Objective To analyze and discuss the effects of preserving the intercostobrachial nerve(ICBN)in modified radical mastectomy for breast cancer. Methods A total of 80 patients with breast cancer were randomly divided into the observation group and control group(n = 40 in each). The ICBN in the observation group were reserved and it was removed in the control group. Operation time,the number of lymph nodes,blood loss and complication rates were compared between groups. Two groups of patients were followed up for abnormal sensory function and relapse and metastasis. Results There were no differences in the operation time,the number of dissected lymph nodes and blood loss(P > 0. 05). There was no difference in complication rate(12. 50% vs 15. 00% )between the observation group and control group(P > 0. 05). There were significant differences in the incidence of abnormal sensory function at the first week(10. 00% vs 52. 50% ),the first month(5. 00% vs 47. 50% ),the third month(2. 50%vs 45. 50% ),the sixth month(2. 50% vs 37. 50% ),and the twelfth month(0. 00% vs 27. 50% )after op-eration between the observation group and control group(P < 0. 05). During the one-year follow-up peri-od,there was no relapse or metastasis. Conclusion Preserving ICBN in modified radical mastectomy can effectively reduce the incidence of abnormal sensory function of the upper limb.

Objective To investigate the incidence of poverty ,population carrying rate and its genetic type through the thalasse‐mia screening analysis of 2 650 cases of childbearing women .Methods Hematologic examination and hemoglobin electrophoresis were applied in people who were laboratory tested the crowd ,screening suspected people ,then use the genetic analysis confirm the diagnoses .Results Preliminary screening of the 536 cases which were suspected the thalassemia (or gene carriers) ,hematologic ex‐amination showed that the red blood cells ,reticulocyte counts in the cases were significantly higher than those in the controls ;and hemoglobin ,mean corpuscular volume (MCV)and mean corpuscular hemoglobin (MCH) were significantly lower .Hemoglobin elec‐trophoresis test showed that in 512 abnormal cases ,68 cases were diagnosed as α thalassemia and 438 cases were β thalassemia(506 cases in total ,accounting for 19 .09% of the total number) .In this area ,Southeast Asia(SEA) heterozygotes(‐SEA /αα) ,right hetero‐zygotes(‐α3 .7 /αα) ,left heterozygotes(‐α4 .2 /αα) ,Hb Constant Spring(‐αCS /αα) were common type of α thalassemia ;CD41‐42 hetero‐zygotes ,CD17 heterozygotes ,CD71‐72 heterozygotes and CD28 heterozygotes were common type of β thalassemia .Conclusion In Guangxi ,there was high incidence rate of thalassemia ,thus ,though premarital and prenancy anterior screening ,guide the rational marriage and pregnancy ,and through the crowd to intervene to prevent common human monogenic death and disabling genetic dis‐orders are of great importance for prepotency promotion and population quality improve .

Objective To investigate the clinical significance of retaining axillary sheath in axillary lymph node dissection of breast cancer surgery. Methods Four hundred and two patients received modified radical mastectomy from January 2004 to January 2008 and followed up for 12 months were retrospectively analyzed. They were divided into two groups (group A and B) according to whether retaining axillary sheath in operation. Compared the morbidities of axillary effusion and edema of upper limbs between two groups. Results The morbidity of axillary effusion after operation in group A (5.3%, 13/243 ) was lower than that in group B (10.7%,17/159)(P＜0.05). Based on the data followed up for 1,6, 12 months after operation, the morbidity of edema of upper limbs in group A were also lower than those in group B (P ＜0.01). Conclusion Retaining axillary sheath when there is no evidence of lymph node metastasis in axillary sheath, will prominently lower the morbidities of axillary effusion and edema of upper limbs,improve the life quality of patients.

To ensure the sooth progression of resident standardized training, the Nineth Peo-ple's Hospital affiliated to Shanghai Jiao Tong University School of Medicine made the following explo-rations for structure organization and rule and regulation establishment: teaching staff construction , student recruiting procedures, training time, training plan and content, examination management and training quality control. It has played a promoting role for the construction and development of resident standardized training base.

Objective To investigate the expression of human papillomavirus (HPV) L1 protein in lesional tissue of condyloma acuminatum and its clinical significance.Methods Forty-three patients with condyloma acuminatum were included in this study,and received CO2 laser therapy.Tissue samples were resected from the lesions of these patients at their first visit before treatment.Immunohistochemistry was used to determine the expression of HPV L1 protein in these samples.Follow up was carried out once every 2 weeks for 3 months to assess the recurrence rate and frequency in these patients after treatment.Results HPV L1 protein was detected in 83.72％ (36/43) of these tissue samples.The expression rate of HPV L1 protein decreased sequentially from patients infected with HPV 6/11,patients with both HPV 6/11 and 16/18,to those with HPV16/18 (x2 =17.90,P ＜ 0.01).During the 12 weeks of follow up,the recurrence rate was 69.77％ (30/43) with the average number of recurrence of 2.16.There was a sequential reduction in the recurrence rate and number from patients with strong expression of HPV L1 protein,to those with moderate expression,slight expression and negative expression (x2 =8.02,46.92,P ＜ 0.05 and 0.01,respectively).The expression intensity of HPV L1 protein was negatively correlated with the recurrence rate and frequency (rs =-0.429,-0.696,respectively,both P ＜ 0.01).Conclusion HPV L1 protein may serve as a helpful molecular biomarker for the prediction of prognosis and recurrence of condyloma acuminatum.

