Objective To explore the surgical indication, the operative procedure and effect of breast-conserving surgery plus combined treatment for the patients with early breast cancer. Methods 51 patients with early breast cancer were treated with breast-conserving surgery (BCS) plus radiotherapy, chemotherapy and hormonotherapy postoperatively. The result of breast-conserving group was compared with 56 patients treated by modified radical mastectomy (control group). Results 25 patients underwent quadrant resection plus axillary lymph node dissection (ALND), 15 patients were subjected to local resection plus ALND, and 11 patients received quadrant resection only. All patients were followed-up for an average of 16.9 months. In BCS group, one patient was found to have local recurrence, and the distant metastasis rate was 0%. In the control group, no patient had local recurrence and the distant metastasis rate was 3.6%. The operative complication rate in BCS group and control group was 13.7% and 33.9% respectively (p﹤0.05). Conclusion Breast-conserving surgery plus combined treatment is safe and satisfactory for early breast cancer. It can be considered as the first choice for the treatment of patients with breast cancer in early stage.

Objective To observe the influence of optimized nursing process on the clinical effect and quality of life of patients with cerebral infarction received intravenous thrombolysis.Methods Sixty-two cerebral infarction patients with thrombolytic therapy in Panzhihua Central Hospital were treated as control group from January 2013 to June 2014,74 cases cerebral infarction patients with thrombolytic therapy as the observation group from July 2014 to October 2015.The control group received routine nursing,the observation group were given optimized nursing process on the basis of routine nursing.The clinical effect and quality of life were compared between the two groups.Results The triage time,referral time and hospital stay time of the observation group were significantly shorter than the control group,the differences were statistically significant (P ＜0.05).The effective rate in the control group was 70.97％,that of the observation group was 87.84％,the effective rate in observation group was significantly better than that of the control group,the difference was statistically significant (P ＜0.05).Compared with before treatment,the life quality of two groups were significantly improved after treatment,the difference was statistically significant (P＜0.05);after treatment,the quality of life in observation groups were better than that of the control groups,the difference is statistically significant (P＜0.05).Conclusion Nursing process optimization can effectively improve the therapeutic effect for the patients with cerebral infarction intravenous thrombolytic therapy,shorten the treatment time and hospitalization time,and can significantly improve the patient' s quality of life.It is valuable for clinical application.

Purpose Chronic nephropathy model was established with New Zealand rabbit, and the development of chronic nephropathy was monitored using virtual touch tissue quantification (VTQ) technique, to provide the experimental basis for chronic renal fibrosis assessment using VTQ technique. Materials and Methods Thirty-eight healthy New Zealand white rabbits were selected, of which 32 were induced into chronic nephropathy model with daily intravenous ear vein injection of cationic bovine serum albumin (C-BSA), with the other 6 rabbits without C-BSA injection as control group. At the end of 0, 2, 4, 6, 8 weeks, VTQ was used to measure the hardness of renal cortex in rabbits, then the rabbits were slaughtered to assess the pathological changes in kidney, correlation analysis between the VTQ parameters and the pathological parameters was performed. Results VTQ value of rabbit kidney cortex at 0 week, 2 weeks, 4 weeks, 6 weeks and 8 weeks was (1.68±0.25) m/s, (1.70±0.31) m/s, (1.87±0.35) m/s, (2.19±0.31) m/s and (2.46±0.46) m/s respectively, difference of VTQ values between 6 weeks and 4 weeks was statistically signiifcant (P<0.05), and also signiifcant when compared 8 weeks with 4 weeks and 6 weeks (P<0.05). Glomerulosclerosis index of 4 weeks, 6 weeks, 8 weeks were 0.81±0.40, 1.43±0.46 and 2.15±0.46 respectively, and tubular interstitial collagen deposition score were (14.29±4.62)%, (26.28±11.06)%, (42.37±10.09)%, which were all significantly higher than that in 0 week and 2 weeks, fibrosis increased gradually with the course, the difference was statistically signiifcant (P<0.05). Correlation analysis showed that the VTQ value of renal cortex was positively correlated with glomerulosclerosis index (r=0.663, P<0.05) and tubular interstitial collagen deposition score (r=0.652, P<0.05). Conclusion VTQ technique is able to detect the VTQ change of renal cortex as the disease progressed in rabbits with chronic renal nephropathy, which was in a positive association with fibrosis index, suggesting that virtual touch tissues quantitative technology can be an important method to evaluate renal ifbrosis in chronic renal nephropathy.

