BACKGROUND:How to keep the intact shape of the breast while treating tumor has been widely concerned by more doctors and patients, breast reconstruction is introduced, developed and considered an important part in the treatment of breast tumors. OBJECTIVE:To explore the feasibility and therapeutic effects of immediate breast reconstruction after modified radical mastectomy and latissimus dorsi myocutaneous flap transplantation. METHODS:We retrospectively analyzed the clinical and pathological features of 42 breast cancer patients under immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap or extended latissimus dorsi musculocuraneous flap. The procedure duration, postoperative complications and cosmetic outcome were assessed. RESULTS AND CONCLUSION:Among the involved 42 patients, 33 cases underwent modified radical mastectomy, retaining the nipple and areola of breast, 9 cases underwent modified radical mastectomy, retaining the skin of breast, 24 cases underwent breast reconstruction with latissimus dorsi musculocuraneous flap, 18 cases underwent breast reconstruction with extended latissimus dorsi musculocuraneous flap. The skin flap and reconstructed breast al survived, without severe complications. According to objective evaluation results, the cosmetic outcome was good in 39 cases and fair in 3 cases. The subjective evaluation results were good in 40 cases and fair in 2 cases. Al the patients were fol owed up for 9-41 months. One patient had bone metastasis 19 months after operation and there was no case with local recurrence. Immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap is a simple and feasible operation process, with optimal effects, high security, and high survival.

Objective:To compare the therapeutic effect of immediate breast reconstruction using latissimus dorsi musculocutane-ous flap after modified radical mastectomy with the conventional modified radical surgery of breast cancer. Methods:A retrospec-tive analysis of 224 female patients with Stage 0 to IIIA breast cancer was conducted. The patients were admitted to the Department of Breast Surgery of Liuzhou People's Hospital between November 2009 and July 2012. The cases were divided into two groups accord-ing to different surgical options:immediate breast reconstruction (IBR) and modified radical surgery of the breast (MRSB). After con-trastive analyses of the postoperative complications, cosmetic results, quality of life, local failure rate, distant metastases and mortality rates between the two groups, the therapeutic efficiency of the two surgeries was evaluated. Results:No statistical differences were ob-served in the postoperative complications between the two groups, such as hydrops, skin flap necrosis, limb exercise and shoulder joint motion, drainage time, and starting time of adjuvant therapy (P>0.05). The patients in the IBR group had a better quality of life than those in the MRSB group (P<0.01). The aesthetic evaluation of the breast reconstruction was favorable in 39 cases and secondary in 3 cases, which surpass the evaluation of the patients in the simple MRSB group. No obvious statistical differences were observed in the distant metastasis rate, local recurrence rate, and mortality rate between the two groups (P>0.05). Conclusion:Compared with the tradi-tional MRSB group, the option of IBR after modified radical mastectomy not only achieves similar therapeutic outcomes but also pres-ents advantages such as better aesthetic effect of the reconstructed breast, easy surgical procedures, high safety, improvement of the breast contour outline, and improved quality of life after operation. Therefore, IBR is a safe and available therapeutic method for pa-tients with early breast cancer.

Objective: To investigate the association between physical activity and the risk of mortality, so as to provide the basis for guiding the elderly to maintain appropriate levels of physical activity. Methods: A retrospective cohort study was adopted. Basic information, weekly physical activity items and duration of the elderly aged 50-71 years old was collected from the National Institutes of Health-American Association of Retired Persons Diet and Health Study database. With all-cause mortality risk as the main outcome indicator, controlling for demographic, dietary and disease factors, the association between the duration, metabolic equivalent and intensity of physical activity and all-cause mortality risk was analyzed using restricted cubic spline and multivariable Cox proportional risk regression model. Results: A total of 266 072 participants were included, with an mean age of (70.11±5.36) years old. There were 155 244 males (58.35%) and 110 828 females (41.65%), with a total of 36 006 deaths by December 31, 2011. The median duration of physical activity was 14.00 (interquartile range, 14.00) h/week and the median metabolic equivalents was 53.00 (interquartile range, 54.71) MET-h/week. Restricted cubic spline analysis indicated that the risk of all-cause mortality declined rapidly within the physical activity range of 0 to 15.0 h/week or 50.0 MET-h/week, but with the continuing increase in physical activity, the decline in the risk of all-cause mortality slowed down (all P<0.05). Multivariable Cox proportional risk regression analysis showed that compared with participants with no physical activity, participants with the duration of 0.1-<15.0 h/week, 15.0-<29.5 h/week, ≥29.5 h/week (HR=0.502, 0.386 and 0.368), or the metabolic equivalent of 0.1-<50.0 MET-h/week, 50.0-<110.8 MET-h/week and ≥110.8 MET-h/week (HR=0.511, 0.379 and 0.354) were associated with a reduced risk of all-cause mortality. The combination of mild (0.1-<5.0 h/week), moderate (≥5.0 h/week) and vigorous (≥1.3 h/week) activities had a lower risk of all-cause mortality (HR=0.320). Conclusions Moderate physical activity is associated with a reduced risk of mortality, and it is recommended to do 15.0 h or 50.0 MET-h of physical activity per week in combination with different intensities.

