Objective To study the clinical characteristics,pathology,and treatment for papillary carcinoma of the breast.Methods The clinical data of 17 patients of papillary carcinoma of the breast admitted in the First Affiliated Hospital of Wen Zhou Medical College were retrospectively analyzed.Results Papillary carcinoma of the breast accounted for 0.64％ of all breast cancer cases hospitalized during last 10 years.All cases had palpable lumps in the breast.12 cases received modified radical mastectomy,2 cases received simple mastectomy,2 cases underwent breast conservation therapy,1 case underwent simple mastectomy plus sentinel lymph node biopsy.15 patients received postoperative chemotherapy,among those 5 cases also received radiotherapy.During a 32.5-month median follow-up ( 1 month to 8 years),one case with bone metastases died 2 years postoperatively and another one died of multimetastases 7 years later.Conclusions The prognosis of papillary carcinoma of the breast is closely related with its pathology type.For intraductal papillary carcinoma low-traumatic therapy is applicable,while in case of infiltrating papillary carcinoma or invasive micropapillary carcinoma ( IMPC ),more aggressive therapies like that adopted for infiltrating ductal carcinoma are recommended.

A wide range of computer and internet applications impact on people's lifestyles andways of thinking profoundly, Internet acculturation is an important research issue in the information age.By the literature review,this paper summed up the themes of medical students' internet acculturation:in-ternet addiction disorder research,internet morality anomie research and internet learning adaptation re-search.Some suggestions for future research were put forward at last.

Objective To investigate the maternal attitude and demands for Institute of Postpartum Care in order to provide targeted services.Methods 285 women were a investigated about maternal attitude and demands towards Institute of Postpartum Care with self-designed questionnaire.Results 97.9％ (279/285) women thought sitting the month (puerperal period) was very important,50.2％ (143/285)women were interested in Institute of Postpartum Care.They thought the main three advantages were energy saving,medical expertise and technology and avoidance of family conflicts;The three major issues were high price,lack of monitoring mechanism and unfamiliar environment and less family company;33 items of services demands over four points accounted for 78.6％,the three modules with highest scores were cleaning services scored 4.64±0.47,newborn services scored 4.45±0.41,consultation service scored 4.41:±0.53.Conclusions Professional postnatal care services have been a trend and social need,and a large proportion of women have great interest and demand on Institute of Postpartum Care which should make full use of its concentrate resources,and provide specific services according to maternal demands for services.It is urgent to build unified service standards and evaluation indicators to improve service quality.

Objective To explore the clinical effects of correction the midface depression.Methods From Aug.2010 to Aug.2015,185 cases of midface depression (aged from 18 to 61 years)were corrected by using structural fat grafting technique,the site and volume were placed as follows,tear trough 1ml,lid cheek groove 2 ml,midcheek groove 0.5 ml,anteriorcheek 4-8 ml,nasolabial fold 1-2 ml,nasal alar base 1-2 ml,evator labii superioris 1-2 ml,zygomaticus major 1-2 ml,buccinator 1-3 ml,and upper lip 3-5 ml.Results 185 cases were followed from 3 months to 3 years and the results were evaluated by visual analogue scales;156 cases of midface depression were corrected after the first structural fat grafting,the midface changed from concave to convex,and acquired prominent malar became more attractive;satisfaction of visual analogue scales were more than 80 ％;only 12 cases needed a second grafting.Conclusions The midface concavity can be corrected effectively by using structural fat grafting technique,the results are satisfied and the technique is safe,simple and effective.

