Objective To explore the clinical efficacy of early breast cancer patients underwent breast-conserving surgery with postoperative chemotherapy and radiotherapy.Methods A retrospective analysis of 128 early breast cancer patients underwent routine breast-conserving surgery was conducted.The clinical effect and cosmetic results were analyzed by the follow-up results of 128 cases.Results (1) The 5-year follow-up rate was 100％,overall survival rate was 95.3％,1-year survival rate was 100％ (128/128) ;3-year survival rate was 98.4％ (126/128) ;5-year survival rate was 95.30％ (122/128).Postoperative follow-up 6 patients died,3 patients died of liver metastases,2 patients died of lung metastases,1 patient died of non-cancerous reasons.The local recurrence rate was 2.34％ (3/128),axillary lymph node recurrence rate was 1.56％ (2/128).The average recurrence time was three years and two months after operation,distant metastasis rate was 3.91％ (5/128).(2) Beauty evaluations of 128 patients with breast-conserving surgery were excellent in 71 cases (55.5％),good in 55 cases (43.0％),and poor'in 2 cases (1.6％).Good,acceptable as acceptance criteria,the acceptance rate was 98％.Conclusion Breast-conserving surgery is not only to a certain extent to solve the pursuit of female beauty,but also improve their quality of life.But only the complete elimination of residual lesions in order to truly ensure that no recurrence of tumor.Therefore,the appropilate survival rate of patients for radiotherapy and chemotherapy can be extended so that the patient's breast to maintain a good shape.Breast-conserving surgery combined with radiotherapy and chemotherapy is superior to the modified radical surgery,and popularization in the hospital.

Objective Carry out the reform of the online learning mode of prehospital training for refresher doctors , and evaluate the effect of reform in Peking Union Medical College Hospital .Methods An exploration was carried out on the refresher doctors prehospital training mode from traditional classroom teaching to online learning , Estab-lished the online learning system .Evaluated the effect of online learning by the way of questionnaire investigation andreexaminationamong289refresherdoctors.Results 289refresherdoctorshavecompletedthestructuredon-line courses of prehospital training , and the average pass rate of the first test was 42.2%.The questionnaire and retest was conducted , A total of 262 doctors completed the work , The recovery rate was 90.7%, and the average pass rate of retest was 74.9%, showing improvement by 32.7%.Conclusions Online learning mode is an effec-tive tool for knowledge dissemination , and has a better learning effect .

Objective To investigate the pathologic base of breast cancer malignant halo.Methods The status of margin of 80 cases confirmed breast nonspecific invasive ductal cancer by pathology were determined preoperatively.80 cases were divided into two groups:malignant halo group and non malignant halo group.The estrogen receptor (ER),progesterone receptor (PR),human endothelial growth factor receptor (CerB-2),nuclear protein antibodies (Ki-67) expression were detected by immunohistochemical method.The histological grade,mitotic count and documented tumor size,patient age and the number of lymph node metastases,breast cancer margin on pathology were observed.Halo tissue were drawn from specimens and the tissue structure were observed.Results Ki-67 expression in malignant halo group were significantly lower than those in non malignant halo group.The observing results of the margin status of breast cancer on ultrasound and pathology were consistent.Halo tissue was mainly composed of fatty tissue and scattered clumps of cancerous tissue,fibrous tissue,normal lobular and tubular.Conclusions Malignant halo is a special manifestation of breast cancer on gray-scale ultrasound.

Objective To discuss the relationship between the expression of programmed death-1 (PD-1) in liver with traditional Chinese medicine (TCM) syndromes and pathological diagnosis in chronic hepatitis B.Methods 156 CHB patients treated in our hospital of infectious diseases department were recruited as an observation group. Based on the principle of informed voluntary and approved by the ethics committee, liver biopsy was adopted to make clear liver tissue pathology. According to TCM classification criteria, CHB patients were divided into five groups: a blood stasis group, a damp heat resistance group, a liver and spleen deficiency group, a liver and kidney yin deficiency group, and a spleen and kidney yang deficiency group. In the same period, 12 healthy persons were recruited as a control group. The PD-1 expression was detected with immunohistochemical SP method, and the correlation between expression of PD-1 in liver tissue and TCM syndrome type and liver pathology was analyzed.Results Different degrees of positive cell expression were found in the liver tissue. With the liver inflammation and fibrosis severity, the number of PD-1 positive cells also increased. The PD-1 expression levels varied with mild, moderate, and severe CHB patients (0.24 ± 0.03, 0.36 ± 0.05 vs. 0.43 ± 0.05) , which were statistically significant (P<0.05) . PD-1 expression levels also varied among different TCM type CHB patients, of which, PD-1 expression of blood stasis type was the highest (0.35 ± 0.04), while the liver and spleen deficiency type was the lowest (0.23 ± 0.03).Conclusion The expression levels of PD-1 has a certain correlation with the patients illness, chronic mechanism, and TCM syndromes. CHB patients can be treated by controlling the expression of PD-1.

