Objective To study the EnCor vacuum negative pressure rotary system in ultrasonic BI-RADS 2~3 scale mammary gland disease application value.Methods Under the guidance of ultrasound, the application EnCor vacuum negative pressure rotary cutting system for 142 patients, 366 cases of breast lesion resection, specimens sent to pathological examination.Results A total of 366 breast lesions, 359 complete resection, the success rate was 98.1%, 2 transit operation, and transfer rate was 0.5%, 5 partial nephrectomy, residual rate was 1.4%.359 complete resection of the pathological results for breast malignant lesions in 4, the infiltrating ductal carcinoma 1, 3 ductal carcinoma in situ;breast benign lesions in 355, of which 132 breast fibroadenoma, adenosis with adenoma formation of 60, 99 breast adenosis, breast adenosis with duct expansion 43, 11 breast intraductal papilloma, one with four individual catheter atypical increase the living.Two transit operation pathological results were fibroadenoma, 5 disease of partial nephrectomy for adenosis with duct expansion.Conclusions The excision of breast neoplasm EnCor vacuum negative pres-sure rotary cutting system, not only small trauma, good cosmetic effect, and reduce misdiagnosis and im-prove the patients'satisfaction.

Objective To discuss the correlation between molecular subtypes of early stage breast cancer patients with positive sentinel lymph nodes and the metastasis of non-sentinel lymph nodes, and find out the factors predicting the metastasis of non-sentinel lymph nodes. Methods The clinical data of 124 female breast cancer patients with sentinel lymph node positive were retrospectively analyzed, and the patients were treated with axillary lymph node dissection. And the correlations were analyzed by single factor analysis and multiple factor Logistic regression analysis. Results Among the 124 patients,non-sentinel lymph node metastasis was in 45 cases (36.3%), and only sentinel lymph node positive was in 79 cases (63.7%). The single factor analysis result showed that the age≤35 years, number of sentinel lymph node positive≥2, macrometastasis of sentinel lymph node had correlation with the metastasis of non-sentinel lymph node (P<0.05 or<0.01);but the molecular type, operation method, maximum tumor diameter had no correlation with the metastasis of non-sentinel lymph node (P>0.05). The multiple factor Logistic regression analysis result showed that the number of sentinel lymph node positive and circumstance of sentinel lymph node positive lesions were the independent risk factors of the non-sentinel lymph node metastasis in patients with sentinel lymph node positive (OR = 4.589 and 2.948; P<0.01 or <0.05). Conclusions The circumstance of sentinel lymph node positive lesions and number of sentinel lymph node positive are the independent risk factors of the non-sentinel lymph node metastasis, but the molecular type is not correlated with the metastasis of non-sentinel lymph node. Predicting non-sentinel lymph node metastasis should be combined with clinical and pathological factors.

Objective To explore the effect of intravenous immunoglobulin (IVIG) on immunity and outcome for sepsis in children.Methods Eighty-four children who met the diagnosis of sepsis were included in study and divided into treatment group (36 cases) and control group (48 cases ).The patients in teatment group were administered IVIG with the dose of 1 g/kg.Peripheral venous blood samples of patients in both groups were collected before (0 h),24 h,72 h and 5 d after administration to detect the numbers of immunocyte including CD3 +,CD4 +,CD56 +,CD19 +,CD8 +cells by flow cytometry and the levels of cytokines including tumor necrosis factor (TNF)-at,interleukin (IL)-10,IL-1 7 by enzyme linked immunosorbent assay.The numbers of immunocyte and levels of cytokines and TNF-a/IL-10 were compared and the mortality at 28 days was assessed between two groups.Results The numbers of CD3 +,CD4 +,CD56 +,CD19 +cells and the levels of TNF-a,IL-17 and TNF-α/IL-10 of patients in teatment group were significantly decreased than those in control group at 24 h,72 h and 5 d afte administration ( P ＜0.05 ) and showed downtrend.However,the level of IL-10 increased significantly (P ＜ 0.05 ) and showed uptrend in treatment group.The number of CD8+ cells had no change.No difference of mortality was observed between two groups (27.7％,10/36 vs 16.6％,8/48,x2 =1.50,P =0.169,OR =1.92,95％ CI:0.671 ～5.510).Conclusion IVIG can suppress the immunity of children with sepsis and has no survival benefit.

