Background and purpose: Paget's disease (PD) of the breast is a rare disease. The survival of PD was reported to be related to the characteristics of the underlying carcinoma. This study aimed to investigate the char-acteristics and survival of PD patients with underlying invasive breast carcinoma (IBC). Methods: Fifty-four patients diagnosed with PD and an associated IBC in Fudan University Shanghai Cancer Center from 2002 to 2007 were re-cruited in this study as study group. Since most PD overexpress HER-2, 72 patients with HER-2-overexpressing breast cancer were randomly recruited as control group. This study compared survival between these two groups. Results:Twenty-five (46.3％) patients in study group had no clinical manifestation of PD and were diagnosed unexpectedly by a histologic examination. Thirty-five (64.8％) patients in study group had tumors larger than 2 cm, twenty-six(48.1％) patients in study group had chance of axillary lymph node involvement. Compared with control group, patients in study group tended to have more events (5-year relapse-free survival: 76.4％ vs 48.5％, P<0.01). In the control group, most events occurred in the first 3 years after operation, while recurrence might happen all along in the 5 years after opera-tion in study group. Patients in study group also had a poorer overall survival than in control group (61.0％ vs 80.6％, P=0.01). Conclusion: Patients with Paget's disease and underlying invasive breast cancer tend to have poorer survival than those with HER-2-overexpressing breast cancer.

The nutritional status of 162 patients with maintenance hemodialysis (MHD) was screened by Nutritional Risk Screening 2002 (NRS-2002) and assessed by Subjective Global Assessment (SGA) at the next day of admission.Among 150 MHD patients who met the study requirement,the nutritional risk was 29.3％ as screened with NRS-2002,and the rate of nutrition deficiency was 41.3％ with SGA assessment,there was no difference between two methods (x2 =18.155,P =0.109) ; According to BMI,the incidence of nutrition deficiencies,overweight and obesity in MHD patients was 13.3％,30.7％ and 29.3％.NRS-2002 and SGA are applicable to nutritional deficiencies assessment in MHD patients,but NRS-2002 is more comprehensive and feasible than SGA.

Objective:To explore the language deficits in a single case of posterior aphasic to test the dual-system model of language processing and provide neurolinguistic basis for clinical language therapy.Method:A circumscribed posterior aphasic was selected,whose language data were collected through spontaneous talk,WAB test,and other language production tasks including picture-naming and sentence repetition.The language data were analyzed with the emphasis on syntax-lexicon dissociation and noun-verb dissociation.Result:For the posterior aphasic,lexicon was severely impaired while syntax was preserved relatively well;in comparison to lexical production,lexical comprehension was preserved better;noun-verb dissociation,especially NSD,was discovered.Conclusion:The syntax-lexicon dissociation and the relevant noun-verb dissociation can serve as powerful evidence for the dual-system model of language processing,and throw light on language therapy for posterior aphasics.

Objective To investigate the protective effect of melatonin and its possible mechanism for repairing in the immature white matter damage due to brain hypoxia-ischemia (HI).Methods Forty-eight three-day SD rats after birth were randomly divided into 3 groups:sham-operated(SHAM) group,HI group and melatonin treatment(MT) group.Periventricular white matter damage (PWMD) to animal models were estabished according to Rice modeling.MT group was treated with melatonin pre-operatively,immediately postoperation,1 hour postoperation and 24 hours postoperation via intraperitoneal injection,and the other groups were injected with the same volume of dissolvent.The rats were executed by decollation after 2 days and 14 days.The histological changes in periventricular white matter were observed by HE staining and immunohistochemistry.Results For the 3 groups,the structure in ope-ration side of the white matter in the peripheral ventricles of the brain 2 days postoperation were significant different (P ＜0.05).The O4 positive cells decreased one by one/greatest in the SHAM group[(75.548 ± 7.333)/hpf] followed by MT group [(59.971 ± 3.635)/hpf],and HI group [(40.511 ± 2.848)/hpf] (P ＜ 0.05).The expression of Casepase-3 increased in the SHAM group (107.724 ± 10.266),MT group (132.289 ± 8.537),and HI group (202.168 ± 14.367),and the difference was statically significant (P ＜ 0.05).Ventricular index was greater in operation side of the white matter in the peripheral ventricles of the 14-day-brain in the SHAM group(0.928 ±0.063),MT group (1.813 ± 0.110),HI group (2.752 ± 0.201),increasingly,while absorbance value of myelin basic protein decreased one by one in sequence(39.504 ± 1.673,21.729 ± 1.614,11.344 ± 1.118).Conclusions MT plays a role in protecting the periventricular white matter via inhibiting the apoptosis of oligodendrocyte progenitor cell,and thus benefits the PWMD.

