to analyze the relationship between the miR-204 expression and clinical features. The expressions of Bcl-2 and SIRT1 were measured by immunohistochemistry ( IHC ) , Spearman correlation analysis was used to analyze the relationship between miR-204 and Bcl-2,as well as SIRT1. We then transfected the miR-204 mimics into CNE-2 cells,then the Western blot was used to detect the expression of Bcl-2 and SIRT1,which were considered as the potential targets of miR-204. Results:The relative expressions of miR-204 was significantly downregulated in NPC tissues compared to those of the matched normal tumor-adjacent tissues(P<0. 05). Low expression of miR-204 was significantly associated with lymphatic metastasis(P<0. 05) and advanced TNM stage(Ⅲ+Ⅳ,P<0. 05). The expressions of Bcl-2 and Sirt1 in lower miR-204 level group were both higher than in higher miR-204 level group ( P<0. 05 ) . Both the mRNA and protin expression in CNE-2 cells were down-regulated after transfection. Conclusion: Low expression of miR-204 is related to the malignant clinicopathological features in NPC tissues,and miR-204 may through down-regulate Bcl-2 and SIRT1 to suppress NPC genesis and development.

Objective To investigate the effect of anti-bleeding gauze (TISTAT) in nasal packing after endoscopic sinus surgery in elderly patients.Methods 72 elderly patients with chronic sinusitis and nasal polyps for endoscopic sinus surgery were divided into two groups:TISTAT group (use TISTAT,n=38) and calcium alginate group(use calcium alginate,n=34).TISTAT and calcium alginate were respectively used as packing materials in TISTAT and calcium alginate group.Hemorrhage in the packing process and after the packing materials removed were observed and compared.The symptoms such as headache、nasal blockage and nose pain during the packing process and 24 hours after the packing materials removed were compared.The recovery of surgery cavity in 4 weeks after surgery which reviewed once a week were checked and compared.Results The tamponade during hemorrhage rates of TISTAT group and calcium alginate group were 31.6％ (12 cases)、58.5％ (20 cases),after removing the tamponade,the total bleeding rates were 15.8％,41.2 ％,two groups had significant difference (P＜0.01) ;TISTAT group nasal pain symptoms in the packing process,packing materials were 12 h,stuffing out after 24 h were (2.8±0.6)、(1.3±0.5),calcium alginate group nasal pain symptoms in the packing process,packing materials were 12 h.stuffing were 24 h were (5.2±0.4)、(4.3±0.6),two groups of nasal pain symptom difference was statistically significant (P＜0.05),but the process of tailing and calcium alginate group blocked nose were (5.4±0.9) 、(8.3±0.6),the two groups had significant difference (P＜0.05).Conclusions The anti-bleeding gauze(TISTAT) has safety and active role in nasal packing after endoscopic sinus surgery in elderly patients with less symptoms and a better surgical cavity recovery.It is an ideal packing material.

Objective To analyze the indications,techniques of MR-guided localization and the imaging features of breast lesion.Methods Hook wire localization was performed in 43 patients whose lesions were only detected by MRI,based on a 1.5 T MR scanner and a special MR biopsy positioning frame.The feasibility of operation and accuracy of localization were explored.Lesion features and pathologic findings were analyzed using Fisher exact test.Results A total of 37 patients (86.0％) with 38 lesions underwent MR-guided localization.Of the 6 patients canceled,the lesions were not obvious in 4 patients,and the positioning was difficult in 2 cases.Of the 38 lesions,17 were masses,20 were non-mass enhancement lesions,and one lesion was undetermined enhancement.There were 11 (28.9％) malignant lesions.The distribution of internal enhancement pattern was different between benign and malignant non-mass lesions (P =0.028),while the other morphological features between benign and malignant were not significantly different (P ＞ 0.05).Conclusions MR-guided localization provides an accurate and safe method for localizing the suspicious lesions on MRI.The morphological findings of these lesions are not characteristic for the differentiation of benign and malignant lesions.

