Breast cancer is the first malignant tumor of women, and the incidence is still rising. Although the overall survival rate of breast cancer is high, the difference in prognosis is significant with different stage. Finding the patients at early stage and commencement of therapy timely by breast cancer screening is the key to reduce the incidence and improve the survival rate. At present, clinical breast examination, ultrasonography, mammography and MRI are still the most common methods for breast cancer screening, but in view of the specific technology and specific population it remains controversial as to which techniques are the best, especially the value of ultrasonography still needs to be confirmed in randomized clinical trials. With the constant improvement of technologies and programs, the breast cancer screening work will be more standardized and optimized.

Objective To evaluate the practical value of ERCP for etiologic diagnosis and treatment of postcholecystectomy syndrome(PCS).Methods A retrospective review of 116 cases of postcholecystectomy syndrome received ERCP in the recent four years in our hospital was undertaken.Of the116 cases,80 cases(68.97 %) had the indications for therapeutic ERCP and were treated by endoscopy.Results The bile duct was visualized in all of the 116 cases(100 %),and the pancreatic duct was visualized in 97 cases(83.62 %).The etiology of PCS was choledocholithiasis in 56 cases(48.28 %),diverticulum adjacent to duodenal papilla or papilla with in the diverticulm in 19 cases(16.37 %),residual of long cystic duct with stones in 15 cases(12.93 %),benign stenosis of terminal commom bile duct in 13 cases(11.20 %),sphincter of oddi dysfuction in 4 cases(3.45 %),tumour of doudenal papilla in 3 cases(2.59 %),stenosis of injured bile duct in 2 cases(1.73 %),sclerosing cholangitis in one case(0.86 %),cholangiocarcinoma in one case(0.86 %),remnant gallbladder with stones in one cases(0.86 %),and chronic pancreatic ductal lithiasis in one case(0.86 %).Fifty-seven cases were treated by EST stone extraction,20 cases by ERBD,23 cases by ENBD,1 case by EMBE,and 1 case by EPS extraction.In the 80 cases treated with endoscopy,75 cases were followed up for 3~12 months,with relief of symptons in 74 cases(98.67 %).Conclusions ERCP is the gold standard for etiologic diagnosis of PCS.PCS is an indication for therapy by ERCP.Therapeutic ERCP is the preferred treatment of PCS cases with an indication for endoscopic treatment.

BACKGROUND: The phakic intraocular lens implantation has advantages of reversibility and accommodative capability, which is a promising refractive operation. Posterior chamber phakic intraocular lens implantation is a developing method for the correction of extreme myopia. OBJECTIVE: To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens implantation for the correction of extreme myopia. METHODS: This study included 18 eyes of 11 patients whose received posterior chamber phakic intraocular lens implantation at Shierming Eye Hospital from March 2006 to January 2009, including 4 males (7 eyes) and 7 females (11 eyes). All patients were followed-up 3-6 months, mean 5.3 months. The refraction, intraocular pressure, contrast sensitivity, glare sensitivity, endothelial cell morphometry, as well as lens opacities were observed. RESULTS AND CONCLUSION: After operation, naked visions of the 18 eyes were better than or equal to preoperative corrective vision, and the astigmatism was relieved obviously. The naked contrast sensitivity and glare sensitivity was better than that before the operation. The anterior chamber depth, intraocular pressure and corneal endothelium counting before and after the operation had no significant difference. No serious complication was detected during the follow-up. The vision decent at night and dazzling sensation occurred in 2 cases. Shot-term observation shows that implanting intraocular lens in posterior chamber to correct high myopia is safe, stable and predictable. This operation is a promising method for correcting high myopia.

This study was aimed to analyze the composition principles of prescriptions for sequela of apoplexy collected in the CNKI by the Traditional Chinese Medicine Inheritance Platform (TCMIP), in order to provide a reference for clinical selection of medication. Prescriptions for the sequela of apoplexy treatment in CNKI were collected. Based on the TCMIP, the medication rules of prescription were analyzed by data mining method after data entry. A total of 190 prescriptions involving 204 herbs for sequela of apoplexy treatment were screened and studied. The herbs for blood-activating andqi-tonifying were used with higher frequency. There were 36 commonly used herbal pairs. The herb pair of Dang-Gui(Radix Angelicae Sinensis) andHuang-Qi (Radix Astragali) was with the highest frequency. The herbal combination with three types of herbs wasDi-Long (Pheretima),Dang-Gui andHuang-Qi. The herbal combination with four types of herbs wasChuan-Xiong (Rhizoma Chuanxiong),Di-Long,Dang-Gui andHuang-Qi. The analysis on association rule showed thatChuan-Xiong,Dang-Gui,Tao-Ren (Semen Persicae),Hong-Hua(Flos carthami) andHuang-Qiwere often combined with each other. A total of 48 core combinations and 11 new prescriptions were mined. It was concluded that the prescriptions for sequela of apoplexy were mainly composed with herbs for blood-activating,qi-tonifying and collateral-dredging. According to the flavor and meridian tropism theory of Chinese medicine, the herbal medication selection in the prescription was mostly warm and hot in nature, sweet and pungent flavor, and the meridian tropism of the liver and spleen meridian.

