Objective To investigate the qualitative diagnostic features of less than 2 cm atypical solitary breast nodules.Methods 52 patients diagnosed with atypical solitary breast nodules as well as the mammography and clinical characteristics were analyzed retrospectively.Results Among those 52 cases of nodular lesions,there were 23 benign nodules and 29 malignant nodules.Among these 29 malignant cases,26 cases were misdiagnosed as benign lesions,the X-ray of which showed the margin of nodules were mostly smooth,the density relatively homogenic yet with no sign of lobulation.Meanwhile,19 cases were diagnosed as malignant lesions, the X-ray of which showed irregular nodules,uneven density with or without multiple calcification,their margin lobulated,ragged, and ambient structure irregularity.In some case their local skin thickened and subcutaneous axungia were turbid.There were 7 cases unable to make timely diagnosis,the X-ray of which showed more or less regular form,uneven or almost even density,ambient structure barely regular,lack typical features.Conclusion To make accurate diagnosis,it is necessary to understand the characteristics of the pathology X-ray of different lesions,the atypical manifestation,plus comprehensive and detailed analysis,combing ultrasound and clinical palpation,MRI,biopsy and follow-ups when needed.

Objective To investigate the incidence and clinical significance of “no flow” (NF) phenomena after primary percutaneous coronary intervention (PCI) in the treatment of acute myocardial infarction (AMI). Methods ninety nine consecutive AMI patients underwent primary PCI were devided into NF group (18 cases) and non NF group (81 cases). The incidence of NF, clinical characteristics, blush grade, ST T segment elevation, peak CPK, left ventricular function and cardiac events were analysed. Results Eighteen patients demonstated NF, the incidence of NF was 18.2%. Compared with non NF, previous MI、diabetes、anterior MI and multivessel disease were more frequently observed in the cases with NF ( P 0.05). Conclusions The incidence NF after primary PCI in the treatment of AMI is 18.2%. The patients with NF show malperfusion in the myocardial microcirculation, larger infarct size, ventricular dysfunction and poor prognosis.

0.05, all statistically insignificant. Conclusions: Primary PCI was equally effective for the treatment of one vessel and multivessel AMI patients.

5 cm in diameter) of soft tissue density with irregular margins in sacrococcygeal region in all patients,the masses were of homogeneous density,no calcification and sacrococcygeal bone erosion,the CT value was 34~24 HU.The organs around the lesions were compressed and displacement.Conclusion In infants,huge homogeneous soft tissue-like and non-calcific mass with irregular margin in the sacrococcygeal region accompanied by bony destruction,hemangiopericyte sarcoma should be considered.

Objective To investigate the method of disinfection and sterilization of ventilator tubes and accessories in order to increase the sterilization quality of them. Methods 120 ventilator tubes and accessories from ICU and emergency department were randomly dividied into the control group,and the study group. Bacteriologic tests were conducted in the two groups. Results There was significat differ-ence in bacteriologic tests between the two groups. Conclusions It is necessary to research into steriliza-tion method of ventilator tubes and accessories.

Objective Folate receptors ( FRs) , overexpressed on the surface of a variety of tumor cells , are potential targets for tumor targeting therapy .This study aimed to prepare an FR-mediated drug nanocarrier with folate conjugated pullulan acetate ( FPA) to target chemotherapeutic agents to FR-overexpressed tumor cells and investigate its tumor-suppressing effect in vitro. Methods The cytotoxicity of epirubicin-loaded FPA nanoparticles ( FPA/EPI NP) against HepG2 and Hela cells was evaluated by MTS assay.The HepG2 and Hela cells were divided into five groups to be treated with NPs (NP control), chlorpromazine, chloro-quine, amiloride, and folate, respectively, followed by detection of the fluorescence intensity by flow cytometry . Results FPA/EPI NP was successfully formulated into NPs , with the mean particle size of (268.5 ±12.0) nm, by dialysis with an almost spherical shape . The drug-loading rate and entrapment rate of FPA/EPI NP were (6.45 ±1.04) and (72.45 ±11.50) %, respectively.The survival rates of the HepG2 and Hela cells were both >95%after 24 hours of incubation with FPA NP at 5, 40, 200, 400 and 1000μg/mL and 90.0%after 72 hours.The survival rates of the HepG2 cells treated with 5, 40, 200, 400 and 1000μg/mL FPA/EPI NP for 24 hours were (92.3 ±5.2), (70.4 ±4.6), (50.0 ±4.0), (41.1 ±4.1) and (27.0 ±3.6) %, respectively.Compared with the NP control group, the Hela cells of the chlorpromazine , amiloride and folate groups showed a significantly lower rate of NP uptake (P<0.05), and so did the HepG2 cells pretreated with chlorpromazine or amilo-ride (P<0.05).At 72 hours, the half maximal inhibitory concentrations (IC50) of FPA/EPI NP against HepG2 and Hela cells were 168 and 105μg/mL, respectively . Conclusion Clathrin-mediated endocytosis and macropinocytosis are involved in the internaliza-tion of FPA/EPI NP in HepG2 cells, while clathrin-and FR-mediated endocytosis in that of Hela cells .FPA NP may serve as a new drug carrier for tumor-targeted therapy .