ObjectiveTo explore the correlation of contrast-enhanced ultrasound (CEUS) parameters and the pathologic parameter of renal fibrosis.MethodsThirty-eight healthy New Zealand rabbits were randomly divided into the blank control group and the experimental group. The rabbits model was built by intravenous injection of C-bovine serum albumin (C-BSA) to rabbits of the experimental group. According to the different time points (2, 4, 6 and 8 weeks) after the injection of C-BSA, the rabbits in experimental group were randomly divided into 4 sub groups, 8 in each group. We collected the data of the CEUS parameters in the control group and the experimental group. Moreover, the renal tissues of the rabbits underwent pathologic examinations. Then, correlation analysis of CEUS parameters with parameters of renal fibrosis was performed.ResultsDynamic changes of CEUS parameters: Renal cortical perfusion reduced from 6 weeks after the injection, manifested as the time to peak (TTP) and mean transit time (MTT) of the experimental group were longer than those of control group and the derived peak intensity (DPI) of the experimental group was lower than that of control group (P<0.05 respectively). The DPI and TTP at 8 weeks after the injection of the experimental group was significantly lower than those of the control group [(26.96±2.34) dbvs (35.04±1.62) db,P<0.05; (24.31±1.82) svs (18.64±1.15) s,P<0.01]. Changes of each renal fibrosis parameter: we found that the results of the glomerulosclerosis indexes of the experimental group (4 weeks, 6 weeks and 8 weeks after the injection) were significantly higher than those of the control group (0.81±0.36, 1.43±0.25 and 2.15±0.30vs 0.13±0.07, allP<0.01). The tubular interstitial collagen deposition scores of the experimental group (4 weeks, 6 weeks and 8 weeks after the injection) were significantly higher than those of the control group (14.29%±4.62%, 26.28%±10.09% and 42.37%±10.41%vs 1.21%±0.15%, allP<0.01). As the disease progressed, the results of each parameter increased. Pearson correlation analysis showed that the TTP of renal cortex was positively correlated with the glomerulosclerosis index and tubular interstitial collagen deposition score (r=0.866 and 0.785, bothP<0.01). The DPI of renal cortex was negatively correlated with the glomerulosclerosis index and tubular interstitial collagen deposition score (r=-0.724 and -0.739, bothP<0.01).ConclusionsThe results showed that CEUS could evaluate microcirculation perfusion of renal cortex. There is a positive association between TTP and fibrosis index. There is a negative association between DPI and fibrosis index. Thus, CEUS is an important method to evaluate the renal fibrosis in chronic renal nephropathy.

Objective To explore the value of SOD activity in diagnosis of central nervous system leukemia (CNSL )by detec-ting SOD activity of cerebrospinal fluid of patients with CNSL .Methods The cerebrospinal fluid of 55 patients from department of hematology of Nanfang hospital of southern medical university were collected from January 2008 to January 2009 ,in which 30 pa-tients suffered with central nervous system leukemia (CNSL group) ,the other 25 patients suffered with acute leucemia without im-paired central nervous system(control group) .The SOD activity of cerebrospinal fluid was detected by the xanthine oxidase meth-od ,while the routine test ,biochemistry test and cell smear of cerebrospinal fluid was detected .Results There were statistics differ-ence in the level of white cell and protein in cerebrospinal fluid between CNSL and control group (P<0 .05) ,but with no difference in the level of cerebrospinal fluid pressure ,glucose ,chlorine(P>0 .05) .There was statistics difference in the level of SOD activity between CNSL and control group(P<0 .05) .The white cell quantity and the protein level in cerebrospinal fluid had negative corre-lation with the activity of SOD ,(r=0 .871 ,P=0 .000 ;r=0 .518 ,P=0 .003) .The activity of SOD in the cerebrospinal fluid had sta-tistics difference before and after intrathecal chemotherapy (P<0 .05) .The activity of SOD in the cerebrospinal fluid whose under 45 year-old (755 .64 ± 345 .77) ,which was significant lower than that of the paitents whose equal with or above 45 year-old (1 420 .49 ± 307 .69)(P<0 .05) .Conclusion The changes of the SOD activity in the cerebrospinal fluid had relation with central nervous system leukemia ,and the SOD activity might be a auxiliary diagnosis index used in central nervous system leukemia by revi-sing age factor .