Distortion product otoacoustic emission (DPOAE) signal can be used for diagnosis of hearing loss so that it has an important clinical value. Continuously using sweeping primaries to measure DPOAE provides an efficient tool to record DPOAE data rapidly when DPOAE is measured in a large frequency range. In this paper, locally weighted least squares estimation (LWLSE) of 2f1-f2 DPOAE is presented based on least-squares-fit (LSF) algorithm, in which DPOAE is evoked by continuously sweeping tones. In our study, we used a weighted error function as the loss function and the weighting matrixes in the local sense to obtain a smaller estimated variance. Firstly, ordinary least squares estimation of the DPOAE parameters was obtained. Then the error vectors were grouped and the different local weighting matrixes were calculated in each group. And finally, the parameters of the DPOAE signal were estimated based on least squares estimation principle using the local weighting matrixes. The simulation results showed that the estimate variance and fluctuation errors were reduced, so the method estimates DPOAE and stimuli more accurately and stably, which facilitates extraction of clearer DPOAE fine structure.
Algorithms ; Hearing Loss ; diagnosis ; Humans ; Least-Squares Analysis ; Otoacoustic Emissions, Spontaneous ; Regression Analysis

Adefovir dipivoxil (ADV) is commonly used as an anti-viral agent in the treatment of chronic hepatitis B,with a dose-and time-dependent nephrotoxicity.Clinical analysis was made in 4 patients with chronic hepatitis B who developed Fanconi syndrome and hypophosphatemic osteomalacia after long-term use of ADV (10 mg/d).

Objective To explore the differential proteins between livers of control and brain dead grups,and to provide an experimental basis for the assessment of liver quality in brain dead rabbits.Methods 60 healthy male New Zealand rabbits were divided into two groups.The brain dead group (n=30) contained rabbits 2 hours (B1),6 hours (B2),and 8 hours(B3) after brain death.The sham group (n=30) contained groups of 2 hours (C1),6 hours (C2),and 8 hours (C3).At the end of the relevant experiments,blood samples and liver tissues were collected.The level of ALT and AST were determined by an automatic biochemistry analyzer and the morphologic changes of the livers were detected by HE staining.The differentially expressed proteins were screened and identified by two-dimensional gel electrophoresis,PDQuest software,matrix-assisted laser desorption ionization time of flight mass spectrometry,and the NCBI database.Results In 8 hour brain dead group,the level of ALT increased comparing with 6 h (P＜0.05),but there was no significant statistical difference in the other groups.Under real time observation with the light microscope,the livers of the brain dead groups had increased edema and infiltration of lymphocytes in the portal area,especially in the 8 hour group.However,infiltration of neutrophils also appeared in the 8 hour control group and all groups had no damage in the liver cell.There were 10 kinds of differentially expressed proteins through the two-dimensional gel electrophoresis,mass spectrometry analysis,and database query.One protein of interest was ALDH2,which showed a gradually decreasing expression in the liver when the braid dead time increased.Conclusion Brain death could lead to no damage of liver function and little damage to liver morphology.The identified protein ALDH2 may be related with liver injury after brain death and could be a new indicator in the assessment of liver quality in brain dead rabbits.

Objective To explore the way to establish the brain death model for rabbits and pathophysiological changes before and after brain death.Methods 80 healthy male New Zealand rabbits were divided into brain death group (n =60) and sham operation group (n =20),The 60 brain death rabbits were established by increasing intracranial pressure in a modified,slow,and intermittent way.The sham operation rabbits were only maintained with anesthesia.Results The 56 brain death rabbits were established successfully and maintained for 10 h with the respiration and circulation supports.2 rabbits died due to anesthetic accident,the other 2 died because of improper pressure.The surgical success rate is 93.3％ (56/60).The changes of mean artery pressure (MAP) and heart rate (HR) in brain death group were more significant than in sham operation group:MAP and HR fluctuated and showed the increased tendency.The mean MAP and HR during increasing intracranial pressure were (400.24±18.36) mm Hg (1 mm Hg=0.133 kPa) and (258.00 ± 25.70) beats/min respectively,which was significantly higher than before and after increasing intracranial pressure (P＜0.05).Conclusions The brain death model for rabbits could be established by increasing intracranial pressure in a modified,slow,and intermittent way successfully and maintained 10 h.the MAP and HR before and after brain death showed characteristic changes.The model is helpful to the further observation of organ changes in brain dead state.

