Objective To investigate the effects of different treatments on elderly patients with breast cancer, and to analyze the factors that affect the treatment effect.MethodsA retrospective analysis was used to analysis the clinical data of elderly patients with breast cancer treated in our hospital from March 2012 to October 2013 were selected as the study object and according to the treatment methods, which were divided into three groups (A, B, C, which a group by breast modified radical surgery combined with intravenous chemotherapy and endocrine therapy, group B with breast modified radical mastectomy+endocrine therapy, group C with breast mass resection and endocrine therapy.The differences of survival rate of 1 groups after three years, 2 years and 3 years were observed, and the difference of survival rate of patients with different clinical pathological characteristics after 3 years was compared.The factors influencing the survival rate of patients after operation were analyzed.ResultsThere was no significant difference in survival rate between the three groups after 1 years, 2 years and 3 years;High differentiation, lymph node metastasis, depth of invasion, T1+T2, TNM stage I+II, immune group of non Yin in the elderly patients with breast cancer of the 3 year survival rate was higher, while patients of different age and diameter of the tumor patients and 3 years survival rate had no significant difference;Will the elderly breast cancer patients age, differentiation degree, tumor size, lymph node metastasis, depth of invasion, clinical stage, immune group of three yin as independent variables, will survival in patients with multi factors logistic regression analysis was used.Statistical analysis available, lymph node metastasis, infiltration depth and the three Yin of the immune group were the risk factors affecting the treatment effect of patients, their OR values were 4.412, 5.138 and 4.085.ConclusionDifferent treatment methods have no significant effect on the survival rate of elderly patients with breast cancer, and lymph node metastasis, depth of invasion and the three Yin of the immune group are the factors that affect the treatment effect.

BACKGROUND:Percutaneous vertebraplasty is a new means for the treatment of vertebral compression fractures and bone metastases. The multiplaner reconstruction with digital substraction angiography (DSA)-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, which can effectively prevent the leakage of bone cement. OBJECTIVE:To explore the value of DSA-Innova 3D in the guidance of puncture of percutaneous vertebroplasty. METHODS:From March 2014 to September 2014, a total of 72 patients with 94 vertebras were selected for percutaneous vertebraplasty, of whom 36 (48 vertebras) with Innova 3D (experimentalgroup) and 36 (46 vertebras) without Innova 3D (control group). Spiral CT scan was performed in al patients to assess the distribution of bone cement. The imaging quality in the two groups was compared by Mann-Whitney U test. RESULTS AND CONCLUSION:CT showed bone cement leakage occurred in 7 of the 36 patients in the control group. Leakages were into the lumber disc in two cases, paravertebral space in two cases, vertebral pedicle in onecase or veins in two cases. However, only one case of bone cement leakage was observed in the experimental group. With the guidance of DSA-Innova 3D, the experimental group had signficantly lower leakage and fluoroscopic time than the control group (P < 0.05). The multiplaner reconstruction with DSA-Innova 3D plays an important role in guiding the percutaneous vertebraplasty puncture, thereby effectively reducing the leakage of bone cement.

Objective To analyze the clinical features and prognosis of urinary calculi in children caused by melamine-contaminated milk. Methods Retrospective analysis of 53 cases of urinary calculi caused by melamine contaminated infant milk powder were performed. Clinical characteristics, lab measurements, colour Doppler ultrasound and CT examination results were collected, and the outcome of treatment and prognosis were followed up. Results In the 53 cases, there were 39 males and 14 females. The main clinical manifestations at admission included crying during urination, abdominal pain, hematuria, oliguria and anuria. Urine pH value was low with average of 5. 32 ±0. 25,blood uric acid was high with average of (638. 69 ±36. 25) μmol/L,blood urea nitrogen was high with average of (8. 35 ± 1. 97) mmol/L The colour Doppler ultrasound and CT examination showed calculi in both or one side kidney,or combined with calculi in both or one side ureter,calculi in one side ureter,or bladder calculi. After medical treatment,all calculi were exported,urine pH values increased to 6. 52 ±0. 47,blood uric acid blood and urea nitrogen decreased to (382. 31 ±29. 57) μmo/L and (5. 15 ±1.92) mmol/L No calculi reoccurred within one year of follow up. Conclusions Medical treatment of urinary calculi in children caused by melamine-contaminated milk powder was effective,and there were less stone recurrence after discharge.

