Objective To explore the clinico-pathological characteristics of primary breast lymphoma(PBL).Methods The clinical data of 36 cases of PBL were analyzed retrospectively.Results Among the 36 cases of PBL,16 patients presented with stage Ⅰa disease,14 patients with stage IIa disease,2 patients with stageⅡb disease,and 4 patients with stage Ⅳ.All of the patients underwent surgery and chemotherapy,and 20 cases had radiotherapy.Thirty three patients(91.7%) were followed up for 3-193 months,during which time,12 patients died,including 2 patients died of brain metastases,five patients died of bone metastasis,and five patients died of diffuse hepatic and pulmonary metastasis.In the 21 surviving patients,the survival time was 3～192 months,and the median survival time was 43.5 months.The overall 3-and 5-year survival rate was 70.1% and 49.0%,respectively.Conclusions Most PBL are NHL.PBL is diagnosed basically by methods of pathology and immunohistochemistry,and operation combined with chemotherapy and/or radiotherapy is the best treatment method.

Objective To investigate the relationship between various stages of chronic hepatitis B virus (HBV) infection and lipid metabolism and its influencing factors.Methods Seventy-two cases of chronic hepatitis B (CHB),40 cases of liver cirrhosis and 17 cases of hepatocellular carcinoma (HCC) were enrolled.One-way ANOVA analyses were used to compare age,gender,liver function,lipid metabolism,and HBV DNA levels of each group.Pearson correlation analysis was used to study the correlation between HBV DNA and lipid metabolism.Binary Logistic regression analyses were performed to explore the risk factors of cirrhosis and HCC in patients with CHB.Results Differences of age,alanine aminotransferase (ALT),albumin (Alb),triglyceride (TG),and cholesterol(CHO) among the three groups (CHB group,cirrhosis group and HCC group) were statistically significant (all P＜0.05).TG levels in cirrhosis and HCC groups were (-0.061± 0.234)lg mmol/L and (-0.061±0.253) lg mmol/L,respectively,which were both significantly lower than that of the CHB group (0.116±0.182) lg mmol/L (F=11.466,P=0.000).CHO level in cirrhosis group was (0.460±0.333) lg mmol/L,which was lower than that in CHB group (0.586±0.101) lg mmol/L (F=4.892,P=0.009).The HBV DNA levels inversely correlated with TG and CHO levels in CHB group (r=-0.266,P=0.024; r=-0.309,P=0.008,respectively).The HBV DNA levels of cirrhosis and HCC patients positively correlated with ALT levels (r=0.355,P =0.007).Old age (OR=1.096,95％CI:1.025-1.172),low Alb (OR=0.000,95％CI:0.000-0.000),and low levels of ALT (OR=0.128,95％CI:0.026-0.641) were risk factors for development of cirrhosis and HCC in CHB patients (all P＜0.05).Conclusions With the progression of liver injuries,TG and CHO levels are reduced.Further studies of correlation between risk factors for the development of cirrhosis and HCC and lipid metabolism in CHB patients are needed.

ObjectiveTo evaluate the clinical effects of early pain intervention provided by an acute pain service team on the efficacy of postoperative patient-controlled analgesia ( PCA).MethodsOne thousand four hundred and sixty-seven patients receiving postoperative PCA in November and December 2011 were enrolled in this study.Patients were excluded from the study if they were ＜ 12 yr,unconscious or uncoorperative.The patients were divided into control group (group C,n =725) and intervention group (group 1,n =742).Group 1 received preoperative systematic pain education on the significance and conect use of PCA including pharmacology of analgesic (sufentanil 100 μg in normal saline 100 ml) by an acute pain service team made up of anesthesiologists and nurses specializing in pain management.The education was repeated immediately before operation and when the patients were discharged from recovery room.While in grup C the correct use of PCA was explained routinely before operation by anesthesiologists and nurses taking care of the patients.The incidence of incomplete analgesia and adverse reactions and patient' s satisfaction were rated.ResultsThe incidence of incomplete analgesia was significantly lower and the patient's satisfaction higher in group 1 than in control group.There was no significant difference in adverse reactions between the two groups.ConclusionEarly pain intervention provided by an acute pain service team is effective in improving the efficacy of postoperative PCA and patient's satisfaction.

