Objective To evaluate the value of real time three-dimensional ultrasound in differentiating benign and malignant breast tumors. Methods One hundred and fifty-three patients with breast tumors were examined with real time three-dimensional ultrasound. The results were compared with post-operative pathological results. Results A sign of malignancy on the coronal plane was observed by three-dimensional ultrasonography,named “sun-like symptom”,because the sign looked like a shining sun:striated hyperechoic or iso-echoic images scattered radially around cancers,together with the distortion of normal tissue.The accuracy of the sign in differentiating benign and malignant breast tumors was 86.93 %( 133/153 ), the sensitivity was 78.38 %( 58/74 ), and the specificity was 94.94 %( 75/79 ). Conclusions Real time three-dimensional ultrasound is a valuable and new technique in differentiating benign and malignant breast tumors.

23 cases were treated with immediate full denture.The second base-remodeling or re-prosthodontic treatment was given 3 months later based on the oral condition.Masticatory efficiency (ME)was measured at each stage.About 30% patients participated in the second base-remodeling procedure with ME of 52.63%.

Objective:To investigate the present situation, methods, advantages and problems of bilingual teaching in medical cytobiology for medical undergraduates. Methods: The bilingual teaching project of medical cytobiology was considered comprehensively from various angles, such as the teaching aim, methodology, teacher training, teaching material selection and examination in specialized course. Conclusion: It is a very important strategic project to develop bilingual education in China. The course of bilingual teaching for medical undergraduates should be student-oriented and carried out step by step.

Objective To explore the short‐term effect of chronic periodontitis patients after implant treatment .Methods Selected 60 cases of tooth loss in chronic periodontitis patients as research group ,a total of 75 implants were placed ,and 50 cases of periodontal healthy teeth missing patients as control group ,a total of 67 implants were placed .Compared two groups of modification sulcus bleeding index(mBII) ,papilla index score(PIS) ,modification plaque index(mPLI) and probing depth(PD) 6 months after op‐eration ,and detected implant sulcular fluid IL‐2 ,IL‐8 content in two groups before and after operation .Results Research group 75 implants had 2 off on their own ,implant loosening degrees 0 ,implant survival rate was 97 .3% ;the control group had no implant failure ,implant loosening of implant survival rate was 100% ,two groups of implant survival rate was no significant difference(χ2 =2 .737 ,P= 0 .098) .The mSBI ,PIS ,mPLI ,PD in research group and control group had no statistically significant(P > 0 .05) .Re‐search group sulcular fluid IL‐2 ,IL‐8 content was significantly higher than those in control group before and after the operation (P< 0 .05) .Conclusion The short‐term effect of implant treatment in chronic periodontitis patients is satisfactory ,without increas‐ing the risk of peri‐implantitis ,and worth of clinical promotion .

AIM: To observe the inhibitory effect of recombinant human endostatin (rhES) on plaque angio-genesis, and to explore the regulatory mechanism of Dll4 /Notch pathway in the anti-angiogenic effect of rhES.METH-ODS: Male Wistar rats were randomized into 3 groups: normal control group (N group), atherosclerotic model group (AS group), and rhES treated group (AS +rhES group).The rats in N group were fed a normal diet, while the remaining 2 groups were established to atherosclerotic rat model via high-cholesterol diet, intraperitoneal injection of vitamin D3 and aor-tic balloon injury.The rats in AS +rhES group received intraperitoneal injection of rhES.The blood total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), interleukin-1 (IL-1) and troponin I (TnI) were measured.The atherosclerotic abdominal aortas were taken for pathological observation.Immu-nohistochemical staining was used to measure the density of neovessels in the plaques, which were marked by CD31.The protein levels of Dll4 and Notch1 in the aortas were analyzed by Western blot.RESULTS: The levels of blood TC, TG, LDL-C, CRP and IL-1 in AS group and AS +rhES group were much higher than those in N group (P <0.05), and no sta-tistical difference between AS group and AS +rhES group was observed.The expression of CD31 in AS group was the high-est among all groups.Compared with AS group, the density of neovessels in the plaques of AS +rhES group decreased sig-nificantly (P <0.05).The protein expression of Dll4 and Notch1 in AS group was lower than that in N group (P <0.05). Compared with AS group, the protein expression of Dll4 and Notch1 increased significantly (P <0.05).CONCLUSION:rhES has the ability to inhibit plaque angiogenesis in rats.The activation of Dll4 /Notch pathway may be the mechanism of rhES in inhibiting plaque angiogenesis.

