Objective To explore the clinicopathological characteristics in young women with breast cancer.Methods The clinicopathological data of 201 cases of breast cancer with age below 35 years from Apr.1997 to Apr.2010 in Anyang Tumor Hospital were retrospectively analyzed and compared with those of 251 cases of breast cancer patients selected randomly with age more than 60 years during the same period.All these cases had undergone surgical treatment and been confirmed by pathologist.Results In the young group,the percentage of patients with the course of disease less than six months was higher than that of the old-aged group [82.09 ％ (165/201),72.11％ (181/251)] (x2 =6.19,P ＜ 0.05).The incidence of the tumor size ≤ 2 cm in the young group was less than that of the old-aged group [19.90 ％ (40/201),30.28 ％ (76/ 251)] (x2 =6.302,P ＜ 0.05).The incidence rate of metastasis of lymph nodes in the young group was less than that of the old-aged group [63.68 ％ (128/201),54.19 ％ (136/251)] (x2 =4.145,P ＜ 0.05).The incidence rate of stage 0～ Ⅰ in the young group was more than that of the old-aged group [11.94 ％ (24/201),17.53 ％ (44/251)] (x2 =2.729,P ＞ 0.05).Conclusion The tumor size in the young group is larger than that in the old-aged group,pTNM classification in the young group is later than that in the latter group and the incidence rate of metastasis of lymph nodes in the young group is higher than that in the latter group.In young patients with breast cancer the percentage of tumors with advanced tumor stage and poor prognosis are more than that in elder breast cancer patients.In addition,these young patients have lower awareness to mammary adenocarcinoma.Young ladies should examine breast cancer by themselves and go to hospital for regular inspections in order to discovere,diagnose and treat cancer earlier.

Objective To investigate the clinical and pathological characteristics, diagnosis and differential diagnosis of uterine intravenous leiomyoma (IVL) , so as to improve the detection of the disease.Methods Five cases of IVL were retrospected, who were treated and diagnosed by clinical gross examination,morphologic features and immunohistochemical staining in Tumor Hospital of Anyang from 2011 to 2015.Results Symptoms of IVL were usually nonspecific, most patients experienced hypermenorrhea, abdominal pain or distension, and pelvic mass.Typical pathological changes were intravenous visible grey weblike or worm-formed nodules, which could be pulled out.Microscopically, the tumors were composed of mild spindle-shaped cells with rare mitotic figure and closely related to blood vessels.The tumors were positive for smooth muscle derived marker, progesterone receptor, estrogen receptor, and negative for S-100, HMB45 and CD34.However CD34 can displayed vascular endothelial cells around the tumor.Conclusion Uterine IVL is a benign tumor with malignant biological behavior, which has different clinical pathological features of leiomyoma ordinary.Surgery is the main treatment method.A satisfactory therapeutic effect can be achieved by selecting the appropriate extent of surgery.Long term follow up of iVL patients after operation is important.

Objective To discuss the influence of grading nursing care by physician-nurse cooperation decision-making on the quality of patient care and disease outcomes,and evaluate the application feasibility of nursing core system in this nursing mode.Methods 379 patients were admitted to departments of orthopedics and endocrinology from two hospital areas of our hospital from January 2011 to January 2012.Patients were divided into two groups according to nursing process.Patients who were given conventional grading nursing were set as the routine group,and patients receiving physician-nurse collaboration grading nursing were set as the collaboration group.The nursing quality and nursing efficiency,and the disease outcome of patients were compared between the two groups.Results The quality of care,the qualified rate of care plan implementation,the coverage rate of health education of patients and the patient satisfaction rate were higher in the collaboration group than those in the routine group.The performing rate of doctor's orders,the awareness rate of patient disease,the average length of hospital stay,compliance of medical orders and re-admission rate of patients with the same or a related disease within three months were significantly different between two groups.The collaboration group improved the matching degree of nursing grade with disease condition,understanding of professional knowledge,recording of nursing records,deficient nursing process,and communication ability of life knowledge,compared with those of the routine group.Conchusions Nursing grading mode by physician-nurse collaboration decision-making can obviously improve the defmition of grading nursing and the general treatment effect of patients,it significantly improved the quality of grading nursing.

