Objective To compare the effects of breast conservative therapy and radical mastectomy in treatment of patients with early stage breast cancer.Methods 76 patients with early breast cancer,informed consent by themselves and their families were divided into breast conservative therapy group(BCT group,2 1 cases)and breast radical group(RT group,55 cases),and BCT group was conducted breast conserving surgery,and RT group Was given radical surgery of breast cancer.The two groups were all given conventional postoperative chemotherapy and endocrine therapy.Then the therapeutic effects and complications were observed and compared.Following up for 1 to 6 years,the recurrence was compared.Results All patients were cured.In BCT group,5 cases of subcutaneous fluid,2 cases offat liquefaction of incision,1 ease of wound infection,1 case of upper limb edema,and in RT group,8 cases of subcu-taneous fluid occurred,5 cases of wound fat liquefaction,2 cases of wound infection,3 cases of upper limb edema,and the difference of complication rate between the two groups had no significant difference(P＞0.05).The scores of quality life of BCT group were significantly higher than those of RT group(t=3.42,3.18,4.07,3.09,2.87,3.26,all P＜0.05).All patients were regularly followed up for 1 to 6 years,local recurrence rate and survival rate of BCT group Was 4.8%(1/21)and 95.2%(20/21),and those of RT group Was 3.6%(2/55)and 96.4%(53/55),and the difference of local recurrence rate and survival rate between the two groups had no statistical significance(all P＞0.05).Conclusion Breast conserving surgery for early breast cancer was safe and feasible without increasing the relapse rate,and could get a good quality of life.

Objective To investigate the diagnostic value of the real-time four-dimensional ultrasound imaging examination in the diagnosis of fetal malformations.Methods Four-dimensional ultrasound prenatal audio and video materials,1 008 cases of 12～20 weeks pregnant were retrospectively analyzed,and the dignostic value for the fetal malformation Was obser red by following-up.Results Four-dimensional ultrasound detection of fetal malformations in 26 cases,27 cases of confirmed postpartum fetal malformations,the rate was 96.3%,1 case of missed diagnosis.missed diagnosis rate was 3.7%misdiagnosis rate was 0.Conclusion The dynamic continuous four-dimensional ultrasound could show the activities of the fetus in uterus,diagnosis of most of the morphological structure of fetal malformations,reduced birth defects in children.

Objective To evaluate and compare the advantages and disadvantages and the clinical application between transvaginal abdominal hysterectomy(TAH)and laparoscopically assisted vaginal hysterectomy(LAVH)on the benign lesions of non-prolapsed uterus.Methods 400 patients with benign lesions of non-prolapsed uterus were divided into two groups,TAH group(202 cases)and LAVH group(198 cases).The effects of clinical treatment of the two groups were compared.Results There were significant differentces between the two groups in operation time,the blood loss,passage of gas by anus,return to normal activities,and overall cost of treatment.However,after 1to 3 months follow-up,all patients were good in terms of outcome.Conclusion Different surgical patterns of hysterectomy had their distinctive advantages.The key point of a successful operation Was to avoid complications of the operation.

Objective To discuss the effect of moxifloxacin sequential treatment on bronchial pneumonia.Methods Patients in study group were treated by sequential treatment,and patients in control group were only intravenously dripped only with moxifloxacin.The clinical effect,changes of clinical symptoms,hospital stay time and adverse events of two groups were observed.Results The cure rate and total effective rate of study group Was significandy higher than control group(x2=8.2,P＜0.05).The clinical fever clearance time,cough disappeared time,and normal chest X-ray time of study group were significantly less than control group(t=2.309,2.617,3.134,3.157,P＜0.05).Conclusion Moxifloxacin sequential treatment of bronchial pneumonia had better effects.It had advantages to shorter hospital stay time,improve the clinical symptoms and reduce the incidence of adverse reactions.

Objective To analyze the clinical features and evaluate outcomes of active pulmonary tuberculosis(TB)patients in floating population.Methods Retrospectively analyzed the clinical data of 68 active pulmonary TB patients in floating population,in comparison with 123 cases of TB patients of local which was treated as control group.Evaluated the outcomes by analyzing the composition of sex and age,tuberculosis type,positive phlegm germ.males and 33 females;so the male to female ratio was 2.73:1,the difference between two groups was statistically significant(x2=3.37,P＜0.05).The age in study group ranged from 18 to 62,the average was(30.23±18.52),and it ranged from 18 to 70 in control group,the average was(46.46±31.50),the difference between two groups was statistically significant(t=25.14,P＜0.05).Among those aged 21 to 30,the incidence in study group was 44.11%(30/68),and in control group it was 24.39%(30/123),the difference between two groups had statistical significance(x2=9.91,P＜0.05).In study group,there were 68 sputum smears,47 of them were positive,and the proportion was 69.11%;In control group,there were 123 sputum smears,70 of them were positive,and the proportion was 56.91%.The difference between two groups had statisticall significance.In study group.there were 22 patients who stopped by themselves accepting treatment,accounting for 34.92%;At same time,in control group,there were 23 patients who stopped by themselves accepting treatment,accounting for 18.67%.The difference of treatment compliance between two groups had statistical significance(x2=6.890,P＜0.05).After 6 months treatment,41 cases were treated in study group,of them 37 cases sputum bacterium turns negative,accounting for 90.24%;the same time 100 cases were treated in control group,of them 92 cases sputum bacterium turns negative,accounting for 92.00%.The difference of sputum bacterium conversion rate in two groups had no statistical significance(x2=0.1 10,P＞0.05).Conclusion The incidence rate of tuberculosis was high in floating population of Pinghu City.The TB patients in floating population could receive the same treatment as those in local population through DOTS treatment.

