Objective To investigate the correlation between pathologic features and contrast?enhanced ultrasound in patients with breast ductal papilloma. Methods From January 2014 to January 2016,80 patients with breast intraductal tumor treated in our hospital were selected,including 20 cases of breast ductal carcinoma (ductal carcinoma group) and 60 cases of benign tumor (benign group). Both groups received conventional ultrasound, ultrasonic angiography,and pathological feature analysis. Results Breast surrounding hyperecho,internal micro calcification,border edge burr and posterior echo attenuation were more frequently seen onconventional ultrasound in ductal carcinoma groupthan inbenign group(P<0.05). The average scores of contrast?enhanced ultrasound were significantly higher in ductal carcinoma group than in the control group(P<0.05). In the ductal carcinoma group, there were statistical significant differences betweenpatientswith different lymph node metastasis dukes staging ,and differentiation types (P < 0.05). Spearman rank correlation coefficient analysis showed that breast intraductal carcinoma lymph node metastasis and dukes staging,differentiation types were markedly correlated with pathological features and ultrasound imaging (r=0.341,0.368,and-0.289;P<0.05). Conclusions Conventional ultrasound and contrast?enhanced ultrasound have very good imaging featuresin the diagnosis of breast intraductal cancer ,and there is correlation between pathologic features and contrast?enhanced ultrasound in patients with breast ductal papilloma,which can provide values for early diagnosis of breast ductal carcinoma.

Objective To develop a microtitration plate en zyme immunoassay to differentiate Candida albicans from Candida dubliniensis isolates using two specific probes s imultaneously.Methods The fun-gus-specific universal primers derived from the internal transcribed s pacer region of fungal rDNA were labeled with biotin,while the C.albicans or C.dubliniensis specific capture probes were coated on the microplates.Genomic DNA purified from the two species was amplified by PCR.The biotinylated p roducts were captured by the probes coated on the microplates.The A 405 value was finally determined by the c olorimetric assay.Results The two species of Candida could be detected specifically.Out of 108clinical isolates originally identified as C.albicans on the basis of germtube formation,two isolates were positive for C.dubliniensis and negative for C.albicans.The other106isolates were positive for C.albicans and negative for C.dubliniensis.Conclusions Two-specific-probe hybridization method is rapid and re liable for differentiating C.albicans from C.dubliniensis.

0.05). Conclusion It is encouraging that ravuconazole is effective against clinical and environmental isolates of C. neoformans, whether the isolates were sensitive to fluconazole or not.

Objective:To compare the satisfaction and tolerability of patients under local anesthesia with conscious sedation and simple local anesthesia in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) .Methods :Sixty patients undergoing EBUS-TBNA operation were randomly divided into local anesthesia with conscious sedation group (Group A) and simple local anesthesia group (Group B) ,with 30 patients in each group .The satisfaction and tolerability of patients , safety and accuracy of operations were observed by preoperative records ,intraoperative observation ,postoperative question-naires and follow-up .Results :Compared with Group B ,the blood oxygen saturations of patients before ,during and after oper-ation in Group A decreased significantly (P<0 .05) .The mean contractive pressure of patients before and during operation in Group A were significantly lower than that in Group B .However ,there were no significant differences in the satisfaction and tolerability ,the incidence rates of complications of patients and diagnostic accuracy in two groups .Conclusions :The simple lo-cal anesthesia in EBUS-TBNA in Outpatient Department is safe and effective ,with good satisfaction and tolerability .

Background and objective Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been widely applied in diagnosing mediastinal and hilar adenopathy. hTis study is further to evaluate value and safety of EBUS-TBNA in diagnosing intrathoracic metastasis from extrapulmonary malignancy. Methods Prospectively analysis of 41 patients suspected intrathoracic metastasis from previous diagnosed/concurrent extrapulmonary malignancies in Shanghai Chest Hospital, with radiologic ifndings showing mediastinal/hilar lymph node enlargement or intrapulmonary lesion requiring EBUS-TBNA examination for pathological diagnosis. Results 41 candidate patients enrolled, and 67 mediastinal/hilar lymph nodes and 5 intrapulmonary lesions were aspirated. 14 intrathoracic metastasis, 10 primary lung cancer, 9 reactive lymphadenitis, 4 sarcoid-like reactions, and 1 tuberculosis was diagnosed by EBUS-TBNA. Sensitivity and accuracy of EBUS-TBNA in diagnosing intra-thoracic metastasis was 87.50%and 95.12%, respectively. Immunohistochemistry (IHC) was performed in 18 malignant tumors to obtain deifnite type or origin, twelve intrathoracic metastasis and 6 primary lung cancer were further conifrmed. Conclusion EBUS-TBNA is a safe, effective method for the diagnosis of intrathoracic metastasis from extrapulmonary malignancy. IHC can provide additional evidence for distinguishing extrapulmonary malignancy from primary lung cancer.