The content of ATP, ADP, AMP, sodium phosphate and sodium pyrophosphate were determined by 31P NMR, the linear range of ATP, ADP and AMP were found to be 0.004-0.080 mol x L(-1), sodium phosphate and sodium pyrophosphate were 0.005-0.100 mol x L(-1). The RSD were 0.40%-1.30%, the recovery were 96.9% - 105.2%. The method has been applied to the determination of ATP injection. The impurities of ATP injection were ADP and sodium phosphate. The content of ATP is in line with the requirement of the pharmacopoeia. The results indicated that the method is of good reproducibility, high accuracy, rapid and simple operation, without pretreatment and interference of other elements, 31P NMR is a new and reliable method of analyzing ATP, ADP, AMP and phosphate.

[Summary] A total of 108 cases of endoscopic thyroidectomy via thoracic approach were conducted in our department between January 2012 and January 2015.The comfortable nursing was applied during the operation.The patients’ body position was adjusted properly according to requirements of the operation at different periods of pre-operation, intra-operation and post operation.No complications due to nursing mistakes or improper position occurred in the 108 patients. Follow-up checkups on the second postoperative day found 2 patients with vomiting.According to the Wong-Banker Faces Pain Scale to evaluate the head and back pain, there were 46 cases of 0 point, 51 cases of 1 point, 11 cases of 2 points.We got the conclusion that the application of comfortable nursing for proper position of patient not only reflects the nursing principle of Patients First, but also improves the entire quality of nursing services.

Objective To study the enhancement effects of the low frequency ultrasound to the apoptosis induced by dihydroar-temisinin in the transplantation human prostate cancer PC-3 cells in nude mice ,and to explore the underlying action mechanism . Methods Prostate cancer PC-3 cells were transplanted into 20 nude mice to establish the solid tumor mode .These nude mice were randomly divided into 4 groups with 5 mice in each group :control group ,dihydroartemisinin group ,ultrasound group and ultrasound+ dihydroartemisinin group .After 13 days and 7 times drug administration ,The positive products of Bcl-2 ,Bax ,VEGF ,Caspase-3 and CHOP were tested by immunohistochemical method .Results The tumor volume were larger in control group and ultrasound group through observed by tumor contour ,and there were liquefication and necrosis region after incised the tumor tissue .Immuno-histochemical examination revealed that the positive products of Bcl-2 and VEGF were decreased in ultrasound+DHA group ,DHA group and ultrasound group .Immunohistochemical examination revealed that the positive products of Bax 、Caspase-3 and CHOP were significantly increased in ultrasound+DHA group ,DHA group and ultrasound group .Conclusion The low frequency ultra-sound can′t cause obvious damage to the normal cell ,which could causing the change of the positive products in transplantation hu-man prostate cancer PC-3 cells .The results show that DHA has this action alone ,the ultrasound may enhance the apoptosis of PC-3 cells induced by DHA.

Objective To review the physiological characters and potential function of chondroitin sulphate proteoglycan,CSPG(NG2) glial cells in the central nervous system. Methods In conclusion of the NG2 glial properties and the global, novel researches on NG2 cells. Results Cells that express the NG2 proteoglycan comprise a unique population of glial cells in the central nervous system.Study on their role in the CNS becomes more and more popular.Previous researches mainly focus on the differentiation and distinction.Now the relationship between NG2 glial cells and neurons,and the synaptic plasticity is becoming a hot topic.Conclusion This review referred the research development of NG2 glial cells,including the differentiation,migration,their interaction with neurons,and the potential role in glial cell regeneration in disease systematically.

Objecive To explore the curative effects of microwave endometrial ablation (MEA) for menorrhagia. Methods A total of 60 cases of menorrhagia, who had failed to respond to drug therapy and no longer desired pregnancy, were treated by MEA. Results Except for 1 case of cervical cannel adhesion, there were no other complications such as uterine perforation. Follow-up for 2 years in all the cases showed amenorrhea in 12 cases (20%), scanty menstruation in 34 cases (57%), normal menstruation in 6 cases (10%) and no improvement in 8 cases(13%), the total effective rate being 87%. The effective rate was 100% (35/35) in patients with dysfunctional uterine bleeding, 70% (14/20) in patients with endometrioma and 60% (3/5) in patients with hysteromyoma , respectively. Conclusions MEA finds a place in the treatment of menorrhagia of whatever causes. It is simple and safe, but the indications must be strictly followed for improving the curative effects.

Objective To explore the status of adult attachment and its relationship with cognitions, emotions, behaviors, and personal relationship of undergraduate from rural areas with left-behind experience( URLB ).Methods This study investigated 4271 rural college students through questionnaires ( Experiences in Close Relationships Inventory Questionnaire, Simplified Coping Style, the Self-Esteem Scale, Center for Epidimiologic Studies Depression Scale, State-Trait Anxiety Inventory, and College Student's Personal Relationship Synthetical Diagnostic Scale), and 1062 URLB were screened.Results 1.URLB have significant difference from those without in attachment avoidance, anxiety, depression, active coping style, self-esteem, and personal relationship ( t = 2.970,8.063,2.192,1.969,-6.605,-2.913,4.065 respectively, P ＜ 0.05 ).2.URLB with higher adult attachment avoidance showed obvious interpersonal difficulties( t =-3.415, P＜0.01 ); those with higher attachment anxiety showed dramatic rise in depression, state anxiety, trait anxiety and interpersonal difficulties ( t = 7.436, 7.961,10.131,2.633,6.764,10.598 respectively, all P ＜ 0.01 )Conclusion The psychological behavior features of URLB were affected by adult attachment.There are needed appropriate psychological interventions to URLB with high attachment avoidence and high attachment anxiety.