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 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 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 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

The mRNA and protein expression of thymidylate synthase (TS), thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) and their relationship with prognosis were investigated. Real-time quantitative RT-PCR (Taqman) was used to detect the mRNA expression of TS, TP and DPD in formalin-fixed and paraffin-embedded 106 samples of epithelial ovarian cancer and 29 normal ovaries. A TATA box-binding protein (TBP) was used as an endogenous reference gene. A relationship between TS, TP, DPD expression and clinicopathologic features was investigated. The protein location and expression of TS, TP and DPD was examined in the same patients by an avidin-biotin-peroxidase immunohistochemistry. TS and TP mRNA expression levels were significantly higher in tumor group than in normal controls, with the average value of TS and TP mRNA being 6.14+/-0.62 and 0.59+/-0.06 in tumor tissue, and 0.71+/-0.14 and 0.16+/-0.04 in normal tissue, respectively. DPD mRNA expression levels were significantly lower in tumor group (0.11+/-0.02) than in normal controls (0.38+/-0.05). There was statistically significant difference in TS and TP mRNA expression levels among different pathological grades and clinical stages (P<0.05), but histological subtype was not significantly associated with TS and TP mRNA expression. DPD gene expression was not significantly associated with any clinicopathological parameters. Immunohistochemistry revealed that TP protein was mainly distributed in nucleus, and TS and DPD mainly in cytoplasm. The protein expression intensity of TS, TP and DPD was coincided with the mRNA expression levels. It was concluded that TS, TP mRNA and protein expression levels were significantly higher in epithelial ovarian cancer, and DPD mRNA and protein expression levels were significantly lower. The expression levels of TS and DPD were related to the patients' prognosis and survival. Combined gene expression levels of TS, TP and DPD represent a new variable to predict the clinical outcome in ovarian cancer. The association of TS, TP and DPD expression levels with survival suggests an importance of these genes for tumor occurrence and progression.

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.

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.

Aim To investigate the protective effects of Aplysin on ethanol-induced oxidative damage in rat pri-mary hepatocytes. Methods Rat primary hepatocytes were obtained via the portal vein collagenaseⅣin situ perfusion technique followed by a Percoll density gradi-ent centrifuge. MTT test was used to determine the op-timum dose of Aplysin and ethanol, and detect the cell vitality in primary hepatocytes. Supernatants of primary hepatocytes were harvested to measure AST and LDH level, and the SOD, GSH-PX activities and MDA con-tent in primary hepatocytes were observed. Flow cy-tometry was used to detect the cell apoptosis rate. DNA damage in primary hepatocytes was detected by single-cell gel electrophoresis assay. The level of mitochon-drial membrane potential in primary hepatocytes was tested by fluorogenic probe JC-1 . The CYP2 E1 activity in primary hepatocytes was detected by colorimetry. The proteins of CYP2 E1 were detected by Western blot. Results 300 mmol·L-1 dose of ethanol and 30 mg·L-1 dose of Aplysin were the optimal dosages and were used in the subsequent experiments. Hepatocyte vitality was significantly increased in Aplysin group compared to that in ethanol group, and Aplysin inhibi-ted the release of AST and LDH(P<0. 05). For Apl-ysin treatment group, the activities of hepatocyte SOD and GSH were significantly increased, and MDA was markedly lowered as compared with those in ethanol group( P <0. 05 ) . Aplysin could alleviate hepatocyte apoptosis significantly, and hepatocyte DNA damage rates of Ⅱ ~Ⅲ level and Ⅳ level were significantly lowered in Aplysin treatment group as compared with those in ethanol group, and Aplysin had evident im-provement in alcohol induced mitochondria damage of hepatocyte. Primary hepatocyte activities and protein expression of CYP2 E1 were markedly lowered in Aply-sin treatment group as compared with those in ethanol group(P<0. 05). Conclusion Aplysin has protective effects on liver oxidative damage induced by alcohol of primary cultured rat hepatocytes by blocking CYP2 E1 activation, relieving oxidative stress, and sharpening the oxidation resistance ability.

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