Objective To assess the value of ultrasonic elastography in the diagnosis of special type breast cancers. Methods Routine ultrasonograms, color Doppler flow images and elasticity images of 13 patients with special type breast cancer confirmed surgical pathologically were retrospectively analyzed. Results The score of mucinous carcinoma, inflammatory breast cancer (1 patient), lactation breast cancer, invasive micropapillary carcinoma, tubular carcinoma and invasive lobular carcinoma (2 patients) were 4-5. The score of 1 patient of invasive lobular carcinoma was 1 and 1 patient of lactation breast cancer was 3. The characteristics of color Doppler flow imaging of majority patients were varies, while no obvious lesion was observed in Paget's disease. Conclusion Ultrasonic elastography is helpful to the diagnosis of inflammatory breast cancer, lactation breast cancer, invasive micropapillary carcinoma of the breast, papillary carcinoma and tubular carcinoma of the breast. Early diagnosis of Paget's disease still depends on pathology.

The association between autoimmunity and lymphoma is bidirectional: patients with autoimmune disorders have an increased risk of developing malignant lymphoma, and autoimmune symptoms occur in the context of malignant lymphoma much more often. The epidemic features, clinical characteristics,and biologic mechanisms that underlie this association have been investigated in many studies, and this review is focused on recent progresses in this area.

OBJECTIVE:To study the incidence of adverse drug reactions(ADRs) and the rational use of Durogesic in in-patients METHODS:37 in-patients treated with Durogesic in Department of Oncology in our hospital were prospectively observed,and its analgesic efficacy and incidence,severity and the outcome of ADRs were evaluated RESULTS:The alleviating effect of Durogesic on carcinomatous pain was 100% Of 37 patients,ADRs were found in 4 cases with a ADR rate of 10 8% CONCLUSION:Durogesic is effective in clinical use,but attention should be paid to monitoring ADRs and avoiding irrational use of drug

Objective To learn the status of core competency of cardiovascular specialist nurses in military hospitals in order to supply evidence to establish contrapuntal training protocol.MethodsThe Competency Inventory for Registered Nurse Scale (by LIU Ming) was distributed to investigate the core competency of 156 registered nurses.The data underwent analysis.Results The overall score of core competency level was (3.17±0.69),the highest mean score was the dimension of legal and ethical practice,and the lowest mean score was the dimension of critical thinking and nursing research apititude.the core competency varied with professional title and staffing.Evident difference existed in different dimensions and total scores.Conclusions The overall core competency is at the upper middle level for cardiovascular specialist nurses.They are competent enough to provide healthcare.The cultivation of nurses' critical thinking and nursing research ability should be strengthened.The nursing administrators should carry out pertinent training for nurses according to their different professional levels.

Objective To explore the difference in pain threshold between related acupoints and the specificity of acupoints in cholecystitis patients.Method Actual measurement was made in 80cases, a normal group of 30 cases (volunteers without psychological and physiological diseases) and a patient group of 50 cases (volunteers with cholecystitis). The probe of an algometer was perpendicularly placed on the selected acupoint, the pressure point was pushed and pressing was stopped immediately after the subject felt pain. The pain thresholds displayed by the measured acupoints were recorded. The pain thresholds of the selected acupoints were compared between the normal and patient groups and thedifferences were analyzed to explore the specificity of acupoints.Result A comparison of the pain thresholds of the Back-Shu points of the Bladder Meridian of Foot-Taiyang between the patient and normal groups showed that there were no significant differences in the thresholds of the left Back-Shu points Geshu (BL17), Ganshu (BL18), Danshu (BL19), Pishu (BL20), Weishu (BL21) and Dachangshu (BL25) of the bladder meridian between the two groups (P>0.05) and there were significant differences in the thresholds of the right Back-Shu points Geshu, Ganshu, Danshu, Pishu, Weishu and Dachangshu of the bladder meridian between the two groups (P<0.01). The pain threshold was significantly lower in thepatient group than in the normal group. A comparison of the pain thresholds of the main points of the Liver Meridian of Foot-Jueyin, the Gallbladder Meridian of Foot-Shaoyang and the stomach meridian between thepatient and normal groups showed that there were significant differences in the thresholds of the right points Liangmen (ST21), Riyue (GB24) and Qimen (LR14) of the liver, gallbladder and stomach meridians (P<0.01) and no significant difference in the threshold of the right point Taichong (LR3) between the two groups (P>0.05). The pain thresholdwas significantly lower in thepatient group than in the normal group. There were no significant differences in thethresholds of the left points Liangmen, Riyue, Qimen and Taichong of the Liver Meridian of Foot-Jueyin, the Gallbladder Meridian of Foot-Shaoyang and the stomach meridian between the patient and normal groups (P>0.05).Conclusion The pain sensitivity of ipsilaterali related acupoints increase and the relative specificity of acupoints exist in cholecystitis patients.

