Multifocality and multicentric breast cancer (MMBC) has been attached remarkable importance.The diagnosis of MMBC is of great importance for breast cancer individualized management,particularly regarding the choice of surgical method.A discovery of MMBC may be verified decisions to perform a wider excision which will avoid the appearance of positive margins.As for the results of conservative surgery developed by MMBC,however,contradictory conclusions exist in the related documents.No general common has been reached.MMBC may also alter the solution of the axillary basin.

As a pattern of manifestation of cerebral small vessel disease,cerebral microinfarct(CMI) is a very common neuropathological change in old people. It is significantly correlated w ith cognitive decline and dementia. This article review s the meuropathology, neuroimaging and clinical significance of CMI.

Objective To analysis newborn stage and long-term physiological and neuropsychological development in children born after assisted reproductive technology(ART),and to evaluate the safety of ART.Methods Eighty-four 6-month-old to 6-year-old children born after ART performed from January 1st,2006 to June 30th,2011 in Reproduction Center of Fuzhou General Hospital were taken as ART group; and 84 matched children born after spontaneous conception were as control group.The physiological and neuropsychological states of these children in their newborn stage and 6-month-old to 6-year-old duration were compared with Chi-square or t test.Results There was no statistical difference in childbearing age of mothers,the prevalence of gestational diabetes mellitus and hypcrtensive disorder complicating pregnancy,delivery mode,living environment,parents' education level,newborn birth length,birth weight,the rate of premature birth,low birth weight,asphyxia and hospitalized to neonatal intensive care unit between two groups (P＞0.05).In ART group,the incidence of growth retardation and abnormal social life skills was 6.0 ％ (5/84) and 1.2 ％ (1/84),and no statistical difference were found comparing with control guoup [4.8％(4/84) and 1.2％(1/84),x2 =0.12 and 0.00,P＞0.05],neither the developmental quotient (95.9±6.1 vs 94.8±5.1,t=1.25,P=0.21).Twins had higher rates of preterm birth [41.8％ (33/79) vs 10.1％(9/89),x2 =22.37,OR=6.38,95％CI:2.81-14.50,P=0.00],low birth weight [51.9％(41/79) vs 6.7％(6/89),x2=42.35,OR=14.93,95％ CI:5.84-38.16,P=0.00],asphyxia [10.1 ％ (8/79) vs 1.1 ％(1/89),x2 =6.69,OR=9.92,95％ CI:1.21～81.15,P=0.01],hospitalized to neonatal intensive care unit [36.7 ％ (29/79) vs 14.6 ％ (13/89),x2 =10.90,OR =3.39,95％CI:1.61-7.14,P=0.00] and growth retardation [11.4％(9/79) vs 0.0％(0/89),x2=10.71,RR=0.11,P=0.00] than singleton.Conclusions ART has no negative effects on children's physical and neuropsychological development.It could increase the incidence of twins,so that it might increase the incidences of preterm labor and low birth weight,which might affect the long-term physical and neuropsychological development of the offspring.

Objective To study on antibacterial effect of active ingredient of se-enriched Macleya cordata.Methods Penicillin sodium and saline as control, detected the average inhibition zone diameter of se-enriched Macleya cordata group ( containing 0.96 mg/mL sanguinarine) on 9 common bacteria with disc agar diffusion method;20% methanol and saline as control, se-enriched Macleya cordata group which the average inhibition zone diameter was minimum, without se-enriched Macleya cordata group and penicillin sodium were diluted with 20% methanol, made concentration of 0.48, 0.24,0.12,0.06, 0.03 mg/mL.minimal inhibitory concentration ( MIC) of each treatment group was determined by agar dilution method, evaluated antibacterial effect of se-enriched Macleaya cordata group.Results se-enriched Macleya cordata group could improve antibacterial effect significantly, the average inhibition zone of 100 μg/mL sodium selenite treatment group was minimum(Φ15.33 mm);MIC of se-enriched Macleya cordata group on E.coli O1 , E.coli P22 , E.Dublin reduced from 0.96 to 0.24 mg/mL;MIC of S.typhimurium and S.suipare were 0.12 mg/mL;MIC of S.aureus and S.suis were 0.06 mg/mL; MIC of E.Dublin and L.murrayi were less than 0.03 mg/mL.Conclusion Se-enriched Macleya cordata improves the antibacterial effect signififcantly, and it lays the theoretical foundation for development and utilization of se-enriched Macleya cordata for future.

Objective To observe the influence of diabetes educationon the treatment compliance and quality of life (QOL) of diabetics and to find out the influencing factors of diabetics' QOL. Methods This study applied the questionnaire of compliance and the SF-36 to make an investigation on diabetics. Ninety diabetics who participated in the course of diabetes education during the period from October 2008 to March 2009, and 205 diabetics who were seen in the first affiliated hospital of China Medical Universitybut never participated in the course of diabetes education during the period from September to October of 2008. By comparing the data with control group and using self-paired comparison, the influence of diabetes education on the treatment compliance and the QOL of diabetics was studied. The factors influencing the QOL of each dimension were analyzed by means of single or multiple regressions. Results The treatment compliance of patients was improved with the number of times that these patients participated diabetes education was increased (P<0.05). The treatment compliance of the patients in hospital who had not participated in diabetes education was improved temporarily. However, 2 weeks after these patients were discharged the treatment compliance of these patients had began to decline. The treatment compliance would be declined if patients discontinued participating education for a long time. After 24 weeks intevention, the total score of compliance of intervention group (42.44±4.10) was higher than control group (35.60±3.90), and also higher than the intervention group before intervention (34.56 ± 4.34) (all P<0.01). The scores of 5 dimensions were significantly different (P<0.05 or 0.01). Of 8 dimensions of intervention group, the scores of vitality, social functioning, role-emotional and mental health were all increased after intervention, with significant differences except for role-emotional (P<0.05). The mental health index of patients with long-term health education was increased to a certain degree. Conclusion Long-term health education plays an active role in treatment. Insisting on taking part in health education regularly can improve the quantity of mental health.

