Objective To retrospectively analyze the clinical characteristics ,pathological features and aetiology of pulmonary carcinoid tumourlets .Methods The clinical data of 10 patients with pulmonary carcinoid tumourlets in the West China Hospital of Sichuan University from April 1976 to October 2013 were collected for conducting the retrospective analysis and combining the lite‐raute review .Results Of the total 10 patients ,3 cases were male and 7 cases are female .9 cases were accompanied by bronchiecta‐sis ,1 case was complicated with lung adenocarcinoma .The clinical manifestations were lack of specificity ,which were dominated by repeated cough ,expectoration ,dyspnea and hemoptysis .The microscopic pathological examination suggested that there were differ‐ent degrees of inflammation reaction or fibrous tissue hyperplasia .All patients had no carcinoid syndrome ,lymph node and distant metastasis .10 cases received the surgical treatment .6 cases were pulmonary hypoplasia ,in which 1 case was carcinoid tumourlets complicating pulmonary sequestration .The postoperative follow up lasted for 5 - 80 months .8 cases had no recurrence and 2 cases were loss of follow up .Conclusion For the middle‐aged women patients with bronchiectasis and poor therapeutic effect ,complica‐ting carcinoid tumourlets should be vigilant ,active surgery combined with the pathologic examination is a suitable clinical decision .

Objective To investigate the effects of endogenous estrogen on blood glucose level,serum insulin level,and plasma total antioxidant capacity in streptozotocin-induced diabetic female mice,and to explore possible protective effects of estrogen on pancreatic islet cells.Methods Female mice were randomly according to body weight divided into four groups:( 1 ) Sham( Sham operation and vehicle administration) ; ( 2 ) Ovx( ovariectomy and vebicle administration ) ; ( 3 ) Sham + STZ ( Sham operation and STZ administration ) ; and ( 4 ) Ovx + STZ ( ovariectomy and STZ administration).The diabetic mice were induced by intraperitoneal injection of streptozotocin (STZ,50 mg/kg ).Blood glucose levels were measured once a week.Results The blood glucose level and malondialdehyde of Ovx group were higher than that in Sham group,while total anti-oxidant capacity ( T-AOC ) was lower than those in Sham group.the blood glucose level and MDA of Ovx+ STZ group were higher than those in Sham +STZ group,while T-AOC and serum insulin level were lower than those in Sham + STZ group.Conclusions Endogenous estrogen may have some protective effects on pancreatic islet function from streptozotocin-induced diabetes mellitus in female mice.

Objective To explore the clinical significance and treatment regimen of sentinel lymph node(SLN) micrometastases and isolated tumor cell metastasis in breast cancer.Methods Ninety-seven breast cancer patients with sentinel lymph node micrometastases or isolated tumor cell metastasis from January 2013 to December 2015 were retrospectively studied.The patients were assigned to axillary lymph node dissection group (ALND,41 cases) and non axillary lymph node dissection group(non-ALND,56 cases) according to the final surgery mode to the axilla.Disease-free survival(DFS) and overall survival (OS) were compared between the two groups.Results Neither clinico-pathological factors,such as age,tumor size,grade,ER/PR status,HER-2 gene expression,Ki-67 expression and the size of the SLN metastasis,nor the treatment,such as breast surgery,postoperative adjuvant chemotherapy,radiotherapy and hormone therapy were found statistically different between the two groups (P ＞ 0.05).There were 96 patients evaluable with a median follow up of 24 months.The DFS of the ALND and non-ALND group was 97.5％ and 96.6％ (P ＞ 0.05),and the OS was 100％ and 98.2％ (P ＞ 0.05) respectively with no difference between the two groups.There were 2 ispilateral axillary recurrence in the non-ALND group and non in the ALND group.Conclusion Axillary lymph node dissection may be omitted for the breast cancer patients with sentinel lymph node micrometastases and isolated tumor cell metastases.But the postoperative adjuvant systemic treatment should be emphasized.

Objective To investigate the nutritional status of elderly patients with diabetic foot ulcers and to explore its influencing factors and relationship.Methods Convenience sampling method was used to recruit 182 elderly patients with diabetic foot ulcers.The mini nutritional assessment (MNA) was adopted to assess nutritional status,and patients' clinical information,hemoglobin A1c,hemoglobin,serum albumin,C-reactive protein were also collected.Results The average score of MNA was 16.36±3.68 for 182 patients,and 121 patients suffered from malnutrition(66.48％),while 61 patients suffered from potential malnutrition(33.52％).The occurrence of malnutrition was positively correlated with age,course of diabetes,classification of foot ulcer,infection,C-reactive protein,hemoglobin A1c and food intake (P＜0.05);the incidence of malnutrition and C-reactive protein for patients with Wagner grade 3 and above were higher than those for patients with low Wagner grades,and hemoglobin A1c and hemoglobin were lower for patients with Wagner grade 3 and above(P＜0.05).Conclusion There was high incidence rate of malnutrition in elderly patients with diabetic foot ulcers,closely related to inflammatory state.Health care providers should provide targeted interventions in time,improve condition of malnutrition,and promote rehabilitation.

