Objective To analyze the clinical value of ultrasound elastography (UE) in qualitative diagnosis of breast tiny (≤ 10 mm) substantive lesions.Methods The clinical UE examination data of recent clinical pathology diagnosis of 82 cases of breast tiny lesions were analyzed retrospectively,and compared with pathology results for statistical analysis.Results With the lesions nature was different,the UE elasticity score of breast parenchymal lesions wasdifferent,the UE overall detection rate of breast small lesions was 93.7％ (89/95).Four points 1 lesion misdiagnosed,pathologic diagnosis of mammary gland fibroma and calcification.Three points 5 lesions misdiagnosed,pathological diagnosis were 1 of invasive ductal carcinoma,2 of intraductal carcinoma in situ,2 of invasive lobular carcinoma.The detection rate of tiny breast cancer was 80.0％ (20/25).There was no significant difference between UE and the pathological diagnosis (P＞ 0.05).Elastic strain rate in the tiny benign and malignant breast lesions had significant difference (P ＜ 0.05).Conclusion UE and real-time strain techniques have larger clinical diagnosis value in breast tiny substantive lesions,and a certain complementary role for the lesions which are difficult to diagnose.

Autoimmune polyendocrinopathy syndrome type Ⅰ( APS-Ⅰ) is a rare autosomal recessive disorder caused by mutations in autoimmune regulator gene( AIRE) . A number of mutations have been described in the AIRE gene of patients with APS-Ⅰ, including nonsense mutation, missense mutation, silent mutation, splice site mutation, insertions and deletions mutation, et al. The mutation characteristics of the APS-Ⅰ pathogenic gene have been reviewed in the article.

OBJECTIVE:To observe clinical efficacy and safety of naloxone hydrochloride combined with Danshen injection in the treatment of neonatal hypoxic ischemic encephalopathy(HIE). METHODS:104 patients with HIE were randomly divided into observation group and control group with 52 cases in each group. The control group was treated with Naloxone hydrochloride injec-tion 0.02 mg/kg,ivgtt,qd and conventional symptomatic treatment;while observation group was additionally treated with Danshen injection 4-6 ml+10% Glucose injection 20 ml,ivgtt,qd,on the basis of the control group. Treatment course of 2 groups lasted for 7 d. Clinical efficacy,symptom and sign recovery of 2 groups were compared,as well as levels of serum MMP-9,IL-6 and TNF-α,cerebral hemodynamic parameters and ADR. RESULTS:There was no statistical significance in MMP-9,IL-6,TNF-α and cerebral hemodynamic parameters before treatment(P>0.05). The total effective rate of observation group(92.31%)was signifi-cantly higher than that of control group (75.00%);after treatment,the recovery time of consciousness disturbance,primitive re-flex and muscle tension in the observation group were shorter than those in the control group;the levels of serum MMP-9,IL-6 and TNF-α in observation group were significantly lower than those in control group;peak systolic flow velocity(PSFV),end-dia-stolic flow velocity (EDTV) were higher in the observation group than in the control group,with statistical significance (P<0.05);resistance index (RI) was lower than in control group,but without statistical significance (P>0.05). No ADR was ob-served in 2 groups. CONCLUSIONS:Naloxone hydrochloride combined with Danshen injection can significantly promote HIE and signs recovery,reduce the levels of serum MMP-9,IL-6 and TNF-α,and improve hemodynamic parameters with good safety.

OBJECTIVE:To study the current situation and developing trend of the antidiabetics used in Guangdong re?gion.METHODS:The antidiabetics used in44hospitals in Guangdong region during the period2000～2003were analysed concerning the kinds of drug,sum of money for consumption and frequency of drug use.RESULTS:The sum of money for consumption of antidiabetics increased year by year so did its proportion in sum of money for consumption of total drug.Among them,consumption of insulin increased very quickly and oral antidiabetics assumed a tendency of increase as well.CONCLUSI_ ON:The variety of insulin is stable and new oral antidiabetics is going into market occasionally in this region,but frequency of use is primary to sulfonylurea,biguanides and glycosidase-inhibitors.

