Objective:To investigate the clinicopathologic features and diagnostic methods of intraductal papillary(IP)lesions of the breast.Methods:The clinical data of 1 679 patients who had been pathologically diagnosed as having IP were analyzed retrospectively.Results:Nipple discharge is the most common clinical symptom of IP. According to the postoperative pathological results, IP patients were divided into solitary IP group and multiple IP group . Nipple discharge was more common in solitary IP group ( P<0.05). Bloody discharge and duct nipple discharge and discharge in unilateral breast were the most common clinical symptom of IP, though the difference was not significant ( P>0.05). The accuracy of diagnosing IP by fiberoptic ductoscopy(FDS) was 88.66% which was significantly higher than that of breast ultrasound and mammography. Solitary IP patients with nipple discharge undergoing FDS before surgery and lesions were more often detected located in general or level Ⅰ-Ⅱ duct system ( P<0.05). Postoperative follow-up did not show malignant transformation in solitary IP group, while there were 4 cases in the multiple IP group of malignant transformation and higher recurrence rate of IP ( P<0.05). Conclusions:Bloody discharge, single duct nipple discharge and unilateral breast involving 1esion and 1esions located in the general or level Ⅰ-Ⅱ duct system are common clinical features of IP. FDS has advantages in the diagnosis of IP with nipple discharge. For fear of recurrence , and malignant transformation in multiple IP, active postoperative follow-up should be carried out.

Objective To investigate the nursing knowledge of rural patients with rectal carcinoma after permanent colostomy.Methods Data were collected on 54 patients with rectal carcinoma after permanent colostomy using the self-designed questionnaire and analyzed by statistical methods.Results The rural patients with permanent colostomy showed low level of nursing knowledge.Scores of patients with different sexes and family income showed significant difference.Conclusions Medical security system and medical staff should provide with more welfare policy and specialty support for the patients in rural areas to promote their knowledge of self-care.

BACKGROUND:The stress distribution in the periodontal ligament of bending root can provide reference for the size and manner of force in orthodontic treatment. On this account, it can optimize the design of orthodontic force. OBJECTIVE:To analyze the stress distribution of root and periodontal ligament in the bending roots of the
maxil ary first molar under different orthodontic forces.
METHODS:The maxil ary first molars with normal roots and bending roots were selected, and then the finite element models of maxil ary first molars and periodontal ligaments were established through CT scan and
Workbench 11.0 finite element analysis software. The models were loaded with six different methods to analyze the stress distribution.
RESULTS AND CONCLUSION:The stress distribution of bending root was mainly concentrated in the tooth
neck, fol owed by the apex. During the overal tooth movement, the stress was smal est on the root, periodontal ligament and alveolar bone. Correction of bending roots needs more accurate positioning and traction.

Objective To investigate the status of second trimester maternal serum screening for Down's syndrome from 2006 to 2009 to evaluate the screening quality in Beijing.Methods Birth defect data (birth defect register) from 2006 to 2009 and screening data reported by certificated screening hospitals from 2008 to 2009 in Beijing were retrospectively analyzed by descriptive statistic method.Results Three hundred and thirty Down' syndrome babies were delivered from 2006 to 2009 in Beijing,among which 166 mothers accepted Down' syndrome serum screening and 85(51.2％) were diagnosed finally according to the screening results;among the 85 mothers,35 were≥35 years old with the detection rate of 62.5％ (35/56),and 50 cases were ＜35 with the detection rate of 45.5％ (50/110).The prenatal diagnostic rate of Down's syndrome babies increased from 26.8％(11/41) in 2006 to 47.4％(46/97) in 2009.The detection rate of Down's syndrome with serum screening increased from 23.1％(3/13) in 2006 to 62.9％(22/35) in 2009.One hundred and fifty-eight 21-trisomy cases accepted mid-term ultrasound screening,among which 62 cases (39.2％) were found abnormal.Conclusions Quality control for second trimester maternal serum screening for Down's syndrome should be improved in Beijing.Second trimester maternal serum screening for Down's syndrome in elderly primipara is not suggested.More attention should be paid on prenatal ultrasound screening.