Objective:To investigate the clinical outcomes of minimally invasive lateral lumbar interbody fusion (LLIF) and the necessity to perform LLIF plus posterior direct decompression in the treatment of severe degenerative lumbar spinal stenosis (DLSS).Methods:In this prospective randomized, controlled trial, we assigned 71 patients, who were 50 to 80 years old, and diagnosed with severe DLSS (Schizas Classification grade C on magnetic resonance imaging), in a 1∶1 ratio to undergo either one-stage LLIF plus posterior internal fixation (treatment group) or CLIF plus posterior internal fixation with laminectomy (control group). Demographic and perioperative data were collected and compared. The clinical outcome measures included Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ) score as well as visual analogue scale (VAS). Patients were followed up for at least 1 year.Results:The treatment group included 36 patients with 46 surgical levels, while the control group included 35 patients with 46 surgical levels. The baseline demographic data of the 2 groups were equivalent in preoperative central canal areas, spinal canal anteroposterior diameter, disc height, ODI, ZCQ score for symptom severity and physical function, as well as VAS scores for back and leg pain. The mean operative time, blood loss, drainage volume and hospital stay of the treatment group are significantly less than the control group (157.2±29.1 min vs. 180.6±26.8 min, 75.6±39.1 ml vs. 108.6±43.3 ml, 136.9±73.9 ml vs. 220.5±121.3 ml, 5.3±1.1 d vs. 6.6±2.3 d). There were 2 cases with dura tear and 1 case with wound infection in control group. Thus, the surgical trauma and complications of the control group were more than the treatment group. At 1-year follow-up, the mean ODI score of treatment group improved from 42.24%±10.70% preoperatively to 18.21%±11.49%, the mean ZCQ symptom severity from 2.89±0.38 to 1.61±0.41, the mean ZCQ physical function from 2.31±0.45 to 1.50±0.37, the mean VAS for back from 5.56±1.19 to 1.97±1.13 and the mean VAS for leg from 4.44±1.81 to 0.94±1.26. At 1-year follow-up, the mean ODI score of the control group improved from 43.65%±14.93% preoperatively to 17.36%±12.15%, the mean ZCQ symptom severity from 2.92±0.52 to 1.65±0.39, the mean ZCQ physical function from 2.37±0.52 to 1.55±0.39, the mean VAS for back from 5.63±1.40 to 2.34±1.47, and the mean VAS for leg from 4.37±2.14 to 0.83±1.20. The ZCQ satisfactory score of both groups were not significant different (1.25±0.45 vs. 1.26±0.43, t=0.07, P=0.944). The mean improvement rate of both groups for ODI, ZCQ symptom severity, ZCQ physical function, VAS back and VAS leg at 1-year follow-up were not significant different (55.43%±27.74% vs. 58.36%±25.06%, 43.07%±17.22% vs. 42.66%±12.95%, 32.25%±23.65% vs. 31.71%±23.24%, 62.65%±21.25% vs. 58.37%±22.44%, 78.94%±26.41% vs. 85.45%±20.53%). One adjacent segment disease was found in each group at 1 year follow-up. Conclusion:CLIF+ posterior internal fixation in the treatment of Schizas Grade C DLSS has satisfactory clinical outcome at 1-year follow-up. Laminectomy increases surgical trauma, but does not significantly improve the clinical outcome at 1-year follow-up.