Objective To elucidate the significance of expressive change in tissues of breast carcinomas.Methods Expression of PTEN protein was detected by immunohistochemistry (SP) in breast carcinomas?atypical intraductal hyperplasia?normal breast tissue. Results The positive rate and expressive intensity of PTEN protein in breast carcinoma were lower and weaker than those in atypical intraductal hyperplasia and normal breast. The intensity of PTEN protein expression was associated with differentiation degree of breast carcinoma, the poorer differentiation of breast carcinoma , the weaker expression of PTEN protein. Comparing with breast carcinoma, the PTEN expression level of atypical intraductal hyperplasia was higher , but It was lower than normal breast tissue. it is helpful for us to assess the carcinogenesis probability of atypical intraductal hyperplasia by detecting the PTEN.

Objective To explore the effect of educational mode on children' s social adaptive capacity (SAC) through investigating its change of children into kindergarten one year later. MethodsFor this study, participants were divided into three groups, namely study group (SG), control group Ⅰ ( CG Ⅰ ) and control group Ⅱ( CG Ⅱ ). ①SG :30 ～ 47-month-old children at their entrance at one kindergarten of Xi' an city were study by the follow-up study method. There were 119 participants in this trial except 22 lost- visitors. The scores of children's SAC were evaluated at their entrance time and one year later respectively, according to the Social Adaptation Scale for Infant-Junior Middle School's Student Revised by Zuo Qi-hua. ②Control group(CG) :The children,whose classes were randomized,of five classes were divided into CG Ⅰ and the other four classes were CG Ⅱ. There were 107children aged at 30 ～ 46 months in CC Ⅰ , 94 children aged at 42 ～ 59 months in CG Ⅱ. The scores of their SAC were also evaluated according to the same scale on September 2006. The cross-section investigation were used to CG Ⅰ and CG Ⅱ. Results① The mean total score of SAC in SG was higher at one year later ( 10. 52 ± 0.77 ) than that at their entrance time( 10.22 ±0.52) (P＜0.01) ,and the total score of SAC in SG was lower at their en trance time than that of CG Ⅰ (10.49 ±0.06)(P＜0.01 ). ②There was no significant difference in children's SAC between SG at the final stage( 10. 52 ± 0.77 ) and CG Ⅱ(10.40 ± 0.67 ) (t = 1.500, P ＞ 0.05). ③There were no significant difference in children's SAC between boarding care mode( 10.34 ± 0.68 ) and day care one( 10.32 ±0.56) (t = 0.182, P ＞ 0.05 ). ④There were no significant difference in children' s SAC between male ( 10.42 ±0.73) and female( 10.51 ±0.68) in the kindergarten.. ConclusionThe gathered living mode can promote the child SAC development, and the boarding care mode or day care one in one year has no effect on children' s SAC.

Objective To study the diagnosis and treatment of protracted bacterial bronchitis (PBB) in children. Methods Children with PBB conifrmed by bronchoscopy were recruited from May 2013 to April 2015 . The clinical data were retrospectively analyzed. Results All 31 cases include 18 boys and 13 girls were recruited. 28/31 were younger than 6 years old. They all complained of wet cough, some of them were reported with wheeze ( 17/31 ) and with ruttle in the lungs ( 16/31 ). White blood cell were in normal range ( 18/31 ) or slightly elevated ( 13/31 ). The C-reactin protein was in normal range ( 28/31 ). Chest X-ray test of 16 cases were normal. Twenty-four cases taken chest computerized tomograph scan, 5 had a sign of tracheobronchial stenosis. The purulent bronchitis without tracheobronchial stenosis were conifrmed by bronchoscopy. Four cases had tracheomalacia. The medians of proportion of neutrophil were 80% in bronchoalveolar lavage lfuid (BALF). The pathogens were identiifed in BALF in 17 cases, 6 with Streptococcus pneumoniae, 6 with Haemophilus parainfluenzae, 3 with Moraxella catarrhalis, 2 with Staphylococcus aureus and 1 with Haemophilus influenzae. The symptoms were improved in all cases and co-amoxiclav was prescribed to most cases when discharged. The course of antibiotics therapy was 2-4 weeks in 23 cases, and more than 4 weeks in 8 cases. Twenty-three ( 23 ) cases were cured but 8 of them relapsed. Another 8 cases were improved but not completely remitted, 7/8 were cured by further treatment for concomitant diseases such as nasosinusitis and allergic rhinitis. Conclusions Children with PBB are typically younger than six years old, and presented with prolonged wet cough and parent-reported wheeze, normal or with ruttle in the lungs. A conifrmed diagnosis was reached by bronchoscopy. The antibiotics therapy were effective, the course should be more than 2-4 weeks, however, relapse were common. When antibiotics therapy does not lead to complete remission, concomitant diseases should be considered.