Objective To explore the factors of treatment adherence for patients with hypertension.Methods Data were collected among 520 patients with essential hypertension from 2009 to 2010.It investigated the factors of treatment adherence for patients with hypertension by self-report scales.Results Structural equation model analysis showed age,self-rated health,self-eificacy,quality of life,family function and health concept were all directly associated with treatment adherence,and these variables explained 52.0％ of the total variance.Self-efficacy and quality of life were regarded as mediators in predicting treatment adherence of hypertensive patients,other variables indirectly affected adherence behavior by two mediators.Age and self-efficacy showed a strong independent predictive role to adherence.Conclusions Healthcare providers should take effective measures to improve treatment adherence for patients with hypertension based on patients characteristic once they make reasons for adherence clear,which can enhance quality of life,control blood pressure and prevent complications.

Objective To investigate the gross tumor volume (GTV) changes in nonoperatively treated lung cancer patients during radiotherapy by off-line analysis using kilovoltage cone-beam computed tomography (KVCBCT).Methods Eighteen nonoperatively treated lung cancer patients were divided into group A (n =13) to receive conventional radiotherapy (1.8-2.2 Gy/fraction) and group B (n =5) to receive accelerated radiotherapy (5-8 Gy/fraction).Group A was further divided into subgroup A1 (n =10) and subgroup A2 (n =3) according to GTV changes.Each patient in group A underwent KVCBCT scan before treatment once a week,and each patient in group B underwent KVCBCT scan before each treatment.KVCBCT and CT images were registered in the treatment planning system to analyze GTV changes.Results Of all patients in group A,77％ showed ＞ 20％ GTV reduction.Subgroup A1 had the maximum GTV reduction in the 4th week of treatment (the 20th treatment) ;Subgroup A1 had a mean reduction of (0.94 ± 9.94)％,with a maximum value of-56.76％.Subgroup A2 showed no correlation between GTV changes and treatment time.Group B had a mean GTV reduction of (-7.41 ± 1.76)％,with a maximum value of -15.91％.Of all patients in group B,71％ showed ≤ 10％ GTV reduction.Small GTV changes were observed in group B.Conclusions There are no regular GTV changes in nonoperatively treated lung cancer patients during radiotherapy.Adaptive radiotherapy is recommended in the cases where GTV is reduced over 20％ in the 20th treatment.

Objective To investigate the effect of early warning face pattern of weight combined with health education in weight management of maintenance hemodialysis patients.Methods Toally 223 maintenance hemodialysis patients hospitalized in the hospital from July to December 2014 (17,617 cases of hemodialysis) were set as the control group and 223 maintenance hemodialysis patients from January to June 2015 (17,281 cases of hemodialysis) were set as the experiment group.The control group was given routine health education and the experiment group was given health education and early warning face pattern of weight.The two groups were compared in terms of the ratio between interdialytic weight gain (IDWG) and interdialytic dry weight ratio (IWGR) as well as the hemodialysis-related complications.Results The IDWG/IWGR ratio in the experiment group was significantly better than that of the control group (P＜0.05).The incidence of hemodialysis-related complications were significantly lower than that of control group.Conclusion Early warning face pattern of weight used in health education can effectively control the patient's interdialytic weight gain (IDWG) and reduce the hemodialysis-related complications.

Objective To investigate the correlation between ankle-brachial index (ABI) and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke admitted to hospital within 7 d after onset from January 2014 to December 2014 were enroled. Bidirectional Doppler flow detector was used to detect ABI. END was defined as the increased National Institutes of Health Stroke Scale score ≥2 or the increased motor score ≥1. The demographic characteristics, vascular risk factors, laboratory parameters, and the incidence of END were identified and analyzed. Results A total of 210 patients with acute ischemic stroke were enroled, including 51 had END and 159 did not have END. Univariate analysis showed that the proportion of patient with ABI ≤0. 9 of the END group was significantly higher than that of the non-END group (43. 1% vs. 22. 0% ; χ2 = 8. 714, P =0. 003). Multivariable logistic regression analysis showed that ABI ≤0. 9 (odds ratio 2. 688, 95% confidence interval 1. 265 - 5. 052; P = 0. 009) was independently associated with END in patients with ischemic stroke after adjusting for the confounding factors, such as age, sex, baseline systolic blood pressure, and ischemic heart disease. Conclusion The low ABI was associated with the occurrence of END in patients with acute ischemic stroke.