Objective To review the contents and effects of behavioral risk factor surveillance system (BRFSS) and analyzed the application of BRFSS,citizens' health condition and its related risk factors in China.Then summarize the related problems in using BRFSS.Methods The literatures about Chinese research of BRFSS were searched from four databases in China,and a qualitative analysis was conducted.Results 18 case control or cohort studies were involved in the final qualitative analysis,the results showed that there was a positive tendency of people' s health related knowledge.However,people' s improvement of health behavior was at a slow speed,and the most popular health related risk factors consisted of smoking,alcohol drinking,lack of physical exercise,unbalanced diets,overweight,etc.Conclusion By using BRFSS,people' s health status and related risk factors could be accessed with flexibility timely and accurately.Thus can make great contributions for accessing,analyzing and tracking health status and health behavior of the population,finding the targeted population and evaluating effectiveness of health intervention,and this will also be helpful for the performance of health promotion programs and formulation of health policy.In addition,new technologies should be added into survey approaches and guarantee of data quality.

Education should include two parts:teaching and learning.Therefore,during the course of medical ehtics teaching,if we want to get better teaching effect,besides the factor of teachers,we must make the students get interest in the studying of medical ethics and arouse the students' initiative and enthusiasm of studying.This thesis would discuss that in the following respects:enhancing the students'initiative and enthusiasm of studying;teacher's deep love for education enterprise and for students;person of exemplary virtue,example is better than precept;performing elicitation teaching method of developing the student's initiative and strictly avoiding cramming method of teaching

Objective To investigate the clinicopathologic characteristics and prognosis of triple negative breast cancer patients. Methods A retrospective analysis was performed for 1042 primary breast cancer patients admitted in the First Affiliated Hospital of Nanjing Medical University from January 2003 to December 2009.All breast cancer patients were categorized into three subgroups by immunohistochemistry:ERBB2 +,HR +/ERBB2 - and triple negative. Results Of 1042 breast cancer patients recruited,183 patients were in triple negative group.The rate of larger tumors ( greater than 2 cm in diameter) and grade Ⅲ in triple negative patients was higher than that in ERBB2 + and HR +/ERBB2 - patients (P ＜0.01 ).The positive rate of p53 status in ERBB2 + patients was higher than that in triple negative and HR +/ERBB2- patients (P ＜ 0.01 ).No significant differences were observed in other clinical variables.In survival analysis,more bone metastases were observed in HR +/ERBB2 - patients than in ERBB2 + and triple negative patients (P =0.006).However,no significant difference was observed in visceral metastases among the subgroups.There were significantly different recurrence-free survivals (RFS) among the three subgroups throughout the follow-up period ( P =0.029),the 5-year RFS of ERBB2 + was 80.3％,which was the worst in three groups. Conclusions Triple negative patients had higher rate of larger tumors (greater than 2 cm in diameter) and grade Ⅲ than that in ERBB2 + and HR +/ERBB2 - patients,while its 5-year RFS was higher than ERBB2 + patients.

ObjectiveTo study the scope of excison in breast-conserving surgery for breast carcinoma.MethodsClinical data of 275 breast cancer patients undergoing breast-conserving surgery in t he First Affiliated Hospital of Nanjing Medical University,the Affiliated Zhenjiang Hospital of Jiangsu University and Changzhou Traditional ChineseMedicine Hospital were retrospectively analyzed.The operation procedure and postoperative adjuvant therapy were carried out with the same protocol.Local and general conditions of patients were followed up regularly.Results271 out of 275 patients got follow-up.The follow-up rate was 98.5％.The follow-up time ranged from 1 month to 117 months,median follow-up time was 34 months.Six patients died of distant metastasis,2 with local recurrence.The 1-year,3-year,and 5-year overall survival rates were 99.5％,98.1％,and 95.7％,respectively.ConclusionsIt is safe to excise 1 cm normal breast tissue with clear margin confirmed by frozen section,followed by postoperative adjuvant therapy,endocrine therapy,and radiotherapy,this improves the life quality of patients with breast cancer.It is safe and effective to determine whether the disease is multicentric or multifocal by mammogram plus clinical breast examination.