Objective To evaluate and recognize the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast and provide imaging information for the early detection and treatment planning Methods All MRI data in 71 patients with histollogically proved DCIS were analyzed retrospectively. The 71 patients were divided into two groups, NI ( pure DCIS, 44 patients) and N2 ( DCIS with microinvasion, 27 patients). According to the BI-RADS descriptors, all lesions were defined as a focus (smaller than 5 mm in diameter), mass and no-mass-like three enhancement types. The morphological features (M1 = focus, M2 = linear or linear-branched, M3 = branching-ductal, M4 = segmental, M5 = focal,M6 = regional, M7 = diffuse, M8 = mass) and the time-intensity curve (TIC) pattern [type l ( persistent enhancement curves), type Ⅱ( plateau), type Ⅲ(washout) and type Ⅳ (the same enhancement as glandular tissue)] were described. Chi-square test was used for the morphological characteristics of lesions.Results The 73 DCIS lesions were found in 71 patients, and 5.5% (n =4) were stippled lesions, 87.7%( n =64) were no-mass-like lesions, 6.8%(n=5) were mass-like lesions. In no-mass-like lesions (n=64), M3 was found in 15 cases, M4 in 34 cases, M5 in 9 cases and M6 in 6 cases, respectively, M3 and M4 were the most common distribution patterns. In N1 group(n =45) and N2 group (n =28), M3, M4,M5, M6 were found in 7 and 8, 21 and 13, 7 and 2, 3 and 3 cases, respectively. There were no statistic differences between two groups (P＞0.05). In 31 showed heterogeneous enhancement, both M3 and M4 were observed in 35.5% (11/31). In 26 clustered ring enhancement lesions, M4 was observed in 88.5% (23/26). Four lesions showed reticular enhancement,2 lesions showed a clumped enhancement and 1 lesion showed homogeneous enhancement. In 5 mass-like lesions, N1 group had 3 cases, N2 group had 2 cases.Four lesions showed lobulated margin, 4 lesions showed speculated margin, 1 mass showed smooth margin.Five mass showed heterogeneous enhancement. Type Ⅰ , type Ⅱ , type Ⅲ and type Ⅳ TIC ( n = 25) were demonstrated in 8, 11, 3 and 3 lesions, respectively. Conclusions M3, M4, especially segmental clustered ring enhancement, are the most common morphological characteristics of DCIS. Type Ⅰ and type Ⅱ TIC are the most common types.

Objective To discuss the values of three screening methods for the detection of early breast cancer,and to analyze the features of the screening cancer.Methods The first screening of breast cancer were performed in 5307 women who aged from 20 to 76 years with median age of 49 years.The three screening methods included physical examination with ultrasound and mammography,physical examination with mammography and mammography only.The rate of recall,biopsy,cancer detection of three methods were analyzed and the mammographic findings were reviewed Chi-square test or Fisher's exact test were used for the statistics.Results The recall rates were 4.90% (49/1001),6.90%(166/2407)and 4.48% (85/1899) in three methods respectively,the biopsy rates were 1.60% (16/1001),1.04% (25/2407) and 0.63%(12/1899),the cancer detection rates were 0.50% (5/1001),0.17% (4/2407) and 0 (0/1899).There were statistical differences among the three groups (X2=12.99,6.264,8.764,P < 0.05).Physical examination with ultrasound and mammnography had the highest cancer detection rate,ten breast cancers were detected and 8 were early stage breast cancer.Of seven cancers detected by mammography,only two were found by ultrasound.A cluster of calcifications were found in 2 cases,linear calcifications in 2 cases.One case presented as a asymmetric density,one as a asymmetric density with calcifications,one as multiple nodules with a duster of calcifications.Two breast cancers presented as asymmetric density were missed on mammography and diagnosed correctly after retrospective review.Conclusion Physical examination with ultrasound and mammography is the best method for breast cancer screening.The breast cancer can be detected by mammography earlier than other methods.

