Ductal carcinoma in situ belongs to the early stage of breast cancer.The treatment of ductal carcinoma in situ is similar with that of the breast cancer.Because of the low mortality rate in patients with ductal carcinoma in situ,there was an excessive treatment in the treatment of ductal carcinoma in situ.So the key to the treatment of ductal carcinoma in situ was to improve the quality of life.The present study shows that the effect of conserving surgery with radiotherapy is same with mastectomy's in the treatment of breast ductal carcinoma in situ.Sentinel lymph node biopsy can also be used to evaluate the patient's axillary status.For patients with ductal carcinoma in situ with breast conserving surgery,radiotherapy and endocrine therapy can reduce the recurrence rate of ipsilateral breast cancer.Radiotherapy and endocrine therapy have also become the standard treatment for ductal carcinoma in situ.

Dystonia is common in children with cerebral palsy. It can cause motor dysfunction, and is frequently associated with altered speech articulation, abnormal swallowing, and excessive drooling. Although trihexyphenidyl (Artane) is an anticholinergic agent with a long history of use in the management of dystonia in adults, information is limited regarding the use of trihexyphenidyl in children. This study reviewed the clinical experience of the use of trihexyphenidyl in children with cerebral palsy for dystonia, with special emphasis on benefits and tolerability.

Dendritic cells(DCs) are known as the most efficient antigen-presenting cells that are potent stimulators of both B and T cell immune responses.The biological characteristics and culture in vitro of DCs,preparation of DC vaccines,experimental and clinical studies in tumor immunotherapy by DC vaccines are reviewed in this article.

Objective To research the visualization of congenital heart disease by three-dimensional echocardiographic(3DE) virtual endoscopy(VE) system. Methods Datasets.from 10 healthy children and 22 patients with congenital heart disease were collected (10 patients with atrial septal defects, 6 patients with ventricular septal defects and 6 patients with tetralogy of Fallot). 3DE heart models were reconstructed by virtual reality computing techniques and visualization in scientific computing techniques. The VE system was programmed under the C++ 6.0 language condition,the visualization toolkit (VTK) platform was employed to carry out the graphics and visualization utilities. The virtual eye can move along the navigation paths in the heart by manual camera movements. Results The VE can provide special information in aspects of intracardiac anatomy, The visible heart models show precisely complex anatomy structure and spatial relationships. 3DE intracardiac endoscopic imaging can thus be visualized and navigated successfully by the VE system. Conclusions 3DE VE is a new system for the visualization of congenital heart disease.

ObjectiveTo study the effect of TCM diagnostic method flow reconstruction and optimized management in the mass injuries emergency previewing reception.MethodsWorking mode of TCM optimized receiving and dispatching flow were established and enforced.Results27 batch of 216 cases were received by emergency previewing reception in 2009～2010.Compared to 2009,patient dispatching time was shorten by 3.0 min,area dispatching time was shorten by 2.9 min in average.Emergency treatment satisfaction was elevated from 65％ to 95％ and rescue successful rate was increased from 82.3％ to 89.6％.ConclusionTCM diagnostic method flow reconstruction and optimized management improved the level of management of in the mass injuries emergency previewing reception and obtained better results.

Objective To investigate the relation of the peripheral blood C-reactive protein (CRP)and procalcitonin (PCT) and multiple organ dysfunction syndrome( MODS ) for patients with multiple trauma.Methods A total of 136 patients with multiple trauma were divided into MODS group (49 cases) and non MODS group (87 cases),and 50 healthy volunteers were chosen as control group. Peripheral blood CRP and PCT concentration were detected at different times. Results The highest concentration of peripheral blood CRP in MODS group was appeared on 48 h [(38.7 ± 2.7) mg/L], CRP concentrations in MODS group were significantly different with non MODS group and control group (P ＜0.05). The highest concentration of peripheral blood PCT in MODS group was appeared on 24 h [(20.3 ± 1.7)μ g/L], PCT concentrations in MODS group were significantly different with non MODS group and control group (P＜ 0.05). Conclusions CRP and PCT are relevant to the occurrence of MODS in trauma acute stage. The observation of peripheral blood CRP and PCT concentrations can predict the occurrence of MODS.