Objective:To explore any effect of electroacupuncture (EA) at the Baihui (DU20) and Dazhui (GV14) acupoints on the learning and memory of rats modeling cerebral palsy (CP), and on the miR-126 regulated VEGF/Notch1 pathway.Methods:Fifty-four male Sprague-Dawley rats 7 days old with an average weight of (20±5g) were randomly divided into a sham operation group, a model group, and an electroacupuncture group, each of 18. All except the sham operation group had a model of CP induced using left common carotid artery ligation combined with hypoxia. Twenty-four hours after successful modelling, the EA group received 14 sessions of electroacupuncture at the DU20 and GV14 acupoints, once every other day. On the 29th day, learning and memory ability were evaluated using a Morris Water Maze. The expression of vascular endothelial growth factors (VEGF and VEGFR-2) was detected using immunohistochemical staining. The levels of notch1 and hes1 protein were quantified using western blotting, and the expression of miR-126 RNA was quantified using reverse transcription polymerase chain reactions (RT-qPCRs).Results:Compared with the sham group, there was a significant decrease in the average learning and memory, and the level of miR126 in the model group, but a significant increase in the expression of VEGF and VEGFR-2 and the levels of notch1 and hes1. Significant improvement was observed in all of the measurements of the EA group compared with the model group.Conclusions:Electroacupuncture at the DU20 and GV14 acupoints can improve the ability of learning and memory of rats modeling CP. The mechanism may be related to regulation of the VEGF/notch1 pathway by miR-126 and its promotion of angiogenesis.

The excretion characteristics of stilbene glycoside (THSG) and its beta-cyclodextrin inclusion in bile, urine and feces after oral administration to rats were studied. Bile for 24 h, urine and feces for 72 h were collected. The content of THSG was determined by HPLC-UV. The established HPLC-UV method was available for the analysis of THSG in excreta and corresponded to the requirement of biological sample analysis. After given THSG and its beta-cyclodextrin inclusion, the amount of prototype THSG in feces were 3.27% and 0.61%, meanwhile THSG in bile were 0.20% and 0.18%, respectively. Only a little THSG was found in urine. The result showed that beta-cyclodextrin inclusion reduced the fecal excretion of THSG. However, the characteristic of urinary and biliary excretion wasn't changed.
Administration, Oral ; Animals ; Bile ; metabolism ; secretion ; Biological Transport ; physiology ; Chromatography, High Pressure Liquid ; methods ; Feces ; Glycosides ; chemistry ; Inclusion Bodies ; secretion ; Injections, Intravenous ; Male ; Rats ; Rats, Sprague-Dawley ; Stilbenes ; administration & dosage ; chemistry ; beta-Cyclodextrins ; metabolism

The incidence of nonsynostotic plagiocephaly in infants is increasing year by year. This article reviews the etiology, types, early assessment, monitoring and diagnosis, and nursing intervention of nonsynostotic plagiocephaly, aiming to further improve the awareness and attention of medical staff and caregivers of infants to nonsynostotic plagiocephaly and achieve early identification and intervention, so as to improve the adverse outcomes of nonsynostotic plagiocephaly.

