To explore the difference of respiratory muscle strength and respiratory drive between lung qi deficiency pattern and spleen qi deficiency pattern in chronic obstructive pulmonary disease (COPD).Forty two cases of COPD were differentiated as lung qi deficiency pattern (n=23, Group A) and spleen qi deficiency pattern(n=19, Group B) and twenty healthy volunteers served as control (Group C). Pulmonary ventilatory function such as forced vital capacity(FVC), forced expiratory volume in one second (FEV 1), FVC/ FEV 1 and maximum voluntary ventilation (MVV) were examined; and the maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and oral blocking pressure were also detected.As compared with Group C, pulmonary ventilation was decreased in both Group A and Group B and more obviously in Group B (P0 05); MIP and MEP in Group B differed from those in Group C (P

At present,the treatment for non-small cell lung cancer (NSCLC) consists of surgery,radiation,chemotherapy,targeted therapy,etc.The epidermal growth factor receptor (EGFR) gene mutation opened a new era of individualized treatment.Multidisciplinary treatment come next after the combination of different treatment approaches,and the modality of targeted therapy like epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in combination with radiation was included.The present work reviews clinical progress for the EGFR-TKI combined with radiotherapy in advanced NSCLC.

Objective To study the value of sentinel lymph node (SLN) for forecasting axillary lymph node metastasis in breast cancer. Methods Fifty-six patients with breast cancer underwent SLN methylene blue mapping and biopsy,as well as axillary lymph node dissection.All lymph nodes received routine HE staining and immunohistochemical examination. Results SLN was successfully identified in 52 cases (52/56,92.8%).Routine pathological examination demonstrated metastasis of SLN in 22 cases and metastasis of non-SLN in 1 case,the false negative rate being 4 3% (1/23).In the remaining 29 cases without pathologically verified metastasis,immunohistochemical staining showed 1 case of CK-19 (+) with EMA (+) and another 1 case of CK-19 (+) with CEA (+),without metastasis of non-SLN. Conclusions SLN methylene blue mapping and biopsy may forecast axillary lymph node metastasis in breast cancer.

Objective To investigate the feasibility of breast conservative surgery for large breast carcinoma(over 3 cm in diameter)after neoadjuvant chemotherapy.Methods A total of 24 patients with breast carcinoma larger than 3 cm in diameter underwent core needle biopsy and neoadjuvant chemotherapy with paclitaxel and/or epirubicin in our hospital from June 2003 to September 2006.The chemotherapy was carried out for 2 to 4 cycles,and then breast conservative surgery was performed in 7 to 10 days.Results After the neoadjuvant chemotherapy,3(12.5%)patients achieved CR,and 21(87.5%)had PR.Pathological CR was detected in 2(8.3%)of the patients.The breast conservative surgery was completed in 14 cases(58.3%),10 patients were converted to modified radical resection.The patients was followed up for 5 to 44 months with a median of 24,during which none of them had recurrence or distant metastasis.Conclusions For patients with large breast carcinoma,breast conservative surgery is feasible after neoadjuvant chemotherapy.

Objective: To classify the AngleⅠ malocclusion subgroups using lateral radiographic films according to their ordinary coordinates and standardized coordinates converted by general procrusts analysis (GPA), and to compare the two kinds of classifications and their valne in diagnosis of malocclusion. Methods: 946 pretreatment lateral radiographic films of patients with Angle'I malocclusion were chosen and their ordinary coordinates were acquired via soft ware. The ordinary coordinates were then converted into standardized coordinates by GPA. All of the films were classified by cluster analysis and discrimination analysis applying the upper two kinds of coordinates respectively. Results: (1) Twenty one subgroups were identified according to the ordinary coordinates of the chosen films with the total differentiate rate of 92.7% and leave-one-out differentiate rate of 68.4% (Classification A). Correspondingly, 20 subgroups were identified according to the standardized coordinates with the two differentiate rates of 87.8% and 71.9% (Classification B). (2) If the ordinary coordinates were discriminated by Classification B, the total differentiate rate and leave-one-out differentiate rate were 79.8% and 60.2 % respectively. If the standardized coordinates were discriminated by Classification A, the two differentiate rates were 79.8% and 60.2 % respectively. (3) There were some subgroups having the similar form in Classification A and their difference mainly arose from the difference of the patient age, while there were no such subgroups like that in Classification B. (4)The proportion of the largest subgroup in total subjects is 15.9% and there were 8 subgroups having the number of subjects over 40 in Classification A, whilethe corresponding proportion and number of subgroups were 74.7% and 2 in Classification B.(5)Classification A and Classification B were both suitable to classify a new subject, but Classification B was required to standalize all of the subjects onc again, which was very complex, while Classification A was more simplified. Conclusion: Classification A and Classification B are interelated. GPA could concentrate the subjects in cluster analysis, which reduces some influence of the age to the classification, but the process to classify a new subject is very complex. Thus if quick diagnosis is needed in clinics, Classification A should be recommended, but the influence of the age should be noted.

