Objective To evaluate the value of X-ray stereoscopic localized biopsy in diagnosis of breast minute calcification.Methods X-ray stereoscopic localized puncture and biopsy in 50 cases with breast minute calcification were analyzed retrospectively.Results In 50 cases,there were 18 cases of breast cancer,in which 3 were carcinoma in situ,10 were in clinical stage Ⅰ,5 were in clinical stage Ⅱ.The other 32 cases were benign lesion,in which there were 6 fibroadenoma ,5 microcyst,1 intraductal papilloma,18 cystic hyperplasia,2 duct ectasia.Conclusion Calcification is an important manifestation in diagnosis of breast cancer,especially the early stage of breast cancer.X-ray localized biopsy is the first and useful method in detecting the position and quality of the caicification.

Objective To evaluate the value of X-ray stereotaxic puncture in the diagnosis of early breast cancer.Methods The X-ray manifestations of 53 cases of early breast cancer verified by pathology were analysed.Results In 53 cases,there were 23 cases of lumps,17 were simple calcification,8 nodes with calcification,12 asymmetry improved density with disorder structue,15 stellatesign,18 augmentation blood,3 conduit breakag.Conclusion Mammography with X-ray stereotaxic localized puncture is the first useful method in diagnosing the early stage of breast cancer.

Objective To explore the method of comfort nursing in patients with nasogastric feeding and observe the influence on enhancement of patients satisfaction degree. Methods Case control study Was used in 162 conscious patients with nasogastric feeding.80 patients from January 2005 to January 2006 were selected as control group and given routine nursing.82 patients from February 2006 to May 2007 were named as the test group and received confort nursing.The satisfaction degree of patients, injury of nasal mucosa, shedding rate of the gastric tube and aspiration rate were investigated with self-designed discomfort questionnaires. Results The satisfaction degree in the test group Was 63.41％,which was higher than that of the control(40.00％,P＜0.01).The rate of nasal mucosa injury, shedding of the gastric tube and aspiration rate were lower in the test group(1.22％,2.44％,1.22％)than those in the control group(8.75％,10.00％,7.50％,P＜0.05).Conclusion The application of comfort nursing in patients with nasogastric feeding contributed to the enhancement of satisfaction degree of patients and nursing quality.

Objective To discuss the clinical efficacy of Mepilex surgical dressing in prevention of pressure sore. Methods 46 patients with high risk factors and Norton grading lower than 10 point were divided into the experimental group and the control group with 23 patients in each group. The control group was given reduction of local pressure, protection of the skin, nutritional support and other conventional measures to prevent pressure sore. Besides conventional nursing measures, the experimental group was given Mepilex to cover the bone eminence place, replaced every 7～10 days. The occurrence and development of the pressure sore was observed on the second, fourth, sixth and eighth week after admission. Results The occurrence rate of the experimental group on the sixth week was 4.55%, and the control group was 26.09%,the difference had statistical significance. The cure rate of the two groups showed no difference on the eighth week. Conclusions Application of Mepilex to treat patients with high risk of pressure sore has good effect.

Objective To investigate the influence of salmeterol with fluticasone on airway inflammation of patients with acute exacerbation chronic obstructive pulmonary disease (COPD).Methods 40 COPD patients in the stage of acute exacerbation were randomly divided into salmeterol with fluticasone group( A group) and controll group (B group).Bronchial alveolar lavage( BAL) was performed as usual.The concentrations of IL-8 and TNF-α in bronchial alveolar lavage fluid(BALF) were measured by ELISA.The results were compared with that of 18 healthy volunteers.Results The levels of IL-8 and TNF-a in BALF of patients in A group(10.60 ± 1.42) μg/L, (14.80 ± 2.05) μg/Land B group( 10.77 ± 1.98) μg/L, (14.70 ± 2.03) μg/L were significantly higher than that of C group (3.40 ±0.65)μg/L, (4.67 ± 1.01) μg/L( all P <0.01) ;Before treatment,the levels of IL-8 and INF-α in BALF of A group( 10.60 ± 1.42)μg/L,(14.80 ±2.05) μg/L and B group( 10.77 ± 1.98) μg/L,(14.70 ±2.03) μg/L had no significant differences (all P > 0.05) ,and the concentrations of IL-8 and TNF-a in BALF in group A (4.39 ± 0.92)μg/L,(5.84 ±1.26) μg/L were significantly lower than that in group B(9.69 ± 1.43) μg/L, (12.88 ± 2.51) μg/L after two weeks treatment ( all P < 0.01).Conclusion Salmeterol with fluticasone could inhibit airway inflammation of COPD patients in the stage of acute exacerbation.

