Objective To examine the association between baseline body mass index (BMI) and overall survival (OS) in lymph node negative breast cancer patients. Methods From Jan. 1st, 1998 to Dec. 30th, 2008, 662 patients with lymph node negative breast cancer were treated at the Breast Center of Peking University Peo-ple’s Hospital. The clinical factors such as menopause status, tumor stage, body mass index (BMI), total triglyc-eride (TG), total cholesterol (TC) and glucose (GLU) were collected. The chi-square test was used to assess the association between obese and other factors. Log-Rank test and Cox regression analysis were performed to make univariate and multivariate analysis. Results The median follow up was 82 months (ranging from 2 to 209 months). The 5-year and 10-year survival was 93% and 82%. Obesity was associated with GLU and tumor stage (χ2=5.224, P=0.031; χ2=6.007, P=0.14), whereas there was no relationship between obesity and other factors. The Log-Rank test revealed statistically significant better survival for non obesity (χ2=4.693, P=0.030), normal GLU (χ2=4.678, P=0.031) and HR positive patients (χ2=7.837, P=0.005). COX regression analysis showed that BMI (χ2=3.874, P=0.049) and HR status (χ2=6.782, P=0.030) had independent influence on overall survival of node negative breast cancer patients. Conclusion Obesity is an adverse prognostic factor for lymph node negative breast cancer patients, which may be associated with obesity-related disorders such as high blood GLU.

Objective To explore the association between the minimum temperature in different seasons and the hospital emergency room visits for cardiocerebrovascular diseases(International Classification of Diseases,tenth vision ICD-10:I00-I99) in Beijing,China.Methods The data of the daily hospital emergency room visits for cardiocerebrovascular diseases(ICD-10:I00-I99)from one of Peking university hospitals,the data of relevant ambient air pollution from the Beijing Municipal Environmental Monitoring Center and the data of meteorological index from China meteorological data sharing service system between 2004— 2006 were collected The time-stratified case-crossover design was used to analyze the data.Results After adjusting SO2,NO2,and PM10,the results showed that each 1 ℃ increase in the daily minimum temperature in summer was associated with the intraday hospital emergency room visits(OR=1.039,P

0.05) . Conclusion Air pollution can increase the risk of low birth weight and preterm birth in the exposed pregnant women.

Objective To explore the association between the daily maximum temperature and hospital emergency visits for cardiovascular and cerebrovascular diseases ( ICD-10: I00～I99) in different seasons in Beijing, China. Methods The data of the daily hospital emergency visits for cardiovascular and cerebrovascular diseases (ICD-10: I00～I99) from a Level-3A hospital in Haidian district in Beijing during 2004-2006 and the corresponding meteorological, air pollution data were collected. The seasonal-stratified case-crossover design and Logistic multiple regression model was used for the data analysis. Results After adjusting the influence of relative humidity, wind speed and atmospheric pressure, for 1℃ increase in daily maximum temperature, the corresponding increase in the hospital emergency visits of the diseases was 17.3%(OR=1.173, 95%CI:1.149～1.197) and 4.2% (OR=1.042, 95%CI: 1.011～1.074) in spring and summer of the years, respectively (P0.05). Conclusion The increase of daily maximum temperature may be a risk factor for daily hospital emergency visits for cardiovascular and cerebrovascular diseases in spring and summer, however, it may be a preventive factor in autumn. The effects of air temperature on health should not be the same in seasons.

Objective To explore the influence of erythropoietin (EPO) on infection induced neonatal rat brain injury at different starting time and its related mechanism.Methods Postnatal day 2 (P2) newborn SD rats were randomly divided into 4 groups:control group (group A),lipopolysaccharide (LPS) group (group B),the early EPO group(group C)and the later EPO group(group D).Pups in group A,B and C were injected different drugs intraperitoneally(group A for saline,group B for 0.6 mg/kg of LPS,and group C for 0.6 mg/kg of LPS and 5 000 U/kg of EPO) once a day for consecutive 5 days(P2-P6).LPS in group D were injected 0.6 mg/kg of LPS intraperitoneally once a day for consecutive 5 days(P2 P6),and with 5 000 U/kg of EPO once a day for consecutive 5 days(P7-P1 1).Rats in each group were given different drugs starting at corresponding time by intraperitoneal injection for 5 consecutive days.Every 10 newborn rats in group A and B were selected randomly on P2(6 h after intraperitoneal injection of drugs for the first time),P7 and P12,the brains were divided into the left and the right hemispheres marked by sagittal suture,using enzyme-linked immunosorbent assay method to evaluate the erythropoietin receptor(EPOR) protein level with the right cerebral hemisphere and reverse transcription-polymerase chain reaction (RT-PCR) method was used to investigate EPOR mRNA level of the left cerebral hemisphere.Immunohistochemical method was adopted to evaluate the expression of myelin basic protein(MBP),glial fibrillary acidic protein(GFAP) and EPOR at specified time point,and HE dyeing for the pathological changes of brain damage in different groups.Results HE staining of the group A presented the normal structure in the neonatal rat brain.Reduced numbers of hippocampal pyramidal cells,expansion of the lateral ventricles and periventricular leukomalacia were found in group B.No leukomalacia or lateral ventricles's expansion in EPO administrated groups and it was more obvious in group C.The EPOR protein and mRNA of group B was increased compared with the group A.The EPOR protein and mRNA levels had a tendency to decline with the increase of age.The MBP expression of group B(107.46 ±3.65)was significantly reduced compared with the group A(146.78 ± 3.13) (P ＜ 0.05),and the expression of EPO groups increased in contrast to the group B,moreover,the group C (126.25 ± 4.42) increased more obviously than that of group D(117.35 ± 3.42) (P ＜ 0.05).The GFAP expression of group B(141.46 ± 11.92 at P7 and 149.48 ± 13.59 at P12) increased significantly than group A(120.63 ± 13.32 at P7 and 119.74 ± 12.48 at P12) (P ＜0.05),the EPO group expressed lower than group B at the P12,and the group C (134.59 ± 12.19) decreased than the group D(137.27 ± 13.87) (P ＞ 0.05).Conclusions EPO shows a protective effect on the cerebral white matter injury caused by postpartum infection,it is superior to administer EPO at early time than later time.The mechanism of the protective effect may be connected with the fact that the infection can induce the expression of brain EPOR and the EPOR expression level has a tendency to decline with the increase of age.