OBJECTIVETo study blood Leptin level of 154 (78 male, 76 female) Chinese obese/non-obese children aged 0 - 14 years during 1999 - 2001.

METHODSThe gender- and age-specific distribution pattern of Leptin and its relationship with anthropometric parameters (waist circumference, waist/hip ratio, lean body mass, fat mass, body fat percentage, BMI/Kaup index etc.) and blood insulin level were recorded.

RESULTS(1) The blood Leptin level in healthy non-obese kids ranged from 1.01 - 29.92 (ng/ml), the mean values and SD were 2.99 +/- 2.13 (ng/ml) [90% confidence interval was 1.36 - 14.21 (ng/ml) in boys and 1.74 - 21.17 (ng/ml) in girls]. There was no significant difference in the blood Leptin level between serum and plasma. (2) The blood Leptin level was higher in overweight/obese kids than that in non-obese kids (P < 0.001). (3) There was significant difference in the blood Leptin levels between boys and girls groups (P = 0.023), especially in non-obese group (P = 0.004). The multiple regression analysis showed that there was no correlation between gender and blood Leptin level when body fat factor was added (P = 0.138, 0.241, 0.990), but there was still a strong correlation between blood leptin level and BMI, FM and BF% (P < 0.001). (4) There was a correlation between blood Leptin level and age (P = 0.005), especially in overweight/obese group and in girls (P = 0.001). The blood Leptin level rose from early puberty, especially in girl group (P = 0.045). There was significant difference in blood Leptin level in different age groups (P < 0.001) (5) There were strong positive correlation between blood Leptin level and BMI, BM and FM%, a weak correlation with LBM, and no correlation with W/H ratio in boys and a positive relationship in girls. The Quatatic equation was better than the linear equation in description of the correlation mentioned above. (6) There was a correlation between blood Leptin from 0 to 7 yr and birth weight (P = 0.001), after 7 yr of age this correlation disappeared (P = 0.456). (7) A positive correlation was seen between blood Leptin level and blood insulin level (P < 0.001).

CONCLUSIONThe blood Leptin level of 0 - 14 years old children is consistent with the level of growth of adiposity tissue and the degree of adiposity rebound.

Adolescent ; Age Factors ; Birth Weight ; physiology ; Body Constitution ; Body Mass Index ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Insulin ; blood ; Leptin ; blood ; Male ; Multivariate Analysis ; Regression Analysis ; Sex Factors

Humans ; Metals ; Microwaves ; adverse effects ; Occupational Exposure ; adverse effects ; analysis ; Workplace

