Objective To study the expressions of estrogen receptor(ER)and progesterone receptor(PR)in elderly patients with breast cancer,and the correlation between their expressions and clinicopathological characteristics.Methods The expressions of ER and PR in 110 elderly patients with breast cancer(over 60 years old)from 1995 to 2004 were detected,and their clinical and pathological features were analyzed retrospectively.Another 110 patients aging 30 to 59 years with breast cancer served as control.Results Breast cancer in aged and non-elderly group had similar pathohistological types,but the aged had more tumors with low-grade malignant types.ER and PR were found to be over-expressed in elderly patients but not in the control.No obvious correlation was seen with clinical pathological stages.The expression levels of ER and PR in 0-3 positive nodes group was higher than ≥4 positive nodes group.Conclusion Elderly patients and non-elderly patients have similar pathohistological types of breast cancer.The former have higher expressions of ER and PR,and their expressions are associated with axillary lymph node status.

OBJECTIVETo evaluate the diagnostic value of micro-movement sensitive mattress sleep monitoring system (MSMSMS) in children with obstructive sleep apnea hypopnea syndrome.

METHODSSixty-five children with the complaint of sleep disorder were collected and detected by polysomnography and micro-sensitive mattress sleep monitoring system overnight at least seven hours. The date from two instruments were analyzed by computer automatically and then modified by two professional staff double-blind separately. The data about the diagnosis of sleep breath disorder and other sleep physiology information were compared between the two groups.

RESULTSSixty-one cases finished the study finally. The mean age of these children was (7.0 ± 2.7) and the youngest was 3 years old, maximum was 13 years old, male children 46 cases, female patients 15 cases, body mass index (BMI) median [25 quantile; 75 quantile] 16.00 [14.80;17.5]kg/m2. Mean PSG measured apnea hypopnea index (AHI) was 4.50 [2.30;10.15] times/h, and mean MSMSMS AHI was 3.63 [2.56; 6.43] times/h. There was a significant correlation between PSG AHI and AHI by MSMSMS (r = 0.935, P < 0.01). A Bland-Altamplot of PSG AHI and MSMSMS AHI was also used to assess the accuracy of MSMSMS. 95. 1% of the data was fallen in the 95% consistency areas. For AHI--5 times/h and nighttime minimum oxygen < 91% or obstructive apnea index( OAT) > 1 time/h and nighttime minimum oxygen saturation < 91 % as threshold value, the MSMSMS diagnosing sensitivity and specificity were 82.9% and 92.3%. The misdiagnosis rate and missed diagnosis rate were 7.7% and 17.1%.

CONCLUSIONSThe MSMSMS offer a simple and comfortable method to monitor children's sleep. It improves the compliance in the process of sleep monitoring. Besides, as a diagnostic tool in the diagnosis of OSAHS on children has a high credibility in AHI.

Adolescent ; Body Fluids ; Child ; Child, Preschool ; Diagnostic Errors ; Double-Blind Method ; Female ; Humans ; Male ; Oxygen ; Polysomnography ; methods ; Seasons ; Sensitivity and Specificity ; Sleep Apnea, Obstructive ; diagnosis

Objective To evaluate the efficacy and safety of combination therapy of Endostar and oxaliplatin plus S-1 ( SOX regimen) in patients with advanced Primary carcinoma of the liver. Methods 32 advanced primary liver cancer patients admitted from February 2012 to August 2014 were assigned to SOX regimen as systemic chemotherapy: oxaliplatin 130 mg/m2 iv d1; S-1 (80 ~ 120 mg, twice-daily) for 14 days; 150 mg Endostar which was dissolved in 210 mL normal saline for 120 h durative transfusion. Treatment was repeated every 21 days. Objective clinical efficacy and adverse effect was assessed every 2 cycles. Serum alpha fetoprotein (AFP) level was also monitored according to the schedule. Results All 32 patients were available to be assessed, the objective response rate (ORR), disease control rate (DCR) ,the clinical benefit response rates (CBR), 1 year survival rate was 15.6%, 46.9%, 56.3%, 58.3% respectively. The serum AFP respond rate was 19.4%. Major adverse effects were myelosuppression and fatigue , mostly graded at 1 ~ 2. There were no treatment-related death. Conclusions These preliminary results suggest that continuous intravenous pumping of Endostar combined with SOX regimen could provide survival benefits with tolerable adverse effects.