Objective: To investigate the effect of different incision breast conserving surgery on the cosmetic effect and prognosis of breast cancer patients. Methods: From January 2014 to October 2016, 76 breast cancer patients with breast conserving indications who admitted to the People's Hospital of Shanxi Province were selected.They were randomly divided into radiation incision group and arc incision group according to random number table method, with 38 cases in each group.The two groups were treated with radiation incision breast-conserving surgery and arc incision breast-conserving surgery.The operation condition, cosmetic effect and complications were compared between the two groups.The Pittsburgh Sleep Quality Index(PSQI) and Self-rating Depression Scale(SDS) scores before and after operation were compared between the two groups.The patients were followed up for 2 years.The 2-year recurrence rate, metastasis rate and survival rate were compared between the two groups. Results: The amount of intraoperative bleeding in the radiation incision group was (22.42±5.34)mL, which was significantly higher than that in the arc incision group [(10.56±1.35)mL](t=12.854, P<0.05). There were no statistically significant differences in incision length, operation time and incidence of complications between the two groups(all P>0.05). The excellent rate of cosmetic effect in the arc incision group was 92.11%(35/38), which was higher than that in the radiation incision group [73.68%(28/38)](χ²=4.547, P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups(χ²=0.106, P=0.774). The postoperative PSQI and SDS scores of the two groups were significantly lower than before operation.(all P<0.05), and the PSQI and SDS scores in the arc incision group were significantly lower than those in the radiation incision group(t=6.872, 12.872, all P<0.05). The 2-year metastasis rate was 2.63%, recurrence rate was 0.00%, and survival rate was 100.00% in the two groups, there were no statistically significant differences between the two groups(all P>0.05). Conclusion The arc incision and radiation incision breast conserving surgery can achieve good curative effect for breast cancer, but the cosmetic effect of arc incision is better, it can improve postoperative sleep quality and depression.

Objective:To investigate the in vitro anti-cancer effect of Vinorelbine (NVB) combined with adriamycin (PLD) on human breast cancer MCF-7 cells and related mechanisms.Methods:The effects of NVB and PLD alone or in combination on the proliferation of breast cancer cells were detected by CCK-8 experiment. Flow cytometry was used to detect cell apoptosis and changes in reactive oxygen species (ROS) levels. Western blot experiment was carried out to detect protein expression.Results:The results of CCK-8 showed that compared with the blank control group, the inhibition rates of the vinorelbine treatment group, the adriamycin treatment group and the combined treatment group were 27.6%, 31.2% and 65.4%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.005 vs 0.001) . The results of flow cytometry showed that the proportion of apoptotic cells in each group was 3.54%, 16.95%, 15.01% and 32.24%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.006 vs 0.005) . The levels of reactive oxygen species in each group were 1, 1.03, 1.06 and 1.57, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.008 vs 0.007) . Western blot results showed that the expression of p-ERK and p-STAT3 decreased after the combination of NVB and PLD, which inhibited the ERK/STAT3 signaling pathway. Conclusions:The combination of NVB and PLD can promote the apoptosis of breast cancer cells and inhibit the proliferation of breast cancer cells with high efficiency and low toxicity. Its mechanism of action may be related to the up-regulation of ROS levels in cells, thereby inhibiting the activation of the ERK/STAT3 pathway.

Objective　To investigate the differences and similarities of cognitive impairment，especially executive function，between patients with Parkinson’s disease（PD） and multi-system atrophy（MSA） by neuropsychological tests. Methods　26 patients with Parkinson’s disease，18 with multi-system atrophy and 20 with normal control were selected continuously. Age，education degree and course of disease were collected in detail. Montreal Cognitive Assessment （MoCA），Trail Making Test （TMT），Stroop Color-Word Test，Clock Drawing Test （CDT） and Rey-Osterriche complex figure test were given to evaluate cognitive and executive function of 26 patients with PD，18 patients with MSA and 20 normal controls randomly selected. Results　Parkinson’s disease group and multi-system atrophy group had significantly lower scores in each test than the control group （P<0.05）. In the MOCA test，the scores of Parkinson’s patients were significantly lower than those of the multi-system atrophy group，［（22.34±3.18） vs（24.31±1.68），P<0.05]. The number of errors in the Stroop chromatogram test in Parkinson’s group was higher than that in the multi-system atrophy group［（10.74±6.31） vs（8.26±4.62），P<0.05]. In the remaining tests，there was no significant difference between PD and MSA patients （P>0.05）. Conclusion　Parkinson’s disease patients and multi-system atrophy patients have different degrees of cognitive impairment and executive function decline than the normal population，Multisystem atrophy in terms of overall cognitive impairment is worse in patients with Parkinson’s disease than in patients with Parkinson’s disease，Parkinson’s disease patients have more attention deficit and more severe system atrophy，while patients with multiple system atrophy are more likely to have decreased self-examination ability and error correction ability.