The occurrence of breast cancer is closely related to genetic factors.BRCA1 and BRCA2,breast cancer susceptibility genes,play important roles in the occurrence and development of breast cancer.The researches on germline mutations in BRCA1 and BRCA2 are of great significance in prevention,diagnosis and treatment of breast cancer.

为提高我院康复科护士的护理水平，采用康复理论学习、技术操作及其分别考核的方法，对护士进行继续教育。结果经统计学t检验，P＜0．01，有显著性差异。证明对护士进行继续教育和考核有明显的提高作用，应予推广实施。

Objective To investigate the ultrastructural changes of retinal pigment epithelium (RPE) and its permeability in spontaneously hypertensive rats (SHR) and explore the relation between these changes and hypertensive retinopathy. Methods The ultrastructure of RPE cells in the SHR aged five、six、seven months was observed with transmission electronmicroscope and compared to its normotensive control strain(WKY) with the same age.Then, lanthanum tracer procedures were carried out to investigate pathological changes of the blood retinal barrier. Results ①In SHR the main pathological changes involved swelling of mitochondria, enlargement of endoplasmic reticula,decrease of RPE cell infolding, and sparseness of microvilli. These degenerations were more serious in older rats with higher blood pressure.②The breakdown of outer blood retinal barrier with permeation of lanthanum tracers were evident in SHR aged six or seven month, however, in WKY and five month SHR the traces were preven ted from passing by tight junctions. Conclusion The degeneration of RPE owing to ischemia and anoxia arises in early period of hypertensive retinopathy. The pathological changes of ultrastructure and permeability might interact with the damage of visual cells and play a main role in the hypertensive retinopathy.

BACKGROUND: With the understanding of pathology of cervical diseases, cervical curvature has become one of
the important indexes of long-term clinical outcome. To restore and maintain cervical curvature has a profound impact on cervical long-term stabilization and cervical biomechanical environment.
OBJECTIVE: To evaluate long-term influence of selective consecutive three-level appliance of intervertebral Solis cage on cervical curvature for spondylotic myelopathy.
METHODS: From June 2008 to December 2010, 22 spondylotic myelopathy patients were treated with
consecutive three-level anterior cervical Solis fusion. There were 14 males, 8 females, with an average age of
45.1 years (ranged from 26-73 years). There were two cases of C2/3/4/5, seven cases of C3/4/5/6, 12 cases of C4/5/6/7, and one case of C5/6/7/T1 , total y 66 intervertebral spaces. Al cases were fol owed up for 2 years.
RESULTS AND CONCLUSION: Average blood loss amount was 40 mL (20-80 mL). Average operation time was 121 minutes (100-175 minutes). After fol ow-up for 30.7 months, al segments were fused. There was no implant migration or vertebral body col apse. Pre-operative JOA score was 11.94±3.61, 15.56±1.13 at 6 months post-operation, and 15.21±1.85 at 2 years after implantation. Pre-operative cervical curvature was (1.86±3.24) mm,(4.83±1.78) mm at 6 months post-operation, and (4.44±3.36) mm at 2 years after implantation. There were significant differences between pre-operative and at 6 months post-operation, pre-operative and at 2 years post-operation (P < 0.05). There was no significant difference between 6-month and 2-year post-operation (P > 0.05). Results indicated that selective consecutive three-level appliance of intervertebral cage for spondylotic myelopathy could improve cervical curvature and have long-term favorable clinical outcomes.

Objective To elucidate the mechanism of angiotensin (Ang) Ⅱ in regulation of renin synthesis and secretion in primary cultured juxtaglomerular granular cells (JGCs). Methods Mice JGCs were isolated and cultured as described before. Real-time PCR was used to demonstrate the expression of angiotensin converting enzyme (CE) and angiotencin receptor (AT1, AT2) in JGCs. Ang Ⅱ was co-cultured with JGCs stimulated by PGE2 and isoproternol or not. Renin activity in supernatant was detected by radioimmunoassay and renin mRNA expression was examined by real-time PCR. Different concentrations of Ang Ⅱ were co-cultured with JGCs with different time (1 h, 4 h and 24 h), cAMP in cell lysate and supernatant was measured by Cayman Cyclic AMP EIA Kit. The cytoplasmic calcium was decreased by BAPTA-AM, and increased by thapsigargin and cyclopiazonic acid, which could be used to observe the cAMP concentration affected by calcium. Adenylyl cyclase type 5, 6 (AC5, AC6) mRNA expression of JGCs co-cultured with Ang Ⅱ was measured by real-time PCR. Results Real-time PCR confirmed the expression of ACE and AT mRNA in JGCs of WT mice. Angiotensin Ⅱ reduced renin secretion in primary cultures of JGCs [(370.6±36.9) vs (299.6±25.7) ng AngI'ml~(-1)·h~(-1), P=0.014]. Angiotensin Ⅱ dose-dependently down-regulated forskolin-stimulated cAMP production in JGCs. Thapsigargin and cyclopiazonic acid decreased cAMP level. BAPTA-AM increased cAMP production obviously [(11.09±0.48) vs (3.55±0.47) nmol/L, P<0.01]. Ang Ⅱ inhibited AC5 mRNA expression by 42.12%, but did not inhibit AC6 mRNA expression. Conclusions Angiotensin Ⅱ can directly inhibit renin synthesis and secrestion maybe through reducing AC-stimulated cAMP levels. Crosstalk between calcium and cAMP system may exist in precise regulation of renin in JGCs.