Objective To observe postoperative analgesia effect of sacral canal injection of dezocine before procedure for prolapse and hemorrhoids operation.Methods A total of 160 patients with mixed hemorrhoid were divided into two groups:observation group(n=80)and control group(n=80).Dezocine 5 mg was injected in sacral canal before operation in observation group and same dose of saline was injected in control group.The postoperative analgesia effect,complication and general condition of patients were observed.Results Compared with the control group,significandy more slightless in pain were found in observation group.There was no effect on the wound healing time of patients.The rate of complication in observation group was lower.Conclusion The sacral canal injection of dezocine was a safe,simple and effective analgesic method.

Objective To observe the clinical efficacy and security of anti-tuberculosis combined with highdose methylprednisolone in treatment of advanced tuberculous meningitis.Methods 77 patients with advanced tuberculous meningitis in our department were randomly divided into the observation group(39 cases)and the control group (38 cases).All of the patients were given initiate antiphthisie treatment,the control group were added dexamethasone,20mg/d,iv drip,then was maintained after improved;the observation group were added high-dose methyprednisolone(500mg/d)by intravenous injection for five days,then was given methyprednisolone 80mg/d to maintain.Two groups were treated with hormone no more than three months.Then the clinical efficacy and adveme reaction were compared.Results The observation group:32 cases of healing,6 cases of effective,1 case of inefficient,the total effective rate was 97.4%and the control group were 22,8,8,78.9%;the difference of total effective rates in the two groups was statistically significant(x2=7.57,P＜0.05).The time of consciousness restoration and defevesence,the white blood cell count,protein chloride and glucose content of cerebrospinal fluid of the observation group were(2.7±1.3)d,(13±5)d,(112.37±27.57)×106/L,(3.04±0.82)g/L,(32.7±6.4)mmol/L and(1.67±0.65)mmol/L;and the control group were(5.2±2.4)d,(19±6)d,(93.74±20.18)×106/L,(1.92±0.64)g/L,(25.4 ±5.2)mmol/L and(1.04±0.34)mmol/L,the difference was statistically significant(t=5.70,4.77,3.88,6.67,5.48,5.31,P＜0.01);The difference of adverse reaction rate between the two groups was not statistically significant (P＜0.05).Conclusion The clinical efficacy of anti-tuberculosis combined with high-dose methylprednisolone in treatment of advanced tuberculous meningitis was better and had advantages in improving symptoms and signs without enhancing the rate of adverse reaction and it was worth to promote in clinical.

Objective To explore clinical effects of laparoscopy applied in the female patients with infertility. Methods 468 cases of female infertility patients were diagnosed and treated by laparoscopy and 168 cases received follow-up survey. Results Among those infertility patients, the patients of normal pelvic cavity and the abnormal one were 49(10.47% ) and 419( 89.53% ). Among those patients of abnormal pelvic cavity .fallopian tube disease in 276 cases(65.87% ) was at the first place. The constituent ratio of endometriosis,ovary tumor,polycystic ovary,uterine myoma,female genital tract malformation and pelvic tuberculosis was 14. 80% ,5. 97% ,4. 30% ,3. 82% , 3. 34% and 1.91% .respectively. The patients of primary infertility and the secondary ones were 208 and 260 cases. In secondary infertility patients 69.23% (180/260) of patients were caused due to fallopian tube diseases,and the constituent ratio was higher than that in primary infertility 46.15% (96/208) (x2 = 14.05 ,P <0.05),while in primary infertility,the constituent ratio of endometriosis and normal pelvic cavity were 20.19% ,15.38% ,which were higher than that in secondary infertility respectively(x2 = 11. 78,11. 16, all P < 0.05). The pregnancy rate of 168 cases followed-up was 45.24% (76/168).47.37% ,84.21% pregnancy occurred within 6,12 months with laparoscopy. The shortest and longest time of pregnancy was 2 and 30 months, respectively. The median was 8months. Conclusion Laparoscopy playd an important role in diagnosis of infertility and improvement of pregnancy rate.

Objective To investigate the value of serum procalcitonin(PCT)level in diagnosis of severe acute pancreatitis(SAP)complicated with infection.Methods 65 cases of SAP who were treated as research subjects and divided into infection group with 47 cases and non-infected group with 1 8 cases according to whether complicated with infection or not.The serum PCT,C-reactive protein(CRP),white blood cell count(WBC),temperature(T)and acute physiology and chronic health standards score(APACHE-Ⅱ)of the two groups were compared and analyzed.Results The serum PCT level of SAP co-infection group was(4.58±1.20)μg/L which was significandy higher than non-infected group,the difference between groups was statistically significant(P＜0.05);but the CRP,WBC,T and APACHEⅡscore compared with non-infected group had no significant difference(P＞0.05).Conchrsion The significant increase of serum PCT level in patients with SAP maybe relate to whether complicated with infection or not.and it was a better diagnosis and observation index for SAP complicated with infection and had important clinical significance.

Objective To study the X-ray imaging characteristics of gouty arthritis. Methods The X-ray plates from gouty arthritis were analyzed. Results The gouty arthritis usually occurred in the first metatarsophalangeal joint. The X-ray findings were dissymmetric swellings of soft tissue,bony erosion defect with sharp and hard edge,narrowed joint space and irregular articular surface,emergence of fiber stiffness,even joint malformations and sublimation or dislocation, associated with hyperosteogeny and nearby osteoporosis. Conclusion Diversification was presented in X-ray findings of gouty arthritis, which could be easily confused with other single or multiple bone joint diseases. As a result, accurate diagnosis should be based on careful analysis about X-ray findings.