Breast Neoplasms ; diagnosis ; China ; Female ; Humans ; Mass Screening ; standards

Though the development of non-surgical treatments has improved the local and systemic control of breast cancer, surgery still plays an important role. For early breast cancer, breast-conserving surgery (via periareolar incision and/or axillary incision for some suitable cases), skin-sparing mastectomy with immediate breast reconstruction and modified radical mastectomy can be chosen individually. For locally advanced breast cancer, neoadjuvant therapy followed by surgery is recommended. Surgery can improve local control and life quality for recurrent and metastatic breast cancer; furthermore, recent evidence also shows some survival benefits. At present, the treatment strategy of breast cancer is surgery-based multidisciplinary approach, and surgery is still the mainstay of treatment no matter in survival and life-quality improving.

Reform on medial service compensation mechanism,as a key point in the heahhcare system reform,runs through the entire reform process.It plays a key role for the establishment and improvement of urban medical care system,medical service system,medical management system and operating system,for its guidance and regulation effects.Such a refonn to build a scientific and perfect compensation model and mechanism will be highly significant for the smooth progress of the new round of healthcare reform and its success in the end.

Child ; Cyclophosphamide ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Nephrotic Syndrome ; drug therapy ; Treatment Outcome

Child ; Evidence-Based Medicine ; Humans ; Kidney Diseases ; therapy

Objective To investigate the clinical characteristics of clavicular defect and nonunion after operation and evaluate the clinical effects of vascularized pedicled pectoralis major clavicular periosteal flap and locking plate fixation plus bone morphogenetic protein (BMP) implantation. Methods From January 2004 to April 2008, 12 patients (mean age, 42.8 years old) with clavicular defect and nonunion were treated in Zhongshan Hospital. The internal fixators were removed, and then fibrous scars and sclerotic bones were cleared. The clavicular detects were fixed with locking plate, with implantation of the BMP. The wound was covered with vascularized pedicled pectoralis major clavicular periosteal flap. Postoperative functional rehabilitation exercises were performed. Results All patients were followed up for 8-24 months (mean 1.2 years). The clinical results were evaluated by Constant-Murley scoring system. The clavicular defects were healed in all patients within 4-7 months, and the internal fixators were successfully removed from some of the patients. Conclusions Vascularized pedicled pectoralis major clavicular periosteal flap combined with locking plate fixation plus BMP implantation is effective in the treatment of clavicular defect and nonunion.

Objective To analyze the relationship between alexithymia and patients' satisfaction under the condition of good quality in the esthetic characters. Methods 211 patients requiring single anterior tooth restoration were treated with all ceramic crowns which were assessed by the good and moderate degrees. Patients received 20-item Toronto Alexithymia Scale (TAS-20) and a visual analogue scale assessing patients' satisfaction (VAS). Chi-squared analysis, correlation analysis and the general linear modeling procedure were calculated for TAS total and factors scores according to age, gender and dichotomized satisfaction. Results 85. 3% patients belonged to the high satisfaction group(VAS scores 80 or higher) and 7.1% reported alexithymia ( total score 61 or higher). No difference across gender was observed in the prevalence of alexithymia and satisfaction. Age was correlated with the TAS scores ( r=0.629) and satisfaction scores ( r= -0.429). According to dichotomized satisfaction,TAS total and factor 1&2 scores were significantly different. When adjusting for the effect of age,the association was existed between TAS scores and san'sfaction( r= -0.68). Conclusion Alexithymia has effect on dental satisfaction.

Objective To investigate the status quo of job enbeddedness and intent to stay among the clinical specialist nurses and to explore the correlation between them. Method A total of 200 clinical specialist nurses participated in the investigation by means of general nurses' questionnaire, job embeddedness scale and intent to stay scale. Results The score of job embeddedness was (3.40 ± 0.46), the dimension of community association scored highest (3.68 ±0.67), the dimension of organization sacrifice the lowest (3.12±0.53) and the intent stay (3.69 ± 0.80). There was a positive correlation between job placement and intent to stay as well as its dimensions of community matching, organization sacrifice (P <0.05 or P <0.01). Community matching served as a major factor in predicting the intent of a specialist nurse. Conclusion Nursing managers should pay attention to the needs of specialist nurses and take relevant measures to improve the job embeddednee level of specialist nurses and thus improve their intent to stay as well.

Objective To explore the effect of Mudan granule combined with zinc sulfate on ankle brachial index in the treatment of diabetic foot dorsal artery sclerosis and its efficacy.Methods 66 cases of patients with diabetic foot dorsal artery sclerosis in this study were selected and divided into 2 group, 33 cases in each group.Control group received mecobalamin injection and zinc sulfate tablet and treatment group received Mudan granule on the basis of control gorup.7 days for a course of treatment and patients received continuous treatment of 4 courses.Clinical efficacy, blood glucose, blood lipids, blood rheology, blood flow dynamics of the dorsal artery of the foot, ankle brachial index, and adverse reactions were compared after the treatment.Results Compared with the control group after the treatment, the total effective rate of the treatment group was higher(P<0.05).Compared with the control group, the serum postprandial 2h blood glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol levels were lower(P<0.05), and high density lipoprotein were higher(P <0.05), the levels of whole blood viscosity high, middle and low shear, plasma viscosity, hematokrit and fibrinogen were lower(P<0.05), the serum levels of appeal index were lower(P<0.05), the blood flow of the dorsal artery, the diameter of the blood vessels and the ankle brachial index were higher (P<0.05), the peak velocity of the dorsal foot artery was lower(P<0.05) .There was no significant difference in the incidence of adverse reactions between the 2 groups.Conclusion Mudan granule combined with zinc sulfate tablet in the treatment of diabetic foot dorsal artery sclerosis was effective with high safety and it could improve ankle brachial index.

BACKGROUND:It is difficult to expose bilateral facet joints in L5 spondylolysis patients compared with non-spondylolysis patients. Thus, vertebral facet joint spacing and height in L5 spondylolysis patients can be used as indirect diagnostic signs that play key roles in the diagnosis of spondylolysis.
OBJECTIVE:To analyze the ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra and the relationship between the lumbar spondylolysis and the relative spacing of articular process.
METHODS:(1) Analysis of anatomical structure characteristics and diagnostic methods of lumbar spondylolysis:The ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra in diagnosing feasibility of lumbar spondylolysis was analyzed. (2) A total of 23 patients with L5 spondylolysis from Department of Orthopedics, Puyang Oilfield General Hospital and 30 normal controls were col ected from April 2013 to February 2015. The ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra was measured between the two groups.
RESULTS AND CONCLUSION:(1) The ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra reflected that the occurrence of L5 spondylolysis was probably associated with the width of L5 vertebral facet joint spacing. (2) Clinical trial results showed that the ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra in L5 spondylolysis patients was higher than normal controls. (3) Results indicate that the ratio of vertebral facet joint spacing and height in L5 spondylolytic vertebra reflects the occurrence of L5 spondylolysis.