Objective To study the management of femoral artery pseudoaneurysm caused by heroin (injection).Methods 11 cases of femoral artery pseudoaneurysm were treated. 4 cases presented with ruptured aneurysm and were treated emergently by direct ligation of the aneurysmal artery through a femoral incision. 2 cases (underwent) elective operation in which the iliac artery was initially exposed through an extraperitoneal (lower) (abdominal) incision to control bleeding, and then the aneurysmal artery was ligated through a femoral (incision).Results All of the operations were successful, and no gangrene of the affected limb occurred.(Conclusions) Arterial ligation for femoral artery pseudoaneurysm caused by heroin injection is simple and (effective). (Intraoperative) observation of distal arterial backflow,measurement of (arterial) pressure and (intraoperative) (arteriography) can improve the safety of the operation.

OBJECTIVE:To study the cost-effectiveness of4dose regimens in treating chronic prostatitis/chronic pelvic cavity pain syndrome(CP/CPPS).METHODS:A total of140patients with CP/CPPS were randomly divided into4groups:Baiyanjing tablets and tamsulosin hydrochloride modified release capsules were administered for Group A;minocycline micro pills and alfuzosin retard tablets for Group B;rexithromycin tablets and doxazosin mesylate controlled release tablets for Group C;and levofloxacin tablets and terazosin tablets for Group D.The cost-effectiveness analysis was performed using pharma?coeconomics.RESULTS:The costs for the Group A,B,C and D were268.8yuan,641.8yuan,660.8yuan and666.4yuan,respectively.The effective rates were71.4%,91.4%,88.6%and91.4%,respectively.The cost-effectiveness ratios were3.76,7.02,7.46and7.29,respectively.The incremental cost-effectiveness ratios of Group B,C and D were18.65,22.79and19.88,respectively as against Group A.CONCLUSION:The treatment cost of CP/CPPS was composed of2parts:an?tibiotics? 1 -receptor blockers.Doctors should make an optimum choice based on patients'previous medication,economic status and physical condition,etc.

Objective To find out the brain function characters of visual information integration and visual working memory with attention deficit hyperactivity disorder (ADHD) children. Methods 1∶ 1 case-control study was used on the study. 45 ADHD children who met DSM-IV criteria were recruited as case group,45 normal children from primary school were chosen as control group. Two groups children received the test of contour-integration,positional noise, temporal order memory, pattern memory. Results The ADHD double eyes' contour integration ( ( 1.62 ± 0. 81 ), ( 1.69 ± 0.87 ) ) were significantly lower than the control group' ( (2.02 ± 1.10), ( 1.98 ±0.81 )). There was no significant difference of double eyes' positional noise between case group( (1.98 ±0.89 ), ( 2.20 ± 1.10 ) ) and the control group ( ( 2.20 ± 0. 97 ), ( 2.30 ± 0. 83 ) ). The temporal order memory,pattern memory ( ( 1.89 ± 1.30), ( 1.18 ± 0.44) ) showed significantly lower in case group(P＜ 0.05 ) than that in control group ( ( 2.98 ± 1.25 ), ( 1. 44 ± 0. 66) ). Conclusion Results indicate that children with ADHD have deficiency in visual perception and the ability of visual information integration, and have significantly deficiency in visual working memory and executive-function.

Objective To explore the effects of virtual reality (VR) combined with motor imagery therapy on the upper limb function of hemiplegic stroke survivors.Methods Thirty-nine hemiplegic stroke patients were divided randomly into a treatment group (n =20) and a control group (n =19).Both groups were treated with motor imagery therapy,but the treatment group also received VR training lasting 20 min/day,6 days/week for 8 weeks.All of the patients were assessed with the Fugl-Meyer (FMA) upper limb assessment,the modified Barthel index (MBI) and electromyography at the beginning and after eight weeks of treatment.Results Before the intervention there was no significant difference between the groups in any of the assessments.After eight weeks of treatment,all the assessment results in the treatment group were significantly better than those in the control group.Conclusion Virtual reality combined with motor imagery therapy can distinctly improve the upper limb motor function of hemiplegic stroke survivors and their ability in the activities of daily living.