OBJECTIVE To investigate the antibiotics resistance and the presence of resistant gene of Staphylococcus aureus isolated from nosocomial infection patients in our hospital.METHODS Antibiotic susceptibility tests were conducted by Microscan WalkAway-40,the antibiotics resistant genes of aac(6')/aph(2″),aph(3')-Ⅲ,ant(4',4″),TEM,tetM,macA,erm and qacA/B of 16 MRSA and 24 MSSA strains were detected by PCR.RESULTS The percentage of MRSA in this investigation was 59.4%,the positive rate of ?-lactamases of 192 S.aureus strains was 98.9%,resistant rate of S.aureus to ?-lactam antibiotics was 52.1-99.0%,and to erythromycin,clindamycin,clarithromycin,ciprofloxacin,norfloxacin,gentamicin and tetracycline was 52.1%,78.1%,85.5%,56.3%,61.1%,55.2%,and 69.8%,respectively,but to nitrofurantoin and sulfamethoxazole/trimethoprim were relatively lower(1.1% and 10.5%) than the others.VISA,h-VISA and VRSA were not measured.To the most of antibiotics,the resistant rate of MRSA was higher than MSSA.The presence of resistant gene of MRSA and MSSA was different.There was more positive percentage of gene in MRSA than in MSSA.CONCLUSIONS Antibiotics resistance of S.aureus isolated from nosocomial infection patients in our hospital is severe.Compared to MSSA,MRSA has higher antibiotic resistant rate and more complicated drug-resistant mechanism.Some measures should be done to reduce the antibiotic resistance of S.aureus.

OBJECTIVE To understand the pathogens of sexually transmitted diseases in pregnant women.METHODS Polymerase chain reaction(PCR) technology was taken to detect out Neisseria gonorrhoeae,Chlamydia trachomatis and Ureaplasma urealytium.RESULTS Among 984 pregnant women 343 were positive(34.9%).Different census register and education background of pregnant women showed significant difference.CONCLUSIONS Attention should be taken for pregnant women to prevent spreading the diseases.

Objective:To study the effect of Levocarnitine preconditionon on the myocardial ultrastructure of ischemic rats and the long last calcium channel. Methods: We randomly divided 30 rats into a control group, a Levocarnitine group and a Dihydrochloride group. After the establishment of ischemic models, we observed the ultrastructure of the ischemic myocardium with optical and transmission electron microscopes, and detected the influx of calcium in the long last calcium channel with the patch clamp. Results: Levocarnitine protected the ultrastructure of ischemic myocardium and inhibited the influx of calcium in the long last calcium channel. Conclusion: Levocarnitine can reduce the severity and extent of ischemia-induced damage to the myocardium, protect mitochondria, stabilize its oxidation, inhibit the long last calcium channel of ischemic ventricular myocytes and lessen the injury induced by calcium overload.

Objectives To explore the influence of standardized treatment and technical flow improvement on the diagnosis and treatment of congenital diaphragmatic hernia (CDH) after prenatal diagnosis. Methods The clinical data of neonates diagnosed with CDH who were hospitalized in neonatal intensive care unit from January 2005 to August 2016 was analyzed retrospectively. Based on the start time of standardized treatment implementation, 93 cases of CDH hospitalized from January 2010 to August 2016 were divided into the intervention group while 15 cases of CDH hospitalized from January 2005 to December 2009 were divided into the control group. The survival rate and complications of clinical outcomes between two groups were compared. Results There was no significant difference in sex, gestational age, birth weight, Apgar score, and CDH position between two groups (P >0.05). The total survival rate was 81.7％ in the intervention group and 53.3％ in the control group, and there was statistical difference (P<0.05). The difference of mechanical ventilation mode and pneumothorax rate between two groups also had statistical difference (P >0.05). The median operation time in the control group was 4.5 h and the intervention group was 49.5 h. The postoperative survival rate was 61.5％ in the control group and 90.5％ in the intervention group, and the differences between two groups were significant (P >0.05). The first blood gas analysis of deaths cases in both groups showed that there were significant differences in pH and PCO2 values (P >0.05). Conclusions Optimization of the clinical management during perioperative period can improve the survival rate of CDH and reduce complications. However, the dead cases in the intervention group had more severe pulmonary hypoplasia.

OBJECTIVE To investigate the staphylococcal cassette chromosome mec(SCCmec) genotype characteristics and antibiotic-resistant genes in meticillin-resistant Staphylococcus aureus(MRSA) isolated from Lianyungang.METHODS The SCCmec of clinically isolated MRSA strains were genotyped with a novel multiplex PCR strategy reported by Zhangetal.Antibiotic-resistant genes of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM,erm,TEM,and ant(4′,4″) were analyzed by traditional PCR.RESULTS The isolates were almost SCCmec Ⅲ positve,only one isolate couldn′t be typed.The positive rates of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM,and erm were 98%,46%,72% and 86%,respectively.TEM and ant(4′,4″) tested were all negative.CONCLUSIONS Almost all genotypes of MRSA prevailing in Lianyungang carry the SCCmec Ⅲ gene.There are high positive percentages of antibiotic-resistant genes of aac(6′)/aph(2″),aph(3′)Ⅲ,tetM and erm in the isolates.The novel multiplex PCR strategy recommended by Zhang et al can be applied into genotyping study of MRSA SCCmec effectively.