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 discuss the value of double-row allograft bone suture anchor in repair of rotator cuff injury. Methods Under assistance of arthroseope, 16 cases of rotator cuff lesions were repaired by using double-row allograft bone suture anchors. There were 10 males and 6 females at average age of 44 years (32-58 years). According to Bigliani classification, there were 6 cases of small ruptures, 8 medial ruptures and 2 large ruptures. After rotator cuff was trimmed and acromial bone was re-shaped under arthroscopy, 2 bone anchors attached to suture lines were implanted in the attachment point of rotate cuff of humerus greater tuberosity side by side. Then, the 4 ends of the 2 suture lines were vertically sutured through tendon of supraspinatus mnscle and tied separately, crossing the 4 ends of 2 knots and penetrated each 2 ends into one bone anchor. Finally, these 2 bone anchors were embedded into 2 predrilled bone holes which were parallel to the former 2 anchors and lower in humerus greater tuberosity. Thus, a web was formed and overlapped on the ruptured rotator cuff. The number of bone anchors was according to the size of rupture. Results All cases were followed up for average 14 months (6-23 months). The mean UCLA score was (21.30±5.6) points preoperatively and (32.4±5.8) points postoperatively. The function of shoulders recovered well, with no pain, recurrence or pulling out of bone anchor. Function was excellent in 10 cases, good in 5 and fair in 1. Conclusions As for repair of rotator cuff injury, double-row bone-anchors under arthroscope can provide a tendon-bone interface better suited for biologic healing of rotator cuff. Bone suture anchor can not leave any foreign object residual and costs less.

Objective To understand the effectiveness of peroral endoscopic myotomy(POEM)for achalasia and secondary severe malnutrition in children and the effectiveness of nutrition support before and after POEM.Method Treatment of POEM,nutrition support(tube feeding by percutaneous endoscopic gastrostomy three months before operation)in one case were recorded and analyzed.Results POEM was successful without any complication such as perforation,bleeding,and pneumoderm.The child suffered from fever after surgery,which was dissolved after symptomatic treatment three days later.Chest pain was relieved after changing position.The diet was changed from liquid to semifluid,and then to normal diet.The child did not have dysphagia.During the 6-month follow-up,the patient had normal diets by oral route.The weight was 32 kg before achalasia and decreased to 18 kg after 9 months(at admission);it then increased to 29 kg after short-time(12 days)parenteral nutrition and long-time(3 months)enteral nutrition by percutaneous endoscopic gastrostomy,and then the patient received POEM.His weight was 30,31,31,29,and 31 kg 1,4,6,9,and 13 months,respectively,after POEM.Conclusion POEM can effectively cure achalasia in pediatric patients and improve the quality of life.Rational enteral nutrition can improve nutrition status and facilitate a successful POEM.

Objective To investigate the plasma levels of tissue factor pathway inhibitor(TFPI)in children with Henoch-Schonlein purpura(HSP)and the changes of it after therapy with heparin.Methods Forty-six HSP children were enrolled in HSP group according to the criterion,and 23 normal healthy children as controls.The plasma levels of TFPI were measured by enzyme linked immunosorbent assay in both groups.Forty-six HSP children were divided into 2 groups randomly:heparin therapy group(n=23)and conventional therapy group(n=23).The plasma levels of TFPI were measured before therapy,on the 7th day and the 14th day after therapy,respectively.Results 1.The plasma levels of TFPI in HSP group [(59.337?21.750)?g/L] significantly decreased than those of control group [(88.761?12.214)?g/L](t=7.185 P

Objective To observe the safety of telbivudine (LdT) application throughout pregnancy in women with chronic hepatitis B (CHB),and to provide evidence-based treatment recommendations for women of childbearing age with chronic hepatitis B.Methods Women with hepatitis B virus (HBV) infection who took LdT before pregnancy and in early pregnancy were followed up prospectively for evaluating maternal and newborn adverse events.All newborns received block of HBV mother-to-child transmission (MTCT) after birth and were followed up for neonatal disorders and effects of maternal and child block.Results Among the 145 cases of pregnant women,143 were diagnosed as CHB and 2 decompensated cirrhosis.One hundred and five (72.4％) patients had HBV DNA＜500 copy/mL and 125 (86.0％) had positive hepatitis B e antigen.There were total 154 times pregnancies including 17 spontaneous abortions,4 ectopic gestation and 9 pregnancies after abortion.One hundred and one cases finished pregnancy,with 100 full term deliveries,1 preterm delivery and 2 twin pregnancies.One fetal with cleft lip and palate was aborted by induced labor in 24 weeks gestation.One baby was born with right double ears; one had benign lymph node under the left ear; and another one was diagnosed with congenital heart disease.Seven of the pregnant women had creatine kinase increased.Eight developed drug resistance.However,none had disease progression during pregnancy.None of the 63 infants was hepatitis B surface antigen positive over the 6 months of follow-up.The prevention of HBV MTCT was 100％ successful.Conclusion It is safe and effective for women with chronic HBV infection to receive LdT treatment throughout pregnancy.