Breast Neoplasms ; classification ; pathology ; Carcinoma, Ductal, Breast ; classification ; Carcinoma, Intraductal, Noninfiltrating ; classification ; Carcinoma, Papillary ; classification ; Classification ; methods ; Female ; Humans ; World Health Organization

BACKGROUND: Hyperlipemia is one of the important risk factors of coronary atherosclerotic cardiopathy. Great attention has been paid on how to explain the correlation between blood lipid and coronary heart disease and the correlation of characteristics and level of blood lipid with coronary heart disease.OBJECTIVE: To probe into the correlation among the characteristics, the level of blood lipid and coronary heart disease in senile people.DESIGN: Case-control observation and stratified analysis.SETTING: Second Cadre Ward of General Hospital of Shenyang Military Area Command of Chinese PLA.PARTICIPANTS: Totally 105 inpatients were selected in coronary heart disease group, diagnosed as coronary heart disease, tallied with WHO Diagnostic Standard on Coronary Heart Diseases, in Second Cadre Ward of General Hospital of Shenyang Military Area Command of Chinese PLA from January 2001 to January 2002. Totally 99 inpatients, by checked, without coronary heart disease and cerebral vascular disorder were selected in the control in the same period.METHODS: 2 mL venous blood was collected in fasting in the morning and the serum was collected after centrifuged at 3 000 r/minute, for 5 minutes. Auto-biochemical analyzer and enzyme kit were used to determine cholesterol, triglycerin, high density lipoprotein cholesterol and low density lipoprotein cholesterol. Compared with the data in the control, the ranges of cholesterol, triglycerin and low density lipoprotein were calculated successively and divided by 10; at the class intervals of 0.53, 0. 39 and 0.29 mmonl/L, the frequency table was worked out. According to the frequency table, P25 (the 25th percentile), P50 (the 50th percentile), P75 (the 75th percentile) and P90 (the 90th percentile) of cholesterol, triglycerin and low density lipoprotein cholesterol were calculated successively. The stratified groups were divided based on P ＜ 25, P25 to PS0, PS0 to P75, P75 to P90 and ＞ P90, by which, the cases belonging to 5 groups were determined in coronary heart disease group and the control respectively. The exposure factor was determined by ＞ P90, compared with other 4 groups, Menta-Haensecel method was used to calculate x2. If the exposure factor was related with coronary heart disease, the relevant coefficient and 95% confidence interval should be calculated. In accordance with the standards (Proposal on Prevention of Abnormal Blood Lipid and Targets of Abnormal Blood lipid on 2-grade Prevention of Coronary Heart Disease), the cases beyond the targets and morbidity were determined in two groups.MAIN OUTCOME MEASURES: Determination of blood lipid, abnormal cases and morbidity in two groups; cases beyond targets of blood lipid and morbidity; stratified comparisons of percentiles in two groups.RESULTS: According to intention measurement, 204 cases entered result and the control, there was no significant difference in cholesterol, triglycerin cases presented hypercholesterolemia, 34.3% cases hypertriglycerlipidemia and 11. 4% cases low density lipoprotein-hypercholesterolemia. It was indicated that the blood lipid was in the normal range among 64. 8% to 88.6% comparison between the cases with cholesterol ≥5.47 mmonl/L and the cases with cholesterol varied from 3.85 to 4.63 mmol/L, the morbidity of coronary heart disease in the former was 2.98 times as high as the latter (x2 = 6.29, 95% confidence interval was 1.27 -6.98) . In the comparison between the cases with cholesterol ≥ 5.47 mmol/L and the cases with cholesterol varied from 4.64 to 5.05 mmol/L, the correlation with coronary Lipid for 2nd Prevention of Coronary Heart Disease, among the patients with coronary heart disease, cholesterol ≥ 4.68 mmonl/L in 54. 2% cases,triglycerin ≥ 1.70 mmol/L in 34. 3% cases and low density lipoprotein ≥ 2.6 mmol/L in 52. 3% cases.CONCLUSION: For senile patients with coronary heart disease, the satisfactory level of cholesterol is 3.85- 4.63 mmol/L. For those with cholesterol ≥ 5.47 mmol/L, compared with those varied from 3.85 to 4.63 mmol/L, the morbidity of coronary heart disease in the former is possibly 2.98 times as same as the latter(x2 = 6.29, 95% confidence interval was 1.27 - 6.98).