Objective Because of local infiltrated growth and spread,the operative resection of hilar (cholangiocacinoma) is very difficult. Recently,combined extended hepatectomy and vascular resection had been performed for treatment of hilar cholangiocarcinoma and has greatly increased the resection rate and survival rate.However, it is associated with high operative morbidity and mortality. The aim of this study is to explore a reasonable hepatic resection strategy, that is safe and beneficial for the patient. Method Sixteen (consecutive) cases of hilar cholangiocarcinoma with involvement of hilar vessels have been treated in our hospital since 1977. En bloc resection of the hilar tumor that included hepatic segment I,IV and involved blood (vessel), as well as hepato-duodenal ligament skeletonization was performed in 15 patients. Results All 15 cases were successfully operated on with a resection rate of 93.8%, and 12 cases with R_0 resection. The operative mortality and in-hospital mortality rate were 0. Temporary bile leak and abdominal infection (respectively) developed in 1 patienteach,with an overall morbidity of 13.3%,and both were cured by non-(operative) therapy. No case of liver failure occurred. Follow up showed the median survival was 22 months and 7 are still alive. Conclusions (1)The resection rate and survival rate for hilar cholangiocarcinoma could be improved by combination of liver and hilar vascular resection.(2)Hilar cholangiocarcinoma mainly spreads to the medial segment(S4) and caudate(S1), and these segments need to be resected in the combined (operation).(3)Although resection of the middle part of liver takes little more time than hemi-hepatectomy and trisegmentectomy, it could preserve more liver parenchyma and reduce postoperative morbidity (such as liver failure) and mortality rates.(4)The resection of the hilar blood vessel involved by tumor was necessary to improve the resection rate and cure rate. Reconstruction of the blood vessel was made selectively by taking the circumstances into consideration.

OBJECTIVE: To determine the relation between the promoter methylation status of RUNX3 gene and clinicopathological parameters, prognosis of non-small cell lung cancer (NSCLC). METHODS: We collected 80 formalin-fixed paraffin-embedded lung cancer tissue samples from NSCLC patients who received postoperative adjuvant chemotherapy with cisplatin. Genomic DNA was extracted through phenol/chloroform extraction. The methylation status of RUNX3 was determined by nested methylation-specific PCR (nMSP). We investigated the pathological and prognostic characteristics of NSCLC stratified by methylation status. RESULTS: The RUNX3 promoter methylation was observed in 20 of the 80 NSCLC samples (25.0%). Methylation of RUNX3 was more frequent in adenocarcinomas (36%) than in squamous cell carcinomas (11%) (P=0.020). In multivariate Logistic regression, positive RUNX3 methylation status (P=0.011) was found to be independent disease-free survival factor as was N stage (P<0.001). Kaplan-Meier curves showed patients with RUNX3 methylation had a significantly poorer overall survival than those without methylation (P=0.003; log-rank test). In multivariate Cox proportional hazards regression analysis, RUNX3 methylation (RR:2.345, 95% CI:1.30-4.865, P=0.022) was a significant independent prognostic factor for the overall survival. CONCLUSION RUNX3 methylation is a significant independent prognostic factor for disease-free survival and overall survival.
Aged ; Carcinoma, Non-Small-Cell Lung ; genetics ; surgery ; Core Binding Factor Alpha 3 Subunit ; genetics ; DNA Methylation ; Female ; Humans ; Lung Neoplasms ; genetics ; surgery ; Male ; Middle Aged ; Prognosis ; Promoter Regions, Genetic ; genetics ; Proportional Hazards Models ; Time Factors

Objective To investigate the correlation between myocardial microcirculation and inflammation in acute myocardial infarction(AMI)by myocardial contrast echocardiography(MCE).Methods Eighty-one AMI patients(AMI group)and 30 healthy adults(normal control group)were enrolled.White blood cell(WBC),hypersensitive C reactive protein(hsCRP)and neutrophilic gtanulocyte percentage(G%)were measured in patients and healthy adults.According to different count of WBC,AMI group was devided into A group(n=40,WBC≥10×109/L)and B group(n=41,WBC＜10×109/L).Myocardial contrast intensity(A),blood flow rate(β)and myocardial blood volume(MBF=A×β)of each segment were measured by MCE during 5-7 days of hospitalization.Results Compared with control group.WBC,hsCRP in A group and hsCRP in B group were significantly elevated(P＜0.05).A,β and MBF in A group were significantly lower than those in B group(P＜0.05).WBC and hsCRP in A group had significant negative correlations with β respectively(BWBC=-0.67,P＜0.05;BhsCRP=-0.5 1,P＜0.05).Conclusions The level of plasma inflammatory factors were remarkably increased after AMI,which had a positive correlation with low microcirculation perfusion.

Objective To evaluate the feasibilities and advantages of different concentrations of sodium alginate (SA) solutions as a submucosal injection solution for endoscopic submucosal dissection (ESD). Methods In vitro study, different concentrations of sodium alginate solutions and normal saline were injected into submucosal of resected porcine esophagus and stomach respectively, then observe and measure the heights of each injection induced mucosal elevations, and their changes over time. In vivo study, the mimic ESD were conducted in healthy pigs to evaluate the mucosal elevation effect and other assistant effects of sodium alginate as a submucosal injection solution. Results The elevation heights of the experiment groups injected with SA solutions were much higher than the control group injected with normal saline. Specially, the elevation created by 1 % SA in porcine esophagus was significantly higher than that of normal saline (P < 0.01) and the elevation created by 3 % SA was significantly higher than that of normal saline in porcine stomach (P < 0.001). In the mimic ESD experiment, mucosal elevation with clear margin occurred immediately after injection with SA solution. And the durable submucosal fluid cushion created by SA protected deeper tissues while facilitating ESD procedure. Conclusion The elevation heights created by SA solutions were greater and more durable than that created by normal saline, which were crucial for ESD. The viscosity property enabled SA to form a stable protective cushion and prevent bleeding by squeezing tissue around the wound, which may decrease perforation and bleeding rate during ESD procedure. Therefore, sodium alginate can be an ideal clinical submucosal injection solution.

