Objective To investigate subsequent treatment methods of nipple discharge after fiberoptic ductoscopic examination.Methods Intraductal lesions of 51 patients with nipple discharge were observed and assessed by fiberoptic ductoscopy.After examination,the patients were treated by various methods according to characteristic appearance of lesions under fiberoptic ductoscopy.The type of lesion with nipple discharge was classified as papillary lesions and nonpapillary lesions.And the papillary lesions could be further subdivided into nodular papillary lesions and irregular papillary lesions.There were 29 cases of nodular papillary lesion,23 of which were treated by local resection and 6 of which were given a simple mammectomy.There was 1 case of irregular papillary lesion,which was treated as malignant tumor after the focus was surgically removed and pathologically confirmed as breast cancer.Nonpapillary lesion was observed in 21 cases,18 of which were treated by local irrigation under ductoscopy,and 3 of which were treated as malignant tumor after the abnormal duct with its lobules was pathologically diagnosed as breast cancer.Results The 51 patients were followed with B-ultrasonography or chest roentgenography for 6～21 months(mean,14 months).No recurrence or metastasis was observed.Conclusions The characteristic appearance of lesion with nipple discharge under fiberoptic ductoscopy is an important evidence for choosing treatment method.

Objective To establishe the reference range of low hemoglobin density (LHD ％) of health population in Humen District of Guangdong,and discuss the clinical application value.Methods Randomly selected from January 2015 to September 2016 in Humen Hospital of Dongguan City physical examination of 1 650 cases of healthy people as control group,and selected the same period by the clinical diagnosis of iron deficiency anemia (iron-deficiency anemia,IDA) group,67 cases of patients with IDA Sysmex XT-1800i fully automatic blood analyzer were used respectively to detect blood routine,and then based on the average haemoglobin concentration (mean corpuscular hemoglobin concentration,MCHC),calculate the LHD％,and the calculation results were analyzed.Results The control healthy crowd LHD％ value was 2.41％ ± 0.85 ％,95％ reference range was 0.74 ％ ～4.08％,male was higher than the female,the difference was statistically significant (t =3.209,P＜0.05).IDA patients before treatment LHD％ was 30.97％ ± 18.65％,significantly higher than the control group,the difference was statistically significant (t=19.536,P＜ 0.01),and with the level of hemoglobin (Hb) showed a negative correlation (r=-0.4313).LHD％ values after treatment in patients with IDA group were significantly lower,but the recovery speed was slower than the Hb and MCHC.By ROC curve analysis,when the cut-off of LHD％ value was 4.10％,the LHD％ for IDA early diagnostic sensitivity of 96.78％,specificity of 100％.Conclusion Established the reference range of low hemoglobin density (LHD ％) of healthy population in Humen district of Guangdong,and LHD％ is IDA good indicator of early diagnosis and curative effect of dynamic monitoring.

Objective To explore an effective and viable way to establish small-for-size liver transplantation model in rats.Methods Male Lewis rats were used as donors and recipients,the grafts were implanted according to Kamada's 2-coff method.Animals were divided into the following groups:Group I (n=28):30% size graft liver transplantation using a median lobe graft,with left lobe,right lobe,caudate lobe and triangle lobe removed in situ;Group Ⅱ (n=36) :30% size graft liver transplantation using a median lobe graft,with an improved technic of lobe resection.7-day survival rat and the technical complications including bleeding,IVC or portal vein stricture and bile leakage were compared between the groups.Results Compared to the Group Ⅰ,the incidence of IVC stricture was significantly decreased in the Group Ⅱ.Other complications showed no significant difference between the two groups.No significant difference were observed in the 7-day survival rate between the two groups(33%,9/28 vs 60%,21/36),( X2 = 0.272,P ＞ 0.05 ),though Group Ⅱ had more survivors 7 days after liver transplantation.Conclusion With improved method of lobe resection,more effective and viable 30% small-for-size rat liver transplantation model can be established.

Objective To survey the status and influence factors of radiology department nurses self-protection behavior. Methods The radiology department nurses′self-protection behavior questionnaire compiled by the researchers were used to conduct a questionnaire survey of 100 nurses in different grade hospitals. Results Scores of the item body fluid of patients with contact contaminated were wearing glovesof second-class hospital and third-class hospital were (3.695±0.73) points and (3.73±0.74) points, and there was no statistically significant different between them (P> 0.05). The other items about self-protective behavior of nurses from different levels of hospitals had some differences (t=-4.24-2.43, P<0.05). Conclusions Self-protective behavior of radiology department nurses is affected by many factors. Nursing managers should take effective measures to improve nurses′self-protective consciousness and ability.