Objective To investigate the diagnostic value of UL-16 binding protein 2 (ULBP-2,macrophage inhibitory cytokine-1 (MIC-1) for pancreatic cancer.Methods The serum samples of 152pancreatic cancer patients,20 precursors of pancreatic cancer,91 chronic pancreatitis patients and 96 age/sexmatched healthy persons were collected.The serum ULBP-2 and MIC-1 levels were determined by using the ELISA kit and were compared with level of CA19-9.A receiver operating characteristic (ROC) curve was constructed to evaluate their diagnostic values for pancreatic cancer.Results The serum levels of ULBP-2 in patients with pancreatic cancer,precursors of pancreatic cancer,chronic pancreatitis and healthy persons were (219.9 ± 182.5),(62.6 ± 11.4),(68.4 ± 36.8),(76.5 ± 40.9) μg/L,the corresponding values of MIC 1 were (3521.3±3903.4),(973.6±589.0),(959.6±879.0),(427.6±317.0) μg/L,while the corresponding values of CA19-9 were (1448.8 ± 3707.0),(12.0 ± 9.3),(38.2 ± 139.0),(7.7 ± 5.0)kU/L.The parameters in pancreatic cancer patients were significantly higher than those in control group (x2 =40.628,71.662,45.505,15.827,36.433,63.494,26.264,73.427,49.088,P ＜ 0.01).The area under ROC curves(AUC) of ULBP-2,MIC-1,CA19-9 were 0.909,0.864,0.818,and ULBP-2 was superior to CA19-9 and MIC-1,however the combined measurement of three markers produced the highest diagnostic yield(AUC =0.982).For early stage pancreatic diseases (precursors to pancreatic cancer and IA stage pancreatic cancer),AUC of ULBP-2,MIC-1,CA19-9 were 0.506,0.837,0.684,MIC-1 was superior to ULBP-2 and CA19-9,however the combined measurement of MIC-1 and CA19-9 produced the highest diagnostic yield(AUC =0.897).Conclusions Serum ULBP-2,MIC-1 levels are significantly elevated in pancreatic cancer patients.The combined measurement of ULBP-2,MIC-1 and CA 19-9 can increase the diagnostic yield for pancreatic cancer.

Objective To observe the effects of family cognitive training on patients with vascular cognitive impairment but without dementia.Methods Sixty patients with non-dementia type vascular cognitive impairment were divided at random into a group which received family cognitive training (30 cases) and a control group (30 cases).The 2 groups all took routine drugs and exercise.The family cognitive training group received cognitive training additionally.Before treatment and after 1 and 6 months of treatment,all of the patients of both groups were assessed using the mini-mental state examination (MMSE),the Montreal cognitive assessment (MoCA) and the modified Barthel index (MBI).Results After 1 month of treatment there was no significant difference between the 2 groups in any of the assessments.After6 months the scores on each item of the MMSE,MoCA and MBI had improved significantly more in the family cognitive training group than in the control group.Conclusion Family cognitive training is effective in treating non-dementia type vascular cognitive impairment.It can delay disease progression and improve cognitive function and ability in the activities of daily living.

Objective To investigate the molecular genetic causes and their characteristics of deafness from patients with nonsyndromic hearing loss in Gansu province.Methods Peripheral blood samples were obtained from a total of 375 patients with nonsyndromic hearing loss to extract genomic DNA.Three genes of GJB2, mitochondrial DNA 12SrRNA, and SLC26A4 were screened for mutations in our study cohort using SNPscan technology.Results Among 375 patients, 23 patients were found to carry the homoplasmic mtDNA12SrRNA A1555G mutation, and 2 patients were detected to carry the homoplasmic mtDNA12SrRNA C1494T mutation.Forty-two cases(11.2%) were caused by GJB2 mutations, including 31cases(8.3%) of homozygous mutations, 11 patients(2.9%) of compound heterozygous mutations, and 25 cases(6.7%) of single homozygous mutations.c.235delC was the most prevalent GJB2 mutation with the allele frequency of 8.8%.Twenty-nine cases (7.7%) were caused by SLC26A4mutations, including 17cases(4.5%) of homozygous mutations, 12 patients(3.2%) of compound heterozygous mutations, and 16 cases(4.3%) of single homozygous mutations.c.919-2A>G and c.2168A>G were the most common SLC26A4 mutation, the allele frequencies were 5.2% and 2.0%, respectively.Conclusion A high incidence of mtDNA12SrRNAA1555G mutation is found in nonsyndromic hearing loss patients from Gansu province, while the incidence of GJB2 and SLC26A4 mutations is similar to the level of the overall Chinese deaf population.These findings demonstrate that a total of 25.6% of deaf patients have inherited hearing impairment caused by GJB2, SLC26A4, and mitochondrialDNA12SrRNA mutations.As a result 36% patients and family member can acquire effective genetic counseling.

Objective To explore the feasibility and safety of early ambulation in patients with acute deep ve-nous thrombosis. Methods The literatures about early ambulation for acute venous thrombosis were collected and the quality of the literature was evaluated by two investigators independently. Results Thirteen published studies were recruited for systematic review,including 10 RCTs and 3 CCTs. The meta-analysis showed that compared with bed rest,early ambulation did not increase the incidence of secondary pulmonary embolism in patients with acute DVT[early activity:22/1408;bed rest:34/1417;RR=0.62,95%CI(0.37,1.03),and the incidence of DVT progression [early activity:48/1523;bed rest:45/1525;RR=0.85,95%CI(0.58,1.24)]. There were no statistically significant differ-ences in mortality,swelling,and pain relief in acute DVT patients. Conclusion Early ambulation did not increase the incidence of thrombus progression and secondary pulmonary embolism in patients with acute DVT compared with bed rest. Besides,early ambulation cannot relieve symptoms of swelling and pain in DVT patients. However,it can relieve the acute pain of DVT patients with moderate to severe pain.