Objective To calculate the biological reference of plasma amino acid on L-8900 amino acid analyzer and to provide reference for clinical diagnosis with domestic reagents replacing original reagent .Methods By testing the original standards and the same batch of plasma (50 cases) ,we compared original reagents with domestic reagents for their performance (including resolution , repeatability ,accuracy ) .We tested the plasma free amino acids of 400 cases of healthy people using the domestic reagents to estab-lish biological reference interval of plasma amino acid ,and do correlation analysis between the amino acids level and liver function . Results (1)Domestic reagents showed high accuracy in the results of 5 consecutive detection of amino acids were high peak separa-tion and high peak retention time and high peak area .(2)Statistics derived biological reference interval of 19 amino acids and 10 kinds of amino acids had significant differences .(3)Correlation analysis showed that ALT and liver function were negatively corre-lated with threonine(P<0 .05) .GLU and valine ,isoleucine ,leucine were positively correlated(P<0 .05) .CHO and negatively cor-related with isoleucine(P<0 .05) .Conclusion Domestic agents can replace the original reagents ,on the basis ,the biological refer-ence intervals of plasma amino acids have great importance to clinical diagnosis and prognosis .

Sixty patients with early diabetic nephropathy (DN) and normal blood pressure were randomly divided into telmisartan treatment and control groups.And the blood biochemical parameters,urinary albumin excretion rate (UAER),the serum levels of homocysteine (HCY) and transforming growth factor-β1 (TGF-β1) were measured at both pre- and post-treatment of 24 weeks.After treatment,the levels ofUAER,HCY [(61 ±26) vs.(98±38) mg/L,(11.70 ±2.86) vs.(14.4±2.8) μmol/L (P＜ 0.01 ) ]and homeostasis model of insulin resistance index,TGF-β1 [ ( 3.17 ± 0.66) vs.( 3.60 ± 0.87 ),(66 ± 14) vs.(77 ± 17 )U/L respectively (P ＜ 0.05 )]in the telmisartan group were significantly lower than those in the control group.It indicated that telmisartan could improve the insulin sensitivity,significantly decrease the serum levels of HCY and TGF-β1,reduce UAER and exert kidney protection effects in the patients with early DN.

ObjectiveTo assess the efficacy of subglottic secretion drainage for preventing ventilatorassociated pneumonia.MethodsData of relevant randomized controlled trials (RCT) from January 1991 to June 2010 were collected,and data were split into two groups,namely draining group and non-draining group.Meta analysis of ventilator-associated pneumonia was carried out for finding the incidence and mortality in patients with mechanical ventilation using the methods recommended by the Cochrane Collaboration.ResultsSeven RCTs met the inclusion criteria and 1647 patients were enrolled.Subglottic secretion drainage reduced the incidence of ventilator-associated pneumonia ( OR =0.45,95％ confidence interval [CI]:0.32 - 0.63 ),primarily by reducing early-onset pneumonia.But the mortalities of ventilator associated pneumonia were not significantly different between the two groups ( OR =1.03,95％ confi dence interval [CI]:0.75 - 1.41 ).ConclusionsSubglottic secretion drainage appeared effective in preventing ventilator associated pneumonia among patients expected to require ＞48 hours of mechanical ventilation,but the mortality was unchanged.

Objective To discuss and evaluate the value of multi slice spiral CT angiography in the diagno -sis of penetrating atherosclerotic ulcer materials .Methods 17 patients of PAU were collected and examined with MSCT,the location,radiological diagnosis and complications of PAU on axial ,CTA and 2D/3D images were analyzed. Results Ulcer-like aortic projections were observed of 17 patients,and connected with aortic cavity ,where narrow neck sign was showed .The indirect signs included localized or extensive IMH ,calcification of aortic wall and dilata-tion of aorta .Conclusion Multi slice spiral CT angiography is an effective method for the diagnosis of PAU by provi -ding valuable information for the diagnosis and treatment .

Objective To investigate the clinical value of multi-slice spiral CTA ( MSCTA ) and image-post processing techniques in diagnosis of acute aortic syndrome ( AAS) .Methods 71 patients with AAS were scanned by TOSHIBA Aquilion 64-slice spiral CT,the images on axial and 2D/3D were analyzed.Results 71 cases included 48 cases of aortic dissection ( AD) ,10 cases of intramural hematoma ( IMH) and 13 cases of penetrating atheroscle-rotic ulcer ( PAU) .MSCT depicted the imaging features of AAS:AD showed intimal flap and true and false lumens;IMH showed crescent or circular thickening of aortic wall .PAU showed a niche filling with contrast medium and pro-truding the aortic lumen ,where narrow neck signwas shown .The location ,radiological diagnosis and complications of AAS were observed in 71 patients.Intervention treatment or surgical treatment was conducted in 27 cases after defi-nite diagnosis .Conclusion MSCT is a fast and noninvasive examination technique , and it can provide important information for the diagnosis and treatment of AAS .