Objective To study the hydrogen sulfide productivity by mononuclear cells in patients with atrial fibrillation (AF). Methods Mononuclear cells were extracted from peripherial blood of 60 AF patients and 30 healthy controls. Modified methylene blue method was used to evaluate the hydrogen sulfide productivity of mononuclear cells. Results Hydrogen sulfide productivity of mononuclear cells from AF patients was 92.5%higher than that from control [10.63 (8.21~14.37) μmol/(min.g protein) vs 5.52 (4.42~8.50) μmol/(min.g protein)]. Hydrogen sulfide productivity of mononuclear cells was correlated with the left atrial transverse diameter (r = 0.276,P < 0.01), while no significant correlation was found between hydrogen sulfide and left ventricular end-diastolic diameter , left atrial anterior posterior diameter , C-reaction protein etc. Conclusion Hydrogen sulfide productivity of mononuclear cells from AF patients is promoted.

Objective To compare the reproducibility and reliability of facial soft tissue landmarks using a direct and an indirect placement methods in facial three-dimensional (3D) soft tissue assessment.Methods 3D coordinates of 37 soft tissue landmarks were obtained respectively in 35 normal healthy volunteers from 3D optical capture system and Materialise's interactive medical image control system (Mimics).Landmarks were affixed on the cutaneous surface (direct method) and marked on the 3D reconstructed craniofacial model (indirect method).Intra-class correlation coefficients (ICCs) and paired t-tests were used to compare the reliability and reproducibility of facial landmarks between two placement methods.Results For the direct placement method,86.5 ％ landmarks had an ICC higher than 0.75.For the indirect placement method,75.7％ landmarks had an ICC higher than 0.75.The inter-observer variability using the direct placement method was (1.259±0.566) mm,which was significantly smaller (P＜0.05) than (1.420±0.638) mm obtained by the indirect placement method.Conclusions Compared with indirect method,direct method has higher reliability and reproducibility in evaluating facial soft tissue.

Objective To analyze the clinical pathologic features and prognosis of triple negative breast cancer. Method A total of 570 cases of breast cancer between January 2005 and June 2007 were analyzed,113 cases were negative for estrogen receptor(ER), progesterone receptor(PR) and HER-2 as the triple negative group, 48 cases were negative for ER, PR and positive for HER-2 as the control group. The clinical pathologic features, recurrence and survival of the patients were compared. Results The median age was 46 years old, 15 cases (13.3%) had a breast cancer family history or oophoroma family history,86.7%(98/113) of pathological types were invasive ductal carcinoma,lymph node metastases were detected in 31.0%(35/113 ) in the triple negative group. No significant difference was found for p53 staining between the triple negative group[58.4%(66/113)positive] and the control group [41.7%(20/48) positive] (P＞0.05).The median time of follow-up was 24 months,the loss was 5 cases, 10 cases (9.3%, 10/108) had local recurrence and metastasis,and 8 cases (7.4%,8/108) died from breast cancer metastases,2-year survival rate was 96.2% in the triple negative group.There was no significant difference in local recurrence and survival time between the triple negative group and the control group (P＞0.05). Conclusions The incidence of triple negative breast cancer is higher than other data reported. Triple negative breast cancer exhibits the same clinical pathological features compared with ER-/PR-/HER-2 + subtypes,and the prognosis is similar to the controls.

Objective To investigate an accurate and applicable localizing method of puncture point for neuroendoscopic third ventriculostomy in neurosurgery so as to ensure that the neuroendoscope is led to the anterior membrane of mammillary body on the base of third ventricle directly. Methods Based on the MR characteristics including multiple directions and angles and high soft tissue resolution, the coordinate of puncture point was measured and calculated for neuroendoscopic third ventriculostomy in MRI. Results~The position of puncture point for neuroendoscopic third ventriculostomy was (127.2?9.9)mm to nasal root, or (17.1?5.6)mm in front of coronal suture and (20.3?4.7)mm to sagittal suture. The angle between the puncturing line and the cerebral falx was (12.3?1.9)?, and the depth from scalp to anterior membrane of mammillary body was (89.3?10.4)mm. Conclusion MRI-guided localization for neuroendoscopic third ventriculostomy is an accurate, simple, safe, painless, and applicable method.

Objective To assess the Chinese System for Cardiac Operative Risk Evaluation (SinoSCORE) model in patients undergoing heart valve surgery at our center.Methods From January 2009 to December 2011,2098 consecutive adult patients who underwent heart valve surgery at our center were collected and scored according to the SinoSCORE model.All patients were divided into three risk subgroups.The entire cohort and each risk subgroup were analysed.Calibration of the SinoSCORE model was assessed by the Hosmer-Lemeshow(H-L) test.Discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve.Results Observed mortality of all 2098 patients was 3.00％.Despite there were significant differences between the SinoSCORE population and our own population sample,the SinoSCORE model showed good calibration(Hosmer-Lemeshow:P =0.783) and discriminative power (area under the ROC curve of 0.752)in predicting in-hospital mortality at the entire cohort.Conclusion The SinoSCORE model give an accurate prediction for individual operative risk in heart valve surgery patients at our center.