Objective To evaluate the perinatal outcome of three types of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR).Methods From January 2010 to June 2013 clinical data of 37 pairs of MCDA twins (74 fetuses)with sIUGR and 40 pairs of normal MCDA twins (80 fetuses) in the same period were analyzed retrospectively.Fetuses with sIUGR were classified into three groups based on umbilical artery Doppler flow.There were 20 cases of type Ⅰ,11 cases of type Ⅱ and 6 cases of type Ⅲ.The perinatal outcome was compared between sIUGR and normal MCDA twins,and among the three types of sIUGR as well.Perinatal outcomes included gestational age at delivery,rate of intrauterine fetal death (IUFD),birth weight,twins discordance of birth weight,neonatal death and survival rate at 6 months.Results The gestational age of sIUGR group at delivery was significantly earlier than that of control group [(33.1 ± 3.0),(36.9 ± 3.2) weeks,respectively],and the rate of IUFD of both fetuses of sIUGR group was significantly higher [5.4％ (4/74),0,respectively],there was significant difference(P ＜ 0.05).In sIUGR group,the average birth weight of large or small twins [(2 030.8 ± 353.4),(1 529.0 ± 432.9) g] was smaller than those in control group [(2 471.5 ± 500.9),(2 346.0 ± 460.3) g],there was significant difference (P ＜ 0.05).The twins discordance of birth weight in sIUGR group was significantly larger [(27.2 ± 2.6)％] than that in control group [(8.0 ± 1.6)％] (P ＜0.05).The gestational age at delivery in type Ⅱ and type Ⅲ [(33.1 ± 5.0),(34.3 ± 2.8) weeks] was significantly earlier than that in control group (P ＜ 0.05).The rate of IUFD of both fetuses in type Ⅱ (18.2％,4/22) was significantly higher than that in type Ⅰ (0) and control group (0) (P ＜ 0.05).In sIUGR group,the average birth weight of small twins in type Ⅰ,type Ⅱ and type Ⅲ was (1 646.0 ± 433.5),(1 332.8 ± 310.5),(1 504.5 ± 382.2) g respectively,all of which was significantly smaller than that in control group (P ＜ 0.05).The average birth weight of small twins in type Ⅱ was smaller than type Ⅰ and the difference was statistically significant (P ＜ 0.05).In sIUGR group,the twins discordance of birth weight in type Ⅰ,type Ⅱ and type Ⅲ was (26.3 ±5.1)％,(31.0 ±1.6)％,(31.4 ±3.3)％ respectively,all of which was significantly larger than that in control group (P ＜0.05).There were no significant difference of the twins discordance of birth weight among the three types of sIUGR (P ＞ 0.05).Survival rate at 6 months in type Ⅱ (63.6％,14/22) was significantly lower than type Ⅰ (95.0％,38/40) and control group (92.5 ％,74/80) (P ＜ 0.05).Conclusions The perinatal outcome of MCDA twins with sIUGR is poor.The outcome is different among the three types of sIUGR,and type Ⅱ is the worst.Type Ⅱ is associated with a high risk of intrauterine fetal demise.It is important to monitor the intrauterine situation closely.

Objective To design a chock-vault antenna for injurious interventional thermotherapy and to evaluate antenna performance change when structure parameters of the antenna are adjusted. Methods Finite element method was used to simulate the distributions of the reflection coefficient and the specific absorption rate (SAR) of the chock-vault antenna of different structure parameters for microwave thermotherapy human muscle tissue model when it worked at 2 450 MHz. The chock-vault antenna for injurious interventional thermotherapy had been optimized. Results This antenna was made.And the reflection coefficient and SAR were measured with human muscle tissue model experiment. The simulation results were validated. Conclusion The SAR distribution of the improved choke-vault antenna does not depend on depth of the insertion tissue. The reflection coefficient can be reduced greatly. The top energy distribution is reasonable.