Objective To explore the application of standard interaction theory in the nursing care of multidrug resistance patients .Methods 113 cases of multidrug resistance inpatients were randomly divided into the observation group (58 cases) and the control group (55 cases).The observation group was give the nursing care based on the standard interaction theory , while the control group used the conventional nursing method .The psychological condition , medication adherence , treatment effect and satisfaction were compared between the two groups.Results After the intervention, the average score of anxiety in the observation group decreased from (18.51 ±3.71) to (8.20 ±2.82); the average score of depression in the observation group decreased from (57.06 ±8.29) to (35.74 ±10.80).The average score of anxiety in the control group decreased from (18.14 ±3.36) to (13.30 ±4.90); the average score of depression in the control group decreased from (56.94 ±7.24) to (54.74 ±7.25).The differences between groups were significant (t=-6.924,-11.100, respectively;P<0.05).The percentage of medication adherence was 96.5% in the observation group, which was significantly higher than 60.0% in the control group.The treatment effect of the observation group (52 cases) was better than (15 cases) in the control group.The satisfaction was (89.53 ±8.187) in the observation group than (79.53 ±10.563) in the control group.The difference between groups was significant (Z=-7.018,-6.646, respectively;t=5.480;P<0.05).Conclusions The standard interaction theory had remarkable effect in the application of nursing care of multidrug resistance patients .It can improve patients ’ psychological condition and medication adherence and satisfaction , thus it is worthy of promoting .

Objective To evaluate left ventricular ( LV ) myocardial mechanical transmural longitudinal displacement ( LD ) and radial displacement ( RD ) with contrast agent and different power irradiation in open‐chest Beagle canines by ultrasound velocity vector images ( VVI) workstation . Methods T he anesthetized open‐chest Beagle canines were assigned into two groups randomly :Group A ( n ＝6) for baseline ,diagnostic ultrasound power irradiation ( 300 mW) 5 min ,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions ; Group B ( n ＝ 6 ) for baseline and intensity ultrasound irradiation ( 1 W ,2 W and 3 W ,5 min respectively) conditions . T he standard short‐axis and long‐axis gray‐scale view s during three complete cardiac cycles in open‐chest Beagle canine models were acquired . T he peak LD subendomyocardium ( LD‐subendo) ,LD subepimyocardium ( LD‐subepi) ,RD subendomyocardium ( RD‐subendo) and RD subepimyocardium ( RD‐subepi ) of LV were analyzed using a dedicated Syngo VVI method . Results In group A ,the LV LD‐subendo ,LD‐subepi ,RD‐subendo and RD‐subepi in the most of segments showed increasing trend in diagnostic power irradiation ,contrast agent irradiation 5 min and contrast agent 20 min compared with baseline condition ,however the differences were not significant ( P ＞0 .05 ,respectively) . T he peak LD‐subendo and LD‐subepi ,RD‐subendo and RD‐subepi of LV in group A with the same condition were significant different ( all P ＜0 .05) . In group B ,LV LD‐subendo in ultrasonic power 3 W was lower than baseline condition ( P ＜ 0 .05 ) ,LV RD‐subendo was higher compared with baseline condition ( P ＜0 .05) . T he peak LD‐subendo and LD‐subepi ,RD‐subendo and RD‐subepi of LV in group B with the same condition were significant different ( all P ＜ 0 .05) . Conclusions On ultrasonic power 3 W ,LV LD‐subendo is decreased resulting to negative inotropic effect and RD‐subendo is increased to maintain the normal heart work .LV LD and RD on diagnostic ultrasound power irradiation 5 min , combined with contrast agent irradiation 5 min ,contrast agent 20 min conditions ,ultrasonic power 1 W and 2 W are not prominent changes .