Objective:To analyze the mediating effect of work-occupation fit between occupational stress and anxiety symptoms in medical staff.Methods:Convenience sampling method was adopted to select participants of one general hospital and three specialized hospitals as respondents for a questionnaire survey in Henan Province from October 2020 to January 2021. A total of 2050 medical staff were investigated, and 1988 valid questionnaires were collected, and the effective rate of the questionnaire was 97.0% (1988/2050) . The "Depression-Anxiety-Stress Scale" and "Worker-Occupation Fit Inventory" were used to evaluate the occupational stress, anxiety symptoms and worker-occupation fit level of medical staff, and the mediation effect of work-occupation fit on the relationship between occupational stress and anxiety symptoms was analyzed using a mediating effect model.Results:The average age of the 1988 medical staff was (32.7±7.8) years old, the positive detection rates of occupational stress and anxiety symptoms were 42.5% (845/1988) and 56.7% (1127/1988) , respectively. Anxiety symptoms of medical staff were positively correlated with occupational stress, negatively correlated with worker-occupation fit ( r=0.831, -0.364, P<0.001) , work-occupation fit was negatively correlated with occupational stress ( r=-0.259, P<0.001) . The results of the mediation effect analysis showed that occupational stress had a direct effect on anxiety symptoms ( β=0.677, BCa 95% CI: 0.648-0.707) , and worker-occupation fit ( β=0.047, BCa 95% CI: 0.039-0.056) , characteristic fit ( β=0.089, BCa 95% CI: 0.074-0.104) , need-supply fit ( β=0.075, BCa 95% CI: 0.062-0.089) , and ability-demand fit ( β=0.035, BCa 95% CI: 0.026-0.044) mediated the association between occupational stress and anxiety symptoms in medical staff, with the mediating effect as a percentage of 6.5%, 12.3%, 10.3%, and 4.8%, respectively. Conclusion:Worker-occupation fit has a mediating effect between occupational stress and anxiety symptoms in medical staff, but mainly direct effect.

Objective:To analyze the mediating effect of work-occupation fit between occupational stress and anxiety symptoms in medical staff.Methods:Convenience sampling method was adopted to select participants of one general hospital and three specialized hospitals as respondents for a questionnaire survey in Henan Province from October 2020 to January 2021. A total of 2050 medical staff were investigated, and 1988 valid questionnaires were collected, and the effective rate of the questionnaire was 97.0% (1988/2050) . The "Depression-Anxiety-Stress Scale" and "Worker-Occupation Fit Inventory" were used to evaluate the occupational stress, anxiety symptoms and worker-occupation fit level of medical staff, and the mediation effect of work-occupation fit on the relationship between occupational stress and anxiety symptoms was analyzed using a mediating effect model.Results:The average age of the 1988 medical staff was (32.7±7.8) years old, the positive detection rates of occupational stress and anxiety symptoms were 42.5% (845/1988) and 56.7% (1127/1988) , respectively. Anxiety symptoms of medical staff were positively correlated with occupational stress, negatively correlated with worker-occupation fit ( r=0.831, -0.364, P<0.001) , work-occupation fit was negatively correlated with occupational stress ( r=-0.259, P<0.001) . The results of the mediation effect analysis showed that occupational stress had a direct effect on anxiety symptoms ( β=0.677, BCa 95% CI: 0.648-0.707) , and worker-occupation fit ( β=0.047, BCa 95% CI: 0.039-0.056) , characteristic fit ( β=0.089, BCa 95% CI: 0.074-0.104) , need-supply fit ( β=0.075, BCa 95% CI: 0.062-0.089) , and ability-demand fit ( β=0.035, BCa 95% CI: 0.026-0.044) mediated the association between occupational stress and anxiety symptoms in medical staff, with the mediating effect as a percentage of 6.5%, 12.3%, 10.3%, and 4.8%, respectively. Conclusion:Worker-occupation fit has a mediating effect between occupational stress and anxiety symptoms in medical staff, but mainly direct effect.