BACKGROUND: Resin-modified glass ionomer (RMGI) cements have higher bond strength, especially can release fluoride. But there are fewer reports of the clinical application for the prevention of decalcification.OBJECTIVE: To test the benefit from using RMGI cement instead of a conventional composite resin in bracket bonding for patients with malocclusion, and observe bracket-failure rates and decalcification on enamel surfaces at pretreatment and at debonding.DESIGN: Observational and comparative trial.SETTING: The Second Hospital Affiliated to Hebei Medical University.PARTICIPANTS: Forty successive patients (358 teeth) with malocclusion admitted to the Department of Orthodontics in the Second Hospital Affiliated to Hebei Medical University, were selected for the study from July to August in 2002. All the patients (21 females and 19 males, mean age 16 years) had normal and complete anterior teeth, good oral hygiene. There were no obvious differences in bilateral teeth. Informed consents were obtained from all the subjects. The experiment was also approved by the ethical committee of the hospital. Experimental materials were RMGI adhesive (Fuji, GC, Japan, Lot 0005111) and composite resin cement (enamel adhesive of Beijing and Tianjin, Tianjin product, Lot 020402). Brackets produced from Hangzhou 3B and 37% phosphoric acid were used.METHODS: ①Bonding brackets: Subjects selected according to random procedure were divided into two groups, each with 20. GroupⅠ: The left buccal surfaces bonded with light-cure RMGI were etching for 30 seconds with 37% phosphoric acid, rinsed with water; the right buccal surfaces bonded with composite resin cement were etching for 60 seconds with 37% phosphoric acid, rinsed with water and dried; Group Ⅱ: After etching for 30 seconds with 37% phosphoric acid, the right buccal surfaces were rinsed with water and bonded brackets with light-cure RMGI. The left buccal surfaces were bonded brackets with composite resin cement after etching for 60 seconds with 37% phosphoric acid, rinsing with water and drying; Attachment of 0.036-cm NiTi wires with ligature to the brackets was conducted 10 minutes after light-curing. The information about differences in bilateral bonding materials was not told to patients. To ensure an equal bonding materials containing fluoride and minimize the error, all the patients were instructed to use toothpaste containing fluoride, a fluoride mouthwash was not prescribed. The treatment period was 9-26 months (mean 18 months).②Patients were rechecked at intervals of 4 weeks postoperatively. Each bonded tooth was checked for loose or missing brackets, and failures were recorded. A color transparency of anterior teeth area was taken using a standardized photographic technique. The enamel surface conditions were classified at a magnification of ×10. The condition of enamel surface recorded was made according to the scoring system by Geiger before treatment and at debonding.MAIN OUTCOME MEASURES: ①The number and site of bonding failures.②Enamel surface conditions at before treatment and debonding.RESULTS: Forty patients were all involved in the result analysis. Eliminating 4 teeth occurring bond failure and 4 teeth of opposite side at anterior teeth, a total of 232 teeth were evaluated.①The number and sit of bonding failures: There was no significant difference between the failure rates of RMGI adhesive and composite resin cement (P > 0.05). Significantly more premolar brackets failed than incisor brackets.②Decalcification of enamel surface: At debonding after treatment, the incidence rates of white spots in the surfaces bonded with the RMGI were significantly lower than that in the composite resin (25.9%, 38.8%, P < 0.05).CONCLUSION:The use of RMGI for brackets bonding results in a significant reduction in the incidence of white spot at debonding. Reducing etching time may obtain a similar survival rate with the routine etching time.

Objective To analyze the data of Human Immunodeficiency Virus (HIV ) screening in Qinnan District of Qinzhou from 2013 to 2015 ,and to provide scientific evidences for the prevention and control of Acquired Immune Deficiency Syndrome (AIDS) .Methods HIV antibody data which was collected from the AIDS laboratory between 2013 and 2015 in Qinnan District of Qinzhou were analyzed .Results Of 3 955 cases of the HIV antibody detecting in the AIDS laboratory from 2013 to 2015 ,200 cases were HIV antibody positive ,and the positive rate was 5 .06% which was decreased compared with previously .The HIV antibody positive rate of man was 9 .26% ,which was higher than women .Among the HIV positive people ,the rate of the ages older than 50 was 25 .36% which was the highest compared to the other age groups .The positive rate of farmers was 30 .83% and the rate of di‐vorced or widowed was 30 .86% and the rate of the illiterate was 16 .08% .Conclusion Man ,farmers ,the age older than 50 years old ,the divorced or widowed and the low degree of education groups are the focus groups of health education and prevention of AIDS .If we can find HIV infectors earlier ,we can control the epidemic of AIDS and formulate the prevention and control strategies better .

