Objective To compare the long-term outcome between breast-conserving therapy with mastectomy therapy for early stage invasive breast cancer through a Meta analysis of the randomized controlled trials published worldwide.Methods Cochrane systematic evaluation was used to search through Cochrane libraries of clinical comparative trials,PubMed,Embase,Cancer Lit,and so on.The quality of literatures was independently evaluated and cross-checked by two evaluators,indicators for assessment including death number at the end of follow-up,locoregional and total recurrence.The results were analyzed with RevMan 4.2.2 software.Results Six articles were involved in the Meta analysis with total 3 933 patients.No statistical difference was found in the death at the end of follow-up between breast-conserving therapy group and mastectomy therapy group(OR=1.05,95% CI=0.93-1.19,P=0.45).Locoregional and total recurrence rate of breast-conserving therapy group were statistical higher than those in mastectomy therapy group(OR=1.64,95% CI:1.10-2.44,P=0.01;OR=1.42,95% CI:1.22-1.64,P

17 Cheqiancao produced in China were identified by UV spectrophotometry. The differences of their UV spectra were listed.

Objective To validate the accuracy of the revised Atlanta classification (RAC) and the determinant-based classification (DBC) for severity of acute pancreatitis.Methods We retrospectively analysed the clinical data from 192 patients with acute pancreatitis who were admitted to our hospital between January 2014 and October 2014.Using the RAC and the DBC,The duration of total parenteral nutrition,length of ICU and hospital stay,operation rate and mortality were assessed in the subgroups,respectively.Results Fluid collections in and around the pancreas was present in 74 patients (38.5％),pancreatic or peripancreatic necrosis in 51 (26.6％),and infection in 18 (9.4％).On the basis of the RAC,106 patients (55.2％),77 patients (40.1％),and 9 patients (4.7％) were classified to have mild,moderately severe,or severe AP,respectively.On the basis of the DBC,11l (57.8％),62 (32.3％),14 (7.3％),and 5 (2.6％) patients were classified to have mild,moderate,severe,or critical AP,respectively.The different categories of severity for each classification system were significantly associated with the duration of total parenteral nutrition,the length of ICU and hospital stay,the operation rate and mortality.Conclusion Both the RAC and DBC accurately classified the severity of AP and differentiated prognosis in the subgroups of patients.

Adenocarcinoma ; diagnosis ; genetics ; metabolism ; therapy ; Animals ; Barrett Esophagus ; metabolism ; Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; diagnosis ; genetics ; metabolism ; therapy ; Esophageal Neoplasms ; diagnosis ; genetics ; metabolism ; therapy ; Gene Expression Profiling ; Genetic Therapy ; Humans ; MicroRNAs ; genetics ; metabolism ; Precancerous Conditions ; metabolism ; Prognosis

Objective To investigate the relationship between carotid atheromatous plaque and its related biochemical indexes and cerebral infarction.Methods 65 cases with cerebral infarction served as cerebral infarction(CI) group and 35 cases of non-cerebral infarction as control group. In both groups,the location,number and nature of carotid atheromatous plaque and diamete of carotid artery were assessed by Doppler ultrasonography,and the related biochemical indexes such as blood lipid,blood glucose and fibrinogen were evaluated.Results Significant differences of the detectable rate of carotid atheromatous plaque and the diameter of common carotid artery were found between CI group[81.54%,( 7.43? 0.07)mm of left side,(7.52?0.60)mm of right side] and control group[28.57%,(7.75?0.10)mm of left side,( 7.97? 0.75)mm of right side]( P

Infected pancreatic necrosis (IPN) is a serious complication which may cause organ failure and death in patients with acute pancreatitis. Surgical debridement is an important therapeutic approach for IPN. With the development of evidence-based medicine, more and more high-level evidences emerge for surgical debridement of pancreatic necrosis tissue, and the traditional treatment strategy has also changed. In the era of minimally invasive surgery, whether 'delayed surgery' should still be executed and how to achieve 'delayed surgery' are the research hotspots in the treatment of IPN. Research evidences reveal that the 'step-up' strategy is not the best strategy for all IPN patients, and alternatives should be explored. In addition, the indications, advantages and disadvantages of open surgery, surgical minimally invasive surgery and endoscopic surgical debridement of pancreatic necrosis tissue have been widely discussed in recent years, and no consensus has yet been reached. At present, the personalized, multidisciplinary, and minimally invasive treatment of IPN is still the mainstream development direction. The authors investigate the timing and strategy of surgical treatment for IPN in order to provide theoretical basis for clinical practice.