Objective To investigate the safety and feasibility of fast track surgery (FTS)in patients with vaginal hysterectomy for non -prolapsed uterus.Methods 1 1 0 cases of vaginal hysterectomy for non -prolapsed ute-rus with benign uterine disease were randomly divided into two groups:fast track group (n =55)and conventional group (n =55).The operative time,intraoperative blood loss,postoperative nausea and vomiting,anal exhaust time, postoperative hospital stay,medical cost and perioperative complications were compared between the two groups. Results In FTS group,the incidence rate of postoperative nausea and vomiting,the postoperative anal exhaust time, hospital stay,cost of hospitalization were 1 6.4%,(1 3.73 ±2.41 )h and (4.38 ±1 .08 )d,(7 541 .00 ± 253.1 7)yuan,respectively,which in the control group were 36.4%,(1 8.56 ±1 .54 )h,(4.89 ±1 .26 )d, (8 1 55.1 5 ±495.89)yuan,the differences were statistically significant between the two groups (χ2 =5.67,t =-1 2.53,-2.28,-8.1 7,all P <0.05).There was no significant difference in the operative complications between the two groups (P >0.05).Conclusion FTS has good security.It can short the hospitalization time,reduce medical costs and improve the quality of life in patients who underwent vaginal hysterectomy for non -prolapsed uterus with benign uterine disease.

Objective To explore clinical value of optimizing the contrast medium injection protocol for dual-source CT high-pitch spiral acquisition in children with complex congenital heart disease.Methods Sixty patients with complex congenital heart disease were prospectively recruited and randomly divided into group A and group B by the random number table method.Patients in group A received a conventional contrast medium injection protocol,i.e.a diluted contrast material with fast and slow rate respectively,and then a flush with normal saline.The volume of contrast medium was 2.0 ml/kg.Patients in group B received an optimized injection protocol,i.e.a four-phase diluted contrast material with contrast/ saline ratio of 8:2,6:4,4:6,2:8 respectively.The volume of contrast medium was 1.0-1.5 ml/kg.Attenuation and noise were measured in superior vena cava,right atrium,right ventricle,the main pulmonary artery,left atrium,left ventricle,ascending and the descending aorta in the two groups and compared by t test.The image uniformity was assessed by t test.Subjective image quality and artifacts of superior vena cava were analyzed by the Mann-Whitney U test.Diagnostic accuracy was evaluated by x2 test.All the patients undergone the surgical treatment and demonstrated 121 abnormalities (22 species) of internal and external heart structure,i.e.56 in group A and 65 in group B.Results There was no significant difference in diagnostic accuracy between group A and group B (A:96.9％,52/56,vs.B:96.4％,62/65;x2=0.28,P=0.59).While,significant difference was found in the amount of consumed iodine between the two groups [A:(15.7±6.5) ml vs.B:(10.4±2.4) ml;t=4.14,P＜0.01].Furthermore,the image uniformity in group B was statistically higher than that in group A[A:(36.5± 18.0)HU vs.B:(272.0± 124.5)HU;t=10.30,P＜0.01].As for subjective image quality,no significant difference were observed (A:3.3±0.5 vs.B:3.5±0.5;Z=396.00,P=0.39);while significant difference was found in artifacts of superior vena cava (A:3.2±0.9 vs.B:3.7 ± 0.7;Z=300.50,P=0.02).Conclusion The optimized contrast medium injection protocol for children with complex congenital heart disease could eliminate the image artifacts of superior vena cava and improve the image quality.

Objective To evaluate the level of IL-17 in rheumatoid arthritis(RA)and explore its clinic value.Methods Serum were collected from 84 RA patients.IL-17 was detected by ELISA.C reactive protein(CRP),glucose-6-phosphate isomerase(GPI),rheumatoid factor(RF),anti-cyclic citrullinated peptide(Anti-CCP)antibody,IL-1? and tumor necrosis factor-?(TNF-?)were assayed,too.The correlations between IL-17 and clinical manifestations as well as laboratory findings were analyzed.Results The serum level of IL-17 in active RA patients was(113.8?21.7)ng/L,significantly higher than that of non-active RA[(76.3?11.9)ng/L,P0.05).There were positive correlations between IL-17 and clinic index,for example swelling joints,tenderness joints and X-ray phase of joints.Conclusion High expression of IL-17 was shown in RA,and related with disease activity.