Background Previous studies showed that the pathogenesis of uveitis is related to γδ T cells.However,it remains unclear that how these cells are involved in experimental autoimmune uveitis (EAU).Objective This study aimed to observe the dynamic changes of γδ T cells in EAU and explore the role of γδ T cells in the pathological process of EAU.Methods Forty-five C57BL/6(B6) mice were assigned to the normal control group (six mice) and EAU model group (thirty-nine mice).The mice were immunized subcutaneously at 6 spots on the footpads,tail base,and flank with emulsion containing human interphotoreceptor retinoid binding protein1-20 (IRBP1-20) emulsified in complete Freund's adjuvant.After immunization,the mice were examined for clinical signs of EAU by using a Genesis-D camera.The changes of histopathology were compared by hematoxylin and eosin staining.Mouse lymphocytes were isolated and purified from the spleens of IRBP1-20-immunized or normal B6 mice by using a γδ T-cell isolation kit.Flow cytometry was used to detect the changes of intracellular expression of interleukin-17A (IL-17A),and then transferred the activated γδ T cells into EAU models to analyze the changes of clinical signs and histopathology of EAU.Experimental study program as well as the use and feeding of the animals were authorized by the Animal Management and Use Committee of Shandong Traditional Chinese Medicine University.Results The inflammatory symptoms in mouse eyes appeared on day 12 after modeling.The initial changes were fundal blood vessel thickening and minimal inflammatory cell infiltration.Then,multifocal chorioretinal lesions,serious vasculitis and linear lesions were observed on days 16-20,along with abundant lymphocyte infiltration in the vitreous and retinal disorganization.The inflammation symptom scores and the pathological inflammation scores at different time points after modeling had statistically significant differences (F =51.399,P =0.000;F =47.342,P =0.000).The inflammatory symptoms in the eyes began to abate from day 28 onwards.The number of γδ T cells was obviously increased during the inflammation phase of EAU at day 16-20 after modeling,with the number of γδ T cells was (5.67 ±-0.49) ％ and (5.78 ±±0.55) ％,respectively,which was significantly higher than (1.53 ± 0.14) ％ before modeling,with significant differences between them (both at P＜0.05),meanwhile CD69 levels and the integrin lymphocyte function-associated antigen-1 (LFA-1) and secreted IL-17A were elavated.The secretion level of IL-17A was (13.40±0.50)％ and (17.80±2.37)％ on day 16 and day 20 after modeling,respectively,which was significantly higher than (1.53 ± 0.19) ％ before modeling,with significant differences between them (P =0.000,0.001).The activated γδ T cells were transferred into EAU model,the inflammation symptom scores were 1.00 (1.00,2.00) after activated γδ T cells were transferred into EAU model,which was significantly higher than 0.75 (0.05,1.00) of the untransferred group (Z =27.00,P =0.03),and the symptoms of EAU were aggravated.Conclusions The proportion of γδ T cells reaches peak in inflammation of EAU,and the cells are activated.The activated γδ T cells in the EAU model play a immune regulation role by secreting IL-17A.

Objective To investigate the mecA gene expression lvevl in clinically isolated Staphylococcus aureus (SA) strains and its correlation with drug resistance .Methods Clinically isolated 186 SA strains were collected .The K-P method was adopted to conduct the durg sensitivity test .Then DNA of these strains was extracted and the mecA gene was amplified by using PCR .Results The detection rate of methicillin-resistant SA(MRSA) was 30 .65% (57/186) ,the positive mecA gene was detected in 56 strains of MRSA and 10 strains of methicillin susceptible S .aureus(MSSA) among 129 strains of MSSA ;except susceptible to vancomycin and linezolid ,the resistance rate of MRSA to ther antibacterial durgs were higher than that of MSSA ,the resistance rate to antibac-terial durgs in the strains carrying mecA gene was higher than that in the strains without carrying mecA gene ,ther difference be-tween them had statistical significance (P<0 .05) .Conclusion Clinically isolated SA strains carrying mecA gene are resistant to multiple antibacterial drugs ,which indicating that mecA gene play an important role in SA drug-resistance mechanism .

