Totally 126 patients with malignant breast tumors diagnosed with ultrasound were followed up.The ultrasonic image characters were analyzed and compared with the pathologic outcomes. Ultrasound had a 92.1%(116/126) veracity in the diagnosis of malignant breast tumor,which were characterized by strong echo in the border of the tumors and halo (72.2%, 91/126).There were differences in ultrasonic images of malignant breast tumors with different pathologic types. Ultrasound can determine the character of most breast tumors.

Objective:To explore and evaluate the application of flipped classroom in the integrated curriculum of pathology and pathophysiology overview.Methods:This study included in 172 students from the 8-year program of clinical medicine of Batch 2016 (observation group), and 142 students of Batch 2014 (control group). The observation group adopted traditional classroom teaching combined with flipped classroom teaching, and the control group used only traditional classroom teaching. In the observation group, the teaching contents were redesigned in the form of flipped classroom. The relevant knowledge points were provided before class. Group discussions and in-class presentations were used in the teaching. And the cultivation of students' learning autonomy, interaction and innovation were emphasized. The teaching evaluation was obtained from the questionnaire survey and final exam performance of the two groups of students. SPSS 21.0 was used for t test. Results:Students in the observation group had high satisfaction with flipped classroom which was helpful to improve students' independent learning ability, oral expression ability and innovative thinking ability. However, there was no significant difference in the final exam scores between the two groups ( P=0.306). Conclusion:Flipped classroom teaching can improve students' interest in learning and stimulate their independent learning and innovation. However, the teaching effect evaluated only by the final performance can't reflect the superiority of flipped classroom, which should be assessed by more evaluation indexes.

AIM: To evaluate the ability of spectral domain optic coherence tomography ( SD-OCT ) parameters to detect progressive structural damage in primary open angle glaucoma ( POAG) by contrasting with visual field. ·METHODS: Retrospectively we evaluated 48 subjects (48 eyes ) of POAG, followed up 14 to 62mo. The parameters of SD-OCT and visual field were obtained. The correlation between the change of visual field measurements and OCT measurements were analyzed. Visual field progression was defined as reproducible drop of at least 2dB of mean deviation (MD) from the baseline visit. ROC curve was made to evaluated the ability of OCT parameters in detect progression of POAG. ·RESULTS: The 25 eyes were classified in progression group and 23 eyes were in non-progression group. No significant correlation was seen between OCT parameters and visual field in non-progression group. In progression group, OCT parameters which were significantly correlated with MD reduce were rim volume ( r=-0. 5997, P=0. 0007), C/D vertical ratio (r=-0. 6309, P=0. 0003), RNFL(r= 0. 4201, P= 0. 0260), and GCC(r= 0. 7080,P<0. 01). ROC curves showed the GCC reflected the reduce of MD accurately (P=0. 013). ·CONCLUSION: Part parameters of SD-OCT can reflect the progression of POAG accurately and provided a new method to detect the damage of visual function of POAG.

Objectives To observe the expressions ofα-smooth muscle actin (a-SMA) and type III collagen (Col-III) of tubuloin-terstitial ifbrosis(TIF) induced by unilateral ureteral obstruction (UUO) in rat and the intervention effect of supplemental hydrogen sul-ifde (H2S). Methods Ninety-six male Sprague-Dawley rats were randomly divided into 4 groups, sham-operated group, UUO model group, NaHS low-dose group and high-dose group. TIF rat model was established via UUO. After UUO operation, low-dose and high-dose group were intraperitoneally injected twice a day with 1.4μmol/kg and 7.0μmol/kg NaHS, respectively. Sham-operated group and UUO model group were given an equivalent volume of normal saline. Eight rats in each group were killed randomly at 7, 14 and 21 days after UUO operation. The concentration of plasma H2S was detected using deproteinization. Renal tubulointerstitial damage was evaluated with routine Hematoxylin and Eosin staining and Masson staining under microscope. The expressions ofα-SMA, Col-III were measured with immunohistochemistry. Results Compared with sham-operated group, renal tubulointerstitial injury was severer in UUO model group and was alleviated after intervention of NaHS. There was signiifcant difference in tubulointerstitial injury among all groups (P<0.01), but no difference was found between high-dose and low-dose group. Exogenous H2S supplement could down-regu-late the expressions ofα-SMA and Col-III in renal tissues (P<0.05). There was no difference between high-dose and low-dose group in the expressions ofα-SMA and Col-III (P>0.05). Conclusions TIF induced by UUO is associated with decreased level of endogenous H2S. H2S supplementation can ameliorate the development of UUO-associated TIF in part through down-regulating the expressions ofα-SMA and Col-III in renal tissues. However, a dose dependent manner between the two doses of exogenous H2S supplementation was not observed.

