Objective:Occult breast cancer (OBC) accounts for 0.3%-1.0%of all breast cancers. Because of the rarity of this dis-ease, its treatment and prognosis remain unclear. Our study evaluated the treatment outcomes and prognostic factors associated with OBC. Methods:A total of 82 patients diagnosed with OBC based on available criteria were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing, China, between January 1968 and June 2014. Except for 16 patients who were treated by needle biopsy or excisional biopsy only and were subsequently excluded, all of the cases reported were included in the study. Of the remaining 66 patients, one was male. Patient data, tumor characteristics, and treatment and outcome variables were evaluated. Overall survival (OS) and disease-free survival (DFS) were analyzed. A unicentric retrospective review of 66 patients with OBC was performed. Re-sults:The median follow-up was 75.5 months (7.0-328.0). No significant differences in OS and DFS were observed between patients who underwent mastectomy plus axillary lymph node dissection (Mast+ALND) and those who underwent breast conservation surgery (P>0.05). Univariate analysis revealed that nodal status is a significant prognosis factor of DFS (P=0.031). Conclusion:No significant difference in treatment outcomes between mastectomy+ALND and breast conservation surgery was observed. Nodal status may be an independent predictor of poor outcomes in OBC patients.

Objective To investigate the value of wide-detector Revolution CTA with 70 kV tube voltage and prospective ECG-gated technique in diagnosis of congenital heart disease (CHD) in infants and children.Methods Forty-five infants and children with complicated CHD underwent echocardiography and wide-detector Revolution CTA.According to the sur gical findings,the diagnostic efficiency of Revolution CTA and echocardiography were calculated and compared.The radiation effective dose (ED) and iodine dose were calculated.The quality of CT images was also evaluated.Results There were 25 separate cardiovascular anomalies including 6 congenital cardiac structure anomalies and 19 congenital extracardiac vascular anomalies.For congenital extracardiac vascular anomalies,there was significant difference of diagnostic accuracy and the detectable rate between CTA (99.77％ [853/855],97.73％ [86/88]) and echocardiography (98.71％ [844/855],88.64％ [78/88];x2 =6.28,5.72,both P＜0.05).The average of ED was (0.20±0.05)mSv and the mean iodine dose was (2.06± 1.09)g.All CT images were qualified for diagnosis.Conclusion The wide-detector Revolution CTA,with the prospective ECG-gated technique and 70 kV tube voltage,can provide high accuracy for assessment of CHD in infants and children,which can keep good image quality,with the low radiation dose.

Objective To explore the diagnosis value of X-ray breast imaging reporting and data system (BI-RADS) combined with wire-guided localization biopsy for breast microcalcifications in impalpable breast cancer.Methods 192 palpation negative patients with 205 microcalcification lesions were detected by mammography.All lesions were classified according to BI-RADS descriptors for calcification and were categorized by the BI-RADS.The patients with BI-RADS category 4a and above underwent X-ray positioning guide wire-guided biopsy and pathological diagnosis.Results In 205 microcalcification lesions,74 (36.1％) were malignant lesions,131 (63.9 ％) were less than benign lesions.The positive predictive value of malignant breast lesions in clustered,segmental,regional linear branching calcifications were higher [83.3 ％ (5/6),100.0 ％ (11/11),100.0 ％ (1/1)],followed by clustered,linear,segmental,regional pleomorphic calcifications [55.9 ％ (38/68),50.0 ％ (1/2),40.0 ％ (8/20) and 33.3 ％ (4/12),respectively].The positive predictive values of malignant in linear branching calcifications and pleomorphic calcifications were significantly higher than those of coarse heterogeneous calcifications,amorphous or indistinct calcifications (x2 values were 34.44,51.87,16.71,29.86,all P ＜ 0.05).The linear branching calcification had the highest possibility.The proportions of malignant lesions in four different types of glands were extremely dense 40.5 ％ (30/74),heterogeneously dense 39.2 ％ (29/74),scattered areas of fibroglandular density 10.8 ％ (8/74) and fat 9.5 ％ (7/74),respectively.Conclusions BI-RADS categorization for breast microcalcification lesions can improve the detection rate of impalpable breast cancer.Linear branching calcification has higher predictive value for malignant lesions.Dense breast is the risk factors of breast cancer,which should be attached great importance.

