Objective To explore the clinical efficacy of early breast cancer patients underwent breast-conserving surgery with postoperative chemotherapy and radiotherapy.Methods A retrospective analysis of 128 early breast cancer patients underwent routine breast-conserving surgery was conducted.The clinical effect and cosmetic results were analyzed by the follow-up results of 128 cases.Results (1) The 5-year follow-up rate was 100％,overall survival rate was 95.3％,1-year survival rate was 100％ (128/128) ;3-year survival rate was 98.4％ (126/128) ;5-year survival rate was 95.30％ (122/128).Postoperative follow-up 6 patients died,3 patients died of liver metastases,2 patients died of lung metastases,1 patient died of non-cancerous reasons.The local recurrence rate was 2.34％ (3/128),axillary lymph node recurrence rate was 1.56％ (2/128).The average recurrence time was three years and two months after operation,distant metastasis rate was 3.91％ (5/128).(2) Beauty evaluations of 128 patients with breast-conserving surgery were excellent in 71 cases (55.5％),good in 55 cases (43.0％),and poor'in 2 cases (1.6％).Good,acceptable as acceptance criteria,the acceptance rate was 98％.Conclusion Breast-conserving surgery is not only to a certain extent to solve the pursuit of female beauty,but also improve their quality of life.But only the complete elimination of residual lesions in order to truly ensure that no recurrence of tumor.Therefore,the appropilate survival rate of patients for radiotherapy and chemotherapy can be extended so that the patient's breast to maintain a good shape.Breast-conserving surgery combined with radiotherapy and chemotherapy is superior to the modified radical surgery,and popularization in the hospital.

Objective To evaluate the clinical significance of CEA mRNA expression in gallbladder bile for early diagnosis of liver metastasis from primary colorectal cancer. Methods [WT5”BZ] A CEA specific nest RT PCR assay was used to detect CEA mRNA expression in the gallbladder bile of 46 patients with colorectal cancer. Results The positive rate of CEA mRNA in gallbladder bile was 74%. The rate was directly proportional to that of live metastasis. Liver metastasis developed in 33% of patients with positive CEA mRNA expression. Conclusions The positive expression of CEA mRNA in gallbladder bile is a proof of prospective liver metastasis.

Objective　 To study the significance of monitoring postoperative hematogenous micrometastasis of colorectal cancer．　 Methods　 The micrometastatic cancer cells in peripheral blood and bone marrow of the perioperative patients were investigated by CK20 mRNA RT-PCR.　 Results　 The positive rates(16.3%) of hematogenous dissemination without relapse or metastasis after operation were significantly lower than that(88.9%) in patients with postoperative relapse or metastasis. There were four types of hematogenous dissemination. (1) Postoperative temporary negatives.(2)Consistant positives. (3) CK-20 turned positive postoperatively. (4) Consistant negatives. All the 6 patients that died had positive CK-20 preoperatively.　 Conclusions　 The hematogenous dissemination of colorectal cancer plays an important role in postoperative relapse. The dynamic monitoring of CK-20 predicts hematogenous dissemination of colorectal cancer.

Objectives: The aim of this study was to define whether growth hormone therapy would reduce the course of postoperative fatigue (POF) in aged patients (60～80 years old) with nutritional support. Methods: Forty aged patients who underwent partial gastrectomy or other operations were randomized into two groups. All patients were treated with the same nutritional support formula.A group of patients was treated with rhGH for 7 day from the third day after operation, and control group treated with placebo.The score of POF, nitrogen balance, transferrin level and body weight were monitored. Results: Score of POF in rhGH group on day 7 and 14 after operation was lower than that in control group(P0.05). Conclusions: Aged patients with rhGH after major operation can recover more rapidly from POF.

Objective:To understand the pain experience of discharged patients after thoracoscopic lobectomy, identify the out-of-hospital pain management needs of patients, and help patients improve the level of out-of-hospital pain management.Methods:The phenomenological method in qualitative research was used in the study, and the Colaizzi 7-step data analysis method was used to analyze the interview data.Results:Six topics were summarized: pain cognition, different pain coping styles, misunderstanding of painkillers, negative emotions, postoperative paresthesia, and lack of professional guidance.Conclusion:Medical staff should strengthen the publicity and education of discharge, pay attention to the follow-up, provide professional guidance for patients outside the hospital, relieve pain and improve the quality of life of patients.

Objective To investigate the feasibility of total hip arthroplasty through a small anterolateral incision. Methods Total hip arthroplasty through a small anterolateral incision was performed in 53 cases (58 hip joints) from February 2003 to December 2003, including 5 cases of simultaneous replacement of bilateral joints, 6 cases of total hip revision, and 4 cases of hip joint rigidity. The surgical modification features were as follows: the patient was placed in recumbent position, with the involved buttock region slightly hanging over the side of the surgical bed and normally drooping; the involved leg was placed in 10? of adduction, which was helpful to the exposure of the greater trochanter; after the exposure of the neck of the femur and the greater trochanter, osteotomy was performed firstly, then the femoral head was dislocated and removed. Results The length of incision was 7~12 cm (mean, 8.5 cm). The operation time was 70~140 min (mean, 88 min). The blood loss was 250~660 ml (mean, 470 ml). No severe complications occurred. Postoperatively, weight-bearing and mobilization exercise were begun in 6~14 days. All the cases were followed for 4~40 weeks (mean, 28 weeks). The Harris hip scores showed excellent outcomes in 37 cases, good in 12, fair in 4, with a rate of excellent or good results of 92.5% (49/53). Conclusions Total hip arthroplasty through a small anterolateral incision is a feasible procedure that is characterized with minimal invasion, less blood loss and quick recovery. It can be applied in total hip replacement for artificial hip joint revision, hip joint rigidity, or congenital dislocation of hip joint.