OBJECTIVE:To provide reference for rational use of anti-tumor essential medicine in the clinic. METHODS:The application of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 was analyzed statistically in re-spects of consumption sum,DDDs,DDC and B/A. RESULTS:The total consumption sum of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 increased from 10 083.65 ten thousand yuan to 15 186.65 ten thousand yuan,with annual increase rate of 22.72%. 3-year total consumption sum was 37 952.45 ten thousand yuan,and the sum of consumption sum of top 10 medicines was 36 742.24 ten thousand yuan,accounting for 96.81%;top 3 medicines were paclitaxel,oxaliplatin and flu-orouracil. During 2012-2014,DDDs had changed to certain extent,and the front medicines contained tegafur,paclitaxel and cyclo-phosphamide,etc;the most increment medicine was paclitaxel (oral),whose annual growth rate was 59.63%;that of tamoxifen decreased year by year,with annual decrease rate of 5.14%. DDC of paclitaxel,oxaliplatin and etoposide were the higher others. Annual B/A of oxaliplatin,fluorouracil and cytosine arabinoside were all lower than 1.00. CONCLUSIONS:The lonsumption sum and DDDs of anti-tumor essential medicine had increased reasonably in 39 hospitals from Chongqing area during 2012-2014,while their DDC had kept stable. Main medicines used in the clinic are suitable for numerous indications,and are expensive.

OBJECTIVE:To provide reference for drug production,parchase and use in local governments,health care depart-ment,hospitals,manufacturers and sales enterprises,etc. METHODS:By consumption sum sorting method,the information of 14 categories and key types in 34 hospitals from Chongqing area during 2012-2014 were analyzed statistically such as sales,produc-tion manufacturers. RESULTS:The consumption sum of 34 hospitals from Chongqing area increased by 15%-17% during 2012-2014. The consumption sum and proportion of anti-infective drugs showed a downward trend,decreasing by 3.28%. Those of respi-ratory system drugs and anti-tumor drugs had the largest increase,with increasing rate of 79.01% and 69.39%,respectively. Do-mestic drugs accounted for about 73% market share,and sales of imported drugs increased more than domestic and joint-stock drugs,increasing by 40.17%. Among 6 Chongqing pharmaceutical manufacturers on the top 100 consumption sum shortlist,total consumption sum of 3 manufacturers had increased;the consumption sum of top 10 foreign pharmaceutical manufactures increased year by year. CONCLUSIONS:The consumption sum of drugs is increasing in Chongqing area. Anti-infective drugs accounted for less than 16%,which is the achievements of clinical application of antibiotics special rectification activities for 3 years. Both respi-ratory system disease and malignant tumor have high incidence in Chongqing area. Domestic drugs still are main types in hospital. Foreign manufacturers develop well in China,but Chongqing pharmaceutical manufacturers show unsatisfactory development pros-pect.

Objective To investigate oxygen nebulizer usage among inpatients in an upper first‐class hospital so that this de‐vice can be used by medical personnel and patients properly .Methods Totally 409 patients were investigated about the usage of the device from May 12th to 30th 2014 ,whose outcomes were analyzed by Excel2007 software .Results The total liquid volume of in‐halation on prescription was much larger than the favorable one ,ranging from 4 to 6 mL .And the Oxygen flow ,ranging from 2 .5 to 3 .5 L/min ,was much lower than the normal flow (ranging from 6 to 8 L/min) .In addition ,all patients failed to breathe normally with occasional deep breaths and failed to gargle timely after corticosteroid inhalation .Only 3% patients cleaned their faces after corticosteroid inhalation ,43 .5% patients sit in an upright position ,44 .0% patients kept the nebulizer vertical during treatment .The accuracy rates of mouthpiece position ,the right time to stop nebulizer therapy ,rinsing the nebulizer with sterile or distilled water and allowing to air dry were 95 .1% ,99 .2% ,and 99 .3% ,respectively .Conclusion There are many common patient use nebulizer incorrectlly in the upper first‐class hospital ,and education and guidance by medical personnel should be strengthened .

