Breast Neoplasms ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; standards ; In Situ Hybridization ; standards ; Neoplasm Invasiveness ; Receptor, Epidermal Growth Factor ; analysis ; metabolism

Objective To observe the clinical efficacy and security of anti-tuberculosis combined with highdose methylprednisolone in treatment of advanced tuberculous meningitis.Methods 77 patients with advanced tuberculous meningitis in our department were randomly divided into the observation group(39 cases)and the control group (38 cases).All of the patients were given initiate antiphthisie treatment,the control group were added dexamethasone,20mg/d,iv drip,then was maintained after improved;the observation group were added high-dose methyprednisolone(500mg/d)by intravenous injection for five days,then was given methyprednisolone 80mg/d to maintain.Two groups were treated with hormone no more than three months.Then the clinical efficacy and adveme reaction were compared.Results The observation group:32 cases of healing,6 cases of effective,1 case of inefficient,the total effective rate was 97.4%and the control group were 22,8,8,78.9%;the difference of total effective rates in the two groups was statistically significant(x2=7.57,P＜0.05).The time of consciousness restoration and defevesence,the white blood cell count,protein chloride and glucose content of cerebrospinal fluid of the observation group were(2.7±1.3)d,(13±5)d,(112.37±27.57)×106/L,(3.04±0.82)g/L,(32.7±6.4)mmol/L and(1.67±0.65)mmol/L;and the control group were(5.2±2.4)d,(19±6)d,(93.74±20.18)×106/L,(1.92±0.64)g/L,(25.4 ±5.2)mmol/L and(1.04±0.34)mmol/L,the difference was statistically significant(t=5.70,4.77,3.88,6.67,5.48,5.31,P＜0.01);The difference of adverse reaction rate between the two groups was not statistically significant (P＜0.05).Conclusion The clinical efficacy of anti-tuberculosis combined with high-dose methylprednisolone in treatment of advanced tuberculous meningitis was better and had advantages in improving symptoms and signs without enhancing the rate of adverse reaction and it was worth to promote in clinical.

Objective To describe the status of resilience and self-care behaviors in chronic heart failure patients and to explore the relationship between resilience and self-care behaviors. Methods It was a cross-sectional survey. The Connor-Davidson Resilience Scale, the self-care behaviors with heart failure questionnaire and the demographic scale were delivered to 150 chronic heart failure patients in Shanghai Changhai Hospital. Results The score of self-care behaviors was (2.63 ± 2.01) points for chronic heart failure patients. The resilience score was (57.56 ± 8.51) points. The resilience was significantly related to the self-care behaviors(r=0.427, P<0.01), and which explained 32.4%of the total variation. Conclusions The chronic heart failure patients have poor self-care behaviors and resilience. More attention should be paid and more action be taken to improve the resilience, then improve the self-care behaviors of patients.

OBJECTIVE: To analyze the situation and the related problems of Chinese patent drugs including toxicity components used in pediatrics, and to provide the suggestion for the development of Chinese patent drugs for pediatrics. METHODS: 264 Chinese patent drugs which were used in pediatrics were collected from national drug standards, and compared with toxicity drug list. The utilization of toxicity drugs were analyzed statistically. RESULTS: About half of Chinese patent drugs for pediatric included toxicity components. Major problems are complex resource of toxicity components, overdose of toxicity components, single disease and pattern, unscientific determination of amount, etc. CONCLUSION: The in-depth study of Chinese patent drugs requires perfecting national drug standards, to developing more rigorous special approval requirements, to establishing the re-evaluation system and to eliminating unsuitable category of Chinese patent drugs.