ObjectiveToinvestigatetheprotectiveeffectandmechanismofscutelarincombinedwith paeoniflorin after permanent cerebral ischemia in rats. Methods Forty-eight adult male SD rats w ere randomly divided into four groups: sham-operation, cerebral ischemia, scutelarin+ paeoniflorin, and cyclopamine (n=12 in each group). A model of permanent middle cerebral artery occlusion w as induced by suture method. The intraperitoneal injection of cyclopamine 6 mg/kg, a specific inhibitor of sonic hedgehog (SHH) pathw ay, at 15 min before ischemia in the cyclopamine group, w hile other groups w ere intraperitoneal y injected an equal volume of saline. At 0 hour and 3 hours after ischemia, the scutel arin+paeoniflorin group and cyclopamine group w ere intraperitoneal y injected scutel arin ( 20 mg/kg ) and paeoniflorin (30 mg/kg), while other groups were intraperitonealy injected an equal volume of saline. Neurological deficit scores w ere performed at 24 hours after ischemia, and then the rats w ere decapitated. The cerebral infarct volume w as measured by using 2,3,5-triphenyltetrazolium chloride (TTC) staining. Real-time fluorescent quantitative polymerase chain reaction and Western blotting w ere used respectively to detect the expression levels of SHH, Patched-1, Gli-1 mRNAs and proteins in the ischemic cortex. Results The neurological deficit scores in the cerebral ischemia group, scutel arin+paeoniflorin group, and cyclopamine group w ere 3.33 ±0.52, 1.50 ±0.55, and 3.67 ±0.52, respectively. The neurological deficit score in the scutel arin+paeoniflorin group w as significantly low er than that in the cerebral ischemia group ( P<0.05), and the neurological deficit score in the cyclopamine group w as significantly higher than that in the scutelarin+paeoniflorin group ( P<0.05). The infarct volume percentage in the cerebral ischemia group, scutelarin+paeoniflorin group, and cyclopamine group were 31.77%±1.19%, 22.94%±2.65%, and 35.53%±0.20%, respectively. The infarct volume in the scutel arin+paeoniflorin group w as significantly less than that in the cerebral ischemia group ( P<0.05), and the infarct volume in the cyclopamine group was significantly larger than that of the scutelarin+paeoniflorin group (P<0.05). The expression levels of SHH, Patched-1, Gli-1 mRNAs and proteins in the cerebral ischemia group, scutelarin+paeoniflorin group, and cyclopamine group w ere significantly higher than those in the sham -operation group (al P<0.05). The expression levels of SHH, Patched-1, Gli-1 mRNAs and proteins in the scutelarin+paeoniflorin group were significantly higher than those in the in the cerebral ischemia group (al P<0.05), and the expression levels of Gli-1 mRNA and protein in the cyclopamine group were significantly lower than those in the scutelarin+paeoniflorin group ( al P<0.05 ). Conclusions The scutel arin combined w ith paeoniflorin has certain protective effect on focal cerebral ischemia injury in rats. Its mechanism is associated w ith the activation of SHH signaling pathw ay.

Objective To observe the effects of a lower-limb rehabilitation robot plus psychological intervention on depression and lower limb motor function of the stroke patients.Methods Sixty stroke patients were randomly divided into a treatment group (n =30) and a control group (n =30).The patients of control group were treated with routine rehabilitation and psychological intervention,while the treatment group were treated with lowerlimb rehabilitation robot,in addition to the interventions of the control group,for 10-20 minutes daily,6 days per week for 8 weeks.Both groups were assessed with Hamilton Depression Scale (HAMD),Simplified Fugl-Meyer assessment (FMA) and Functional Ambulation Category (FAC) before and at the end of 2,4 and 8 weeks of treatment.Results There was no significant difference between the 2 groups in all the assessment parameters before and after 2 weeks of treatment.At the end of 4 weeks of treatment,both groups improved significantly with regard to the scores of HAMD,FMA and FAC classification,and the treatment group improved to a significantly greater extent than the control group (P ＜ 0.05).At the end of 8 weeks of treatment the scores of HAMD,FMA and FAC classification were further improved significantly in treatment groups when compared with values obtained at the end of 4 weeks after treatment,but the scores of the control group was not significantly improved at the end of 8 weeks when compared with those at the end of 4 weeks of treatment.Conclusion Lower-limb rehabilitation robot plus psychological intervention can significantly help relieve the post-stroke depression and improve lower motor function of stroke patients.