Objective To study the role of CFZ in the amelioration of hepatic function in cancer cachexia and its associated mechanism.Methods Forty BALB/c mice were selected.BALB/c mice were divided into 4 groups randomly,including a healthy control group (HC),a CFZ prevention group (CP),a CFZ treatment group (CT) and a cancer cachexia group (CC).Cancer cachexia model was induced by injecting murine colon 26 adencarcinoma cells into male BALB/c mice intraperitoneally.Following administration of CFZ intraperitoneally twice a week to CP and CT groups on the days 5 and 12 after tumor cells injection,respectively,all mice were acrificed on day 19.hepatic function was detected by automatic biochemistry analyzer,The concentration of inflammatory cytokines and CRP were detected by ELISA.The mRNA and protein expression of IκBα and p65 were detected by real-time PCR and western blotting.Results Compared with HC group,CP group and CT group,the albumin in CC group was significantly decreased,and the concentration of glutamate transaminase,total bilirubin,direct bilirubin and triglyceride were significantly increased,(221.67±12.38)U/L、(315.53±13.60)U/L、(1.65±0.32)mmol/L、(0.88±0.21) mmol/L、(4.98±0.32)mmol/L respectively.Liver biochemical test of CP group [(108.27±16.55)U/L、(180.45±15.28)U/L、(1.15±0.27) mmol/L、(0.58±0.12) mmol/L、(2.93±0.18) mml/L) and CT group [(148.56± 18.16)U/L、(247.18±21.64)U/L、(1.34±0.19) mmol/L、(0.69±0.16) mml/L、(3.75±0.28) mmol/L] was improved after CFZ treatment,and CP group was better than that of CT group.The concentrations of TNFa,IL-1,IL-6 and CRP in CC group [(156±9.56)ng/L、(762±9.46)ng/L、(962±9.12) ng/L、(772±10.04 ng/L)] were significantly higher than those in HC group[(16.42±5.63ng/L、174±9.61 ng/L、206±8.27 ng/L、397±10.2 ng/L)],CP group[(71.25± 4.41 ng/L、398±9.72 ng/L、398±9.72 ng/L、483±9.71 ng/L)] and CT group [(113±8.01 ng/L、506±8.74 ng/L、703± 7.76ng/L、651±11.31 ng/L)].The expression of IκBα in HC group,CP group and CT group were higher than that in CC group,and the difference was statistically significant.The expression of IκBαwas was more obvious in CP group than that in CT group.Compared with HC group,the expression of p65 in CP group,CT group and CC group was significantly increased,respectively,and the difference was statistically significant.The expression of p65 in CP group was lower than that in CT group(P=0.000).Conclusion CFZ ameliorates hepatic function in cancer cachexia mice,which may be related to the inhibition of NF-κB resulting in liver function improvement,the inhibition of tumor growth and the consumption of skeletal muscle.

Objective:To analyze the effect of behavior-oriented teaching in the teaching of pediatric nursing interns.Methods:A total of 63 pediatric nursing interns from March 2018 to December 2019 were selected as research objects. According to their admission, they were divided into control group ( n=31) and observation group ( n=32). The control group was taught by routine nursing teaching, and the observation group was taught by behavior-oriented teaching. After one month of intervention, the mastery of professional knowledge and the core competence of nursing interns were compared. Fatigue scale (FS-14) and mental health symptom checklist 90 (SCL-90) were used to evaluate their clinical nursing stress. SPSS 22 0 for t test and chi-square test. Results:The scores of nursing interns in the observation group were higher than those in the control group [(88.29±10.42) vs. (82.56±9.03)], with statistically significant differences ( P<0.05). After learning, the score of core competency inventory for registered nurse (CIRN) of nursing students in the observation group was higher than that in the control group ( P<0.05). After learning, the scores of FS-14 and SCL-90 in the observation group were lower than those in the control group, and the difference was statistically significant ( P<0.05). Conclusion:The application of behavior-oriented teaching can improve the professional knowledge and nursing skills of pediatric nursing interns, improve their core competence, alleviate their work pressure, and improve the quality of nursing teaching.

This paper summarized the characteristics, rehabilitation needs, and situation and problems of stroke dysfunction in China. Approaches and methods of family rehabilitation were also discussed.