Objective To evaluate the value of fine needle aspiration (FNA) and core needle biopsy (CNB) in highly suspicious breast malignant lesions in terms of diagnostic accuracy,complication rate and cost-effectiveness.Methods We retrospectively reviewed records of patients with imaging diagnosis of BI-RADS 4c or 5 categories who have undergone either FNA or CNB under ultrasound guidance in Peking University People's Hospital from 2012 to 2014.Sensitivity,specificity,diagnostic accuracy,positive predictive,negative predictive,false positive rate,false negative rate,accuracy rate and unsatisfactory rate (non-diagnostic rate) were calculated and compared between FNAC and CNB.The complication of the procedures,operation time and cost were assessed.Results Among 638 consecutive cases,273 of them underwent FNA,and 365 underwent CNB.The accuracy rate of FNA and CNB were 99％ and 97.2％.The sensitivity,specificity,diagnostic accuracy,positive predictive,false positive rate and false negative rate were similar between the two groups.The unsatisfactory rate of FNA was significantly higher than that of CNB (25.3％ vs.10.9％,x2 =22.59,P =0.000).There was not severe complication in either groups,while subcutaneous ecchymosis and hematoma were more common in FNA group than in CNB group.The operation time of FNA was shorter than that of CNB (4.8 ± 1.3 min vs.15.5-± 1.7 min,P =0.000).The waiting time for final pathological report was shorter in patients undergoing FNA (1 vs.3 days).An estimated cost for FNA was RMB 447.5 Yuan/case,whereas that was 995 Yuan/case for CNB.Conclusions FNA and CNB are both accurate and safe preoperative diagnostic procedures.FNA is a simple and cost-effective method.

Objectives To observe the clinical efficacy and safety of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemia.Methods 29 older patients with acute myeloid leukemia treated from June 2010 to December 2016 were randomly divided into observation group and control group.Observation group(n=14)were treated with decitabine combined with half of CAG(aclacinomycin,cytarabine,granulocyte colony-stimulating factor)regimen.The control group(n=15)were treated with CAG regimen.Results The overall effective rate was higher in observation group(78.6%)than in control group(53.5%),but there was no statistically significant difference(χ2=2.042,P=0.153).The rate of lung infections was significantly lower in observation group(28.6%)than in control group(73.3%),(χ2=5.811,P=0.016).The survival time of patients was significantly longer in observation group(17.5±5.7 months)than in control group(12.6±6.2 months),the difference was statistically significant(t=2.211,P=0.018).Conclusions The treatment program of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemiais is safe and effective,which is worthy of clinical promotion.

Objective: To explore the correlation among overweight, obesity and markers of prethrombotic state in patients with coronary heart disease (CHD). Methods: A total of 288 patients to hospital from 2013 to 2014 and diagnosed as CHD by coronary angiography were selected. According to body mass index (BMI), they were divided into CHD control group (n=106), overweight group (n=121) and obesity group (n=61). Levels of fibrinogen (Fg), plasma D dimmer (D-D), von Willebrand factor (vWF), antithrombin Ⅲ (AT-Ⅲ) and plasminogen activator inhibitor (PAI)-1 were compared among three groups, then received correlation analysis.Results: Compared with CHD control group, there were significant rise in levels of triglyceride, total cholesterol, fasting blood glucose and mean arterial pressure, morbidity rates of hypertension and diabetes mellitus in overweight group and obesity group, P<0.05 or <0.01. Compared with CHD control group, there were significant rise in levels of Fg [(2.89±0.60) g/L vs. (3.54±0.63) g/L vs. (3.92±0.94) g/L], D-D [(282.13±73.15) ng/ml vs. (390.04±73.54) ng/ml vs. (471.92±80.38) ng/ml], vWF [(108.62±24.66)% vs. (138.45±25.96)% vs. (161.20±29.39)%] and PAI-1 [(6.97±1.28) ng/ml vs. (9.60±1.73) ng/ml vs. (12.33±2.16) ng/ml] in overweight group and obesity group, P<0.01 all, and those of obesity group were significantly higher than those of overweight group, P<0.01 or <0.05; AT-Ⅲ level [(89.94±17.99)% vs. (69.89±20.22)%] significantly reduced in obesity group (P<0.05). Pearson correlation analysis indicated that BMI was positively correlated with markers of prethrombotic state [Fg: r=0.536, P<0.001; D-D: r=0.250, P<0.001; vWF: r=0.611, P<0.001;PAI-1: r=0.788,P<0.001). Conclusion: BMI is positively correlated with markers of prothrombotic state in CHD patients.

