Objective To investigate the effects of different treatments on elderly patients with breast cancer, and to analyze the factors that affect the treatment effect.MethodsA retrospective analysis was used to analysis the clinical data of elderly patients with breast cancer treated in our hospital from March 2012 to October 2013 were selected as the study object and according to the treatment methods, which were divided into three groups (A, B, C, which a group by breast modified radical surgery combined with intravenous chemotherapy and endocrine therapy, group B with breast modified radical mastectomy+endocrine therapy, group C with breast mass resection and endocrine therapy.The differences of survival rate of 1 groups after three years, 2 years and 3 years were observed, and the difference of survival rate of patients with different clinical pathological characteristics after 3 years was compared.The factors influencing the survival rate of patients after operation were analyzed.ResultsThere was no significant difference in survival rate between the three groups after 1 years, 2 years and 3 years;High differentiation, lymph node metastasis, depth of invasion, T1+T2, TNM stage I+II, immune group of non Yin in the elderly patients with breast cancer of the 3 year survival rate was higher, while patients of different age and diameter of the tumor patients and 3 years survival rate had no significant difference;Will the elderly breast cancer patients age, differentiation degree, tumor size, lymph node metastasis, depth of invasion, clinical stage, immune group of three yin as independent variables, will survival in patients with multi factors logistic regression analysis was used.Statistical analysis available, lymph node metastasis, infiltration depth and the three Yin of the immune group were the risk factors affecting the treatment effect of patients, their OR values were 4.412, 5.138 and 4.085.ConclusionDifferent treatment methods have no significant effect on the survival rate of elderly patients with breast cancer, and lymph node metastasis, depth of invasion and the three Yin of the immune group are the factors that affect the treatment effect.

Objective To prove the application of bilingual teaching in the child health care curriculum. MethodsEnglish dubbing and Chinese subtitling DVD coursewares of child growth and development were played to medical interns.The interns were asked to do questionnaires to examine feasibility and effectiveness. Results In 8-year program medical students,77.8% of them and 64.8% of the 5-year nutrition professional students could understand the contents of more than 90%.If there was no Chinese subtitles,the ratio were only 5.6% and 6.4%.Most students preferred English subtitles and dubbing,and endorsed the model of bilingual teaching. Conclusion DVD coursewares with Chinese subtitles and English dubbing can be widely used in the teaching of child health care.

Objective To investigate the expression and distribution of Kv1.6 in rat hippocampus after status epilepticus (SE) induced by lithium and pilocarpine to explore the relationship between Kv1.6 and epileptogenesis.Methods Forty-eight healthy male Sprague-Dawley rats were randomly divided into experiment group and control group.The rats in each group were randomly assigned into 6-hour,1-day,2-day and 3-day subgroups (n =6).Electroencephalography (EEG) of rats in both groups were recorded to show the electrical activity of the rat brains.Nissel staining was performed to investigate the pathological changes,and immunohistochemistry and Western blotting were applied to analyze the expression and distribution of Kv1.6.Results (1) The EEG of rats in control group showed α wave with uniform amplitude,while the EEG in rats subjected to pilocarpine injection showed slow waves and spike waves with irregular amplitude and rhythm.Sustained spike waves were observed during SE.(2) Nissl staining showed that 6 hours after SE,the neural morphology of hippocampi in experiment group was as the same to that in control group.There was no change in neuronal morphology and numbers.However,1 day after SE,the structure of hippocampi was discrete and the number of neurons was decreased.Two and 3 days after SE,the number of neurons in hippocampi decreased further.Swelling and deformation of neurons were seen.Nissl bodies emerged,decreased or even disappeared.(3) There was no statistically significant difference in the expression of Kv1.6 in CA3 and CA1 areas between experiment group and control group 6 hours after SE (all P＞0.05).One day,2 days and 3 days post SE,the expression of Kv1.6 in CA3 area (0.117 ±0.040,0.135 ±0.029,0.112 ±0.050) decreased obviously compared to control group (0.192±0.054,0.201 ± 0.062,0.184 ±0.042;t---3.861,3.745,5.579,all P ＜0.05);and the expression of Kv1.6 in CA1 area (0.114 ± 0.02,0.082 ± 0.031,0.106 ± 0.043) decreased significantly compared to control group (0.165±0.036,0.187 ±0.025,0.172 ±0.052;t=3.221,6.360,3.645,all P＜0.05).The expression of Kv1.6 did not show statistically significant difference in DG area between experiment group and control group at all time points examined (P ＞ 0.05).The Western blotting showed the same trend.Conclusion The decreased expression of Kv1.6 may play a role in the epileptogenesis.