Objective To evaluate influence of patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) on expressions of serum inflammatory cytokines in elderly patients with hemi or whole hip replacement using cemented artificial joint. Methods Elderly patients undergoing hip replacement were selected and were divided into PCIA group and PCEA group. VAS scores were calculated at 12 h postoperatively. Patients whose VAS scores were not more than 2 at postoperative 12h were included. 30 cases in each group were finally included. Fifteen cases were randomly chosen in each group and underwent sample blood drawing for assays. Expressions of serum inflammatory cytokines were detected by ELISA , RT-PCR and Western-blot. Results Gene and protein expressions of TNF-a as well as IL-6 in group PCEA were lower and expression of IL-10 was higher than that in group PCIA. Serum level of TGb-β was higher in group PCEA detected by ELISA. There was no significant difference in expression of IL-8 between groups. Conclusions PCEA may better promote expressions of anti-inflammatory cytokines and inhibit expressions of proinflammatory cytokines. PCEA is superior in maintenance of inflammatory cytokine balance.

Objective To investigate the clinical application of the coblation in the treatment of the infant with sleep-disordered breathing. Methods The clinical data were reviewed from 161 infants, who had the cobtilaon tonsillectomy and/or adenoidectomy sugeries in our hospital from January , 2008 to June, 2012. Among the 161 SDB cases, there were 85 obstructive sleep apnea hypopnea syndrom cases and 76 primary snoring cases. After 12 months, the follow-up visit is cut off in January, 2013. Successful follow-ups had been done to 161 infant with SDB. And the clinical efficacy and the occurrence of the complications were investigated. Results the intra-operative blood loss was 10 mL or less. 2(1.24%) were delayed hemorrhage with less pain afteroperation. One year after the surgery, there were 141 cured (87.6%), 15 with apparent effects (9.3%), 3 with effective results (1.9%), 2 with no effect(1.2%)and the total effective rate is 98.8%. Conclusion It is minimally invasive, safe and effective to use coblation to remove tonsil and adenoid in the treatment of infants with sleep-disordered breathing.

Objective To observe the cerebral activation pattern in patients with cervical dystonia (CD) during finger movements and the changes caused by botulinum toxin injection by functional MRI.The possible etiological mechanism of CD and effect of peripheral botulinum toxin treatment on the level of central nerves system are investigated.Methods A designed functional MRI block with complex finger movements was applied and 11 patients with CD as well as 11 age and gender matched controls were scanned.Compare the activation pattern of CD pre/post treatment groups versus health controls.Evaluate and compare the symtom severity with Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).Make a correlation analysis between activation pattern alteration and TWSTRS change in CD pre/post treatment groups.Results An reduced extent of activation in patients with CD was demonstrated compared to healthy controls in ipsilateral putamen,prefrontal cortex and contralateral somatosensory cortex to the direction of the head deviation,while an elevated extent of activation in ipsilateral precuneus and fusiform with statistic significance.At the time point of 4 weeks after botulinum toxin treatment patients showed no evident difference with healthy controls except for the decreased activation in contralateral precuneus to the direction of the head deviation.TWSTRS of patients with CD decreased from (20.02 ± 5.52) to (4.11 ± 4.34) with statistic significance (t =11.71,P =0.000) after botulinum toxin treatment.There was a positive correlation between cerebral activation pattern change in some cerebral areas (ipsilateral primary somatosensory cortex,premotor cortex,supplementary motor cortex,insula,fusiform,hippocampus with parahippocampa as well as contralateral middle temporal cortex and hippocampus with parahippocampa to the direction of the head deviation) and TWSTRS score decrease.Conclusions There are widespread abnormalities in cortical and subcortical activation pattern in patients with CD,which might due to dysfunction of sensory-motor integration.We speculate a basic pre-dystonic state is present in affected body parts prior to clinical symptoms appear.Botulinum toxin fulfills its subsequent central effect by reorganizing and normalizing the cerebral cortex in patients with CD.

