ObjectiveTo use the rapid screening of low vision and cataract of Zhangjiakou agricultural region by free pupil hole bottom digital camera,to approach cataract needed operation and rural cataract of Zhangjiakou by free pupil hole bottom digital camera.MethodsTo screening of low vision and cataract of above 55 years the crowd of Zhangjiakou 10 suburban county.ResultsThe actual screening 438000 persons,lower visual acuity 41787persons,total number of screening 9.5％,binocular parallax 22305 persons,total number of screening 5.09％,All of the low number of total vision 64092 persons( 14.6％ ).The screening was also found,cataract 12439 persons,total number of screening 2.74％,cataract needed operation 4623 persons,total number of screening 1.06％.ConclusionUsing non-mydriatic fundus digital camera Zhangjiakou agricultural regions of low visual acuity and cataract rapid screening was feasible,Zhangjiakou agricultural area cataract prevention should focus on Zhangbei,Hong Bao,Shangyi County in a remote mountainous area,Zhangjiakou agricultural areas to establish an information sharing,efficient operation of multiple departments linkage mechanism.

AIM:To approach the therapeutic effects of mycophenolate mofetil(MMF)in hormonal resistance nephrotic syndromes.METHODS:Patients were diagnosed as nephrotic syndrome and treated with prednisone at the dose of 1 mg?kg-1?d-1 for over 8 weeks,and 24 patients with unsatisfactory results or were palindromic were selected,and several patients in the 24 patients had been treated with cyclophosphamide or cyclosporine A.All patients were treated with MMF combined with low dose hormone.The initial dose of MMF was 1.0-1.5 g/d for 3 months,later the dose were reduced,and the maintenance dose of MMF was 0.5-1.0 g/d,the dose of prednisone was 5-20 mg/d,the follow-up visit period more than six months.The changes on urine protein,serum albumin,liver function,renal function were compared before and after treatment.RESULTS:Before and after treatment,urine protein decreased from(3.4?1.7)g/d to(0.9?0.2)g/d,serum albumin increased from(19.6?5.4)g/L to(36.1?7.7)g/L.serum creatinine level decreased from(105.7?6.4)?mol/L to(90.1?5.8)g/L.20 patients(83.3%)pathogenetic condition were relieved,15 patients(65.2%)were with complete remission.5 patients(20.8%)were partially recovered,and 4 patients(16.6%)had no response.The adverse effects were observed,including gastrointestinal events(n=8,33.3%),bacterial pneumonia(n=4,16.6%),herpes zoster(n=1,4.1%),hepatic function mild damage(n=3,12.5%).CONCLUSION:It is safe and effective to combine MMF with low dose hormone in treatment of hormonal resistance nephrotic syndrome,which could become a therapeutic option for refractory nephrotic syndrome(RNS).

Objective To explore the clinical characteristics,pathology,prognosis and proper treatment of tubular carcinoma of the breast. Methods The clinical data of 11 patients with tubular carcinoma of the breast treated in Peking Union Medical College Hospital were retrospectively analyzed.Results The incidence of tubular carcinoma of the breast account for 0.4% of the total breast cancer cases.Eight out of 11 cases had palpable painless lumps in the breast.Six cases received modified radical mastectomy,among which one patient received modified radical mastectomy of both sides.Four patients underwent breast conservation therapy.Sentinel lymph nodes biopsy was conducted in 2 patients.By immunohistochemistry ER was positive in 6 cases,PR was positive in 7 cases,2 cases were axiilary lymph node positive.Three patients received chemotherapy.Two patients received endocrine therapy(tamoxifen or aromatase inhibitor).Other patients received combined therapy including radiation,endocrine therapy and chemotherapy.All the patients have been followed up from 1 month to 7 years and within the period there is no recurrence,metastasis and death. Conclusion Tubulax carcinoma of the breast is a kind of low malignant tumor.Proper surgery and adjuvant therapy is important to improve survival and the quality of life.

AIM: To investigate a new method for identification of traditional Chinese medicine injection by FTIR. METHODS: For the steadiness of spectra, the factors of effecting spectrum's information quality were all investigated scientifically over the experiment procedures and instrumental setting, such as the preparation of samples, resolution ratio, scanning times, repeating scanning times, etc. The traditional Chinese medicine injections were used as the analytical samples such as Radix Isatidis, Rhizoma Chuanxiong, Flos Carthami, Radix Astragali and Herba Houttuyniae. RESULTS: Although all these original spectrums were similar at a certain degree, the FTIR combined with computer aided analysis, such as the cluster analysis and derivative spectrometry comparability calculation could be used to identify these injections. CONCLUSION: The method of identification by FTIR is non destructive testing, cheap, clean, fast, simple and convenient. The result indicates this method is suitable for establishing identification database of traditional Chinese medicine injections.