In recent years, lower and lower class attendance has plagued the quality of uni-versity teaching. To solve this problem, this study conducted a questionnaire survey in accordance with the concepts of the Education Reform microscopic systems engineering and the method of SIMPP. The results showed that factors affecting student classroom attendance included two aspects: the sub-jective and objective factors. Indicators related to the subjective factors were: the personal attitude when faced with failure exams, the personal learning interest and personal grasp of the main source of knowledge. Indicators related to the objective factors were: school and teachers. Also, this study gave some suggestions on how to improve students' classroom attendance to provide data basis and refer-ence for further study on class attendance.

College students' self cognition of the learning effectiveness influences their learning behavior greatly. Focusing on college students' self cognition of their learning effectiveness, and then standardizing their learning behavior is one of the important work of educators in colleges. Therefore this paper has designed the questionnaire of the influencing factors of learning effectiveness self cog-nition, used SIMPP analysis method to analyze it, and set up the relation model. The analysis shows that college students' self cognition of learning effectiveness is influenced not only by students' dili-gence level and the recognition degree of specialized subject, but also by the factors such as the attitude when you get the bad results. The result provides data basis and scientific basis for future practice and relevant research for educators in colleges.

Objective To investigate the value of clinical characteristics in diagnosis of vocal fold paralysis (VFP) and arytenoid dislocation .Methods Eighty - eight patients of VFP and 27 patients of arytenoid dislocation were studied , by comparing the causes , laryngeal morphologic characteristics and laryngeal electromyography (LEMG) .Results The causes of 88 VFP patients included surgery (45 cases) ,neck trauma(2 cases) ,idiopathic causes(16 cases) ,infection(16 cases) ,and tumor invasion - related(9 cases) .Of the 27 arytenoid dislocation pa‐tients ,24 had a history of endotracheal intubation and the others had a history of gastric tube insertion .The vocal folds were mostly fixed at the paramedian position ,followed by the abducent position and the median position .No significant differences were found in laryngeal morphologic characteristics between the two groups ,including vocal fold shape , glottis vertical symmetry , mucosal waves , supraglottic compensation , glottis closure and arytenoid movement .The LEMG of VFP patients appeared as denervation patterns ,reinnervation potentials ,or electrical si‐lence ;the recruitment patterns appeared as mix or simple patterns ;the evoked potentials were absent .Of the VFP patients ,54 cases(61 .36% % )were found synkinesis of involved posterior cricoarytenoid and two of them also in ‐volved thyroatenoid .The patients with synkinesis had lower percentage of vocal fold bowing and higher percentage of glottic vertical asymmetry compared to the ones without synkinesis .Of the VFP patients whose cause was surgery or neck trauma ,the median - position fixed vocal folds were mostly observed in the patients with duration of less than 1 month or with synkinesis .Of the 27 arytenoid dislocation patients ,20(74 .07% )showed normal LEMG pat‐terns and 7(25 .93% )showed apparent LEMG abnormality on the affected side .Conclusion The causes of vocal fold paralysis and arytenoid dislocation are different .Laryngeal morphologic characteristics have limitations in distinguis‐hing vocal fold paralysis from arytenoid dislocation .The shape and position of involved vocal folds of the VFP pa‐tients are correlated with duration ,nerve regeneration and synkinesis .

Objective To observe the near future curative effect and toxicity of the combination of weekly dose of cisplatin in the treatment of elderly patients with esophageal cancer intensity-modulated radiotherapy observa-tion.Methods 60 patients with locally advanced esophageal cancer patients aged by method randomly were divided into synchronous chemotherapy group( CRT group) and 30 cases of radiotherapy alone group( RT group) 30 cases,the two groups using 6MV-X ray intensity modulated radiotherapy,radiotherapy dose:DT 60 Gy/30/6 week.The CRT treated group was given cisplatin 20-25mg/m2 in the radiotherapy of second day,1 times per week,a total of 6 times. Results Radiotherapy and chemotherapy, radiotherapy group recent effective rate were 80.0% and 63.3%, the difference was statistically significant(χ2 =5.934,P<0.05),P< 0.05).The main toxicity was myelosuppres-sion,radiation esophagitis,basically I and II,no statistically significant difference between the two groups(P>0.05). Conclusion Intensity modulated radiotherapy combined with weekly dose of cisplatin in the treatment of elderly patients with esophageal cancer significant short-term effect,less adverse reactions,patient tolerance is good,which is worth the clinical promotion.

A method for the determination of B6-pyridoxamine (PAM), pyridoxal (PAL) and pyridoxine (POL) by RPLC was proposed. The procedure included the addition of 0.1M H2SO4 to the sample, hydrolysis for 30 min at 120℃, centrifuging, filtration and direct analysis by ODS Cl8 column. PAM, PAL and POL were completely separated, when the flow rate of the mobile phase (pH2.0-2.1) was 1.0-1.5ml/min. Quantitation by a fluorescent detector was performed with Exc: 293 nm and Em: 395 nm. The recovery ranged from 99 to 103% with CV 5.0-5.3%. The method was simple, rapid, sensitive and reproducible.