Objective To study the relationship among resilience,self feeling of inadequacy and alexithymia in depressive undergraduates,and to provide a theoretical basis for the prevention and intervention of depression among undergraduates.Methods 500 undergraduates of two universities in Hebei Province were collected by cluster sampling method.Beck depression scale,adolescent resilience scale,Toronto alexithymia scale and self feeling of inadequacy scale were applied to undergraduates.The survey results were analyzed statistically.Results The detection rate of depression was 28％(119/426) in undergraduates.Total score of Alexithymia Scale(69.99±9.43) was higher than the norm(65.70±7.98),and the difference was statistical significant (P＜0.05).The score of self feeling of inadequacy had a significant difference between male (149.88±28.00) and female(138.58±28.79) (P＜0.01).Neither gender nor grade had significant difference in depression,alexithymia and resilience(P＞0.05).Self feeling of inadequacy was positively correlated with alexithymia (P＜0.05).Resilience was negatively correlated with self feeling of inadequacy and alexithymia(P＜0.05).For the depressive undergraduates,self feeling of inadequacy served as a full mediator between the resilience and alexithymia,whereas for the non depression undergraduates it was a partial mediator.Conclusion Depression undergraduates have serious alexithymia,serious self feeling of inadequacy and poor resilience.Self feeling of inadequacy serves as a mediator between the resilience and alexithymia in depressive and non-depressive undergraduates.

Objective To determine the effect of video-assisted retroperitoneal debridement in treatment of infected necrotizing pancreatitis.Methods The clinical data of patients with infected necrotizing pancreatitis was retrospectively analyzed.Heart rate,mean arterial pressure,body temperature and indicators for inflammatory response including level of WBC,CRP and procalcitonin before and after VARD treatment were compared.Results After VARD treatment,the heart rate (preoperative vs.postoperative 8 h,108 ± 22/min vs.95 ± 17/min),mean arterial pressure (preoperative vs.postoperative 12 h,66 ± 18 mmHg vs.79 ± 19 mmHg) and body temperature(preoperative vs.postoperative 24 h,38.3 ± 1.7 ℃ vs.37.3 ± 1.3 ℃) improved significantly (all P ＜ 0.05).Level of WBC [preoperative vs.postoperative 48 h,(13.8 ±6.6) × 109/L vs.(10.1 ±5.2) × 109/L],CRP(preoperative vs.postoperative 48 h,145 ± 88 mg/L vs.95 ± 4 mg/L) and procalcitonin (preoperative vs.postoperative 48 h,1.4 ± 0.7 μg/L vs.0.9 ± 0.4 μg/L) also decreased significantly(all P ＜ 0.05).Conclusions VARD therapy can significantly reduce systemic inflammation and improve the general condition of infected necrotizing pancreatitis patients.

Objective To determine the effects of cyclooxygenase-2 (COX-2) on risk stratification and prognosis of patients with gastrointestinal stromal tumor (GIST).Methods Literatures in the Cochrane libraries of clinical comparative trials,PubMed,EMBASE,Cancer Lit and Chinese BioMedical Literature from 1966 to 2012 were retrieved using the Cochrane systematic evaluation method.The original data were extracted and crosschecked by 2 reviewers.The indicator for assessment including positive rates of COX-2 in GIST patients with different tumor diameters (＜5 cm versus ≥5 cm),mitosis of cancer cells (＜5/50 HPF versus ≥5/50 HPF) and National Institute of Health (NIH) risk stratifications (very low + low versus intermediate + high).The relationship between COX-2 expression and recurrence and metastasis of GIST was evaluated.All the data were analyzed using the RevMan 5.1 software with Meta analysis.The heterogeneity between studies was analyzed using the I2.The binary data were presented by odds ration (OR) and 95％ confidence interval (95 ％ CI).Results Seven articles with a total of 415 patients were included in the analysis.The COX-2 expression did not correlate with the tumor diameters,NIH risk stratifications and tumor metastasis and recurrence (OR =0.60,0.72,2.46,P ＞ 0.05),but with the mitosis of cancer cells (OR =0.46,P ＜ 0.05).Conclusion COX-2 expression is partly correlated with risk stratification of GIST,but has no effect on the prognosis.