OBJECTIVE: To explore the effects of Gymnadenia conopsea alcohol extract (GcAE) on the collagen synthesis in rat lungs exposed to silica and the influence on antioxidase activities, level of lipid peroxidation (LPO). METHODS: One hundred and twenty rats were randomly divided into control group, silica group, and GcAE-treated group. Silicotic animal models were established by direct tracheal instillation of silica into rat lungs surgically. From the second day of model establishment, rats in GcAE-treated group were orally given GcAE [8 g/(kg x d) corresponding to raw herb]. At 7, 14, 21, 28 and 60 days after establishment of the animal model, eight rats in each group were sacrificed, and samples were collected. The malondialdehyde (MDA) content, superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities in plasma were assayed by a spectrophotometer. Types I and III collagen were detected by Sirius red polarization and microscopy, and measuered by Image-Pro Plus Version 4.5 for Windows software. RESULTS: GcAE could reduce the lung/body weight ratio of rats exposed to silica, the synthesis of types I and III collagen of the lungs and the level of lipid peroxidation, increase the activities of SOD and GPx. CONCLUSION: GcAE can ameliorate the silica-induced pulmonary fibrosis by increasing the activities of antioxidase and alleviating the damage of lipid peroxidation to the lungs.

Objective To investigate the value of PET/CT in the diagnosis of ovary sex cord-stromal tumor (SCST), and the correlation of PET/CT findings with pathological features.Methods PET/CT findings of 40 patients (median age 57 years) with ovary SCST confirmed by pathology from November 2011 to December 2015 in Shengjing Hospital were retrospectively analyzed.ROI was drawn and SUVmax was calculated.The correlation of imaging features with pathological structural features was analyzed.Two-sample t test and one-way analysis of variance were used.Results Pathological results showed 27 patients were ovarian thecoma-fibroma group (20 patients with theca cell tumor, 7 patients with fibroma), 12 patients had granulosa cell tumor and 1 patient had sertoli-leydig cell tumor.Solid mass with or without cystic low-density area was found in 24 patients, 14 cases were cystic-solid tumors, and 2 cases showed cystic mass with irregular and thickened septations.SUVmax between solid and cystic-solid tumors was not significantly different (2.94±1.64 vs 3.77±1.40;t=2.325, P>0.05).There was no significant difference of SUVmax among theca cell tumors, fibromas and granulosa cell tumors(3.00±1.42, 2.32±1.04 and 3.68±1.65, respectively;F=2.036, P>0.05).Slight or moderate 18F-FDG uptake in solid component was demonstrated in 35 patients (SUVmax 2.96±1.25).Other 5 cases with high 18F-FDG uptake (SUVmax 6.31±0.96) were confirmed malignancy or malignant potential by pathological results, including 2 solid theca cell tumors, 2 cystic-solid granulosa cell tumors and 1 solid sertoli-leydig cell tumor.Conclusion There are some features to diagnose ovary SCST on 18F-FDG PET/CT imaging, which have some correlation with pathological features.

Objective To explore the clinic value and efficacy of color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation for secondary hyperparathyroidism. Methods Fifty-six cases of secondary hyperparathyroidism who came from nephrology department of Beijing Friendship Hospital in the period of September 2012 to September 2013 were treated by color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation. One hundred and thirty-eight glands underwent this treatment and were evaluated by contrast enhanced ultrasound before, during and after operation. The levels of serum parathyroid hormone (PTH) were measured before and at 1 week, 1 month, 6 months and 1 year after treatment. Results The whole 56 cases achieved 1 month follow-up and 34 cases and 12 cases achieved 6 months and 1 year follow-up, respectively. Two special cases had been excluded. The PTH levels of 54 cases were signiifcantly different between after and before treatment [(369.5±183.4) ng/L vs (1321.6±471.4) ng/L, t=10.727, P=0.000]. The PTH levels continued to fall at the ifrst week after treatment, but there was no statistical signiifcance between the ifrst week and the ifrst day after treatment [(324.6±172.8) ng/L vs (369.5±183.4) ng/L], while there was signiifcantly different between the ifrst week after treatment and before treatment [(324.6±172.8) ng/L vs (1321.6±471.4) ng/L, t=9.364, P=0.000]. The PTH levels increased from (324.6±172.8) ng/L to (332.5±164.9) ng/L at 1 week and 1 month after ablation, while there was no signiifcant difference.But there is signiifcantly different between 1 month after treatment and before treatment (t=11.348, P=0.000). The PTH level at 6 months after treatment [(205.2±136.3) ng/L] and 1 year after treatment [(177.1±171.5) ng/L] had signiifcant difference compared with the value before treatment (t=8.737, P=0.000; t=7.655, P=0.017). Conclusion Color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation can be considered as a feasible and effective nonsurgical alternative treatment for secondary hyperparathyroidism patients.