Objective To analyze the trend of maternal mortality ratio (MMR) and cause of death in Shanghai from 1996 to 2015.Methods To collect the material about the maternal death and the maternal death audit from 1996 to 2015,and to analyze the MMR,the cause of death and the result of the maternal death audit of Shanghai from 1996 to 2015 retrospectively.Results (1) The change of MMR:the MMR in Shanghai decreased from 28.84 per 100000 live births in 1996 to 6.66 per 100000 live births in 2015.(2) The characteristic of maternal death:the proportion of Shanghai citizens was 27.4％(121/441) and the proportion of migrant women was 72.6％(320/441).The women with advanced maternal age was 8.2％(20/243) since 1996 to 2005,and increased to 16.7％ (33/198) since 2006 to 2015.Maternal deaths during pregnancy increased from 27.6％(67/243) in the first 10 years (1996-2005) to 35.4％(70/198) in the recent 10 years(2006-2015).The intrapartum maternal deaths was 6.2％(15/243) in the first 10 years and in the recent 10 years it was zero.The proportion of postpartum deaths in the first 10 years and in the recent 10 years were 66.3％ (161/243) and 64.6％(128/198) respectively.(3) The cause of maternal death:During the recent 10 years,indirect obstetric causes [63.1％(125/198)] was more than direct obstetric causes [36.9％(73/198)] for the first time.The death causes changed significantly.Postpartum hemorrhage remained the leading cause of maternal deaths,but the specific mortality rate (SMR) of postpartum hemorrhage decreased significantly from 7.42 per 100000 live births in the first 10 years to 1.51 per 100000 live births in the recent 10 years.The maternal deaths because of heart disease and cerebrovascular disease rose to the second and the forth reasons.(4) Maternal death audit:the avoidable maternal death ratio decreased from 3.66 per 100000 live births in the first 10 years to 1.86 per 100 000 live births in the recent 10 years.Conclusions During the past 20 years,the MMR of Shanghai decreased significantly and was close to the level of developed countries.In recent years,the causes of maternal death become more complicated.With the implementation of the second child policy,women with high risk factors increase,so government investment,policy support should be strengthened to optimize the management.

Objective To study the correlation between non-alcoholic fatty liver disease (NAFLD)and glycosylated hemoglobin (HbA1 c) in middle-aged and aged population.Methods A total of 4 127 inservice workers and retirees aged 45 years old or above from one petrochemical enterprise in Ningbo were enrolled in our study.The waistline,body mass index,blood pressure,fasting blood-glucose,blood lipid profile,glutamyltranspeptidase,HbA1c and epigastrium B ultrasound were investigated.According to the quartile of HbA1c level,participants were divided into four groups,namely,Q1 group ≤5.2％,Q2 group ＞ 5.2％-5.4％,Q3 ＞ 5.4％-5.6％ and Q4 group ＞ 5.6％.The prevalence of NAFLD and clinical characteristics of each group were analyzed.Logistic regression was used to predict independent risk factors of NAFLD.Results The morbidity of NAFLD was 27.2％ with 31.9％ in male and 21％ in female,which was significantly higher in men.In Q1,Q2,Q3 and Q4 group,the prevalence of NAFLD were 18.5％ (178/961),22.8％ (185/812),25.6％ (280/1 095),38.1％ (480/1 259) respectively.With the increase of HbA1 c level,the morbidity of NAFLD increased synchronously.The age,systolic pressure,total cholesterol,low densitylipoprotein cholesterin and fasting blood-glucose were all elevated according to the increase of HbA1 c in 1 123 NAFLD patients.Multi-factor logistic regression analysis indicated that high HbAlc level was the risk factor of NAFLD (OR =1.67,95％ CI 1.15-2.43,P =0.007).Conclusion HbA1c is an independent risk factor of NAFLD and both of these are closely related to blood lipid metabolism disorder.

Objective To investigate the correlation of endothelial function variation with pulse pressure index in Uygur acute coronary syndrome patients in Xinjiang. Methods Uygur patients were divided into acute coronary syndrome group (n=208) and control group (n=157) according to their Coronary angiography results. Height, weight and blood pressure were measured on admission and basic medical history were recorded. Fasting blood glucose (FBG), three acyl glycerin (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) were ex-amined using fasting venous blood;Plasma Coagulation FactorⅧ(CFⅧ) and von Willebrand factor(vWF)were examined using ELISA. Results There are no statistical difference in age, gender, history of hypertension, diabetes history, history of smoking, drinking, body mass index, PPI, HDL-C and FBG between two groups. The systolic pressure, diastolic blood pres-sure, pulse pressure, TG, TC, LDL-C and vWF, CFⅧlevels in acute coronary syndrome group were higher than those in the control group (all P<0.05). The levels of plasma vWF and CFⅧwere positively correlated with pulse pressure and PPI, it also was positively correlated between the levels of plasma vWF and CFⅧ(P<0.01). Conclusion The endothelial func-tion was significantly impaired in Xinjiang Uygur patients with acute coronary syndromes, and vascular endothelial damage was positively correlated with pulse pressure and PPI. The pulse pressure and PPI can be used to evaluate the vascular endo-thelial function indirectly.