Objective To investigate the endoluminal ultrasonographie characteristics of adenoearcinoma and mucous adenocareinoma of the rectum. Methods The ultrasonographie characteristics of thirty eases of advanced adenoeareinoma of the rectum and twenty-eight eases of rectal mucous adenoearcinoma were analyzed retrospectively in comparison with their eorresponding pathologic images. Results In advanced adenocareinoma of the rectum, 28 eases manifested rough endoluminal surface, of which 19 marked by thickened changes without arrangement of layers, 10 had indistinct arrangement of layers in some areas and one had clear arrangement of layers. In the deepest margin of infiltration, 17 eases manifested sentus, homed or knot-like protuberance, while 5 marked by wavy margins, and 8 cases had clear and fiat margins. In 25 eases of rectal mucous adenocareinoma, 20 manifested smooth endoluminal surface. With regard to infiltration of tumors to rectal wall, 6 cases manifested clear arrangement of layers, while 13 had clear arrangement of layers in part and 6 had no clear arrangement. In the deepest part of infiltration, 8 eases manifested slippery and fiat margins and 10 manifested wavy margins and 7 had a few sentus, homed or knot-like protuberance locally. According to ultrasonic results of the depth of infiltration to rectal wall in comparison with pathologic findings, 25 eases were diagnosed accurately, while in two cases the diagnosis was too shallow and in three eases it was too deep. In rectal mucous adenocarcinoma, 10 cases got correct diagnosis and 14 were diagnosed superficially and one got too deep. The accuracy of ultrasonic diagnosis on rectal mueoas adenoearcinoma was apparently lower than that of adenoeareinoma and most of the misdiagnosis were too superfieiai. Conclusion There are different ultrasonographie characteristics of rectal adenoeareinoma and rectal mucous adenoeareinoma, which can be helpful for the typing of rectal carcinoma and avoiding excessively superficial misdiagnosis.

The study of gene mutations in leukemia has made great progress during the past decade,which brought innovative changes in understanding of the biological nature and development law of various leukemia.It improves not only the diagnosis,classification and prognosis of leukemia,but also the development of targeted drugs and therapy,which has greatly improved treatment of various types of leukemia.Research on gene mutations is still a hot topic in the 56th American Society of Hematology (ASH) annual meeting in 2014.Research progress in this area and related reports in the 56th ASH meeting will be introduced together with the authors' work experience in this article.

Objective:This study was conducted to evaluate whether or not immediate breast reconstruction influences quality of life and patient body image satisfaction outcomes among Chinese women with breast cancer compared with modified radical mastecto-my. Methods:Sixty patients with breast cancer and were operated from July 2011 to July 2012 in Cancer Institute&Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were included. These patients were divided into two groups:Ⅰ(30 patients) underwent modified radical mastectomy andⅡ(30 patients) underwent mastectomy with immediate breast reconstruction. Pa-tient satisfaction with breast reconstruction was evaluated by functionally assessing cancer therapy-breast cancer scale (FACT-B) and the scales that we designed. Results:No significant differences were observed between the two groups in terms of baseline characteris-tics, histopathological characteristics, and incision conditions (P>0.05). The patients in groupⅡ(immediate breast reconstruction) ex-hibited improved body image satisfaction outcomes (41.1 ± 10.8 vs. 33.2 ± 8.8, P=0.003);this difference was still observed after adjust-ment for confounding factors was performed by multiple linear regression. No significant difference was found between the two groups in terms of total FACT-B score and psychological evaluation score (P>0.05). Conclusion:Chinese women who prefer immediate breast reconstruction exhibited an improved body image satisfaction.

Objective To evaluate the security and biocompatibility of a new kind of absorbable high-strength PDLLA-CPP composite, which is used for internal fracture fixation. Methods According to the national standard of the procedure of appraise in food security and toxicology, micronucleus test of bone marrow cell, spermatic aberration test, chromosomal aberration test, and teratogenic test were measured with IP maximal tolerance dose of maceration extract from PDLLA-CPP composites. Meanwhile, chondrocyte culture with PDLLA-CPP composite was used to evaluate the effect of PDLLA-CPP composite on cartilage cell proliferation. Results Micronucleus test of bone marrow cell, spermatic aberration test, chromosomal aberration test, and teratogenic test were not affected by IP maximal tolerance dose of PDLLA-CPP maceration extract. PDLLA-CPP composite also had no cytotoxicity on cartilage cell proliferation. Conclusion PDLLA-CPP is a new and safe medical material with good biocompatibility and absorbability.

