Humans ; Lichen Planus, Oral ; psychology

Objective To study the clinical features,diagnosis and management of small cell carcinoma of the bladder (SCCB).Method The clinical data of 18 cases of patients with small cell carcinoma of the bladder were analyzed retrospectively and the literature were reviewed.There were 16 males and 2 females,ages 54 to 81 years (median age,61 years).Clinical manifestations included gross hematuria in 11 cases,urgency in 2 cases,dysuria in 2 cases and postoperative review after TURBT of bladder urothelial carcinoma in 3 cases.The median tumor size was 3.35cm (ranged,1.0 to 6.0 cm).2 cases underwent TURBT and intravesical chemotherapy regularly were followed after surgery.3 cases underwent partial cystectomy,intravenous chemotherapy combined with radiotherapy was followed in one case,the other 2 cases refused the following therapy.13 cases underwent radical cystectomy,intravenous chemotherapy was followed in 2 cases,pelvic radiotherapy was followed in 2 csaes and intravenous chemotherapy combined with radiotherapy was followed in 2 cases,the other 7 cases refused the following therapy.Results 11 cases were pure SCCB,7 cases were mixed SCCB,all with urothelial carcinoma.T1N0M0 in 3 cases,T2N0.1M0 in 4 cases,and T3N0-2M0 in 11 cases.The duration of follow-up was from 5 to 35 months after surgery.9 cases died of tumor metastasis,9 cases are still alive,except 1 case with lymph node metastasis,the other 7 cases are free of tumor recurrence or metastasis.Conclusions SCCB is rare,with high malignant degree and poor prognosis.The prognosis of the pure SCCB may be worse than the mixed SCCB.The diagnosis depends on pathology examination.Radical cystectomy is the main treatment method,the strategy of bladder-preserving may be an attempt for proper SCCB patients.Adjuvant therapy plus surgery may be better.

Objective:To provide policy recommendations for Beijing public health departments to grasp the dy-namic allocation of healthcare resources and the advantage of medical functional dispersal, and making appropriate health policies to rationally adjust the allocation of health resources. Methods:To study the dynamic function of Bei-jing medical, this study uses the method of accounting of cases summary of the annual report on health finance through the descriptive analysis of the gross fixed capital formation in various regional government-run health facili-ties. Results:The results of this study show that the quality of medical health administrative resources was higher, but effectively dispersed in 2015. By contrast, the basic public health resources allocation was unbalanced. Conclu-sion:This study puts forward the corresponding health policy suggestions. On one hand, it is important to make fur-ther policy to encourage high quality medical resources to be effectively relieved and the regional planning should be done according to market demand by avoiding the blind construction at the early stages. On the other hand, much at-tention should be paid on the balanced development of the basic public health service ability and the coordinated de-velopment of administrative capacity in health, and supporting policies should be formulated, which should rationally allocate the public health resources for a better overall medical functional dispersal.

Objective To explore the value of preoperative diagnosis for breast cancer patients in different locating ways. Methods The tissues were gotten by core needle biopsy from 146 breast cancer patients through different locating ways,and were taken for histopathological examinations and were compared with postoperative pathologic results. Results Seventy-four cases were biopsied with ultrasound-guide (ultrasound-guide group), and 72 cases with free-hand (free-hand group), without serious complications.Compared with postoperative pathologic results,the false negative rate in ultrasound-guide group was 5.41%(4/74);the false negative rate in free-hand group was 18.06% (13/72). The accuracy of the ultrasound-guided biopsy was higher than that in free-hand (U = 13.63,P ＜ 0.01 ). Conclusions Preoperative ultrasoundguided biopsy and postoperative pathologic examination has no significant difference, with high consistency.The study provides a good basis for selection for clinical work,so as to the more effective guide for the comprehensive treatment of breast cancer patients.

Objective To evaluate the effects of endogenous NO on the chemosensitivity of human breast cancer cell. Methods MCF-7 cells were cultured as monolayer, incubated with cytokine IL-1β. The pro-duction of NO was detected by NO assay. The expression of iNOS protein was measured by Western blotting. Establishing control group and experimental group, the chemosensitivity of MCF-7 cells incubated by L-NMMA and L-Arg to ADM and 5-Fu was studied by MTT assay. Results There was a positive correlation of dose-dependence between NO production and IL-1β concentration. MCF-7 cells expressed plenty of iNOS by induetion of IL-1β. There was no significant difference on iNOS whether L-NMMA and L-Arg existed or not. Incubating MCF-7 cells with 0. 5 μmol/L or 1 μmol/L ADM, the survival rate of experiment group was remarkablely decreased(P < 0.05) ; L-NMMA significantly increased survival rate of experiment group(P < O. 05) ; L-Arg decreased survival rate of experiment group(P < 0.05). Conclusion The induction of IL-113 in MCF-7 cells can increase the production of endogenous NO, which increases MCF-7 cells' sensitivity to chemotherapy.

