Objective To compare the clinical efficacy of breast-conserving surgery and modified radical mastectomy for early breast cancer and their influence on quality of life.Methods 78 patients with early stage breast cancer were divided into two groups by random number table,and 39 cases in each group.The control group was given modified radical mastectomy,while the observation group was given breast-conserving surgery.The clinical efficacy,surgical conditions and quality of life scores were compared between the two groups.Results The operative time,blood loss,incision length and the average hospital stay of the observation group were (60.23 ± 5.21)min,(44.73 ± 4.22) mL,(4.72 ± 1.02) cm and (9.52 ± 0.86) d,which were significantly lower than those of the control group(t =7.88,8.32,8.89,6.42,all P ＜ 0.05).The postoperative physical factors,mental factors,psychological factors and social factors scores of the observation group were (67.44 ± 3.87),(48.64 ± 3.73),(117.34 ± 8.33)and (61.56 ± 5.32),which were significantly higher than those of the control group (t =5.43,5.87,6.29,7.11,all P ＜ 0.05).The postoperative 3-year local recurrence,distant metastasis and survival rate showed no significant differences between the two groups (x2 =1.22,1.09,1.29,all P ＞ 0.05).Conclusion Breast-conserving surgery in the treatment of early breast cancer has significant effect,and it has less trauma,less bleeding and cosmetic results,and it can be used as the preferred method for the treatment of early breast cancer,which is worth to be further applied in clinical.

OBJECTIVE:To study the active fraction of the seeds of Hovenia Dulcis Thunb.to treat acute alcoholism.METHODES:The seeds of Hovenia Dulcis Thunb.were divided into five parts:superitical fluid extraction(SFE)part,chloroform extraction part,ethyl acetate extraction part,n-butanol extraction part and water extraction part.The effects of the active fraction of the seeds of Hovenia Dulcis Thunb.on ebriety latency,ebriety rate,mortality,and ethanol concentration-time curve of the alcoholism mice were investigated.RESULTS:The ethyl acetate extract could prolong the ebriety latency of the mice,decrease ebriety rate and mortality of the alcoholism mice,and significantly decrease serum ethanol concentrations at 0.5,1,and 1.5h after alcohol administration(P

OBJECTIVE:To determine the content and establish HPCE fingerprints of polysaccharides of the T.jackii seed.METHODS:The content of polysaccharides of the T.jackii seed was determined by phenol-vitriolic colorimetry and the fingerprints of polysaccharides were established by HPCE.RESULTS:The content percentage of polysaccharides in the seed of T.jackii was6.56%,with average recovery rate at98.3%and RSD at2.31(n=5).There were two kinds of polysaccharides in the seed of T.jackii.CONCLUSION:There is no significant difference with regard to the contents and components of polysacc_ harides in the T.jackii seeds from different origins.

Objective To analyze the main problems in quality of TCM decoction pieces in Jinzhou TCM Hospital of Hubei Province in 2012;To enhance management measures for quality control of TCM decoction pieces, with a purpose to better apply TCM to clinic. Methods The total batch number and disqualified batch number of warehouse entry inspection of TCM decoction pieces in Jinzhou TCM Hospital were collected, and the reasons for rejected TCM decoction and pieces were analyzed. Results Totally 5677 batches of TCM decoction and pieces in the hospital in 2012 were assessed. 210 of them were disqualified, accounting for 3.7% of the total batches. The disqualification was mainly caused by preparation (72 batches), storage (106 batches), and the quality of original medicine (32 batches), accounting for 34.29%, 50.48%, 15.24%, respectively. Conclusion Production, preparation, and storage of TCM decoction pieces should be standardized. The quality inspection of TCM decoction pieces should be strengthened, with a purpose to make sure the safety and effectiveness of medication in clinic.

Objective To explore the affect of citalopram on Hamilton Depression Scale (HAMD) ,self rating Depression Scale (SDS) score ,high sensitive C reactive protein (hs‐CRP) ,heart rate variability (HRV) ,andrenin angiotensin systerm(RAS) levels of patients with coronary heart disease complicated with anxiety‐depression .Methods 160 cases of patients with coronary heart disease and anxiety depression in January 2012 to August 2014 were selected ,they were randomly divided into observation group and control group according to the list of number table methods ,the control group of 80 patients used routine treatment methods ,while 80 patients in observation group were added with citalopram on the basis of conventional therapy ,after 6 weeks of treatment ,the clinical efficacy and changes of the HAMD ,SDS score ,score ,and hs‐CRP ,heart rate variability ,and renin angiotensin levels of two groups were compared .Results (1)The total clinical effective rate of the observation group was 93 .75% ,significantly higher than 70 .0% of the control group ,the difference was statistically significant (χ2 =10 .21 ,P<0 .05);(2)HAMD score ,SDS score ,hs‐CRP of the observation group was significantly lower than that of the control group ,the difference was statistically signifi‐cant(t=12 .98 ,9 .43 ,11 .86 ,P<0 .05);(3)HRV of the study group was significantly higher than that in the control group ,there was a statistically significant difference (P<0 .05);(4)Angiotensin II of the observer group were (93 ± 26)ng/L ,Angiotensin Ⅱ of the control group were (37 ± 14)ng/L ,the difference was statistically significant (P<0 .05) .Conclusion Citalopram has a signifi‐cant efficacy in treatment of patients with coronary heart disease combined with anxiety‐depression ,which is safe and reliable that is worth clinical popularizing and applying .