【Objective】To observe the effect of Zhuyun Prescription Ⅲ(ZPⅢ),which is composed of kidney-tonifying and spleen-strengthening herbal medicine,on T lymphocyte antigen recognition receptors(TCR?&T) in luteal insufficiency abortion rats with deficiency of kidney.【Methods】Forty SD rats were equally randomized into 5 groups: blank control group,model group,high-and low-dose ZPⅢ groups(in the doses of 7.08 and 3.54 g?kg-1?d-1,respectively) and allylestrenol tablets(1.5 mg?kg-1?d-1) group.Luteal insufficiency abortion rats model with deficiency of kidney was established by hydroxyurea(450 mg?kg-1)and mifepristone(3.75 mg?kg-1).The uterus weight,the amount of embryo and the abortion rate were observed,and the peripheral blood levels of TCR?&T and CD3+T lymphocytes were detected with flow cytometer.【Results】The uterus weight and the amount of embryo were decreased,and the abortion rate was increased in the model group(P

OBJECTIVEThis study aims to determine the awareness oral medical interns about occupation safety protection of knowledge and to present a scientific basis for perfecting the occupation safety education system and standard protection behavior.

METHODSA self-designed questionnaire that used a retrospective questionnaire survey on 425 stomatological interns, scoring, and statistical analysis of the survey were performed. The questionnaire included occupation safety prevention knowledge, behavior cognitive, and protective behavior, among others.

RESULTSThe questionnaire recovery rate was 100%, and the average scores of the prevention knowledge and behavior cognitive were 4.55 ± 0.91 and 4.40 ± 1.05, respectively. More than 90% interns can conduct the conventional protection, and less than 40% can perform special protection. For the item "occupation safety protection knowledge", the scores of three grade III hospitals were higher than that of stomatological hospitals and second level of first-class hospitals; the difference was statistically significant (P < 0.001). For the items "behavior cognition" and "protective behavior", the scores of the second level of first-class hospitals were lower than those of grade III hospitals and stomatolgical hospitals (P < 0.001). The second level of first-class hospitals was relatively poor in safety protection knowledge, behavioral cognitive, and protection behavior. The average score was higher for than for boys in the three contents, and the average score of interns accepting pre-job training was higher than those rejected; the difference was statistically significant (P < 0.001).

CONCLUSIONThe occupation safety knowledge of oral medical interns is not sufficient, and the protective behavior is poor. Schools and hospitals should strengthen the intern occupation safety and protection education and improve the status of occupation safety behavior.

Clinical Competence ; Humans ; Internship and Residency ; Occupational Health ; Occupations ; Oral Medicine ; education ; Retrospective Studies ; Surveys and Questionnaires ; Universities

Objective To evaluate the value of technetium-99m methoxy isobutyl isonitrile(99Tcm-MIBI) tomography and integrated CT scan in preoperative localization diagnosis of primary hyperparathyroidism (PHPT). Methods 31 patients with PHPT were selected .15 minutes and 90 minutes ( delayed images ) after intravenous administration of 99 Tcm-MIBI 370 MBq, static anterior planar images of the neck and chest were obtained .99 Tcm-MIBI tomography and integrated CT scan were acquired after the delayed images .All patients received neck ultra-sound scan before surgery .The imaging findings were compared to the pathological results .Results The detec-tion rate of hyperparathyroidism lesions of 99 Tcm-MIBI dual-phase imaging and 99 Tcm-MIBI tomography and regis-tration with integrated CT scan was 87.1%and 93.5%respectively, without statistical significance (P>0.05). However , they were both higher than ultrasound scan which had a detection rate of 64.5%.The differences had statistical significance (χ2 =4.039 and 7.884 respectively , P<0.05 ) .The detection rate of parathyroid hyper-plasia of 99 Tcm-MIBI tomography and registration with integrated CT was both 80.0%, higher than that of the ul-trasound test(40.0%)and 99Tcm-MIBI dual-phase imaging(40.0%).The fusion imaging with integrated CT scan provided detailed anatomy data and more information for surgical doctors .Conclusions 99 Tcm-MIBI tomography and registration with integrated CT scan can improve the detection rate of PHPT compared with 99 Tcm-MIBI dual-phase imaging , provide detailed anatomy data , and has high clinical value in preoperative localization diagnosis of PHPT.

