Objective To analyse the X-ray characteristics of the intraductal papilloma and to improve the diagnostic accuracy.Methods The mammographic data of 80 cases of intraductal papilloma of breast by pathology were analysed.Results 24 cases showed circular filling defect, 12 cases showed stringy filling defect,ductal blocked in 30 cases, ductal dilation in 48 cases. Conclusion Galactography is a effective method for diagnosing intraductal papilloma of the breast.

Objective: To investigate the effect of epidural block analgesia on childbirth, mother and child. Methods: A retro-spective study was used. Totally 200 primipara were divided into two groups according to the analgesia method. The 100 cases in the observation group was undergone lumbar epidural puncture and cathetering at the 2-3 section when the cervix was with 2-3cm opening, 0. 075% ropivacaine hydrochloride and sufentanil 10ml was infused firstly, and then 0. 075% ropivacaine and sufentanil was infused continuously through a self-control analgesia pump at the speed of 6-8ml·h-1 till the cervix was nearly all opened. The other 100 cases in the control group were without anesthesia when the cervix was with 2-3cm opening. The analgesia effect, labor time, delivery mode, postpartum hemorrhage amount, fetal distress and postpartum hemorrhage of the two groups were compared. Results:The analgesic ef-fective rate of the observation group was 97. 0%, which was significantly higher than that of the control group (10. 0%, P<0. 05). The first stage of birth process in the observation group was significantly shorter than that in the control group (P<0. 05), and the va-ginal delivery rate was significantly lower than that in the control group (P<0. 05). The incidence of neonatal asphyxia, 1min Apgar score, 24-hour postpartum hemorrhage amount and bleeding rate showed no statistically significant difference between the two groups (P>0. 05). Conclusion:Ropivacaine at low concentration combined with sufentanil used in epidural block analgesia has promising analgesic effect, which can shorten labor time to promote the smooth delivery.

To analyze the data of 284 smoking patients visiting the clinic during January 2009 to December 2011.There were 273 males and 11 females with a mean age of 49 years and an average length of 26 years of smoking 24 cigarettes per day.The average volume fraction of exhaled carbon monoxide was 16 × 10-6.The average score of Fagerstrom test of nicotine dependence (FTND) was 5.The importance,confidence and preparation of quitting smoking were graded at an average of 8.5,6.7 and 7.6 respectively.Abstinence rate was 66.1％ at 1 month and 50.9％ at 3 months.A particular focus was placed upon those smokers with more serious nicotine dependence and longer smoking years.They knew much about the importance of smoking cessation,but there was a lack of confidence.Smoking cessation improves abstinence rate via behavioral counseling,psychotherapy and medication.We should strengthen publicity of smoking cessation and smoking cessation clinic to attract more patients with heightened confidence through treatment.

ObjectiveTo evaluate the effect of psychological and behavioral intervention combined with varenicline smoking cessation clinics and to analyze predictors of successful quitting.Methods Subjects were collected from quitters who went to receive consultation and intervention in “smoking and related diseases” clinic at Zhongshan Hospital,Fudan University from March 2009 to September 2010.Eligible subjects were screened and divided into strengthen follow-up group and control group.The 4 weeks continuous abstinence rate from week 9 through week 12 were observed logistic regression model and used to analyze the predictors of successful quitting.Results Subjects who are addicted to nicotine received strengthening psychological and behavioral intervention combined with varenicline in smoking cessation clinics.The total continuous cessation rate during the 9th-12th week was 52.3％,with 60.9％ (28/46) and 46.2％ (30/65) of strengthen follow-up group and control group respectively.The most frequent adverse effects were nausea 39.6％ (44/111),insomnia and abnormal dreams 17.1％ ( 19/111 ).Adverse effects were tolerable and withdraw symptoms were few.Preparation and medication time can be used as predictors of successful quitting.Conclusion The quit rate of varenicline therapy combining with strengthen intervention is high and strengthening psychological and behavioral intervention could increase the success rate more obviously,which is a good choice for cessation therapy in smoking cessation clinics.Better preparation and regular adequate treatment can improve quit rate.

Objective To investigate CT features and the staging of the ovarian cystadenocarinoma.Methods The CT findings of 73 ovarian cystadenocarcinomas proved by surgery and pathology in 52 cases were analyzed.CT staging in 41 cases with whole abdominal scan was made and the CT finding was compared with operative results.Results Of 73 ovarian cystadenocarcinomas,23(31.5%) tumors were typeⅠ(mainly cystic),32(43.8%)tumors were type Ⅱ(mixed) and 18(24.7%) tumors were type Ⅲ(mainly solid).The preoperative stage accuracy for stage Ⅲ patients was 90.9%.Conclusion CT manifestations of ovarian cystadenocarcinoma are varient,the definite diagnosis can be made by typical appearance.CT scan has a high accuracy in staging of preoperative.