Objective:To put forward some suggestions for the national health development in the filed of health expenditure indicators .Methods:Two health expenditure indicators and four health outcomes indicators were chosen from WB and WHO official websites , and researches on the relationship between health expenditure and outcomes were conducted .We put forward proposed value of the health cost indicator .Results: With different levels of GDP per capita , the scatter diagram of health expenditure and GDP per capita had different rules .When health outcomes were taken into consideration , the rules were the same .When GDP per capita was at different level , better health outcomes were not related to higher health expenditure .Input-output ratio should be taken into consideration fully . Suggestions:The study should be dynamic as GDP develops .More factors can be added in the research , if the data of the factors is available .In this study , the GDP per capita was divided into 4 sections .The division standard of the GDP per capita can be more delicate .What is more important for the development of health expenditure is not contin-uing input , but better input-output ratio because of diminishing of marginal returns .One set of standards cannot be a-dapted to all countries and districts .We should give full consideration to the improvement of people's health instead of increasing input because the ultimate goal is the former .

Objective To explore the clinical characteristics,treatment and prognosis of ductal carcinoma in situ of the breast.Methods We retrospectively analysed 430 patients with a diagnosis of DCIS in Cancer Hospital of Tianjin Medical University from January 1991 to December 2005,to evaluate the clinical characteristics,treatment and prognosis.Results Overall survival rate of 430 patients was 94.9％ (408/430).10 cases died of breast cancer recurrence,7 for local recurrence,3 for metastsis.Tumor size,TNM stages and structural pattern of pathlogy were prognosis impacting factors (P ＜ 0.05).The 5-year survival rate for combination radiotherapy and breast-conserving surgery group was 100％,and 10-year survival rate was 97.1％,comparing traditional modified radical mastectomy 5-year survival rate of 98.3％and 10-year survival of 96.7％ (P ＞ 0.05).The overall survival rate of surgery alone group (89.9％) was lower than the post-operative comprehensive treatment group (96.8％),(P ＜ 0.05).Conclusions Treatment of DCIS should be based on primary tumor's clinical stage and histologic characters.Breast-conserving surgery enjoys the same outcome as traditional modified radical mastectomy.

Objective To measure the expression of activin receptor-like kinases 1(ALK1)in dermal fibroblasts from patients with systemic scleroderma(SSc)and to estimate its role in the production of fibronectin and plasminogen activator inhibitor-1(PAI-1).Methods Dermal fibroblasts were isolated from the lesions of 12 patients with SSc as well as the normal skin of 14 healthy controls,and subjected to a primary culture.The third-passage fibroblasts were used in the next experiment.Western blot and indirect immunofluorescence technique were utilized to quantify the expression of ALK1.A specific siRNA targeting ALK1 was designed,constructed,and transiently transfected into the control dermal fibroblasts,which were then classified into 2 groups to be cultured with or without the presence of transforming growth factor(TGF)-β1 for 72 hours followed by the detection of fibronectin and PAI-1 expression with Western blot.Results As Western blot and direct immunofluorescence technique showed,both control and SSc fibroblasts showed an expression of ALK1 in the cytoplasm and membrane,and the expression intensity of ALK1 in SSc fibroblasts was significantly higher than that in the control fibroblasts(1.97 ± 0.05 vs.1.12 ± 0.03,t =50.96,P ＜ 0.05).The expression of ALK1,fibronectin and PAI-1 was decreased by 90％,58％ and 31％ respectively in specific siRNA-transfected SSc fibroblasts compared with the control siRNA-transfected fibroblasts.TGFβ1 significantly increased the expression of ALK1,fibronectin and PAI-1 in the control siRNA-transfected fibroblasts,but the increase was markedly inhibited by the siRNA-targeting ALK1.Conlusion TGFβ1 can promote the production of fibronectin and PAI-1 via ALK1 in fibroblasts,and ALK1 may be involved in the development of sclerosis in SSc.

Objective To optimize a W/O microemulsion formulation of troxerutin and evaluate its physical properties such as morphology, droplet size, stability and content of troxerutin. Methods The W/O microemulsion was optimized using a pseudoternary phase diagram and the area of the microemulsion region was used to screen and determine microemulsion components.HPLC assay was used for determination of the loading content. Results The optimal formulation contained lecithin, ethanol, isopropyl myristate and water (23.30:11.67:52.45:12.59).The microemulsion was physicochemically stable with round shape and uniform size, and the mean droplet size was about 50. 20 nm. Conclusion Microemulsion was developed successfully.It will expect to be the new preparation for troxerutin.

Objective To explore the relationship of methylenetetrahydrofolate reductase (MTHFR)gene C677T,factor V(FV)gene G1691A and prothrombin(PT)gene G20210A polymorphisms to unexplained recurrent early spontaneous abortion(URESA).Methods One hundred and twelve patients with URESA and 100 women with at least 1 normal pregnancy and without any miscarriage were analyzed for MTHFR,FV and PT gene polymorphisms by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).Results MTHFR gene T/T genotype and T allele frequencies were increased in URESA patients[38.4%(43/112)and 59.8%(134/224)]versus controls[18.0%(18/100)and 43%(43/100),P