Objective To investigate the relative factors of insulin resistance(IR)during elective abdominal surgery and the mechanism of IR induced by surgery.Methods Fourteen patients underging elective abdominal surgery were studied.Fasting blood glucose(FBG),fasting plasma insulin(FPI),plasma TNF-α,IL-6 and CRP were tested for elective surgery patients on the day before,during operation and on one day after surgery.Insulin resistance index(HOMA-IR)and the index of insulin secretion(HOMA-β)were ealculated with homeostasis model assessment(HOMA).Insulin receptor and GLUT4 mRNA expression in skeletal muscle were assessed before operation and at the end of operation by use of RT-PCR.Results Significant differences were found in fasting blood glucose (5.95±1.08)mmol/L vs(8.92±2.41)mmol/L,fasting plasma insulin(19.95±3.33)mU/L vs(25.44±5.36)mU/L,IL-6(33.98±5.01)ng/L vs(45.29±7.81)ng/L and plasma TNF-α(86.70±9.27)ng/L vs(114.46±15.33)ng/L during and after operation(P＜0.01).A significant elevation of HOMA-IR levels was found after operation compared with that before operation[(9.59±2.89)vs(4.111.86)](P＜0.001).However there wag no significant difference in HOMA-β among three points(groups)of time(P=0.103).The result of RT-PCR showed that the expression of GLUT4 in muscle of patients at the end of operation reduced significantly compared with preoperation(t=12.488,P＜0.001)but there was no significance in INSR mRNA expression(P=0.165).ISI showed negative correlation with opermive time(r=-0.736、P＜0.001),blooding during operating (r=-0.594、P=0.032)and post-operative TNF-α(r=-0.641、P=0.018).Conclusion Insulin resistance occurs in elective abdominal surgery patients.The defective site is at postreceptor.To shorten the operation time,control the intensity of surgery and reduce the bleeding is helpful for decreasing IR.

Objective To evaluate the display ability and the clinical application of multislice spiral CT virtual endoscopy (CTVE) in the diagnosis of vascular diseases. Methods Fifty-six patients were examined by CT virtual endoscopy.32 patients also had DSA for comparison.18 patients were confirmed by operation (3 patients also had DSA).9 patients with pulmonary embolism were confirmed by other examinations and treatments.Results 56 patients showed successful CT virtual endoscopy images.CT virtual endoscopy images could clearly show the inner wall and inner structures of the vessels,mural thrombus,calcification form,stenosis of the vessels,the true and false lumina of aortic dissections,the lesion of false aneurysm,and the anatomic relationship between the lesion and surrounding structures of the normal vessels.Out of the 32 patients with vessel abnormalities on DSA,24 patients (75%) showed the lesions on CTVE.17 out of 18 patients with operation showed the lesions on CTVE.All 9 patients with pulmonary embolism showed the abnormalities on CTVE.Chi-square test:? 2=5.2809,P=0.071 patients showed the vascular diseases on CTVE in 56 patients (84%).Conclusion MSCT virtual endoscopy could provide more information of the vessel by displaying the inner wall and allowing users to map the vessels in a display.It is helpful in correct diagnosis and guiding surgery.

Objective To evaluate the effectiveness of multiple spiral CT angiography in diagnosis of pulmonary embolism.Methods 16 patients clinically suspected of pulmonary embolism underwent multiple spiral CT angiography.Emboli were found in the 8 patients of all on multiple spiral CT angiography.5 of the patients were reexamined with this method 20 to 30 days after thrombolysis. Results In 8 patients with pulmonary embolism,43 vessels were involved with pulmonary embolism.The presence of pulmonary embolism on CT was seen as a total occlusion,partial filling defect,mural filling defect et al;dilated of pulmonary artery trunk;all signs with deceleration of pulmonary blood or “mosaic sign”. 5 patients were reexamined with this method.The emboli dissoved partly or entirely.Conclusion Multiple spiral CT angiography is a noninvasive and effective method for examining pulmonary embolism.

Objective To study the expressions of EGFR and VEGF in endometrium after danazol pretreatment and the pathological changes of endometrium. Methods A total of 60 patients with anovulartory functional bleeding were randomly divided into two groups: Danazol group and control group with 30 cases in each group. Danazol group were given transcervical resection of endometrium with danazol pretreatment, and control group without any pretreatment. The endometrium resected from uterus was sent for histological assessment, observation of the grandular quantity and stromal loose degree, and of the expressions of EGFR and VEGF in endometrium. Results The endometrium of patients who took Danazol were almost in proliferative phase(similar to early proliferative phase).The numbers of endometrial glands near the basal layer with Danazol pretreatment were lower than that in the control group; the stromal components (+～) were more compact than the contral group (～). The expression intensity and rates of EGFR and VEGF in glands were higher than those of stromal components. Danazol decreased the expression of EGFR and VEGF in endometrium compared to the control group. Conclusion Pretreatment with Danazol can suppress the prolifieration of endometrial cells, thin the endometrium,and disperse the glands, compact the stromal components, and it can also reduce the expressions of EGFR and VEGF in endometrial glands and stromal components compared with the control group.