OBJECTIVE:To systematically review the efficacy and safety of mizolastine combined with H2 recepter antagonists in the treatment of chronic urticaria,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,CBM,CJFD,etc.,randomized controlled trials (RCT) or QRCT about mizolastine com-bined with H2 recepter antagonists(test group)versus mizolastine alone(control group)in the treatment of chronic urticaria. After quality evaluation and data extract,Meta-analysis was conducted by using Stata 12.0 statistics software. RESULTS:A total of 12 RCT were included,involving 1 188 patients. Results of Meta-analysis showed the effective rate [RR=1.23,95%CI(1.16,1.31), P<0.001] in test group was significantly higher than control group,subgroup analysis showed the the efficacies of different combi-nation of mizolastine and other drugs were significantly better than control group;there was no significant difference in the inci-dence of adverse reactions between 2 group[RR=1.01,95%CI(0.71,1.44),P>0.05]. CONCLUSIONS:The effective rate of mizo-lastine combined with H2 recepter antagonists is significantly higher than mizolastine in the treatment of chronic urticaria,with bet-ter safety. Due to the limit of methodological quality and sample size,it remains to be further verified with more rigorously de-signed and long-term follow-up of large-scale RCT.

Objective To study the relationships between polymorphisms of angiotensin-converting enzyme (ACE) gene and methylenetetrahydrofolate reductase (MTHFR) gene and pregnancy induced hypertension (PIH). Methods Ninety-nine PIH patients (PIH group), including 21 mild cases, 24 moderate cases and 54 severe cases and 54 normal pregnant women (control group) were recruited.The polymorphism of ACE gene was detected by PCR, and that of MTHFR gene was detected by PCR-RFLP. Results In PIH group, the frequencies of genotypes II, ID, and DD of ACE gene were 20.2%, 37.4% and 42.4% respectively, the frequencies of genotypes CC, CT, and TT of MTHFR gene were 53.5%, 31.3% and 15.2% respectively. There existed significant difference between genotypes DD, CT and D allele in PIH group and control group. Compared to mild PIH group, the frequencies of genotypes DD and CT in severe PIH group were significantly higher. The susceptibility to PIH in individuals with genotypes CC+DD was 2.648 times that of the controls. However, individuals with genotypes CT+II and CC+II were less susceptible to PIH in comparison to the controls. Logistic regression analysis showed that genotype DD and D allele were associated with PIH, genotype CT was associated with severe PIH. Conclusion Genotypes DD and CT may be the risk factors of PIH; genotype II may have a protective effect against PIH. There may exist some interaction between polymorphisms of ACE gene and MTHFR gene in the pathogenesis of PIH.

BACKGROUND: Proper physiochemical method can alleviate or eliminate the antigenicity of natural xenogenic bone and preserve its natural porous reticular system so that its structure and components are in conformity with physiological requirements. It is expected that xenogenic bone becomes a kind of substitutive material in bone transplantation.OBJECTIVE: It was to adopt generative culture of marrow stromal cell and complex culture of ceramic xenogenic bone in vitro to understand the influence of ceramic xenogenic bone on morphology, growth, adhesion and proliferation of marrow stromal cell in rabbits.DESIGN: Blank, control experiment was designed.SETTING: Center Laboratory of First Hospital Affiliated to Kunming Medical College.MATERIALS: Five Japanese big ear white rabbits of 3-month old were employed, body mass varied from 1.5 to 2.0 kg, of either sex.INTERVENTIONS: The experiment was performed in Center Laboratory of First Hospital Affiliated to Kunming Medical College from June to October 2003. With physiochemical management, the fresh pig rib bought from market was prepared into ceramic xenogenic bone and was verified with Xray diffractometry to be mainly composed of hydroxyapatite. It was verified with scanning electron microscopic observation that such material presented porous meshwork system as osteogenie tissue. Five Japanese big ear white rabbits were employed to collect 1mL marrow for each. PRMI 1640culture solution was used to dilute it into suspension of marrow stromal cell and the cells of upper layer were collected for culture. With 1×106 cells/bottle, they were vaccinated to 8 culture bottles of 25 mL and generated at the ratio of 1:1. The prepared ceramic xenogenic bone was placed into culture bottles, 5 pieces in each bottle, totally for 5 bottles, taken as experimental group and the other 3 bottles (without xenogenic bone ) were taken as the control. The culture ended in 2 weeks and a part of cultured material was used for observation with phase microscope and scanning electron microscope.MAIN OUTCOME MEASURES: Influence of ceramic xenogenie bone on morphology, growth, adhesion and proliferation of marrow stromal cell in rabbits were observed with phase microscope and scanning electron microscope.to 14 days after vaccination, cell proliferation was connected to be monolayer meshwork. Generative culture: in 24 hours, adhesion was accomplished and the cells grew well in both experimental group and the cortrol.In the experimental group, fibroblastic cells were arranged more closely rabbits with scanning electron microscope: in experimental group, it was visible in 2 weeks of generative culture that some counected reticular fibroblastic cells adhered with the inner wall of reticular pores and porous base of ceramic xenogenic bone as well as the surface of bone trabecula.The cells were mostly fusiform, triangular or multiangular.CONCLUSION: Ceramic xenogenic bone is mainly composed of hydroxyapatite and presents reticular porous structural system of osteogenic tissue, which will not produce harmful effects on morphology, growth, adhesion and proliferation of marrow stromal cell and it is expected to be used in complex graft for repair of bone defects with bone marrow.