OBJECTIVE This study was conducted to analyze the underlying bacterial pathogens of the tonsils and adenoids in children with sleep-disordered breathing(SDB).METHODS The core tissue from the tonsils and/or adenoids of 163 SDB children was cultured aerobically. Of the 163 cases, 120 children underwent adenoidectomy and tonsillectomy simultaneously(A+T), 39 children underwent adenoidectomy(A) and 4 tonsillectom(T) only. 124 children who underwent tonsillectomy were subdivided into two groups based on history(with or without a history of recurrent tonsillitis). 71 children with the history were enrolled in the 'recurrent tonsillitis group' and 53 children without the history were enrolled in 'non- recurrent tonsillitis group'.RESULTS Of the total 120 cases who underwent A+T, 114(95.00%) cases had same distribution of bacteria detected in both sides in the same patient. Besides this, 17 cases in whom mixed organisms were identified in both sites shared common pathogen. No significant difference in the detection rates of staphylococcus aureus and haemophilus influenzae were found when we compared seasons(Tonsil:χ2=8.538,P=0.201; Adenoid:χ2=5.427, P=0.490). No significant difference in the type and detection rate of essential bacteria was found when we compared between recurrent tonsillitis group and 'non-recurrent tonsillitis group' (χ2=3.028,P=0.387).CONCLUSION The bacterial isolates from the tonsils and adenoids are virtually identical in type and detection rate in the same SDB patient. The bacterial distribution of the tonsillar and adenoidal core is unaffected by the seasonal variation and history of recurrent tonsillitis.

Objective To explore surgical approach for internal mammary node biopsy in patients with breast cancer. Methods Modified radical mastectomy and incised intercostal muscles for internal mammary node biopsy was performed on 113 patients. The distance from the internal mammary artery to the lateral sternal border, and the intercostal distance between the two costal cartilage were measured. Anatomical location and maximal diameter of the excised nodes were recorded. Results The internal mammary artery runs through intercostal space along the lateral sternal border. The distance from the internal mammary artery to the lateral sternal border was (10. 9?4. 5) mm, (11.6?2.9) mm, (9.6?3.6) mm and (4.5?3.5) mm in the first, second, third and fourth intercostal space, respectively. The distance between the two costal cartilage was (14. 2?4. 1) mm, (16. 2?4. 2) mm, (13. 9?4. 3) mm and (9.9?3. 6) mm in the first,second, third and fourth intercostal space, respectively. Two hundred and seventy-nine internal mammary nodes were excised from 113 patients. The anatomical location of the internal mammary nodes which embedded in the fatty tissue surrounding internal mammary artery were 41. 2% at the medial side, 51. 6% at the lateral side and 7. 2% in an anterior plane to the internal mammary artery. Metastases in the internal mammary node were detected in 26 patients. The lymph nodes metastasis were detected only in the internal mammary nodes in 5 cases. Conclusion Internal mammary node biopsy via intercostal space is a feasible, minimally traumatic, low-risk procedure.

Objective:To investigate the efficacy of bevacizumab on the treatment of serious peritumorous brain edema. Methods:A total of 16 patients with malignant brain tumors and serious peritumorous brain edema, (13 cases of lung cancer, 2 cases of breast can-cer, and 1 case of recurrent glioblastoma) were analyzed. Treatment with glucocorticoids, osmotic dehydration, and other convention-al approaches were not effective for these patients. Bevacizumab was administered at a dose of 5 mg/kg at least once every three or four weeks. The Karnofsky performance score (KPS) and the changes in cerebral edema symptoms, such as cerebral edema volume, tu-mor volume, edema index (EI), and changes in magnetic resonance imaging (MRI) were compared before and after treatment. The t-test and least-significant difference method were used to compare treatment groups. Results:All bevacizumab-treated patients had re-duced symptoms. The KPS after treatment was significantly higher than that before treatment (P<0.001). The cerebral edema vol-umes, tumor volumes, and EI of 16 patients were significantly decreased (P<0.05). Bevacizumab caused mild clinical side effects. Con-clusion:Preliminary results showed that treatment of serious peritumorous brain edema with bevacizumab was safe and effective.

Objective:To evaluate the capacity and level of melting point determination of chemical drugs in the laboratories par-ticipating in the proficiency testing. Methods:Two test samples were prepared, and the labs volunteered to participate in the proficien-cy testing program ( PTP) . The melting point determination was performed according to the general principle 0612 in part four of Chi-nese Pharmacopoeia (2015 edition), and the results were analyzed by robust statistics and the determination proficiency of the laborato-ries were evaluated by Z-score. Results:The analysis showed that two test samples were homogeneous and stable, which met the re-quirements of the PTP. Totally 31 laboratories had satisfactory results, which accounted for 83. 8%. Conclusion:The majority of the participant laboratories can accurately determine the melting points of test samples, and the information is very helpful to the next profi-ciency testing program.