Objective To explore the correlation of ultrasonographic,pathologic,and clinical findings of breast fibroadenomas.Methods 157 cases of breast fibroadenomas demonstrated by pathologic findings were examined with color Doppler ultrasound prior to biopsy.Images were classified according to ultrasound characteristics and analysed with latter pathologic findings.Results Ultrasound images of 157 cases could be divided into 6 types:uniformity( n =82),linage( n =37),bicolor( n =15),nodule-in-nodule (n =3),cyst-massity mixed ( n =9),calcify( n =11).5 cases were mistakenly judged to breast cancer on ultrasound images(1 ease in the linage,1 case in the cyst-mass mixed,3 cases in the calcify).Accurate ratio of ultrasound diagnosis was 96.82％.Pathologic finding:①Uniformity type,hyperplasia of both the gland and fibrous tissue of tumor in order.② Linage type,hyperplasia fibrous tissue in belt.③ Bicolor type,significant difference in the proportion and arrangement of the hyperplasia gland and fibrous tissue.④Nodule-in-nodule type,extensive hemorrhagic infarction in tumor.⑤Cyst-massity mixed type,hydatoncus,metaplasia in great sweat gland,hyperplasia conduit epithelial,conduit cystic-expansion.⑥ Calcify type,fibroadenomas on growth of static or regression transformation,and calcify of interstitial tissue.Conclusions Ultrasonic diagnosis and its simple typing is an accurate,simple and effective way for the diagnosis of breast fibroadenoma,which may improve the accuracy of diagnosis rate for breast fibroadenoma.It is helpful for choosing the surgical remedies.

Enhanced recovery after surgery (ERAS)is a new concept of accelerating the recovery of patients through a series of multi-mode strategies based on evidence-based medicine date in perioperative period. The perioperative fluid therapy is an important part of ERAS, including three phases of preoperative、intraoperative and postoperative. Its aim is to maintain the circulation volume to ensure circulation stability and effective perfusion of tissues, to avoid tissue ischemia and hypoxia, and to reduce surgical stress, maintain internal environment stability, reduce postoperative respiratory and circulatory complications, thus accelerating recovery. Fluid therapy has been controversial, Goal-directed Fluid Therapy is a recognized method.This article reviews the latest advances in preoperative, intraoperative and postoperative fluid therapy on the guidance of ERAS and its influence on postoperative outcomes.

Objective To investigate the clinical efficacy and psychological status of three kinds of drug therapy in patients with generalized anxiety disorder. Methods 90 patients with generalized anxiety disorder in our hospital from January 2015 to December 2016 were selected,and according to the different treatment methods divided into the observation group A, observation group B and observation group C,45 cases in each groups. The observation group A with venlafaxine treatment, observation group B with tandospirone treatment, observation group C treated with Laura Si; comprehensive observation of 3 groups of patients with clinical treatment, improve psychological status and the incidence of adverse reactions, drug compliance, strict record the relevant data and comparative analysis. Results 3 groups of patients with clinical curative effect, no significant difference ; observation group A patients psychological status were better than those observed in B and C group. The incidence of adverse reaction was lower than observed in B and C group, medication compliance was higher than B, C group, the difference was statistically significant (P<0.05). Conclusion The patients with generalized anxiety disorder can choose Vin Rafa Sin, tandospirone, Laura Si treatment, but Vin Rafa Sin on the psychological status of patients with improvement is more significant, less adverse reactions, medication compliance of patients, is worthy of clinical application.

Objective To explore the proper proportion of effective fractions in Shengmaisan(saponins of Radix ginseng,saponins of Radix ophiopogonis,Lignans of Fructus schisandrae)in different anoxia models.Methods Acute cerebral hypoxia was induced by sodium nitrite and decapitation in mice,and the orthogonal design was used in these two models to find the proper proportion of three effective fractions.The gasping time of the mice,which were decapitated was observed to compare the anti-anoxia effects of XZF with other clinical drugs,and cerebral ischemic reperfusion injury model of mice was also used to study the effect of XZF on related biochemical index.Results XZF(the proportion of saponins of Radix ginseng,saponins of Radix ophiopogonis,Lignans of Fructus schisandrae as 7 ∶ 2 ∶ 6)significantly prolonged the gasping time,and decreased brain nitrogen monoxidum(NO)content after reperfusion of the mice at dosages of 50 mg/kg and 150mg/kg.Meanwhile,XZF also reduced malondialdehyde(MDA)content and increased superoxide dismutase(SOD)activity at the higher dosage.Conclusion XZF obtained by experimental screening exerts a significant protective effect on cerebral ischemia injury in mice,which provide some pharmacological evidence for further development of new modern Chinese drug composed with effective fractions for cerebral vascular diseases.

Objective To explore the profiles of physical activity domains among professionals with different occupational activity patterns.Methods A cluster random sampling method was used to recruit employed adults aged 30-60 years in Beijing as well as Zhejiang province.The information on the physical activity domains was collected with a revised Global Physical Activity Questionnaire (GPAQ).Results Of 3 326 professionals,about 30.79％,50.75％ and 18.46％ adults had Class Ⅰ (mostly sedentary reading or writing during work time) ,Class Ⅱ (mostly working with arms or legs with little effort) ,and Class Ⅲ (working with effort)occupational activity patterns,respectively.The median volume of leisure time activity and bicycling were all 0 Met-min/week,and no significant difference of domestic activity volume was detected among all the three classes of professionals.Of all the non-occupational activity volume among three classes of adults,domestic activity accounted for the most proportion (58.87％) performed by adults of Class Ⅱ,traffic activity accounted for the most proportion (34.2％) by those of Class Ⅲ,and leisure time activity accounted for the most proportion (12.7％) by those of Class Ⅰ.Most time was spent in sedentary behaviors by those of Class Ⅰ after hours.Conclusions Besides the generally low level of moderate activity,the diversity of the domains of physical activity among this population was evident.It is necessary to develop appropriate technology to improve physical activity for professionals with different occupational activity patterns.