Objective To explore the feasibility and effectiveness of interventional transcatheter destruction of the aortic valve to establish an animal model with acute aortic valve regurgitation. Methods Eight healthy goats were used for this study. A limited sternotomy approach was used to access the apex of the heart. Puncturing of the apex of the heart was performed to establish a wire track, then, under fluoroscopic guidance a 10 F sheath was inserted along this track of hard wire until to the ascending aorta above the aortic valve. The internal sheath was removed. Via the 10 F sheath a 10 mm occluder of ventricular septal defect (VSD) was introduced into the ascending aorta above the aortic valve. The sheath was pulled back to the left ventricle, while the occluder remained in the ascending aorta above the aortic valve. Then the occluder was quickly pulled back into the left ventricle in order to make some certain damage to the aortic valve. And an acute aortic valve regurgitation model was thus established. Angiography of ascending aorta above the aortic Among the 8 animals, two died of acute left ventricular failure on the spot due to excessive regurgitation blood flow after the operation. Macroscopically, damage of the aortic valve was seen. In the six survivors, angiography of ascending aorta above the aortic valve and Doppler echocardiography showed that moderate degree of regurgitation was detected in 5 and small amount of regurgitation in one. Two experimental goats with moderate degree of regurgitation died of heart failure separately at seven days and fifteen days after the operation. The remaining four experimental goats survived for more than three months. Follow- up checkups with echocardiography suggested the presence of mild- moderate degree of regurgitation. Conclusion Acute aortic valve regurgitation model in experimental goats can be established through transapical transcatheter damage of aortic valve by quickly pulling back a VSD occluder which has been placed in the ascending aorta above the aortic valve. This method is clinically feasible, technically simple and repeatable, the result is reliable, and the degree of regurgitation is controllable.

Background:Colorectal polyps,especially adenomatous polyps are the precusor of colorectal cancer. Screening and polypectomy by using colonoscopy is an important approach for prevention of colorectal cancer. Aims:To conduct a retrospective analysis among 1 613 cases of patients with colorectal polyps in Jiading District,Shanghai,China for guiding the management of colonoscopy surveillance of colorectal polyps. Methods:A total of 2 652 colorectal polyps detected by colonoscopy from Jan. 2013 to Aug. 2014 in the Endoscopy Center of Shanghai Ruijin Hospital Northern Branch were recruited in the study. Clinicopathological features of the polyps,coincidence rate of biopsy pathology and polypectomy pathology,and the re-detected polyps in colonoscopic follow-up were analyzed. Results:In 2 652 colorectal polyps,1 996 (75. 3% )were located in distal colon;adenomatous polyps accounted for 77. 5%(2 056 / 2 652)of the polyps detected by colonoscopy,of which 804(39. 1% )were found to have intraepithelial neoplasia. Both biopsy pathology and polypectomy pathology were obtained in 447 polyps,with an overall coincidence rate of 60. 4% ;as for adenomas,the coincidence rate was 68. 1% . Two hundred and eighteen pathologically proved polyps were found in a 1. 5-year colonoscopic follow-up, among which 74. 3% were adenomatous polyps;the re-detection rate of polyps located in proximal colon or less than 1. 0 cm in diameter was significantly higher than polyps located in distal colon and more than 1. 0 cm in diameter, respectively(12. 3% vs. 6. 9% and 9. 0% vs. 4. 5% ,P all < 0. 01). Conclusions:Adenomatous polyps account for high proportion of colorectal polyps detected by colonoscopy. Pathological examination of resection specimens and periodical follow-up are important for patients with colorectal polyps after endoscopic polypectomy.

OBJECTIVE To investigate the incidence of the mitochondrial DNA 12SrRNA A1555G and connexin 26 gene (GJB2) in Chinese northwest population with nonsyndromic sensorineural hearing loss,and to explore the relationship between mitochondrial DNA A1555G and mutation of GJB2 gene. METHODS Blood samples were obtained from 221 patients with nonsyndromic sensorineural hearing loss in Northwest of China; Genomic DNA was extracted from the isolated leukocytes ; Screening the mitochondrial A1555G mutation by PCR-Alw26l digestion and sequence analysis, PCR and direct sequencing were used to analyze the coding region of GJB2 gene. RESULTS The homoplasmic A1555G mutation was found in 21 individuals of 221 patients,17 of these 21 patients had been treated with aminoglycosides. Eleven different variants of GJB2 were found in all patients ,the disease-causing mutations of GJB2 were 44 individuals in these patients(44/221), The mutation 235delC is found in 54.54 % of all disease-causing mutations ; Among 21 patients with the A1555G mutation, 11 cases were found polymorphic change in GJB2 gene ,only 1 case had V37I heterozygous mutations ,other 9 cases were not found any nucleotide changes of GJB2 gene. CONCLUSION The mtDNA 12SrRNA A1555G mutation has a high incidence in Chinese northwest population with non-syndromic sensorineural hearing loss.The 235delC mutation in the GJB2 gene is most frequent mutations responsible for non-syndromic hearing impairment in this region .It is unlikely that the GJB2 gene is a major modulatory factor for hearing loss due to the A1555G mutation in Chinese population.