Objective\ To prepare a digoxingen labelled cRNA probe for human tyrosine hydroxylase(hTH 2).Methods\ Using molecular cloning techniques the recombinant plasmid pGEMTH 2 was constructed.According to analysis of restriction endonucleases,the pGEMTH 2 contained the DNA fragment of hTH 2 gene and inserting sit preparation was correct for cRNA probe.From recombinant plasmid pGEMTH 2 prepared cRNA probe was identified by dot blot hybridization.Results\ The dot blot hybridization showed that the positive reaction sites were purple blue.Conclusion\ This probe prepared in present study was sensitive and reliable.This probe might provide a tool for identifying the effect of gene therapy in animal model of Parkinson disease.

Objective To investigate the clinical value of detection of fluorescence quantitative PCR in detection of HBV DNA and HBV markers.Methods 653 hepatitis B patients in our hospital from 2013 April to 2013 December were selected.First ELISA method using HBV-M model for qualitative detection of the blood samples,the detection order:Hepatitis b virus surface antigen (HBsAg),Hepatitis B surface Antibody(HbsAb),Hepatitis B e Antigen(HbeAg),hepatitis Be antibody(HbeAb),hepatitis B core antibody(HbcAb);Then the FQ-PCR method for the quantitative detection of HBV-DNA,different HBV-m model test results were compared..Results Big 3 this world[1(+)、3 (+)、5 (+)model]and[1 (+)、3 (+)model ]of the HBV-DNA positive rate was 97.97%,94.74% was significantly higher than that in other mode(P<0.05).Big 3 this world[1(+)、3(+)、5(+)model]HBV-DNA expression level is the highest(5.59 ×106 ±2.42 ×105 )copies/mL was significantly higher than that in other mode(P<0.05).Conclusion Combined with qualitative and quantitative detection of HBV-DNA HBV-M,which is of great value to clinical early diagnosis and therapy.

Objective:The aim of this paper is to analyze and evaluate the equity and utilization efficiency of public health resource allocation in 31 provinces and cities in China, and provides reference and basis for public health resource allocation planning. Methods:The allocation of public health resources was evaluated by cluster anal-ysis and used data envelopment analysis was to explore the efficiency of public health resource allocation. Results:The degree of aggregation of public health resources in densely populated and economically developed provinces and cities were greater than or close to 1 , and the difference with the population concentration was mostly less than 0 . The degrees of aggregation in less economically backward provinces were less than 1 , and the difference with the popula-tion concentration was mostly more than 0 . The average technical efficiency of public health resource allocation was 0. 44, and the mean of pure technical efficiency and scale efficiency were 0. 74 and 0. 64 respectively. Conclusion:The degrees of aggregation of public health resources in economically developed provinces and cities are higher, but the corresponding population is poorly distributed based on population distribution. For economically backward prov-inces and cities, the geographical availability of public health resources is poor. In addition, due to unreasonable re-source allocation structure and proportion, public health resources configuration efficiency is relatively low.

Objective: To observe the effect of oxymatrine ointment on chronic eczema in mice, and preliminarily explore the mechanism. Methods:Thirty-two Kunming mice were randomly divided into four groups including oxymatrine ointment group, blank model group, blank ointment group and positive drug group treated with compound dexamethasone acetate cream. Eczema skin was con-tinuously treated with drugs for 14 days. The mice were sacrificed on the 15th day, and the eczema skin was clipped from back to make histological sections. The changes of inflammation were observed, and the inflammatory cell count was obtained. Meanwhile, heart blood was collected, and serum was obtained by centrifugation. The serum levels of IL-4 and IL-1β were determined by ELISA. Re-sults:The inflammatory cell count in oxymatrine ointment group and the positive drug group was lower than that in the blank model group and the blank ointment group (P<0. 05). The pathology results showed that oxymatrine ointment could improve chronic eczema symptoms, reduce the inflammatory cell infiltration and decrease edema, which was similar to the effects of compound dexamethasone acetate cream. In the respect of molecular immunology, the IL-4 and IL-1βlevels in serum showed no significant changes in oxymatrine ointment group (P>0. 05). Conclusion: Oxymatrine ointment has certain anti-inflammatory effect on eczema, and the mechanism needs to be studied further.