Objective To evaluate the influence of rectal washout on the prognosis of rectal cancer after anterior resection.Methods Data of 144 patients with rectal cancer undergoing anterior resection at Chinese Academy of Medical Science Cancer Hospital between May 2006 and November 2007 were reviewed.69 patients received rectal washout and 75 patients did not.The incidences of recurrence and 5-year disease-free survival rates were compared.Data were analyzed by SPSS 13.0 software packet,using x2 and t inspection.Kaplan-Meier method was used to calculate postoperative survival rate.Results Washing sample was positive for malignant cells in 55 patients (79.7％).The incidences of recurrence were 4.6％ and 6.7％ in washout group and no-washout group respectively (x2 =0.368,P =0.721).The five-year disease-free survival rate was 79.7％ in washout group and 74.7％ in no-washout group(x2 =0.517,P =0.553).Conclusions Free malignant cells were ubiquitous in rectal lumen during anterior resection,and there was a high positive rate of cytological examine for washout sample.Rectal washout may reduce local recurrence and prolong patients' survival.

Twenty-six eyes which appeared rejection after allograft penetrating keratoplasty between April 2003 and April 2004 in Shandong Shi'erming Eye Hospital were collected, including 16 males and 10 females, 9 cases were repeated relapsing viral keratitis, 8 cases were traumatic posterior corneal leucoma, 5 cases were corneal decompensation caused by various intraocular surgery, 2 cases were congenital leucoma, and 2 cases had other symptom. The rejection occurred at 2 month to 2.5 years after operation. Among them 19 cases were transferred to our hospital and asked adding traditional Chinese therapy because western medicine was ineffective in other hospital. All cases were received local treatment with hormone and non-steroidal anti-inflammatory eyedrop, some cases applied systemic administration with glucocorticoid, mainly based on eye black immunosuppression decoction, potion daily, twice per day, the average time of medication was 11-42 days. Clinical symptoms were served as observation indexes, results showed that the total effective rate of the 26 cases were 100%. The bulbar conjunctiva hyperemia and edema was reduced, corneal opacity became light, and rejection was complete response in 9 cases, 5 of 19 cases which were transferred to our hospital were exempted from operation, and the average vision was improved three lines. It was found that purging liver and eliminating dampness compound Chinese medicine can rapidly reduce anterior chamber's inflammatory response and backoff corneal neovascularization in clinical practice.

Objective To compare the therapeutic effects in respect of ventilatory response and the change of hemodynamics of two modes of mechanical ventilation [ proportional assist ventilation (PAV) vs.Bi-level positive airway pressure ventilation (BiPAP) ] on patients with acute cardiogenic pulmonary edema (ACPE).Methods Thirty-two patients diagnosed as ACPE were recruited from May 2008 to April 2009.After conventional therapy ( cardiotonic,diuretic,vasodilators,oxygen) were ineffective for half an hour,32 patients were randomly divided into three groups:control group ( 12 cases kept conventional treatment without mechanical ventilation),BiPAP group ( 12 cases were treated with BiPAP mode of non-invasive mechanical ventilation plus conventional treatment) and PAV group (8 cases were treated with PAV mode of non-invasive mechanical ventilation along with conventional treatment ).Results PaO2,RR and oxygenation index were improved significantly in three groups after 1 hour treatment ( P ＜ 0.05 ).While PaO2 and oxygenation index in noninvasive ventilation groups were higher than those in control group ( P ＜0.05 ).The time required for amelioration of dyspnea in noninvsaive ventilation groups was shorter than that in control group ( P ＜ 0.05 ).The peak airway pressure and the index of degree of comfort ( VAS score,auxiliary respiratory muscles score) in PAV group were lower than those in BiPAP group (P ＜ 0.05 ).Conclusions Both modes of noninvasive mechanical ventilations could improve the oxygenation and relief of dyspnea in patients with ACPE.PAV and BiPAP had the similar effect in patients with ACPE.The synchronization and comfort in PAV group were better than those in BiPAP group.The PAV mode of noninvasive mechanical ventilation was well accepted by patients with ACPE.

Objective To observe the clinical efficacy of HMME-SDT therapy for the treatment of hypertrophic scar (HS) of rabbit ear.Methods 60 white rabbits were randomly divided into five groups.The model group and HMME-SDT treatment group were used to establish the models of hypertrophic scar in ears.Results The effect of HMME-SDT on the fibroblastic density in the hypertrophic scarring models was observed in rabbit ears.The HMME-SDT could lower the fibroblastic density,compared with the model group,with significant difference (P＜ 0.05).The effect of HMME-SDT on the collagen area density was noted in the hypertrophic scarring models in rabbit ears.The HMME-SDT could lower the collagen area density,compared with the model group,with significant difference from the fourth week of the epithelialization (P＜0.01).Conclusions HMME is an effective sonosensitizer.HMME-SDT can significantly inhibit hypertrophic scar of rabbit ear.