ObjectiveTo investigate and analyze the doctor-patient communication skills of medical students and hereby to explore the efficient training system.MethodsUsing the questionnaires and statistic analysis,we focused on the doctor-patient communication skills of the observed 914 medical students in our college,their awareness of doctor-patient communication and the existing problems in the field.Results96.6％ of medical students realized the importance and necessity of doctor-patient communication,while 62.7％ of them lacked such kind of communication skills.Additionally,some other problems are exposed in medical history taking.ConclusionDoctor-patient communication skills might be the most important prerequisite for establishing harmonious relationship between doctors and patients,improving the quality of medical service and reducing the number of medical disputes.Consequentially,it's time to redesign relevant curriculum,to improve the old-fashioned training methods,to enhance the practice of doctor-patient communication training.Furthermore,improvements of teaching quality and a scientific evaluation system are also effective approaches to resolving the issue.

Objective To study the relationship between severity of coronary artery lesion and serum level of apolipoprotein A5 (ApoA5). Methods The level of serum total cholesterol (TC), triglyceride (TG), high-den-sity lipoprotein cholesterol (HDL-C ), low density lipoprotein cholesterol (LDL-C ), apolipoprotein A1 ( APOA1), apolipoprotein B (APOB) ,Lipoprotein(a) and uric acid(UA) were examined in 114 patients with coronary heart disease(CHD) and 40 healthy control subjects;Enzyme-linked immunosorbent assay (ELISA) methods was used to determine APOA5. The eoronay heart disease patients were divided into tree groups by the severity of coronary artery lesion: that is one, two and three vessel lesion. Results Compared with control group, APOA5, ApoA1, HDL-C lev-el of CHD groups were lower(P <0.01 or P<0.05) ,TG ,LP(a)and UA were higher(P <0.01 or P <0.05) ,the difference of TC, LDL-C and APOB were not significant (P>0.05 ). In the subgroups of CHD patients, The serum APOA5 concentrations were signficant different between the CHD patients and control group( F=18.605 ,P<0.01 ). Along with the severity of coronary artery,the level of ApoA5 concentrations had a lower trend. The level of ApoA5 was negatively correlated with serum TG level ( r=-0.208, P=0.040) and LP (a) ( r=-0.088, P <0.001). The level of APOA5 had a positive correlation with the serum HDL-C (r= 0.241, P = 0.016). Conclusion There is negative correlation between severity of coronary artery lesion and serum level of ApoA5. The decrease of ApoA5 maybe a risk factor.

Objective To explore the correlation between serum concentrations of apolipoprotein (Apo) AV and adiponecfin in patients with coronary heart disease (CHD). Method The levels of serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C) , ApoA I and ApoB were examined in 99 subjects by biochemistry department. Enzyme-linked immunosorbent assay (ELISA) method was used to determine ApoA V and adiponectin. All subjects were divided into CHD group(59 patients) and control group(40 patients). Results The concentration of TG was significantly higher than that in control group [(1.79±1.28) mmol/L vs (1.27±0.79) mmol/L]. The concentrations of HDL-C, ApoA V and adiponectin in CHD group were signifi-cantly lower than those in control group[(1.17±0.25) mmol/L vs (1.29±0.26) mmol/L, (186.71±78.20) μg/L vs (250.29±110.38)μg/L, and (3.81±0.15)mg/L vs (5.33±0.37) mg/L,P<0.05or <0.01]. Serum ApoA V was negatively correlated with TG (r =-0.208, P = 0.040), but positively correlated with HDL-C (r = 0.241, P= 0.016) and adiponectin (r = 0.238, P= 0.018). Conclusions The patients with CHD have decreased serum levels of ApoA V and adiponectin, but increased levels of TG. ApoA V and adiponectin influence the development of CHD.

Objective To investigate the widespread of the liver cancer risk factors in Wuwei city,where low-incidence for liver cancer and offer the cause clue to first-level prevention. Methods Investigate the risk factor and family history of the Wuwei city resident who wlth liver cancer by using case-control study.Estimate the liver cancer heredity mode with the method of Penrose and simple segregation analysis,calculate the degree of heritability with the metllod of Falconer,s regression.Detect the content of the resulting and promoting cancer fungi,volatility N-second nitroso compound in the meal,nitrate and nitrite in the drinking water and the vitamin C in the health adults'serum by means of culturing appraisement,experiment examination etc.Results The risk factom of liver cancer in the Wuwei city were history of viral 'hepatitis type B,kinsfolk tumor,the eating salting or mildewed foods,cirrhosis,drinking surface water,well water,or wine.By using segregation analysis and estimation of heredity mode show that the morbidity of liver cancer discrepancy to the monogenic inheritance mode,maybe the polygenic inheritance mode in Wuwei city.The h~2 of index case first degree relative was 58.74%.Picking out 8 kinds of nitrosamine,14 kinds of resulting and promoting cancer fungi from resident meal.The content of nitrate and nitrite was (38.97±3.14) mg/L,(0.086±0.043) mg/L respectively in shallow well water,the vitamin C in the health adults'serum in summer was(5.74±2.79)mg/L.Conclusion It can be seen that the history of viral hepatitis type B,kinsfolk tumor,eating salting or mildewed foods,cirrhosis,addicted to drink;higher content of nitrate and nitrite in the drinking water and strong carcinogens such as volatility N-nitroso compound in the meal,and also lackingprotection factors such as vitamin C are the risk factors of the Wuwei city resident who with liver cancer,Theinherit susceptivity is the internal environment of resulting cancer change.