Twenty adult male rats, weighing 200～300 g were divided into 3 groups: (1) Six. animals were stimulated through two electrodes fixed on the tail to produce somatic pain.(2) Six animals were stimulated by increasing pressure in the stomach through an air balloon to cause visceral pain. And 8 animals served as control.All the animals were sacrificed and their neurohypophysis were fixed in 4％ glutaraldehyde and 1％ OsO_4 successively. Their section were cut with an LKB microtome and observed under H 500 electron microscope.The experimental results summarized as follows:1. The bodies of pituicytes under the pain stimulation were hypertrophied. The rough endoplasmic reticulum, polyribosomes and mitochondria were increased. The Golgi complex was well developed. There were numerous elliptical vesicles appearing in the cytoplasm of pituicytes.2. The number of large lipid masses was increased while the processes of pituicytes engulfed the degenerative neurosecretory terminal into them and the pituicyte digted it finally.3. Neurosecretory granules were decreased but the synaptic small vesicles were increased in the dilated parts of neurosecretory fibers after the pain stimulation.4. The continuous network of perivascular space and interstitial space between the dilated parts of neurosecretory fibers were widened.

The purpose of this research work is to study the influence of experimentally produced pain on the uhrastructural changes of the nerve endings of the neurosecretory fibers from hypothalamus to neurohypophysis.Twenty adult male rats, weighing 200～300 g were divided into 3 groups: (1) Six animals were stimulated through two electrodes fixed on the tail to produce somatic pain. (2) Six animals were stimulated by increasing pressure in the stomach through an air balloon to cause visceral pain. And 8 animals served as control.All the animals were sacrificed and their neurohypophysis were fixed in 40％ glutaraldehyde and 1％ OsO_4 successively. Sections were cut with an LKB microtome and observed under H500 electron microscope.The following conclusions were drawn from the observed results:1. The neurosecretory granules in the fibers from hypothalamus to neurohypophysis grew up to maturity by increasing in size gradually as they passing down from hypothalamus to neurohypophysis.2. Basing on the morphological exhibition of the neurosecretory granules, we get the impression that the neurosecretion might be released either by molecular dispersion or by exocytosis.3. There were a great number of discrete smooth vesicles grouped in cluster in the dilated parts of neurosecretory fibers. These vesicles had been called as "synaptic" or "synaptoid" vesicles. They might be really synaptic vesicles and containing acetylcholine. Other vesicles with irregular profile and varying in size, collapsing vesicles and vacuoles might be the residues of the neurosecretory granules after discharging their content.4. Many synaptic vesicles were concentrated at the axolemma of the dilated parts of neurosecretory fibers and the membranes were thickened and leaving a synaptic cleft.5. In the exprimental groups after pain stimulation the neurosecretory granules decreased in number and the synaptoid vesicles increased in number and the neurosecretory granules showed a wide pale halo. The number of irregular vesicles and ghost of granules were increased. This phenomenon might show that the excretion of neurosecretory material and neurotransmitters was enhanced.6. Neurohemal zones were the barrier for the neurosecretory material entering into blood. Acetylcholine, endogenous opiatelike substances and gamma-aminobutyric acid (GABA) might play a control role for neurosecretion at this site.7. This experimental results supported the action mechanism of endogenous opaitelike substance and morphine could produce an important role directly in neurohypophysis.

Objective To study the status quo of nursing human resource configuration and structure of neonatology department in China's economically developed areas.Methods Using judgment sampling and multi-stage stratified sampling,investigations were conducted by the self-designed questionnaire in letter in 2012.Results In 2012,both the bed nurse ratio(1:0.79) and doctor nurse ratio (1: 1.22) met the Health Ministry's standards (1:0.58-0.61 and 1: 2) respectively.Age distribution of neonatology nursing staff was from 25 to 34 years old (55％).The distribution of wordng experience was average.Nurses with junior college degree as the main body took up 48％,with primary title as the main body 66％,and the appointment system accounted for 42％.The nursing personnel with young ages,senior skilled,higher education degree,and advanced titles were concentrated in Grade Ⅲ-A hospitals and public hospitals of women and children.In terms of distribution equity,two Gini coefficients of geographical and population distribution were both less than 0.35 and near zero,which indicated relatively perfect equity.Conclusions The stock and per capita of neonatology nursing human resources in China's economically developed areas were insufficient in the long run and showed imbalanced allocation among hospitals with different levels.The allocation structure failed to meet the needs of nursing disciplinary development.