Objective To probe into clinical value of real-time three-dimensional echocardiography (RT-3DE) in evaluating global and regional left ventricular function in patients with acute inferior, posterior and lateral myocardial infarction(MI).Methods The study consisted of 41 normal subjects and 23 patients with acute MI.RT-3DE was performed and three-dimensional image data was analyzed offline with software.A series of global and regional left ventricular volume curves were plotted.Regional and global diastolic volumes, regional and global systolic volumes, regional and global ejection fractions, regional stroke volume to global diastolic volume were compared respectively between control group and MI group.Results By contrast with control group, global left ventricle function and regional left ventricle function in the zones with infarction and part of the zones close to infarction had significant difference( P＜0.05),however,no effective statistic change was found in the most of the distal zones of infarction( P＞0.05).Conclusions RT-3DE can accurately evaluate measurement the left ventricular global and regional function in patients with acute MI.

Objective To explore the relationship between the red cell volume distribution width (RDW)in patients with ges-tational diabetes and insulin resistance(IR).Methods A total number of 160 pregnancies performed in Guangzhou Women and Children’s Medical Center from January to October 2016.Matching 80 patients with gestational diabetes (the GDM Group)with 80 healthy pregnancies according to their age,gestational weeks and times.Their inflammatory parameters (hs-CRP,neutrophil-to-lymphocyte ratio,RDW)were respectively examined.HOMA-IR was calculated by testing the level of FBG and FIns.The association of the red cell volume distribution width with insulin resistance was analyzed.Results The level of four inflammatory parameters (hs-CRP,WBC,neutrophil-to-lymphocyte ratio,RDW)were significantly higher than that the control group (t=5.695,5.232,3.337,7.814,all P<0.01).Pearson correlated analysis suggested that RDW had positive correlation with HOMA-IR (r=0.58,P<0.01).Conclusion The RDW level were elevated in the GDM patients and had positive correlation with HOMA-IR,which indicated that IR was associated with inflammation and provided proof to research mechanism of GDM.

Objective To analyze setup errors and guide the calculation of margins from clinical target volume (CTV) and planning target volume (PTV) in esophageal cancer patients treated with tomothcrapy by the MVCT image-guided system.Methods Sixty-four esophageal canccr patients trcated with tomotherapy in our hospital in 2016 were randomly selected.MVCT images were acquired after patients' positioning and co-registered with KVCT images.The setup errors of x,y,and z translations and roll rotation were analyzed with the t-test or one-way ANOVA.Meanwhile,PTV margin was calculated based on the formula of M =2.5 Σ + 0.7δ Results According to the formula,the CTV-PTV margins in the x,y and z directions are slightly different between cancers located in the cervical,upper thoracic,middle thoracic,and lower thoracic segments.In patients with upper thoracic esophageal cancer,the average setnp error in the yaxis was lower when the head-neck-shoulder thermoplastic film fixation was used than when somatic thermoplastic film fixation (P=0.000);the setup errors of z-axis with somatic thermoplastic film fixation in the fifth and sixth weeks were slightly less than those in the first several weeks (P =0.036);the setup errors acquired by three image registration patterns were similar (x-axis P=0.868,y-axis P=0.491,z-axis P=0.169,roll P=0.985).Conclusions In the treatment of patients with esophageal cancer,the setup errors are large,but the MVCT in the TOMO HD system can greatly reduce the setup errors,ensuring the accuracy of each treatment.It is further recommended that in clinical practice,different CTV-PTV margins should be used for the treatments of esophageal cancers located in different segments.Patients with upper thoracic esophageal cancer are advised to use the head-neck-shoulder thermoplastic film fixation.

Objective To investigate the development of early myocardial perfusion with myocardial contrast echocardiography (MCE) combined with dipyridamole stress echocardiography in diabetic rats . Methods The diabetes mellitus (DM) group comprised 40 male diabetic rats ,induced with streptozotocin . The control group comprised 40 normal male rats ,comparable body weights with the DM group .The DM group was divided into four subgroups (0 week ,2 weeks ,4 weeks and 8 weeks after diabetic model established) and the control group was also divided into four subgroups matched with the DM group .Each rat was performed with conventional echocardiography ,MCE at baseline and after dipyridamole stress .The reserve parameters were compared between the control group and the DM group .In addition ,the differences among four subgroups in the control group and the DM group were compared ,respectively .Results MCE demonstrated that the 4 weeks and 8 weeks DM subgroup had lower myocardial blood velocity reserve and myocardial blood flow reserve than the control subgroup .The myocardial blood volume reserve was reduced in the 8 weeks DM subgroup ,too .Conclusions The impairment of myocardial perfusion in the DM rats are detected earlier with the MCE combined with dipyridamole stress .