Objective To explore the relationship between different smoking status and hypothyroidism in six iodine-suitable areas of China. Methods A total of 8187 residents were investigated by cluster sampling in six cities, and 7448 residents were included in the survey. The height, weight, waist circumference, and blood pressure were measured by filling out epidemiological questionnaire. Blood samples were collected to detect thyroid stimulating hormone ( TSH) , thyroid peroxidase antibody ( TPOAb) , and thyroglobulin antibody ( TgAb) . Results The mean TSH, TPOAb, and TgAb positive rates in passive smoking and active smoking groups were all lower than those in non-smoking group ( all P<0.01) . In the active smoking group, the TSH value decreased by 0.023 units for every unit increase in smoking index. The positive rates of TgAb and TPOAb in both passive smoking and active smoking groups were lower than those in non-smoking group (all P<0.01). Active and passive smoking reduced the prevalence of hypothyroidism (both P<0.01). Among women, the risks of clinical hypothyroidism and subclinical hypothyroidism were reduced in both active and passive smoking groups. Besides, the risk of subclinical hypothyroidism decreased significantly when the smoking index was more than 70. In male population, the risk of subclinical hypothyroidism in active and passive smoking group decreased. Besides, the risk of clinical hypothyroidism and subclinical hypothyroidism decreased significantly when the smoking index was more than 70. Conclusion Smoking in iodine-suitable areas may reduce TSH level and the positive rates of TPOAb and TgAb.

This paper summarized the clinical experience of XU Fengqin in the treatment of hypertension in the elderly. It is believed that the basic pathogenesis of hypertension in the elderly is liver and kidney depletion， and the key is ascendant hyperactivity of liver yang and spleen failing to transport. Therefore， the theory of “combination of disease and symptoms” is put forward that the four common clinical symptoms of hypertension in the elderly， including morning hypertension， non-dipper hypertension with abnormal circadian rhythm， postprandial hypotension and orthostatic hypotension， should be differentiated and treated with prescription in accordance with the characteristics of the corresponding pathogenesis. Specifically， the pathogenesis of morning hypertension is mainly liver-kidney yin deficiency and ascendant hyperactivity of liver yang， for which the treatment method of enriching liver and boosting kidney， calming the liver and subduing yang is suggested， and Qingxuan Jiangya Decoction （清眩降压汤） in modifications can be used. For non-dipper hypertension with abnormal circadian rhythm， the pathogenesis is mainly phlegm-dampness obstruction and clear yang failing to ascend， and treatment method should be dissolving phlegm and dispelling dampness， calming the liver and extinguishing wind， with Banxia Baizhu Tianma Decoction and Modified Honglong Xiahai Decoction （半夏白术天麻汤合加味红龙夏海汤） in its modifications. Regarding postprandial hypotension and orthostatic hypotension， the pathogenesis is mainly spleen-stomach depletion and clear yang failing to ascend， and thus the method of supplementing the center and boosting qi， raising yang and lifting the sunken is advised with Buzhong Yiqi Decoction （补中益气汤） or Yiqi Congming Decoction （益气聪明汤） in the modifications.

OBJECTIVE：To systematicall y evaluate the efficacy and safety of a new oral anticoagulant Ⅹ a inhibitor （apixaban，rivaroxaban，edoxaban）in the prevention and treatment of venous thromboembolism （VTE）in cancer patients ，and to provide evidence-based reference for rational use of drugs in clinic. METHODS ：Retrieved from Cochrane Library ，PubMed， Embase，CBM，CNKI，VIP and Wanfang database ，randomized controlled trials （RCTs）about Ⅹa inhibitor （trial group ）versus routine treatment or placebo （control group ）in the prevention and treatment of VTE in cancer patients were collected. After literature screening ，data extraction and quality evaluation was evaluated by using biasrisk evaluation tool recommended by Cochrane System Evaluator M anual 5.1.0，and Meta-analysis was conducted by using Rev Man 5.3 software. RESULTS ：A total of 7 RCTs were included ，including 5 666 patients. Meta-analysis showed that recurrent rate of VTE in trial group was significantly lower than control group [RR ＝0.58，95％CI（0.47，0.71），P＜0.000 01]；there was no statistical significance in the incidence of major bleeding [RR ＝1.12，95％CI（0.67，1.85），P＝0.67] and clinically relevant non-major bleeding [RR ＝1.06，95％CI（0.72，1.55）， P＝0.77] between 2 groups. CONCLUSIONS ：Ⅹa inhibitors can effectively reduce the recurrent risk of VTE in cancer patients ， safety comparable with routine treatment （placebo）.

Iron is an indispensable nutritional element for human growth and development. It has a protective effect on cardiovascular. The changes and metabolism of iron can affect the physiological and pathological state of the body. Current research has confirmed that iron overload will promote the synthesis of cholesterol and increase lipid metabolism disorders. Lipid metabolic disorders in the body easily induce the occurrence and development of related metabolic diseases, and increase the hidden dangers of the outbreak of relevant risk factors. This article reviews iron and lipid metabolic and other metabolic diseases and natural products to prevent diseases through iron metabolic pathway, which aims to provide more powerful references for in-depth research on the mechanism of metabolic diseases and related diseases and target drug research and development.