Objective To investigate the regulatory mechanism of Notch signaling pathway by YAP in non-alcoholic steatohep-atitis(NASH)liver fibrosis,and assess the intervention effect of Cigu Xiaozhi prescription in detoxification and phlegm treatment.Methods C57BL/6J mice were randomly divided into different groups,including a normal group,NASH liver fibrosis model group,verteporfin(VP)intervention group,VP+Chinese medicine(Cigu Xiaozhi prescription)low-dose group,VP+Chinese medicine high-dose group,and dimethyl sulfoxide control group.The methionine/choline-deficient diet combined with low-dose CCl4 was used to construct the NASH liver fibrosis model.The degree of liver fibrosis was evaluated using hematoxylin and eosin(HE)and Masson staining.Four protein factors associated with liver fibrosis were detected using enzyme-linked immunosorbent assay,and hydroxyproline levels in the mouse liver was determined using the alkaline water method.The localization of α-SMA,ColⅠ,YAP,and Notch1 proteins in the liver was determined using immunohistochemistry.Additionally,the mRNA and protein expression levels of the Notch signaling pathway molecules,namely Notch1/2,J agged1,and DLL4,were assessed using real-time quantitative PCR and Western blotting analyses,respectively.Results The HE and Masson staining results revealed that the liver cells of NASH liver fibrosis mice were swollen and the cytoplasm was transparent.Additionally,evident fibrosis was observed in the hepatic lobule,portal area,and sinus;it was accompanied by heightened levels of inflam-matory cell infiltration,a large number of fat droplets,and instances of local hepatocyte necrosis,dissolution,and cirrhosis.The four factors associated with liver fibrosis showed a substantial increase(P<0.01).α-SMA,ColⅠ,YAP,and Notch1 were localized in the cytoplasm of hepatocytes.YAP,Notch1/2,and Jagged1 were highly expressed in the liver(P<0.01)but were downregulated after intervention with VP and VP+high and low doses of Cigu Xiaozhi prescription(P<0.05).Meanwhile,DLL4 factor was upregulated in the VP+high-dose of Cigu Xiaozhi prescription group(P<0.05).Conclusion YAP may inhibit activation of the Notch pathway by downregulating Notch1/2 and Jagged1 and upregulating DLL4,thereby interfering with the occurrence of liver fibrosis in NASH.Treatment with Cigu Xiaozhi pre-scription may inhibit Notch signaling pathway activation by downregulating YAP,Notch1/2,and Jagged1 and upregulating DLL4 through its multi-components and multi-targets properties,ultimately slow the progression of liver fibrosis in NASH.

OBJECTIVETo investigate the possibility and short-term effect of high dose chemotherapy with peripheral blood stem cell support in the preoperative therapy of breast cancer, and-its influence on the following operation and would healing.

METHODSThree patients with T(3)N(1)M(0) (III(a)), T(4)N(1)M(0) (III(b)), T(4)N(1)M(1) (IV) of breast cancer were diagnosed histopathologically. After receiving HDC/APBSCT, the 3 patients were operated on. HDC/APBSCT process included 2 cycles of FEC induction chemotherapy; PBSC mobilization, APBSC collection and cryopreservation and PBSC infusion; and high-dose chemotherapy, APBSC infusion and supportive therapy. The therapy consisted of CTX2.5 g/m(2), VP-16 600 mg/m(2), and cerboplatin 600 mg/m(2) delivered on day 1, APBSC infusion 48 h later, rhG-CSF (150 microg, BID) was administered 4 h after infusion of APBSC until WBC was higher than 10 x 10(9)/L. During HDC/APBSCT, the patients were protected in the air laminar flow room with supportive therapy of antibiotics, anti-virus and anti-fungus drugs. They left the air laminar flow room after their WBC was greater than 2 x 10(9)/L. Case 1 was treated by radical mastectomy, Case 2 by improved radical mastectomy, Case 3 by improved radical mastectomy and transplantation of skin for the large area.

RESULTSRapid recovery of bone marrow function was observed in all 3 patients. Operation was performed 4 weeks after HDC/PBSCT in Cases 1, 2 and 33 days in Case 3. No influence was seen on operative procedure and would healing, especially in Case 3 with a large area of skin transplantation. Two patients with stage III(a) and III(b) have been alive since the treatment for 30 months and the other with stage IV died of brain metastasis 16 months later.

CONCLUSIONSHDC/APBSCT as a preoperative therapy for breast cancer has no influence on the coming surgery and would healing, even on skin transplantation for a large area. It has a practical response in stage III(a) and III(b), but it is still controversial in stage IV. This method as a salvage therapy for patients with breast cancer of intemuediate or stage.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; therapy ; Combined Modality Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Mastectomy, Radical ; Middle Aged ; Neoplasm Staging ; Preoperative Care ; Salvage Therapy