Objective To evaluate the left ventricular(LV)myocardial mechanical changes with contrast agent and different power irradiation in open-chest beagle canines.Methods The anesthetized open-chest beagle canines were assigned into two groups randomly:group A(n=6)for baseline,diagnostic ultrasound power irradiation(300 mW)5 min,combined with contrast agent irradiation 5 min and contrast agent 20 min conditions;group B(n=6)for baseline and intensity ultrasound irradiation(1 W,2 W and 3 W,5 min respectively)conditions.The peak circumferential strain(CS),longitudinal strain(LS)and radial strain(RS)of LV myocardial wall were measured and analyzed using a dedicated Syngo velocity vector imaging(VVI)method.Results In group A,the peak CS and LS were increased significantly on diagnostic power irradiation,contrast agent irradiation 5 min and contrast agent 20 min(all P <0.05,respectively) compared with baseline condition;there was no significant difference of the peak RS on diagnostic power irradiation,contrast agent irradiation 5 min and contrast 20 min compared with baseline condition(P >0.05).In group B,the peak CS and LS were higher on power 1 W than on baseline condition(P <0.05), the peak RS was increased gradually on power 1 W than on baseline condition(P >0.05);the peak CS,LS, RS were lower on power 2 W than on baseline condition(P >0.05);the peak of CS,LS were lower on power 3 W than on baseline condition(P <0.05);the peak of RS was decreased gradually without significant changes between power 3 W on baseline condition(P >0.05).Conclusions These findings indicate potential positive inotropic effects with diagnostic ultrasound power irradiation 5 min,combined with contrast agent irradiation 5 min,contrast agent 20 min conditions,power 1 W and negative inotropic effects with power 3 W on LV myocardial CS,LS deformation.LV myofiber deformation reactions appear no significant differences on LV myocardial RS deformation in same disturbed setting.

Objective To study the clinical efficacy and safety of microwave ablation (MWA) in the treatment of autonomous functional thyroid nodules(AFTN) . Methods Sixty-seven nodules of 53 AFTN patients who refused or were not suitable for surgical resection and 131I therapy were enrolled in the study . All the nodules were evaluated by ultrasound ,color Doppler flow imaging ( CDFI) and contrast enhanced ultrasound(CEUS) ,and all of them were benign and confirmed by pathology . And then ,percutaneous MWA was performed . Fluid isolation and mobile ablation were used to completely inactivate the nodules ,and CEUS was used to evaluate the efficacy of the treatment . The following items included thyroid hormone level ,nodule volume ,nodular blood supply ,thyroid radionuclide imaging ,conscious symptom ,beauty score and complication . Finally ,the factors influencing the curative effect were analyzed . Results The follow-up period was at least 12 months . Compared with before treatment ,the differences of thyroid hormone level , the volume of nodules ,the nodule blood supply were statistically significant ( P ＜ 0 .01) . The 61 hot nodules" changed to cold or warm nodules" . The differences between the improvement ratio of conscious symptoms and beauty scores were statistically significant( P ＜ 0 .05) . The cure ratio in this study was 81 .13% ,and the incidence of complications was 11 .32% ,and the recurrence ratio was 4 .48% . The nodule volume≥14 .04 ml or in a dangerous position were the main factors affecting the curative effect . Conclusions MWA can inactivate the AFTN in situ ,make it lose the secretory function and reduce the volume of nodules . Therefore ,percutaneous MWA guided by ultrasound and CEUS treatment of AFTN can be regarded as another safe and effective treatment besides surgical resection or 131I therapy .

Objective To explore the prognostic value of neuroimaging score in patients with acute vertebrobasilar artery occlusion(VBAO)with successful revascularization.Methods A total of 83 patients with acute VBAO who underwent endovascular treatment with successful recanalization,modified thrombolysis for cerebral infarction grade 2b or 3 were retrospectively selected.Based on baseline diffusion weighted imaging(DWI)sequences,posterior circulation infarcts were assessed using the novel posterior circulation score(N-PCS),brainstem score(BSS),and posterior circulation Alberta stroke program early CT score(pc-ASPECTS).A 90 d modified Rankin scale(mRS)score ≤2 points was defined as functional independence.The predictive value of the three scores was assessed by the receiver operating characteristic(ROC)curve analysis.Results The N-PCS[median(interquartile range):2(1-2)vs 4(2-5)]was statistically significant between the functional independent group(50 cases)and the poor group(33 cases)(P＜0.001).Multifactorial logistic regression analysis showed that age[adjusted odds ratio(OR)1.08;95％confidence interval(CI)1.02-1.14;P=0.006],baseline National Institutes of Health Stroke Scale(NIHSS)(adjusted OR 1.12;95％CI 1.03-1.20;P=0.005),and N-PCS(adjusted OR 2.84;95％CI 1.30-6.19;P=0.009)were independent prognostic factors for a favorable prognosis.Conclusion The N-PCS based on DWI can predict the prognosis of acute VBAO patients with successful revascularization.