0.05, while the differences between 2 groups in cooling effects on the points of cooling 2.5 hours and 4.0 hours were significant, F

Objective To evaluate the efficiency of combined screening for chromosomal abnormalities in the first trimester and the ultrasound characteristics of these fetuses.Methods Retrospective study for 5000 singleton pregnancies by combined screening of trisomies 21,18,13 and Turner syndrome.Risk algorithms were developed for calculation of patient-specific risks for each of the three trisomies based on maternal age,fetal nuchal translucency,free β human chorionic gonadotropin and serum pregnancy associated plasma protein A at 11 to 13 +6 weeks of pregnant.The value of nuchal translucency (NT) and β-hCG and pregnancy-associated plasma protein A (PAPP-A) level were inputted computer,and calculate the risk value (≥ 1 ∶ 270) by automatic analysis software.Two hundred and four cases with high risk were performed transabdominal chorionic villus biopsy to detect the fetal chromosomal karyotypes.Meanwhile,other ultrasonic characteristics of fetal were elevated.Results (1) Five thousand cases of pregnant women were detected,including 4983 normal cases,62 cases were induced labor for a variety of reasons in the second trimester,including 40 cases with normal karyotype but with congenital heart disease,17 cases of chromosome abnormalities (9 cases trisomy 21,2 cases trisomy 18,1 cases trisomy 13,4 cases 45X),2 cases spina bifida,2 cases digestive tract obstruction,1 cases giant bladder.One case with low risk of fetal chromosomal abnormalities in combined screening,but high risk of age (maternal age were over 40 years old),it was 21 trisomy syndrome after the prenatal diagnosis.(2) Five cases of nasal bone loss in 9 cases of trisomy 21 (5/9),5 cases with three tricuspid regurgitation (5/9),4 cases of venous ductus a wave flow reverse (4/9),3 cases of fetal nasal bone loss accompanied by tricuspid regurgitation and venous ductus a wave flow reverse (3/9).One case of nasal bone loss in 2 cases of trisomy 18,2 cases were tricuspid regurgitation and venous ductus a wave flow reverse.Two cases in 4 cases of 45X had venous ductus a wave flow reverse.There were 8 cases (0.16％) nasal bone absence in 4983 cases of normal karyotype fetus,48 cases (0.96％) of tricuspid regurgitation and 44 cases (0.88％) of venous ductus a wave flow reverse.Thirty-two cases in 40 cases (80％) of fetal congenital heart disease were tricuspid regurgitation,30 cases of venous ductus a wave flow reverse (75％).Eight cases of nasal bone absence normal karyotype fetus were found the nasal bone at 20 weeks gestation.Conclusion Combination screening of nuchal translucency with serum markers in the first trimester were high detection rate and low false positive rate; a wave reversion and fetal nasal bone absence accompanied by tricuspid regurgitation can improve the detection rate of abnormal karyotype; abnormalities ultrasound marker may be associated with fetal congenital heart disease at 11-13 +6 weeks of pregnancy.

Objective To assess the clinical value of fetal chromosomal aneuploidy diagnosed by free fetal DNA in maternal plasma in 11-13+6 gestational weeks.Methods A total of 2 650 pregnant women who had prenatal care in Tianjin Center Hospital of Obstetrics and Gynecology from January 1,2010 to December 31,2010 were included.Each of them had an ultrasound scan to measure fetal nuchal translucency thickness.Maternal serum free β-human chorionic gonadotropin and pregnancy-associated plasma protein A test was performed as part of screening for chromosomal abnormalities.Results of ultrasound and maternal plasma biochemical analysis were entered into the database,and converted into multiple of median (MoM) by factors such as maternal age,weight,ethnicity,smoking history and mode of conception.The cutoff value was 1 ∶ 270.Meanwhile,20 cases had cell free fetal DNA (cffDNA) test and the ratio of the single nucleotide polymorphism on two alleles of plancenta-specific 4 (PLAC4) were measured in 16 cases.T-test,rank sum test,MannWhitney U test and Chi-square test were used as statistical methods.Results (1) A total of 74 cases were judged as high-risk,among which 35 cases underwent transabdominal chorionic villus sampling (18 cases had cffDNA test),37 cases underwent amniocentesis at the week of 20,and two cases of Rh negative did not receive the invasive examination.Totally 20 cases,including two Rh negative cases,had the cell-free fetal DNA test.(2) By cffDNA test of maternal plasma,two cases of 21 trisomy,one case of 18 trisomy,two cases of 45,XO and one case of balanced translocation were diagnosed.(3) In the two cases of 21 trisomy,maternal plasma G/A ratio ofPL4C4 RNA-single nucleotide polymorphism alleles was 1.00 (0.98,1.02) ; in 14 pregnancies with normal chromosome,the ratio was 1.055 (1.02,1.13,Z=3.5).There was no significant difference (P=0.066).Conclusion Diagnosing of fetal chromosomal aneuploidy by cffDNA in maternal plasma is feasible and noninvasive with high negative predictive value,and can be used in Rh-negative pregnant women for prenatal screening and diagnosis.