Recurrent cerebral infarction (RCI) is very common in clinical practice. Intracranial and extracranial vessels diseases closely associate with the recurrence of cerebral infarction. Hypertension, diabetes, high homocysteine, etc., result in vascular stenosis and more in-farction recurrence by atherosclerosis and arterial plaque formation. Study of the etiology of RCI is important for the secondary prevention of cerebral infarction.

Objective To investigate the clinical characteristics and diagnostic methods of multiple endocrine neoplasia ( MEN) 2B. Methods The clinical data collected from 4 cases with multiple endo-crine neoplasia type 2B, who had been diagnosed and treated from July .1980 to Jan.2012, were retrospec-tively analyzed.Of the 4 patients, 3 males were diagnosed at the age of 14, 24, 21, respectively, and 1 fe-male was diagnosed at age of 23.Two cases had the first diagnosis of thyroid mass during the physical exami-nation, and the adrenal tumors and hypertension were first diagnosed in other two cases , respectively.All four cases had multiple mucosal neuromata .Of whom, three cases had medullary thyroid carcinoma and pheochromocytoma , two cases had Marfan syndrome figure , and one case had pheochromocytoma and Marfan syndrome.Two cases were accompanied by paroxysmal hypertension , and the highest systolic blood pressure was over 200 mmHg (1 mmHg=0.133 KPa).Two cases of pheochromocytoma were found during follow up . Three cases had bilateral adrenal tumors .The thyroid mass was diagnosed by ultrasonography , and the pheo-chromocytoma was confirmed by ultrasonography , CT and 24-hour urine catecholamine test .Adrenalectomy and thyroidectomy were carried out during the treatment process .To clarify the RET mutation status , exons and adjacent introns from 10th to 16th of RET proto-oncogene were sequenced in two patients . Results Gene analysis of two cases confirmed the activating mutation at the sites of 918 in exon 16 of RET proto-on-cogene in which methionine was replaced by threonine ( ATG-ACG) .Among the 3 cases with medullary thy-roid carcinoma , two patients were treated by total thyroidectomy and neck lymphadenectomy , one was opera-ted by subtotal thyroidectomy .For the treatment of pheochromocytoma , adrenal tumor resection was carried out in 3 cases, but not in the other one .Patients were followed up for 2 to 15 years postoperatively , 1 case without tumor recurrence and metastasis , 2 cases with multiple metastases . Conclusions The diagnosis of multiple endocrine neoplasia type 2B mainly depends on endocrine tests , ultrasonography and CT .Surgery is the primary treatment .When pheochromocytoma coexists with other tumors , pheochromocytoma should be re-moved first .

Objective To evaluate the effect and safety of glibenclamide for gestational diabetes mellitus (GDM).Methods Cochrane Central Register of Controlled Trials (CENTRAL),Medline,EMBASE,Science Citation Index,CNKI,VIP,Wanfang Data,and CBM were searched for the randomized controlled trials (RCTs) of glibenclamide for gestational diabetes from the date of establishment of the databases to March 2013.The bibliographies of the included studies were searched,too.The included studies were evaluated by GRADE.The extracted data were analyzed by Rev-Man 5.1 and GRADEprofiler 3.2.2.Results Five RCTs were included.Effectiveness (such as maternal postprandial glucose,HbA1C) and adverse perinatal outcomes (such as the change of the pregnant women body weight,cesarean section rate,maternal hypoglycemia incidence,birth body length,incidence of hypoglycemia,jaundice,newborn being in the care unit,congenital malformations,stillbirth,and mortality neonatal) showed no differences between glibenclamide (alone or complemented with insulin) group and insulin group (P＞0.05).However,compared with insulin group,higher maternal fasting blood glucose,higher birth weight of newborn infants,and incidence of macrosomia were shown in glibenclamide group.Conclusion Glibenclamide can effectively control maternal blood sugar,and would be a promising alternative therapy for GDM,without adverse effect on fetal growth and development,but with the higher incidence of neonatal macrosomia.Due to the limitations of the included studies,more large-sample,high-quality RCTs are required.

Objective:This study aims to explore the relationship between respiratory tract of chemotactic cytokines and nitric oxide levels of infection.Methods:40 cases of patients as the observation group during August 2012 to August 2013 were selected in our hospital respiratory department of internal medicine were respiratory tract infection , healthy subjects 30 cases as the observation group,the observation group at the time of admission ,admission after 3 d,the 7 d after be admitted to hospital ,hospital of cytokines (TNF-α),nitric oxide (NO) and interleukin (IL-6,IL-17,IL-10) level difference,and were compared with the control groups Results:Patients in the observation group at the time of admission ,admission after 3 d,compared with 7 d after admission,discharge of TNF-α,NO,IL-6,IL-17,IL-10 level differences were statistically significant (F=10.849,P<0.05),with the extension of treatment time,symptoms gradually improved until the patients with respiratory tract infection , can be found in the above indexes all time is gradually decreased;the observation group the 3 d after be admitted to hospital ,the 7 d after be admitted to hospital discharge ,TNF-α, NO,IL-6,IL-17,IL-10 levels were compared with admission differences were statistically significant Conclusion: By measuring the levels of cytokines and NO levels in patients withrespiratory tract infection ,can judge the prognosis of patients.

Cerebral infarction is caused by cerebral blood supply disturbance, and then results in cerebral hypoxic ischemic lesions, with the manifestation of neurofunction deficit. This article summarized the application of positron emission computed tomography in treat-ment of cerebral infarction.