Objective:To investigate the etiology, clinical characteristics and outcome of severe pneumonia-associated hemophagocytic lymphohistiocytosis, and to analyze the risk factors for mortality.Methods:Clinical data of patients with severe pneumonia-associated hemophagocytic lymphohistiocytosis admitted to Shenzhen Children′s Hospital from February 2009 to February 2019 were retrospectively analyzed.The data included clinical characteristics, etiology, clinical manifestations, laboratory data, treatment and outcomes of the patients.The clinical characteristics and laboratory data of the survival group and the death group were compared by independent sample t-test. Results:(1) Clinical characteristics: the patients were aged from 3 months to 8 years and 7 months, including 15 males and 15 females.Severe pneumonia-associated hemophagocytic lymphohistiocytosis accounted for 2.74% (30/1 096 cases) of severe pneumonia in the same period.(2) Etiology: Mycoplasma pneumoniae infection was found in 8 cases (8/30 cases, 26.67%), virus infection in 7 cases (7/30 cases, 23.33%, including 5 cases with adenovirus infection, 1 case with EB virus infection, and 1 case with cytomegalovirus infection), Mycoplasma pneumoniae complicated with adenovirus infection in 4 cases (4/30 cases, 13.33%), bacterial infection in 3 cases (3/30 cases, 10%), and fungal infection in 2 cases, Mycobacterium tuberculosis infection in 1 case.The pathogens were not identified in 5 patients.(3) Clinical manifestations: fever and hepatomegaly were present in all patients.Besides, 86.67% (26/30)patients had fever duration more than 10 days, 83.33% (25/30 cases) patients had cough, 76.66% (23/30 cases) patients had splenomegaly, and 33.33% (10/30 cases) patients had nervous system symptoms.Laboratory data showed varying degrees of reduction of binary and ternary systems in 80.00%(24/30 cases) of the patients.Liver function impairment was found in half of the patients, and serum ferritin and lactate dehydrogenase levels were elevated in all patients.(4) The mortality rate was 30.00% (9/30 cases). The differences in age, hypertriglyceridemia and high serum ferritin levels between the survival and death groups were significant (all P<0.05). Conclusions:Severe pneumonia-associated hemophagocytic lymphohistiocytosis is a disease with a high mortality rate.Patients with Mycoplasma pneumoniae and adenovirus pneumonia are more likely to suffer from secondary hemophagocytic lymphohistiocytosis.Younger age, hypertriglyceridemia and high serum ferritin levels are indicative of poor prognosis.

Objective To retrospectively analyze the clinical characteristics of 5 cases with recurrence of congenital tracheoesophageal fistula (rTEF) and to further understand the diagnosis and treatment of this disease.Methods We totally diagnosed 5 cases of rTEF from September 2015 to July 2016 in the department of respiration of Shenzhen Children′s Hospital.The clinical materials,characteristics,risk factors of recurrence and diagnostic methods were analyzed.Results Two cases were diagnosed of rTEF at 8 years after the first repair,one case was at one year after the initial repair and two cases were at 1 to 2 months after their operations.Three cases manifested mainly in bucking after feeding,recurrent pneumonia and growth retardation.One case was admitted for vomiting and abdominal distension.One case was asymptomatic.Esophageal anastomotic leaks occurred in three cases and esophageal trictures occurred in four cases after their repairs.Three cases accompanied with gastroesophageal reflux and five cases with tracheomalacia.Four cases were performed esophagography,but only two cases were suspected of recurrence.All of five cases were performed bronchoscopy.One case was diagnosed of rTEF directly.Two cases were found suspected fistulas.And another two cases were only found surgical scars.But these four cases were confirmed by Methylene blue test observed by bronchoscopy.Conclusion Although the leading clinical manifestations of rTEF are respiratory symptoms and feeding difficulties,sometimes rTEF is asymptomatic.Because rTEF is usually complicated with the other diseases with similar symptoms,it is possible to miss the diagnosis.Esophageal anastomotic leaks and trictures are the risk factors of recurrence.Bronchoscopy is the first choice for the diagnosis of rTEF,and Methylene blue test is golden standard.Thoracotomy is recommended for the treatment of rTEF.

Objective To investigate the distribution of surfactant protein-B(SP-B) gene single nucleotide polymorphisms and to clarify the correlation between SP-B gene polymorphisms and idiopathic interstitial lung disease(ILD) in children.Methods Sixty-seven children with idiopathic ILD(case group) and 102 children without idiopathic ILD(control group)were selected from October 2013 to September 2016 in Shenzhen Children's Hospital and the First Affiliated Hospital of Guangxi Medical University.Total exons and flanking region of SP-B were detected by high-throughput sequencing,genotype and allele distribution of exon 4(T131I)were analyzed.Results SP-B exon 4(T131I) genotypes could check out three genotypes:namely CC,CT and TT.The frequencies of genotype CC,CT and TT of exon 4(T131I) in the case group were 67.16%,25.37%,7.46%,and in the control group were 56.86%,35.29%,7.84%,respectively.There was no significant difference in genotype distribution between the two groups(χ2=1.981,P=0.371).Frequency of allele C was 79.85% in the case group and 74.51% in the control group,no significant difference showed between the two groups(χ2=1.288,P=0.256).In the control group,the mutation frequency of SP-B exon 4(T131I) was 43.14%(44/102),compared to the frequency of mutations in the population data in the thousands of human genome programs was 52.00%,in European was 53.88%,in South Asia was 45.50%,and in American was 41.93%(P>0.05);but the frequency of gene mutations was 26.39% in East Asia and 80.18% in Africa,there were significant differences compared to the control group(P<0.05).Conclusion The genetic polymorphism of SP-B exon 4(T131I)is not correlated with the susceptibility of idiopathic ILD in children.The mutation frequency of SP-B exon 4(T131I)is related to the race and the region.