Objective To investigate the pharyngeal bacterial pathogens of children's community acquired pneumonia(CAP)in hospital,and provide evidences to clinical empirical therapy.Methods Three hundred and fifty-nine patients with CAP were selected.Before the treatment,pharyngeal swabs was taken for culture to find bacteria,then to be done drug sensitivity quantitative test and examed the extended spectrum β lactamages(ESBLs).Results The positive rate was 21.7%(78/359)and bacteria was 82 strains.It was mainly consisted with gram negative bacteria(73.2%,60/82),and klebsiella pneumonia (30.5%,25/82).Streptococcus pneumonia(18.3%,15/82)was the most common in gram positive bacteria.Klebsiella pneumonia was resistant to amoxicillin.Drug resistance of ESBLs producing strains was increased.Streptococcus pneumonia was highly resistant to erythromycin,clindamycin,and tetracycline.The ratio of bacteria infection in infancy age(34.6%.47/136)was higher than others.Conclusions Gram negative bacteria is significant pharyngeal bacterial pathogens in CAP of children.The most common ono is klebsiella pneumonia,and the corresponding one in gram positive bacteria is streptococcus pneumonia.Clinical doctors should avoid using high antibiotic-resistance drugs.

Objective To observe the clinical efficacy of desloratadine citrate disodium tablets combined with narrow band ultraviolet B in the treatment of pityriasis rosea.Methods According to the digital table,88 pityriasis rosea patients were randomly divided into the two groups.45 cases of the study group were treated by desloratadine citrate disodium tablets combined with narrow ultraviolet B,43 cases of the control group were treated by desloratadine citrate disodium tablets alone.The both two groups applied Binghuangfule cream.The therapeutic effect and safety of the two groups were compared.Results The cure rate in study group was 71.11％,which of the control group was 51.16％,the difference was not statistically significant (x2 =3.69,P ＞ 0.05).The effective rate of the treatment group was 91.11％,which of the control group was 69.77％,the difference between the two groups was statistically significant (x2 =6.43,P ＜ 0.05).Conclusion The result reveals that desloratadine citrate disodium tablets combined with narrow band ultraviolet B is more effective and worthy to be used in clinical practice.

Objective To investigate clinical effect of breviscapine combined with nerve growth factor in treatment of ischemic optic neuropathy . Methods 80 patients with ischemic optic neuropathy from March 2014 to March 2016 in our hospital were selected and divided into the control group and observation group, 40 cases in each group.The control group was treated with nerve growth factor, hip injection 30ug, one times a day, while the observation group was treated with breviscapine combined with nerve growth factor, 80 mg breviscapine added to 500 mL glucose intravenous infusion, one times a day.Then the changes of visual acuity, visual field loss difference (LV), the average damage of vision (MD), the average vision light sensitivity ( MS ) , adverse reactions, curative effect were compared between two groups.Results After treatment, the total effective rate in the observation group was significantly higher than the control group, the difference was statistically significant (P<0.05), the visual acuity of the observation group was significantly higher than that of the control group, the difference was statistically significant (P<0.05), LV, MD was significantly lower than the control group, the difference was statistically significant (P<0.05), MS was significantly higher than the control group, the difference was statistically significant (P<0.05).There was no difference in adverse reactions between the two groups.Conclusion Breviscapine combined with nerve growth factor in the treatment of ischemic optic neuropathy can improve nerve function of patients , improve the therapeutic effect.

Child ; Humans ; Vesico-Ureteral Reflux ; therapy

Objective To clinically analyze the feature of paroxysmal hemicrania in order to improve our cognition toward it.Methods Eight patients,3 men,5 women,aging 17 to 74 years old,were prospectively analyzed over the past 2 years in our hospital.Results Their age of onset was from 9 to 60years old(mean 42.5±16.3).Seven of the 8 cases were treated with indomethacin,out of whom 5 got an immediate and complete response and one of them remitted partially.Another stopped taking indomethacin because of gastroenteric side effects.She was treated with verapamil and prednisone and partial relief was gained.Conclusions Paroxysmal hemicranial is a rare benign disorder.which needs our improved understanding.The patient who is diagnosed with paroxysmal hemicranial should firsfly receive indomethacin.and standard anti-cluster headache medications or other non-steroid anti-inflammatory drugs is used if she/he can not get relief and (or)tolerate the adverse effects.