Objective To investigate the role of hypoxia induced factor-1 α (HIF-1 α) signaling pathway in development of nonacoholic fatty liver disease (NAFLD) by using a rat model.Methods Forty SD rats were randomly divided into 5 groups (normal control group,4 weeks model group,8 weeks model group,12 weeks model group,and 16 weeks model group according to random number table).NAFLD model was induced by high fat diet.Serum biochemical parameters and liver histological examinations were observed.The HIF-1α,peroxisome proliferator-activated receptor α (PPARα),and nuclear factor-κB (NF-κB) mRNA transcriptions of liver tissue were detected with realtime PCR.Results Compared with the control group,a remarkable rise of serum alanine amiotransferase,triglyceride,cholesterol,and reduction of high density lipoprotein-cholesterol were observed in rats treated with high fat diet after 12 weeks and 16 weeks (P＜0.05).Compared with model group,steatosis,grade of inflammation,and degree of fibrosis in the liver were also significantly aggravated.Fed with high fat diet for 8 weeks,the expression of HIF-1α was significantly higher than that in the control group;the expression of PPARα in 4 weeks group was significantly higher than that in the control group.The expression of PPARα was again significantly elevated in 16 weeks group (P＜0.05);NF-κB expression was increased gradually with high fat diet (P＜0.05).The expression of HIF-1 α mRNA was related with PPARα (r =0.82,P＜0.05) and NF-κB (r =0.67,P＜0.05),and PPARα mRNA was related with NF-κB (r =0.78,P＜0.05).Conclusion HIF-1 α signaling may regulate PPARα/NF-κB and seems to be related with development of NAFLD.

Objective:To investigate the value of serum anti-PLA2 R as a diagnostic marker of idiopathic membranous nephropathy( IMN).Methods:All available articles about serum anti-PLA2 R as a marker of IMN which were published at home and abroad from 2009.1 to 2013.12 were pooled from the databases of PubMed,Elsevier,Springer,CNKI,VIP and Wanfang database et al. The quality of the papers were evaluated by the quality assessment for studies of diagnostic accuracy studies( QUADAS).And then a meta-analysis was conducted by the statistical softwares of Meta-Disc and Stata.The diagnostic value of serum anti-PLA2 R in IMN was evaluated by the statistical indicators of pooled sensitivity, pooled specificity, pooled likelihood ratio and summary receiver operating characteristic curve( ROC curve).Sensitivity analysis was performed by reducing a paper in order,and publication bias was tested by Egger funnel plot.Results: Seven articles were selected to the meta-analysis according to the inclusion criteria and 967 cases were included in the study ( 454 IMN patients and 513 controls ).Heterogeneity test showed no heterogeneity threshold effect ( Spearman correlation coefficient was 0.107,P=0.819),but there was heterogeneity caused by non threshold effects(Cochrane-Q was 16.89,P=0.009 7).So random model was used to pool the effect size.The overall combined effect sizes:sensitivity was 69%,95%CI:0.65-0.73;specificity:98%,95%CI:0.96-0.99;pooled positive likelihood ratio 16.37,95%CI:4.06-65.95;pooled negative likelihood ratio 0.32,95%CI:0.24-0.43;AUC of SROC:0.854 0,Q*=0.785 0.Sensitivity analysis showed that this research was stable and reliable and Egger funnel plot showed little publication bias.Conclusion: Serum anti-PLA2 R is an useful biomarker to the diagnosis of IMN.

Objective To investigate the clinical efficacy and side reaction of tandospimne citrate capsules on treating patients with depression after stroke.Methods Seventy-eight patients who were diagnosed as anxiety and depression after stroke were taken as our subjects.They were randomly divided into control group (n =40) and treatment group (n =38).Patients in the control group were given conventional therapy for cerebral vascular disease and psychological treatment,while in the treatment group were given the same treatment besides tandospimne citrate capsules of 10 mg per times,3 times/d oral,and course of both two groups for 4 weeks.The patients of two groups were scored according to Hamilton Depression Scale(HAMD) at the time of pre-treatment and post-treatment.And the the clinical efficacy and side reaction were observed and compared.Results (1) HAMD scores of treatment group in 2,4 weeks after treatment had significantly lower than that before treatment ((8.09±2.21) vs.(6.31 ±2.28) vs.(11.98 ±2.17),P ＜0.05).HAMD scores of control group in the treatment at 2week was as same as that in 4 weeks((10.57 ±2.53) vs.(8.91 ±2.31)).There was statistically significant difference in two groups in 2,4 weeks after treatment in terms of HAMD scores(P ＞0.05).The total effective rate of control group was 31.6％ (12/38),and 92.5％ (37/40) in treatment group,and the difference was significant(x2 =63.69,P ＜ 0.01).In the course of treatment in the two groups,there were no obvious adverse reactions.Conclusion Tandospirone citrate capsules show the clinical curative effect in the treatment of anxiety and depression after stroke,and no obvious adverse reactions.