Objective To investigate the correlation between high myopia and MMP-2 in aqueous humor (AH), by comparing the protein level of MMP-2 in AH from patients with cataract combined with high myopia and with emmetropia. Design Experimental study. Participants 30 AH samples of patients with age-related cataract. Methods AH samples were collected from the patients with age-related cataract during phacoemulsification, including 15 AH samples from patients combined with high myopia (experimental group) and 15 AH samples from patients with emmetropia (control group). The expression of pro-MMP-2 and MMP-2 in AH were ana-lyzed by Western blot technique. Main Outcome Measures The gray value of MMP-2 protein band detected by Western blot. Results The level of pro MMP-2 was statistically higher than that of MMP-2 in experimental group (430.4±57.3 versus 294.5±35.2, t=10.400, P= 0.000) and control group (402.8±57.7 versus 280.3±49.7, t=8.400, P=0.000). There was no statistically difference in the level of pro-MMP-2(t=1.320, P=0.200)and MMP-2 (t=0.900,P=0.375) between the two groups. Conclusions No abnormal expression of MMP-2 was detected in AH from patients with high myopia, according to this study based on limited samples. Pro-MMP-2 was the main form of MMP-2 in AH of patients with cataract combined with high myopia or emmetropia, which possessed potential ability of transferring into form of active MMP-2. (Ophthalmol CHN, 2009, 18: 260-264)

Objective To improve hand hygiene compliance among healthcare workers (HCWs)in a stomatological hos-pital,and effectively reduce healthcare-associated infection(HAI)rate.Methods According to WHO hand hygiene guide-line and implementation scheme of hand hygiene,a systemic and step by step hand hygiene promotion plan was formulated, the plan was divided into five steps:full alert,baseline investigation,improvement,tracking,and retrospective analysis. Hand hygiene compliance among HCWs before and after the promotion of activities was analyzed and compared. Results Through hand hygiene promotion activities,the questionnaires showed that average score of knowledge about hand hygiene among HCWs enhanced from 58.33 to 77.40 (increased by 32.69%);the average hand hygiene compliance rate increased from 24.28%(59/243)to 49.81%(133/267),the difference was significant(χ2 =35.331,P =0.000);hand hy-giene status at five moments for hand hygiene improved markedly.Conclusion Hand hygiene promotion has a significant in-fluence in hand hygiene among HCWs in this stomatological hospital.

Objective To investigate anterior migration of spinal cord after anterior cervical decompression and reconstruction for cervical spondylosis and its mechanism.Methods Eighty-one patients with cervical spondylosis who underwent anterior decompression and reconstruction were reviewed and evaluated retrospectively.There were 44 males and 37 females,with an average age of 52.3 years (range,37-72 years).The distance from anterior margin of the spinal cord to posterior wall of the spinal canal (Da),and medium of the spinal cord to posterior wall of the spinal canal (Dm) in magnetic resonance imaging were measured preoperatively and postoperatively.The recovery rate was calculated comparing the Japanese Orthopaedic Association (JOA) scores before and after operation.Results The average following up was 20.7 months (9-48 months).According to the measure on MRI,preoperative Da and Dm were 11.11±1.59 mm and 6.30±0.84 mm respectively,which were significant different from postoperative Da 11.63±-1.47 mm and Dm 6.62±0.80 mm.The postoperative Da and Dm at C3-4,C4-5,C5-6,C6-7 levels had statistically significant differences compared to preoperative Da and Dm,except for ones at C2-3 level.The significant migration rate was 43.2％(35/81),which reached △Da ＞2 mm or △Dm ＞1.3 mm.Preoperative cervical curvature index (CCI) was 10.0％±6.3％,which was significant different from postoperative CCI 13.5％±6.5％.JOA score increased from 9.7±1.5 preoperatively to 13.7±1.1 at one week postoperatively,and 13.9±1.3 at 6 months postoperatively.But the JOA score decreased at 6 months postoperatively compared with that at 1 week postoperatively in 15 cases.Among them,14 cases got the standard of spinal cord migration based on MRI measurement.No other severe complications were found in these 81 cases.Conclusion Anterior migration of the spinal cord commonly occurred after cervical decompression and reconstruction via anterior approach,and some patients might suffer from the secondary compression of the cervical spinal cord.