AIM: To estimate the efficacy of milrnone in treatment of congestive heart failure. METHODS: 122 cases of chronic congestive heart failure with different etiology were divided into milrinone group and dabutamine group randomly. Milrinone group accepted milrinone (10 mg?d -1 ) for 5 days, and dabutamine group accepted dabutamine (160 mg?d -1 ) for 5 days. The efficacy of treatments was evaluated. RESULTS: The effectiveness rates of cardiac function improvement were 93.9 % and 76.7 % in milrinone group and dabutamine group, respectively (P

Objective To study the traditional Chinese medicine treatment in headache in menstruation of Ma Dazheng professor. [Methods]The paper expounds Professor Ma’s experience in treating headache in menstruation by analyzing the etiology, pathology, summaring the clinical thoughts and citing some typical cases. [Results]After the syndrome differentiation methods fitting which were from Ma Dazheng professor of TCM, good resulets have been achieved in the each model headache of dialectical classification. [Conclusion]The causes of headache have a lot, but according to the characteristics of the patients with the clinical syndrome differentiation, choosing precision wil get very good curative effect, it is a good guide for clinical treatment in a headach in menstruation.

Objective To investigate the changes of cesarean section rate and indications in different level hospitals of different areas in China during 2000 to 2009. Methods Literatures published in Chinese journals on variation of cesarean section rate and indications from 2000 to 2009 were analyzed. Cochran-Armitage test was used to analyze the trend. The differences of cesarean section rate between different areas or different level hospitals were analyzed by chi-square test.Results Forty-nine papers were enrolled in this study.Cesarean section rate had risen from 2000 (32.1％,10 353/32 258) to 2009 (52.5％,3674/6992)(Z=-20.8267,P＜0.01).During 2000 to 2008,the average cesarean section rate of level one grade A hospital was 45.7％ (3754/8214),which was higher than 34.5％(25 015/72 507) in level three grade A hospital and 32.3％(28 140/87 121) in level two grade B hospital (P＜0.05,respectively).Except for level three grade A hospital,cesarean section rate had risen in the other two level hospitals during 2003 to 2008. The average cesarean section rate was 58.6％ (4982/8502) in northeast area during 2000 to 2007,which was higher than that of other areas (P＜0.01); and the average cesarean section rate was 27.5％ (12 264/44 595) in central China and 33.0％ (23 239/70 421) in southern China,which were lower than that of other areas (P＜ 0.01 ). Social factor,instead of dystocia,became the most important indication for cesarean section,and its proportion kept rising annually,from 11.3％ (1170/10 353) in 2000 to 27.1％(2094/7726) in 2008 and remained above 20.0％(5159/24 691) since 2004.The proportion of scar uterus rose from 6.7％(694/10 353) in 2000 to 12.5％ (459/3674) in 2009. Conclusions Cesarean section rate rises fast and its major indications had changed in China. It is suggested that special method should be taken to control the current situation.

Burnout, Professional ; psychology ; China ; Faculty ; Humans ; Research ; Social Support ; Teaching ; statistics & numerical data

Objective:To explore the influencing factors of physicians' professionalism,to understand the cognitive status and changes of professional responsibility and put forward the corresponding strategy.Methods:The satisfaction and cognitive status of physicians'professionalism were investigated using the self-designed questionnaire that adapted to medical staff,and the data was analyzed using statistical software SPSS19.0.Results:It showed that the satisfaction with the job itself was quite high.But they thought that the work risk was high,their own value was difficult to realized,and the professionalism was lack of cultivation.Conclusions:It suggests to put forward measures and suggestions from the perspective of system reform,vocational education,hospital culture,social atmosphere,decision-making of doctors and patients together.

The paper describes the connotation of a hospitals leaping development, presents the significance of such development, and puts forward several relationships that must be properly handled in order for a hospital to achieve leaping development. These include: ①the relationship between priorities and generalities; ②the relationship between objective possibility and subjective initiative; ③the relationship between ardor and soberness; ④the relationship between innovation and convention; ⑤the relationship between speed and quality; ⑥the relationship between the future and the present; ⑦the relationship between academic leaders and the building of the academic echelon; ⑧the relationship between the construction of the management contingent and the construction of the technical contingent; ⑨the relationship between scale and actual strength; ⑩the relationship between hardware and software; B11the relationship between change and stability; and B12the relationship between leaders and the masses.