Objective To explore the effect of preserving intercostobrachial nerve (ICBN) in axillary lymph node dissection on sensory disturbance for breast cancer.Methods Clinical data of 146 cases of stage Ⅰ,Ⅱ and Ⅲa breast cancer patients treated by modified radical mastectomy was analyzed.The patients were randomly divided into two groups.Retention group included 67 patients who were performed axillary lymph node dissection preserving ICBN,and 79 cases undergoing axillary lymph node dissection were taken as control group.Data of the two groups were assessed to compare the operation time,nunber of lymph nodes dissection and sensory abnormalities of upper arms.Results In the follow-up of 1,3 and 6 months,the incidence rate of the lateral upper ann sensory disturbance were 17.9％ and 74.9％,11.9％ and 60.7％,7.4％ and 59.5％ respectively in the retention and control group,and the difference was statistically significant (x2=46.78,P＜0.001;x2=36.54,P＜0.001;x2=42.80,P＜0.001).Meanwhile,there was no obvious difference between the retention and control group in operation time and number of lymph nodes(P＞0.05).No local recurrence after operation occurred in the follow-up of 8 months to 5 years.Conclusions For stage Ⅰ,Ⅱ and Ⅲ a breast cancer patients undergoing axillary lymph node dissection,retaining ICBN can significantly reduce the chance of the postoperative medial upper arm sensory disturbance,improve the quality of life with no increase of local recurrence rate.

Objective To investigate the relationship among the expression of miR-340 protein, occurrence, development and metastasis in triple-negative breast cancer (TNBC). Method 60 patients with breast cancer, from January 2006 to December 2012, according to the immunohistochemistry expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER-2), were divided into TNBC (33 patients) and non-TNBC (27 patients), and the breast cancer tissues (15 patients) were also selected at the same period, and the expression of miR-340 protein were detected by the immunohistochemistry. Results The positive expression of miR-340 protein was 73.33%in adjacent tissues of breast cancer, 51.52%in TNBC, 29.63%non-TNBC, the expression differences of each group were statistically significant(χ2=7.671,P<0.05). The expression of miR-340 protein in TNBC and non-TNBC patients were no significant difference in age, menopausal status and tumor size;while there were obvious correlation among clinical stage, lymph node metastasis and protein expression of miR-340 in TNBC(P<0.05). Conclusion The gene of miR-340 involves in the occurrence, development and metastasis of TNBC, they would be one of the purposes gene therapy in TNBC.

Objective To explore the surgery methods for multiple fibroadenoma of breast,provide a ref erence for the surgical treatment of breast multiple fibroadenoma.Methods The clinical data of 152 cases of breast multiple fibmadenoma admitted from January 2008 to October 2012 in Department of Breast Surgery,Obstetrics and Gynecology Hospital of Fudan University were analyzed retrospectively.All the cases were applied intraoperative B-ultrasound guided,taken the areola incision through breast subcutaneous layer approach for resection of multiple breast fibroadenoma.The surgical incision design,surgical procedures and results of operations were analyzed.Results All 152 cases fibroadenoma were resected which were guided by B-ultrasound with areola incision.One month and three months after operation,the assessment of physician-patient for the scars were different.There was no significance in the Pearson Correlations which were 0.894 (P =0.106) and 0.905 (P =0.065),respectively.But twelve months later,it satisfied with the appearance of scar,either the patients or the doctors (P ＜ 0.05).The Pearson Correlation was 0.946 (P ＜0.001).Conclusions B-ultrasound guided areola incision through the breast subcutaneous layer approach could removal multiple breast fibroadenoma at one time,patients were satisfacted with the good cosmetic results,we believe this operation method has short operation time and good clinical value.

Objective NAC therapy was used to observe the effect of TNF-?,hs-CRP,PaO2,PaCO2and lung function in patients with COPD,so as to evaluate the therapeutic effect. Methods 65 patients with COPD were recruited and the patients were randomly divided into 2 treatment groups:control group (n=31) and experimental group (n=34). Patients in the two groups received the conventional treatment of COPD in unchanged dosage for the duration of the study except stopping using antibotic drug after infection was resolved. NAC tablets were taken orally at a dose of 600mg once a day in experimental group. After 8 weeks treatment,we appraised lung function and the plasma level of TNF-?,hs-CRP,PaO2 and PaCO2. Results Compared with normal controls,the plasma levels of TNF-? and hs-CRP increased significantly. The higher level of those ,the higher lung function class was in 65 COPD patients,and there was significant effect(P

Objective To analysis and summarise the feature of conventional ultrasound(US) and contrast-enhanced ultrasound(CEUS) of anterior mediastinal tumor.Methods From April 2011 to March 2015,24 patients,diagnosed as anterior mediastinal tumor by chest CT and could be detected by conventional US,were enrolled in this study.Among them,there were 11 lymphomas,5 thymic carcinomas and 8thymomas.The US and CEUS,micro flow imaging(MFI) and time intensity curve(TIC) parameters were evaluated respectively.Results Compare with lymphoma and thymoma in US,there were significant difference between the tumor shape and internal echo respectively (P ＜0.05,P ＜0.05).Compare with lymphoma and thymoma in CEUS,there were significant difference between the display rate of microvascular and feature of enhancement respectively (P ＜ 0.05,P ＜0.05).The result of TIC in different tumors were analyzed respectively.The rise time of lymphoma was early than thymoma,but the half time of wash out of lymphoma was later than thymoma,there was significant difference between the two diseases respectively(P ＜0.05,P =0.01).Further more,the arrive time of invasive thymoma was later than noninvasive thymoma,there was significant difference between the two diseases (P ＜ 0.05).Conclusions CEUS could further assess the characteristic of microvascular perfusion in anterior mediastinal tumors,based on the evaluation of conventional US.It could have a potential clinical value and a development capacity for differentiation diagnosis.