Objective To explore the diagnosis value of ultrasound-guided COre needle biopsy(CNB)and frozen sectionin breast cancer.Methods There were 41 cases of breast tumor which were suspicious with ultrasonography,and using Bard automatic biopsy device was applied for percutaneous puncture by ultrasound-guided in breast neoplasms.Tissue samples were harvested for frozen soetion pathologic examination.compared with 42 clinical cases of the turnour which suspicious with ultrasonography were excised in operation room(B group)during the same time.Results The outcome of frozen sections were finished in 30～40 miutes.Thirty-nine cases were diagnosed to be malignant,36 cases were infiltrated ductal carcino and 3cases were infiltrated lobular carcinoma,two cases were severely non-type hyperplasia the sensitivity of sonographically guided CNB for the diagnosis of breast cancer was 95.1%.one operation was finished in 60 to 120 minutes,the average is 68.19±12.41 minutes.In group B,sensitivity of diagnosis of breast cancer was 97.6%(P＜0.05).One operation was finished in 120 to 200 minutes,the average was127.88±11.50 minutes(P＜0.05).Conclusion It can achieved higHy diagnostic rate,and have benefit of setting down the operations program and the operating time was curtailed when breast cancer was utrasound-guided by CNB and examinede with frozen section.

OBJECTIVE A surveillance study was performed for nosocomial infections in order to investigate the change in antimicrobial resistance of Klebsiella pneumoniae,especially the strains isolated from 1999 to 2004.METHODS K-B test was used for the antibiotics susceptibility test and the results were read based on National Committee for Clinical Laboratory Standards(NCCLS) of the USA.The situation of ESBLs-producing strains of K.pneumoniae was investigated.RESULTS Totally 326 K.pneumoniae strains showed the highest susceptibility to imipenem.Ceftazidime,cefepime,and cefoperazone/sulbactam also showed excellent activity against K.pneumoniae.The prevalence of ESBLs from 326 strains was 20.2%.CONCLUSIONS It is important to study the drug resistance in nosocomial infections by K.pneumoniae.

Objective To explore the early diagnosis of lower extremity deep venous thrombosis (LDVT)and evaluate the therapeutic effect of anticoagulant therapy in hospitalized patients with acute ischemic stroke. Methods　According to Wells model for suspecting lower extremity deep venous thrombosis,patients with suspected LDVT were confirmed by compression ultrasonography. If the patients diagnosed with LDVT had no contraindications to anticoagulant therapy,they were treated with low molecular weight heparin(LMWH)subcutaneous injection and oral warfarin at the same time.The dosage of oral warfarin was determined by Roberts'age adjusted warfarin loading protocol.LMWH was stopped when the patients'international normalized ratio(INR)was 2.0～3.0 for two consecutive days. Results From January 2003 to August 2007,2067 cases with acute ischemic stroke were admitted to the department of neurology in Huizhou Municipal Central Hospital including 18 cases with LDVT and the incidence was 0.9%.The patients with LDVT all had paralytic extremities including 13 left legs and 5 right legs with deep vein thrombosis.All the 18 cases were treated by anticoagulant including 17 cases with oral warfarin treatment for 3 months.Symptoms in all LDVT patients were eliminated.12 cases had been observed for one year and 5 cases for three months after they stopped taking warfatin.There were no patients with pulmonary thromboembolism and LDVT recurrence. Conclusions　By using Wells model for suspecting LDVT,patients with acute ischemic stroke-complicated LDVT can be timely diagnosed.The goal of prompt and enough anticoagulant can be achieved according to Roberts'age adjusted warfarin loading protocol.Because of racial difference,population difference and other unknown factors,the incidence of acute ischemic stroke patients with complicated LDVT is much lower in Huizhou.It suggests that it should be unnecessary to use LMWH in patients with acute ischemic stroke to prevent LDVT in Huizhou.