Objective To investigate the relevant factors of neonatal ventilator-associated pneumonia(VAP),and to provide a theoretical basis of prevention and treatment.Methods Retrospective analyed the clinical data of 145 critically ill neonates,who were treated with mechanical ventilator from Jan 2006 to Dec 2009 in the Third People′s Hospital of Wenzhou City,NICU.According to whether the neonates were occurred VAP,they were divided into two groups:VAP group(52 cases) and without VAP group(93 cases).Results Fifty-two out of the 145 neonates developed VAP.The incidence of VAP was 35.86%,the main relevent factors were the gestational ages,birth weights,the duration of mechanical ventilation and the times of intubation.There was significant difference between the two groups (P<0.05).The main pathogens were opportunistic bacteria,and mostly were G-bacilli.Conclusion The incidence of VAP has a close conclusion with the gestational ages,the birth weights,the duration of mechanical ventilation and the times of intubation.Regulate the use of breathing machine,strengthen aseptic operation,and select effective antibiotic can control the occurrence and development of VAP.

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.

Objective To investigate the imaging manifestations of metastasis in the nasal cavity and paranasal sinuses. Methods Twelve lesions of 10 patients with pathologically proved metastasis were retrospectively reviewed, including 6 renal clear cell carcinoma, 2 pulmonary adenocarcinoma, 1 colorectal carcinoma and 1 hepatic carcinoma. All the patients underwent CT and MRI scan.Among them,9 patients had contrast enhanced MRI scan and 5 patients had dynamic contrast-enhenced MRI as well. The location, bone changes, shape,margin,density,signal intensity, and enhancement characteristics of the lesions were observed. Results The metastasis involved spheno-ethmoid area(n=3), ethmoid sinus (n=2), maxillary sinus (n=2), nasal cavity(n=2), fronto-ethmoid area(n=2) and sphenoid sinus (n=1). All 12 metastatic lesions demonstrated bone destruction with tumor bone formation in 1 lesion. The CT displayed 10 metastases showed equal density, one mixed density was high, another form of low-density mixed. MR imaging showed equal signal in 9 lesions, while low-mixed signal in 3 lesions on T1WI compared with grey matter were found. On T2WI, 11 lesions showed high mixed signal and homogeneous low signal in 1 lesion. All 12 lesions demonstrated markedly heterogenous enhancement after intravenous administration of contrast media. Of 5 cases with dynamic contrast-enhanced MRI scanning, 4 lesions demonstrated wash-out time-signal intensity curve (TIC) pattern and 1 lesion demonstrated plateau pattern. Conclusions Renal carcinoma is the most common primary tumor for nasal cavity and paranasal sinuses metastasis. A typical imaging finding is located in the ethmoid sinuses, the soft tissue mass surrounded with rich blood supply multiple sinuses and significant bone destruction.

Objective:To describe our diagnostic and therapeutic experience of patients with urinary tract endometriosis.Methods:We performed a retrospective analysis of 22 cases of urinary tract endometriosis with histopathological results from 2001 to 2007.Results:The mean patient age was 36.0 years.Of the 22 patients,4 had bladder involvement and 18 ureteral involvement.In those with bladder endometriosis,the diagnosis was made by cystoscopy and biopsy in 4 patients.The treatments consisted of partial cystectomy in 3 patients and transurethral resection of the bladder in 1 patient.One of the patients who underwent transurethral resection of the bladder experienced 1 relapse.The relapse was treated with partial cystectomy.In the patients with ureteral endometriosis,the diagnosis was mainly established by ultrasound(18 cases),intravenous urography(11 cases),retrograde pyelography(7 cases),CT(14 cases) and MRI(5 cases).The treatments consisted of ureterolysis in 1 patient,ureteroneocystostomy in 4,and ureteral resection and end-to-end anastomosis in 13 of them.All the patients pathologic results were of endome-triosis.Conclusion:Urinary tract endometriosis is an uncommon disease.Partial cystectomy should be considered as the therapeutic option for bladder endometriosis.For cases of ureteral endome-triosis,the first technique depends on the location,extent and depth of the lesion.

Objective To explore the effects of cognitive rehabilitation on aphasia for the patients with severe traumatic brain injury. Methods 40 patients with traumatic brain injury following aphasia were randomly divided into simple language group (n=20) and language- cognition group (n=20). Both groups received conventional therapy and language therapy, and the language-cognition group received cognitive rehabilitation additionally, 30 minutes 1 day for 1 month. Results The index of Chinese Rehabilitation Research Center Aphasia Examination (CRRCAE) improved significantly after treatment in both groups (P<0.01). There were significant differences in all the indexes of CRRCAE (P<0.05) between 2 groups after treatment except dictation (P>0.05). Auditory comprehension correlated with orientation, visual perception, spatial perception, motor praxis, visuomotor organization and thinking operations. Conclusion Cognitive rehabilitation can improve the language function of traumatic brain injury patients with aphasia.