0.05).The serum PICP of tubercular meningitis children after 4 neeks glucocorticoid therapy (108.85?46.13) ?g/L was significantly lower than that in control group((154.38)?47.98) ?g/L and glucocorticoid- pretreatment (152.99?44.78) ?g/L (P

Objective To explore strategies and measures to improve hand hygiene (HH)compliance and correctness of health care workers (HCWs)in a large hospital.Methods The WHO multimodal hand hygiene improvement strategy was adopted by healthcare-associated infection(HAI)management department of a hospital,measures consisted of five key com-ponents,including:system change,education and training,evaluation and feedback,reminders in the workplace,and insti-tutional safety climate.HH compliance and correctness of HCWs were observed by infection control practitioners,HH compliance and correctness in January-June of 2012 (pre-intervention)and January-June of 2014 (post-intervention)were compared,effectiveness of intervention strategies were evaluated.Results HH compliance rate and correctness rate of post-intervention were both higher than pre-intervention (75.92% [8 369/11 023]vs 53.67% [5 127/9 553],P <0.001;94.11%[7 782/8 269]vs 83.88%[3 642/4 342],P <0.001).Of different occupations,HH compliance rates of doctors and nurses were significantly different before and after intervention (both P <0.001),while workers and staff of other oc-cupations before and after intervention were not significantly different(both P >0.05).Except ‘after body fluid exposure’, HH compliance rates of the other four indications for HH before and after intervention were significantly different(all P <0.001).Conclusion HH compliance and correctness of HCWs can be improved after adopting WHO multimodal hand hy-giene improvement strategy.

Objective To explore the tobacco control project based health education curriculum reform's effect of improving medical students' tobacco control.Method Choosing the students of two classes of students in preventive medicine specialty of Harbin Medical University as the research object, investigating the students respectively with the questionnaire prepared uniformly by 7 schools before and after the course.All data were coded by Epidata 3.0, and SPSS 18.0 was used to carry out the relevant information for the chi square test and t test.Result The sample size of baseline survey was114 and after the intervention was 87.The knowledge pass rate of the girls before and after the intervention were 87.3％ (48/55) and 98.2％ (54/55) respectively (P=0.000).The boys' awareness rate of the secondhand smoke safety level were 13.6％ (8/59) and 21.9％ (7/32) respectively, and the girls were 13.0％ (7/55) and 31.5％ (17/55) (P=0.021).Students interested in tobacco increased from 79.8％ (91/114) before intervention to 90.8％ (79/87) after intervention (P=0.033).Students willing to work in the tobacco related increased from 52.2％(59/114) before intervention to 66.7％ (58/87)after intervention (P=0.044).The girl who replied after intervention I am not smoking now, but won't smoke either when working in the disease control in the future reached as high as 96.4％ (53/55), but the students were lack of confidence to help people to stop smoking.Conclusion The reform of social practice activity curriculum designed for tobacco control project is effective, and it is urgent to strengthen the training of preventive medical students' smoking cessation skills and enhance their confidence.

Objective To monitor ventilator-associated event (VAE) for the first time in an intensive care unit (ICU) in China,understand the applicability,incidence,and clinical significance of VAE in China.Methods Targeted monitoring on VAE was performed among patients ≥18 years and with mechanical ventilation (MV)＞2 days in the ICU of a hospital between January 2014 and September 2015,incidence of VAE was calculated,and patients were grouped according to whether or not they had VAE,prognostic factors were analyzed statistically.Results A total of 1 004 patients were monitored,the total hospital stay was 13 795 days in patients who used ventilator,307 (30.58％) cases of VAE occurred,incidence of VAE per 1 000 ventilator-days was 22.25.Univariate analysis showed that patients with VAE had longer length of ICU stay and MV,and higher mortality rate than patients without VAE when they moved out of ICU (all P＜0.05).Multivariate logistic regression analysis showed that VAE was independent risk factor for length of ICU stay,duration of MV,as well as mortality when patients moved out of ICU(all P＜0.05).Conclusion Judgment of VAE is based on MV parameters,it is more objective and accurate.There is a high incidence of VAE among ICU patients,it may lead to poor clinical outcomes,and has good values for the targeted monitoring on ICU patients in large comprehensive hospitals of China.

This study left flavonoids and alkaloids Chinese herbal monomer with common parent nucleus as cream base carriages drug respectively, cream base were prepared with stable span 60-tween 80 emulsification system. The near-infrared stability analysis technology was performed to quantitatively characterize the physical stability of cream. Base on the theory of gel network structure, theory of emulsification, theory of solubility parameter and theory of double layer, the influence mechanism of Chinese herbal monomer on physical stability of cream was discussed. The results showed that tetrahydropalmatine, matrine and naringenin had similar solubility parameter value with cream base material, creams prepared with those Chinese herbal monomer have higher Zeta potential value and stronger physical stability, and that those creams had similar microstructure information with cream base. However, a larger solubility parameter difference exists between baicalin, baicalein, berberine, palmatine and cream base material. Creams prepared with those Chinese herbal monomers had lower Zeta potential value and poorer physical stability, and that those creams had great different microstructure information with cream base.
Drug Stability ; Drugs, Chinese Herbal ; chemistry ; Emulsions ; chemistry ; Kinetics ; Skin Cream ; chemistry ; Solubility