Objective To explore the clinical characteristics and treatment of paroxysmal supraventricular tachycardia (PSVT) in children. Methods The clinical data of 67 children with PSVT were analyzed retrospectively, and the therapeutic effects of different treatments were compared. Results The clinical manifestations of infants were paleness, shortness of breath, irritability and sweating, and children showed chest tightness, palpitations, abdominal discomfort and fatigue. The curative effect of electric cardioversion, transesophageal atrial pacing, physical therapy, and drug therapy was statistically different (P<0.05), The different cardioversion rates of them were observed for the treatment of paroxysmal supraventricular tachycardia. The cardioversion rate of transesophageal atrial pacing, was the highest, and the rate of physical therapy was the lowest. There was no significant difference in the cardioversion rate between propafenone, digoxin and amiodarone. Conclusion The clinical manifestations of PSVT in infants are atypical and easily to be ignored. There are many methods for treatment of PSVT. The vagus nerve can be stimulated first, and, if no response, either drugs or electric cardioversion and transesophageal atrial pacing can be used. The cardioversion rate of transesophageal atrial pacing is higher. The drug effectiveness for the treatment of PSVT depends on many factors, and our choice of medication varies from person to person.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Lung Neoplasms ; genetics ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Receptor, EphB4 ; genetics

Objective To analyze the distribution and drug resistance characteristics of pathogenic bacteria isolated from blood cultures in the infected patients in our hospital during 2009-2013 to provide the newest evidence for the clinical anti-infection ther-apy.Methods The bacterial identification and drug susceptibility test were performed by applying the VITEK-32 System.The dis-tribution situation and the drug susceptibility test results of pathogens isolated from blood culture specimens in our hospital during this period were analyzed.Results 2 301 strains of positive bacteria were isolated from 14 006 cases of blood culture during these five consecutive years.The positive rate was 16.4%.Among them,1 303 strains were Gram positive bacteria(56.6%),954 strains of Gram negative bacilli(41.5%)and 44 strains of fungi(1.9%).Gram-positive bacteria were mainly Staphylococcus aureus,coagu-lase negative staphylococci(CNS),etc.Gram-negative bacteria were mainly E.coli,Klebsiella pneumoniae,etc.E.coli and Klebsiella pneumoniae were highly sensitive to carbapenem,amikacin,cefoxitin and antibacterial drugs containing enzyme inhibitor.The detec-tion rates of extended-spectrumβ-lactamase(ESBL)-producing Escherichia coli and Klebsiella pneumoniae were 55.8% and 18.4%respectively.Acinetobacter baumannii in blood culture had serious resistance to most of antibacterial drugs.Conclusion The kinds of pathogens isolated from blood culture are complex with different sensitivity to antibacterial drugs.Timely understanding the re-sults of blood culture has the important significance to adjust the treatment scheme in clinic and timely discover drug-resistant strains for serve clinic better.

Objective To investigate the clinical efficacy and side reaction of tandospimne citrate capsules on treating patients with depression after stroke.Methods Seventy-eight patients who were diagnosed as anxiety and depression after stroke were taken as our subjects.They were randomly divided into control group (n =40) and treatment group (n =38).Patients in the control group were given conventional therapy for cerebral vascular disease and psychological treatment,while in the treatment group were given the same treatment besides tandospimne citrate capsules of 10 mg per times,3 times/d oral,and course of both two groups for 4 weeks.The patients of two groups were scored according to Hamilton Depression Scale(HAMD) at the time of pre-treatment and post-treatment.And the the clinical efficacy and side reaction were observed and compared.Results (1) HAMD scores of treatment group in 2,4 weeks after treatment had significantly lower than that before treatment ((8.09±2.21) vs.(6.31 ±2.28) vs.(11.98 ±2.17),P ＜0.05).HAMD scores of control group in the treatment at 2week was as same as that in 4 weeks((10.57 ±2.53) vs.(8.91 ±2.31)).There was statistically significant difference in two groups in 2,4 weeks after treatment in terms of HAMD scores(P ＞0.05).The total effective rate of control group was 31.6％ (12/38),and 92.5％ (37/40) in treatment group,and the difference was significant(x2 =63.69,P ＜ 0.01).In the course of treatment in the two groups,there were no obvious adverse reactions.Conclusion Tandospirone citrate capsules show the clinical curative effect in the treatment of anxiety and depression after stroke,and no obvious adverse reactions.