ObjectiveTo investigate the effects of caffeine citrate (CC) on the neuronal proliferation and apoptosis and long-term learning ability in neonatal rats with hypoxia-ischemic brain damage (HIBD).MethodsForty-eight 7-day-old Sprague-Dawley neonatal rats were randomly divided into 3 groups: sham operation group (n=16), HIBD group (n=16), HIBD + caffeine citrate group (CC group,n=16). Rats in HIBD and CC groups received ligation of left common carotid artery followed by 2 hours of hypoxia to establish HIBD model. Rats in CC group were injected intraperitoneally with CC (20 mg/kg) before and at 0 min, 24 h, 48 h, and 72 h after hypoxia-ischemic (HI), and rats in the other two groups were injected intraperitoneally with an equal volume of normal saline at the corresponding time. Meanwhile, from postnatal day 10, each rat was injected intraperitoneally with 5-bromo-2’-de-oxyuridine (BrdU) (50 mg/kg) for 5 consecutive times, once every 12 h. On postnatal day 12, BrdU in the hippocampal dentate gyrus and cleaved caspase-3 in the hippocampal CA1 area were detected by immunohistochemistry, and neuronal apoptosis in hippocampal CA1 area were detected by TUNEL staining. On postnatal day 28, long-term learning and memory ability of rats was tested by Y maze.ResultsThere was signiifcant difference in the number of BrdU-positive cells in brain tissues of rats among three groups (F=101.38,P<0.01). The BrdU-positive cells in HIBD group and CC group were signiifcantly more than those in sham operation group (P<0.05). There was signiifcant difference in the number of cleaved caspase-3-positive cells in hippocampal CA1 area among three groups (F=379.77,P<0.01). The cleaved caspase-3-positive cells in CC group were signiif-cantly fewer than those in HIBD group but signiifcantly more than those in sham operation group (P<0.05). The TUNEL-pos-itive cells in hippocampal CA1 area were signiifcantly different among three groups (F=505.92,P<0.01) which was most in HIBD group and fewest in sham operation group and signiifcant difference was found through multiple comparison (P<0.05). The total learning number of avoiding electric shock tested by Y maze was signiifcantly different among three groups (F=32.05, P<0.01) which was most in HIBD group. Correct response rate was significantly different among three groups (F=24.99, P<0.01) which was lowest in HIBD group.ConclusionsCaffeine citrate can improve the ability of long-term learning and memory in neonatal rats with hypoxia-ischemic brain damage, the mechanism of which may be related to reducing the neuronal apoptosis after hypoxia ischemia.

Objective To envaluate the accuracy of Photoplethysmograph pulse wave in monitoring stress reaction to harmful stimulation. Methods Patients (n=75) were randomly assigned to three groups according to the dosages of fentanyl that were administrated ( 4, 5 and 6 g/kg were given to F4, F5, F6 group respectively (n=25) in each group. Heart rate (HR), Systemic blood pressure (SBP), Diastolic blood pressure (DBP), SpO2, the skin temperature of finger, perfusion index (PI), epi?nephrine(E) and Norepinephrine (NE) were recorded at following time points:just in operation room (T1), 2 min after induc?tion (T2), at intubation (T3),1 min (T4) and 5 min (T5) after intubation. And the PPGPW was printed and measured at the same time points. Results PPGA and PI were significantly increased while E and NE were significantly decreased in T2 and T5, compared with those baseline at T1 (P < 0.05). At T3, PPGA and PI were significantly decreased while NE markedly in?creased in group F4 and F5 compared to T1. At T3, E in group F4 were remarkably increased h while E in group F5 were of no obvious changed, compared with those at T1(P<0.05). PPGA and PI increased while E and NE decreased in group F6 at T2, T3 ,T4 and T5 compared with those at T1 (P<0.05). In summary, PI was negatively correlated with plasma E and NE while PP?GA was negatively correlated with plasma E and NE .Conclusion PPGA and PI are negatively associated with intensity of stress response. And they can reflect the stress reaction during the induction period of intravenous anesthesia accurately.