Objective To investigate the relationship between single nucleotide polymorphism (SNP) of transcription factor 7-like 2 (TCF7L2) at locus rs7903146,rs290487,rsl1196205,rs 12255372 and genetic susceptibility in women with gestational diabetes mellitus (GDM).Methods As a case-control study,100 pregnant women with GDM and 100 healthy pregnant women in the Maternal and Children Health Hospital of Jiangxi Province were recruited from January 2010 to July 2013.Clinical parameters,including body mass index (BMI),fasting insulin (FINS),fasting plasma glucose (FPG) and homeostatic model assessment-insulin resistance index (HOMA-IR) were measured after admission to hospital.Allelespecific PCR was used to analyze the SNP of TCF7L2 at locus rs7903146,rs290487,rs11196205,rs12255372.Results (1)The BMI,FPG,FINS and HOMA-IR in GDM group were(27.4±3.0) kg/m2,(5.6±1.0) mmol/L,(6.2±3.4) mU/L and 1.8± 1.0,and were (24.2±2.9) kg/m2,(5.3±0.8) mmol/L,(4.5±2.8) mU/L,1.2± 0.8 in the control group,respectively.The differences had statistically significance (P＜0.05).(2)The SNP of TCF7L2 gene,locus rs7903146 were CC,CT and TT genotype; the SNP of locus rs290487 were CC,CT and TT genotype; and the SNP of locus rs1 1196205 were GG and CC genotype; while the SNP of locus rs12255372 was GG genotype.(3)The distribution frequencies of genotype CC,CT and TT at locus rs7903146 in the GDM group were 40％ (40/100),36％ (36/100) and 24％ (24/100),respectively.While in the control group,they were 55％ (55/100),38％ (38/100) and 7％ (7/100),respectively.The frequencies of C and T allele of rs7903146 were 58％and 42％ in the GDM group,and in the control group they were 74％ (148/200) and 26％ (52/200).The differences of genotype distribution and C/T allele frequency of rs7903146 between the two groups were statistically significant (P＜0.05).(4)The distribution frequencies of genotype CC,CT and TT at locus rs290487 in the GDM group were 12 ％ (12/100),36 ％ (36/100) and 52％ (52/100),and were 16％ (16/100),34％ (34/100) and 50％ (50/100) in the control group.The frequencies of C and T allele of rs290487 were 30％ (60/200) and 70％ (140/200) in the GDM group,and were 33％ (66/200) and 67％ (134/200) in the control group.There was no difference of genotype distribution and C/T allele frequency of rs290487 between the two groups (P＞0.05).(5)The distribution frequencies of genotype GG and CC at locus rs1 1196205 in the GDM group were 99％ (99/100) and 1％ (1/ 100),while those in the control group were 100％(100/100) and 0％.The frequency of G and C allele of rs1 1196205 were 99％(198/200) and 1％(2/200) in the GDM group,while in the control group were 100％ (200/200) and 0.There was no difference of genotype distribution and G/C allele frequency of rs11196205 between the two groups (P＞0.05).(6)The distribution frequencies of genotype GG at locus rs12255372 were 100％(100/100) in both the GDM group and the control group.The frequencies of G allele of rs12255372 were 100％ (200/200) in both the GDM group and the control group.There was no difference of genotype distribution and G allele frequency of rs12255372 between the two groups (P＞0.05).(7)After adjusting for age,gestational age,BMI,FPG and FINS,pregnant women with TT genotype at locus rs7903146 were more likely to have hyperglycemia compared with the C allele carriers (OR=2.77,95％ CI:1.03-7.57,P＜0.05).Conclusions The polymorphism of locus rs7903146 in TCF7L2 gene may be associated with genetic susceptibility in women with GDM.TT genotype is likely to be risk factor in the pathogenesis of GDM.

Objective To assess the therapeutic effect and opportune time of surgical treatment of hepaticolithiasis . Methods The clinical data of 92 patients with hepaticolithiasis who underwent surgical treatment were analyzed retrospectively. Results (1) The incidence of postoperative complications was 14.1% (13/92 cases), in choledochoscopy group it was 9.3%(4/43 cases) and in the non choledochoscopy group 18.4%(9/49 cases) ; in the emergency operation group it was 36%(9/25 cases) and in selective operation group 5.97%(4/67 cases) . (2) The incidence of residual stones was 22.9%(21/92 cases); in choledochoscopy group it was 13.9%(6/43 cases) and the non choledochoscopy group 30.6%(15/49 cases); in emergency surgery group it was 36%(9/25 cases) and in selective operation group 17.9%(12/67 cases).(3)One pationt died from ACST two days after operation . All of the patients were followed up for 4-10 years; there were 80 cases (86.9%) who had a good therapeutic outcome. Conclusions Logical surgical procedure associated with choledochoscopy and appropriate timing of surgical intervention can markedly improve the effect of surgical treatment of hepaticolithiasis and reduce the incidence of postoperative complications.