With dwindling number of new antibiotics and inappropriate use of antibiotics, the emergence and spread of antibiotics resistance occurs commonly in healthcare institutions worldwide. In China, antibiotics are commonly overprescribed and misused. This study is to assess the effect of the nationwide special campaign on antibiotic stewardship program (ASP) at specialized hospitals in China by investigating prescription information from 2011 to 2012. Data on the hospital consumption and prescription of systemic antibiotics were obtained from four specialized hospitals, including maternity, children's, stomatological and cancer hospitals. Systematic random sampling was used to select outpatient prescriptions and inpatient cases. A total of 105 specialized hospitals in 2011 and 121 specialized hospitals in 2012 were analysed. The defined daily doses (DDDs) per 100 inpatient days, the percentage of antibiotic use in outpatient prescriptions, and the percentage of antibiotic use in inpatient cases were used as measurements of antibiotic use. The overall antibiotic use density in the selected hospitals decreased between 2011 and 2012 from 39.37 to 26.54 DDD/100 inpatient days (P<0.001). The percentage of antibiotic use in outpatient prescriptions (range: 24.12%-18.71%, P=0.109) and inpatient cases (64.85%-60.10%, P=0.006) also decreased within the two years. Significant changes were observed among regions and different hospitals within the two years. And antibiotic consumption was correlated with the type and size of specialized hospital in 2012, but not with the regions. This analysis of antibiotic consumption of specialized hospitals allows relevant comparisons for benchmarking and shows that national ASP has improved antibiotic rational use in China. The data will assist policymakers in formulating effective strategies to decrease antibiotic overuse and identify areas that require further work.

Objective To valuate the left ventricular function and myocardial fibrosis using Dopple tissue imaging(DTI) and integrated backscatter(IBS) in diabetic cardiomyopathy(DCM) rats. Methods Diabetes mellitus(DM) in healthy male SD rats was induced by single injection of streptozotocin (STZ,Sigma) into intraperitoneal at a dose of 65mg/kg body weight. Left ventricular fractional shortening (LVFS),ratio of peak early to late diastolic mitral inflow velocity(E/A) by color Doppler flow imaging-pulsed wave (CDFI-PW), ratio of peak early to late diastolic mitral annulus velocity (Ea/Aa) by DTI,myocardial calibrated IBS (IB%), cyclic variation of IBS(CVIB) by IBS, were determined in rats of 4,12 and 24 weeks after DM was induced. Heart weight index(HWI), Masson's trichrome staining, expression of connective tissue growth factor(CTGF) and activity of sarcoplasmic reticulum Ca2+ -ATPase(SERCA2a) in heart were measured, while the age-matched health rats served as control group. Results ① Diastolic dysfunction of left ventricular was found in diabetic rats detected by CDFI-PW(E/A<1) at the 4th week,and developed gradually. Pseudonormal filling(E/A>1) was found in major diabetic rats at the 24th week,which could be identified by DTI(Ea/Aa<1). The IB% of left ventricular posterior wall was significantly higher in diabetic rats than those in the control group( P<0.05), but the CVIB of the 24th week diabetic rats was lower(P<0.05). The LVFS had no great alteration in six groups(P>0.05).②Compared with the control group, the activity of SERCA2a was reduced, while HWI, collagen volume fraction(CVF),perivascular collagen area(PVCA) and the expression of connective tissue growth factor(CTGF) protein in heart were increased in diabetic rats (P<0.05), and correlation between IB% and HWI, CVF, PVCA,CTGF was significant (P<0.05). Conclusions DTI and IBS can assess early left ventrieular diastolic function and fibrosis of diabetic cardiomypathy in STZ-induced diabetic rats. DTI echoeardiography can identify "pseudonormal" mitral inflow patterns. DCM may be relatived with overexpression of CTGF and decreasion of SERCA2a activity.

[Objective] To investigate the anti-proliferative and apoptosis effect induced by Honokiol (HNK) on human myeloid leukemia cell line U937 cells in vitro.[Methods] After treated with different concentration of HNK,Hoechst33342 fluorescent staining was used to detect cell apoptosis;the growth inhibition ration of U937 cells and PBMCs were analyzed by MTT assay;the apoptosis ration was detected by flow cytometry;mitochondrial membrane potential was explored by rhodamine 123 stain;Caspase3/7 protein activity kit was used to test the Caspase3/7 activity;the Caspase-3 and Caspase-7 mRNA levels were detected by real-time fluorescent relative-quantification reverse transcriptional PCR (FQ-PCR).[Results] Honokiol could significantly inhibit the proliferation of U937 cells in terms of the indexes of IC50/U937 11.8 μg/mL and IC50/PBMCs 40.3 μg/mL,and the anti-proliferative effect was in a time and concentration dependent manner;Flow cytometry analysis manifested that Honokiol could induce U937cells apoptosis by Annexin V/PI double Annexin V/PI fluorescein stain;Honokiol significantly inhibited the mitochondrial membrane potential of U937 cells and enhanced the ability of Caspase3/7 and the mRNA expression levels,but not the PBMCs.[Conclusion] HNK can inhibit U937 cells proliferation and induce cells apoptosis via activating Caspase 3/7.