Objective To explore the association of estrogen receptor β expression with different stages and molecular subtypes of invasive breast cancer.Methods The clinicopathologic data of 446 invasive breast cancer cases was retrospectively analyzed.ERβ expression was evaluated by types and stages.Results Of all 446 invasive breast cancer cases,328 (73.5％) were ERβ positive.The ERβ positive rate was 77.9％ (240/308) and 63.8％ (88/138) in ERα + group and ERα-group,respectively.The ERβ expression in breast cancer was positively correlated with ERα (P ＜ 0.01) while it had no correlation with PR,histological grade,HER-2 and Ki-67 (P ＞ 0.05).ERβ expression was not significantly different among different age,tumor size and axillary lymph node groups(all P ＞ 0.05).A total of 418 invasive breast cancer cases were recruited for pathologic stage and NPI analysis,including 168 cases at stage Ⅰ,152 cases at stage Ⅱ and 98 cases at stage Ⅲ.ERβ expression was not significantly different among different stages of breast cancer(P =0.743).Analyzed in these 418 cases,NPI was ＜ 3.4 in 126 cases,3.4-5.4 in 207 cases and ＞ 5.4 in 85 cases.ERβ expression was not significantly different among different NPI group (P =0.644).The ERβ positive rate in Luminal A subtype,Luminal B1 subtype,Luminal B2 subtype,HER-2 subtype and TN subtype was 75.6％ (88/118),75.9％ (110/145),85.2％ (46/54),68.4％ (39/57) and 62.5％ (45/72) respectively.ERβ expression was significantly different between Luminal subtype and non-Luminal subtype (P =0.007).Conclusions ERβ was not differentially expressed among different breast cancer stages and NPI groups.ERβ was differentially expressed in different breast cancer molecular subtypes.

Objective This study was performed to investigate the levels of HSP70 in tissue in pemphigus as a possible new theoretical basis for further elucidate the pathogenesis of pemphigus.Methods The expression of HSP70 in 62 patients with pemphigus was determined by immunohistochemistry,and the normal skin was taken as control.Results The results showed that the positive cells of HSP70＞75 ％ in the blisters of pemphigus vulgaris and the positive cells of HSP70＞50％ in the inflammatory cells near the blisters,and the expression of HSP70 was significantly higher than that in normal skin,which was statistically significant(Z=5.42,4.73,P＜0.01).Conclusion The abnormal expression of HSP70 in inflammatory cells and psoriasis of pemphigus patients showed that HSP70 is involved in the pemphigus.

OBJECTIVE To acknowledge the current administrative situation in gastrointestinal endoscopies in Xi′an health settings.METHODS Using standard questionnaire to investigate endoscope disinfection related knowledge of the staff,facilities and layout in endoscopy room,washing and decontamination process and operating records.Samples were collected from gastrointestinal endoscope channels,biopsy forceps,disinfectants and the water in bottles.Then laboratory analysis was employed to check bacteria count,pathogen and efficient components of disinfectants.RESULTS Among 35 hospitals monitored,manual cleaning the endoscope was used by 29 hospitals,from which 75% samples were up to standard of guideline.The qualification rate of using automatic washing devices and acidic electrolytic water to disinfect endoscope was 15% and 78%,respectively.All biopsy forceps were up to standard.78% Efficient components of glutaraldehydes were up to 2%.CONCLUSIONS The rate of using automatic washing devices to clean gastrointestinal endoscopy is still low.It is important to strengthen supervision of hospital gastrointestinal endoscope disinfection to control nosocomial infection.

Objective To observe the relation between onset age and the motor complications involved Parkinaon' s disease (PD).Methods The detailed clinical information of 195 patients with idiopathic PD and good response to L-dopa were recorded and followed up.The data were calculated with SPSS statistic software.Results Although the time interval between the onset of the disease and the use of L-dopa was significantly longer in the 57 early-onset patients as compared to the 138 later-onset ones ((3.88±3.33) years vs (2.36±2.21) years, t = 3.142, P = 0.002), the time interval between the use of L-dopa and the occurrence of motor complications was not significantly longer in the early-onset group ((3.81±2.06) years vs (4.24±2.00) years, t = -0.888, P = 0.378).There was no difference in the constituent ratio of non-L-dopa use from onset between early-onset and later-onset PD groups (28.07% (16/57) vs 27.54% (38/138), χ2 = 0.006, P = 0.940).There was also no difference in the dosage of daily L-dopa use when motor complications occurred between early-onset and later-onset PD groups ((601.8± 296.7) mgvs (655.6±192.5) mg, t = -0.912, P=0.365).Seven-tenths of the patients with an onset age younger than 40 years old carried the risk of motor complications after using L-dopa for 5-years and those older than 70 years had the risk at a rate of 1/10.Conclusions Delaying the of use of L-dopa may not necessarily delay the onset of motor complications.The high incidence of motor complications among younger patients may not be related with drug dosage and the type of drug firstly chosen.Younger onset age does inerease the ineidence of motor complicatious.

Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer. Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer.

Objective:To analyze the distribution, clinico-pathologic features, and survival status of different subtypes in axillary lymph node-negative invasive breast cancer patients. Methods:In this study, data of 183 patients were included and retrospectively ana-lyzed in terms of age distribution, clinico-pathologic features, disease-free survival (DFS), and overall survival based on different sub-types (luminal, basal-like, and HER-2 over-expression). Results:No significant differences in age, tumor size, and TNM stage was ob-served among different subtypes. The relapse rates of luminal, basal-like, and HER-2 over-expression subtypes were 3.9% (4/102), 20.4% (10/49), and 6.3% (2/32), respectively (P=0.002). The death rates of luminal, basal-like, and HER-2 over-expression subtypes were 2.0%(2/102), 6.1%(3/49), and 3.1%(1/32), respectively (P>0.05). Kaplan-Meier analysis showed that the DFS of basal-like sub-type was much lower compared with that of the luminal and HER-2 over-expression subtypes (P=0.002). Cox analysis showed that the subtype was an independent prognostic indicator (P=0.001). Conclusion:In node-negative invasive breast cancer, no significant differ-ences in age distribution, tumor size, and TNM stage was observed among different subtypes. The basal-like subtype has the worst prog-nosis. Therefore, subtype is an important independent prognostic indicator.