Objective To research the impact of axillary limph node group dissection oriented by senti-nel lymph nodes instead of axillary dissection on upper limb lymph edema and disease -free survival ( DFS ).Methods We designed a randomized controlled research , which included 205 cases of operatable breast cancer (AJCC 7th:stage I or stage IIa)from Jan.2011 to Jan.2013.Those cases were separated into 2 groups randomly ( random number method ):group A underwent mastectomy ( or lumpectomy ) and axillary group lymphadenectomy oriented by sentinel lymph node biopsy ( SLNB) ( if positive continued for ALND ) while group B underwent mastec-tomy(or lumpectomy)and axillary lymph node dissection(ALND).All patients underwent SLNB by blue dye method and received adjuvant therapy after surgery according to National Comprehensive Cancer Network ( NCCN) guideline and Chinese anti-cancer association guideline .Results There were 101 cases in group A and 104 ca-ses in group B , but 1 case in group A was excluded for false negative of SLN.The midium follow-up was 30 months.There were no significant differences of average age , tumor size, grade, estrogen receptor (ER),proges-terone receptor ( PR) and human epidermal growth factor receptor 2 ( HER2 ) expression between the 2 groups. Group A had a lower frequency of lymph edema than group B (4.0%vs 17.3%,χ2 =9.384,P=0.002), and al-so a milder degree ( mild 2%vs 11.5%,middle 2%vs 3.8%,severe 0%vs 1.9%).There were no significant differences of upper limb sensory disorder (14.0%vs 16.3%,χ2 =0.218,P=0.641), neither of DFS(Log-Rank analysis:3-year average DFS 32.89 months vs 33.72 months,χ2 =0.186,P=0.667;Cox risk model analysis:HR=1.395,P=0.495)between the 2 groups.Conclusion Axillary group lymphadenectomy oriented by SLNB can reduce the happening of lymph edema from ALND and has a comparative effect on DFS as ALND .

Objective:To evaluate the clinical application of vancomycin in a cancer hospital in order to promote the rational use of vancomycin. Methods:The records of 66 patients treated with vancomycin in 2015 were reviewed and analyzed in the respects of in-dications of medication, pathogenic examination, usage and dosage, course of treatment, drug combination, drug monitoring and drug utilization index(DUI). Results:Among the 66 cases, most drug use was rational, which accounted for 69. 70% with DUI of 0. 82. There were still several types of irrational drug use including no medication indications, irrational usage and dosage, too long or too short course of treatment, irrational combination and prophylactic use time. Conclusion:The application of vancomycin is basically ra-tional, while irrational phenomenon still exists. The management and supervision should be further strengthened in order to promote clinical rational drug use and ensure medication safety of patients.

Objective:To analyze the prophylactic use of antibiotics during the perioperative period of typeⅠincision operation in a cancer hospital in order to promote the safe, effective and rational use of antibiotics. Methods:The rationality of 480 cases of typeⅠincision operation from January to December in 2013 and from January to December in 2014 was evaluated respectively, and the analy-sis and comparison were performed on the prophylactic use of antibiotics. Results: Through the pharmaceutical intervention including the special evaluation carried out by clinical pharmacists, the use of antibiotics gradually reached the rational level. Conclusion: The participation of clinical pharmacists in the use management of antibiotics in typeⅠincision operation can improve the rationality of the drugs used in clinic.

Objective:To establish an HPLC method for the determination of paclitaxel and docetaxel in plasma to provide refer-ence for the individualized treatment regimen and the evaluation of curative effect and adverse reactions. Methods:Paclitaxel and do-cetaxel were used as the internal standard for each other. The samples were precipitated by acetonitrile and separated on a DikMA Dia-monsil C18 column with a mixture of acetonitrile-water (55: 45) as the mobile phase. The flow rate was 1. 2 ml·min-1 . The column temperature was set at 25℃. Paclitaxel and docetaxel were detected by UV-detection (λ= 227 nm). Results: A linearity was ob-tained within the range of 0. 078-10. 0 mg·L-1 for paclitaxel and docetaxel. The limit of quantitation was 0. 039 mg·L-1 . The aver-age recovery of paclitaxel and docetaxel was 99. 85% and 100. 35%, respectively. The inter- and intra-day RSD were both less than 5% and the RSD for freeze-thaw stability was below 10%. The plasma concentration of paclitaxel in clinical samples was within the range of 0. 18-6. 16 mg·L-1 and obvious individual difference was shown. Conclusion:Therapeutic drug monitoring is very important due to the obvious differences in plasma concentration of paclitaxel and docetaxel. The established method is sensitive, accurate, con-venient and rapid in r the therapeutic drug monitoring, and is useful for the adverse drug reactions monitoring and pharmacokinetic study.

Objective To screen for microRNA (miRNA) involved in fetal rat lung development.Methods Fetal lungs were collected at their 16 d,19 d and 21 d of gestational age,and were observed after HE staining.Differentially expressed miRNA (fold change＞ 1.0) were screened by miRCURYTM locked nucleic acids chip.Some differentially expressed miRNA were selected for further analysis to investigate their change trends in 16 d,19 d and 21 d of gestational age.Results (1) Under the observation after HE staining,in gestational age 16 d group,original bronchus was dendritic distributed,with thick interstitial,rare capillary and no alveolar structure existed; in gestational age 19 d group,primary alveolar was seen,interstitial became thinner,and more capillaries were found; in gestational age 21 d group,more alveolar septa were identified and pulmonary acinus cavity was extremely expanded.(2) Two hundred and two differentially expressed miRNA were found.Among them,many miRNA were firstly reported in rat fetal lung development,suchas miRNA-3560 (8.4211415,4.8889050),miRNA-126 * (7.5239524,1.5118160),miRNA-186* (0.980 325 0,0.688 447 5),miRNA-466c* (0.977 220 0,0.877 227 0),miRNA-195 (13.549 629 0,0.985 488 8),miRNA-34a (12.426 133 0,0.604 066 2) and miRNA-466b-1 *(0.993 153 1,1.732 802 3).(3)The expression of miRNA-466c * and miRNA 186 * decreased as the gestational age increased from 16 d to 21 d,while expression of miRNA-195,miRNA-3560,miRNA-466b-1 *,miRNA-126 * and miRNA-let-7b increased; miRNA-34a expression increased during 16 d to 19 d.miRNA 17-92 family expression decreased,while expression of most let-7 family members (except let-7i and let-7e) increased from 16 d to 21 d of gestational age.Conclusions These miRNA might play an important role in the physiological mechanisms of fetal lungs development.