Objective To improve the knowledge of paediatric pulmonary arterial hypertension(PAH) and to elevate the level of early diagnosis and treatment.Methods The clinical data of 45 PAH patients admitted in Shanghai Children's Hospital from Jan.2006 to Dec.2012 were reviewed,including clinical manifestation,laboratory examination,diagnosis,treatment and prognosis.Results Of the 45 PAH patients,21 cases (46.7％) were male and 24 cases (53.3 ％) were female,with an average age of 2.5 years old.Among them idiopathic PAH was in 24 cases (53.3 ％) and secondary PAH was in 21 cases [including interstitial lung disease in 4 cases,upper airway obstruction in 3 cases,systemic lupus erythematosus in 3 cases,hepatic disease in 3 cases,including hepatic hemangioma 1 case,liver cirrhosis portal hypertension 1 case and autoimmune hepatic sarcoidosis 1 case,tachycardia induced cardiomyopathy in 2 cases,extensive pulmonary small artery stenosis in 2 cases,human immunodeficiency virus (HIV) infection in 1 case,hypothyroidism in 1 case,and familial PAH in 2 cases].Main clinical manifestations were anhelation after exercise (71.1％),fatigue (68.9％),cough (48.9％),chest tightness (26.7％),chest pain (33.3％),syncope (8.9％),et al.The most common physical signs were splitting of the second sound in pulmonary valve area (93.3％),followed by tricuspid murmur (77.8％),cyanosis (53.3％),hepatomegaly (42.2％),hydropericardium (28.9％),and oedema (11.1％),et al.Twenty-seven cases did cardiac catheterization,compared with idiopathic PAH and secondary PAH,pulmonary artery systolic pressure,mean pulmonary artery pressure,pulmonary capillary wedge pressure,pulmonary arteriolar resistance index had significant difference(P ＜ 0.05).Thirty-one cases' condition improved after treatment,11 cases without any improvement and 3 cases died during follow-up visit.Conclusions PAH is a rare disease with no specific symptom and can be easily misdiagnosed in children.Ultrasonic cardiogram and cardiac catheterization are helpful in diagnosis.Actively looking for the cause can improve the prognosis.

Objective To investigate the status and requirement of knowledge of reproduction and acquired immunodeficiency syndrome (AIDS)/sexually transmited disease (STD) in pregnant adolescents with abortion in order to conduct proper interventions. Methods Two hundred and ninety-one unmarried pregnant adolescents below 22 years old with abortion completed questionnaires which involved the information on individual social-demographics characteristics, knowledge of reproduction, AIDS/STD and sex-related beliefs, attitudes and partners. Results Among these 291 adolescents, 37.7% experienced first sexual intercourse before 19 years old, 69.1% performed well in the knowledge of reproduction, and 62.6% and 43.5% did well in the knowledge of AIDS and the knowledge of the other STD, respectively. The rate of implementation of contraception was far less than that of awarenesss of contraception(P<0.05). These pregnant adolescents were not enthusiastic for seeking reproductive knowledge, and 45.0% would like to acquire the knowledge from professionals. Conclusion The knowledge of reproduction and AIDS/STD in the pregnant adolescents is not adequate, and they fail to carry out the proper behaviors of contraception. More education should be conducted on AIDS/STD prevention and contraception among pregnant adolescents.

Objective To evaluate the effect of peer educatio n program by the application of the peer education on human immunodeficiency vir us/aeguired immune deficiency syndrome(HIV/AIDS) prevention and the analysis of the change on knowledge, attitude and behavior about HIV/AIDS among technical sc hool students in Shanghai. Methods Three technical schools in Shanghai were selected randomly. Two classes of each school were selected randomly as education group and the students added up to 284.Two hundred and sixty-one students of another 2 classes in each school were selected as the interior control group. Some freshmen came from medical un iversity were carefully trained as peer educators to conduct the education inclu ding 6 models. The same questionnaires were carried before and after the educati on in both groups. Results After peer education the score of average knowledge abo ut reproductive health, HIV/AIDS, STD was significantly higher than before (P 0.05). Conclusions The conduction of the peer education on HIV/AIDS pr evention among technical school students is effective in promoting the knowledge level,but the change of attitude and behavior is a long term. So we highly adv ocate that not only the health education for HIV/AIDS especially safe sex shall be given and strengthened among technical school students in order to promote t he notion of self-protection but also the conception of care others especially t he HIV/AIDS. J Appl Clin Pediatr,2005,20(2):167-169