BACKGROUND: Some studies have revealed that plasma levels of D-dimer and fibrinogen are closely related to blood coagulation status before any occurrence of cardiovascular disease and cerebrovascular disease.OBJECTIVE: To investigate the difference in plasma levels of D-dimer and fibrinogen, two markers of prethrombosis, between elderly patients with cardiovascular or cerebral vascular disease and elderly and younger healthy persons.DESIGN: Case analysis based on patients.SETTING: Cadre ward of a military general hospital of Chinese PLA.PARTICIPANTS: From October 2000 to March 2002, 153 patients with cardiovascular disease and 116 patients with cerebral vascular disease, aging over 60 years, hospitalized in the Second Cadre Ward of the General Hospital of Shenyang Military Area Command of Chinese PLA were selected into this study. Meanwhile, healthy persons with normal results of physical examination conducted in this hospital were selected as controls. Of all the control persons,68 with an age less than 60 years were allocated into the younger control group and the other 98 persons were allocated into the elderly control group.METHODS: On the second day after hospitalization, a venous blood sample was taken from each patient. For those receiving medications of aspirin, their venous blood samples were taken on the 4th day after withdrawal. The plasmas of the samples were measured by using STA Compact, a fully automatic coagulation analyzer(Diagnostica Stago) and the auxiliary kit. The level of D-dimer was detected by employing the immunoturbidimetry assay(ITA) And the concentration of fibrinogen was measured by using the magnetic bead technologies.MAIN OUTCOME MEASURES: The plasma levels of D-dimer and fibrinogen were detected in each group.RESULTS: All the 435 participants entered the statistical analysis procedure. The plasma levels of D-dimer and fibrinogen of elderly control group [(0.91 ±0.51) mg/L and (3.69±1.25) g/L] were significantly higher than those of the younger control group[0.48 ± 0. 15) mg/L and(3.12±0.76) g/L] (t=2.39-2.66, P ＜ 0.05) .The plasma levels of D-dimer and fibrinogen of the elderly cardiovascular group [ (1.35 ± 0. 72) mg/L and(4. 16 ± 1.30) mg/L] and the elderly cerebral vascular group [(1.16±0.98) mg/L and(4.05±1.98) g/L]were significantly higher, as compared with the elder control group and the younger control group( t = 4.23-5.41, P ＜ 0.01 ).CONCLUSION: Compared to the younger control group, the plasma levels of D-dimer and fibrinogen of elderly population increase significantly, especially in those with cardiovascular disease or cerebral vascular disease.

Objective To investigate the role of Toll-like receptor4 (TLR4) activation in spinal cord in a rat model of persistent postoperative pain evoked by skin/muscle incision and retraction(SMIR).Methods Ninetysix male SD rats weighing 200-250 g were randomly divided into 4 groups(n =24 each):group sham operation; group SMIR; group SMIR + IT scramble siRNA and group SMIR + IT TLR4siRNA.The rat model of persistent postoperative pain evoked by SMIR was established according to the method described by Flatters.The TLR4 siRNA were administered intrathecally for 7 days starting from 1 day beforc surgcry.Pain behavior was assessed by paw mechanical withdraw threshold (MWT) to Electronic von Frey Anesthesiometer stimulation at 1 day before and 1,3,7,12,and 22 days after operation.Four animals were sacrificed at each time point in each group for detection of the expression of TLR4 protein in the spinal cord by Western blot analysis.Results Compared to group sham group,MWT was significantly descreased at 3,7,12,and 22 days after operation,while the expression of TLR4 protein in the spinal cord were significantly increased at 3,7,12 days after operation in group SMIR and group SMIR + IT scramble siRNA ; IT TLR4siRNA significantly attenuated the hyperalgesia induced by SMIR and descreased the expression of TLR4 protein at 3,7,12 days after operation in group SMIR + IT TLR4siRNA.Conclusion TLR4 activation in spinal cord plays an important role in the development of SMIR-evoked persistent postoperative pain in rats.

We applied a new teaching mode,combining problem-based learning (PBL) with extended teaching in clinical internship and case discussion,in order to adapt to the new situation in infectious diseases.The teaching efficacy was evaluated by questionnaire and classroom effect.The results showed that the new mode cultivated the students' self-learning ability and broadened their professional perspective.

AIM: To observe the realgar induced the apoptosis of eosinophils from bronchoalveolar lavage fluid in asthmatic guinea pigs and investigate the mechanism that realgar treated asthma.METHODS: The morphology of apoptosis of eosinophils was observed by Giemsa staining and electron microscope.The rate of apoptosis of eosinophils was assayed by the flow cytometry.RESULTS: The characteristic changes of the apoptosis in both light microscope and electron microscope were shown after 6 hours treatment of realgar.Flow cytometry showed that the rate of apoptosis of the eosinophils was increased with both increasing realgar concentration and prolonging realgar action time to the cells.CONCLUSION: Realgar promotes the apoptosis of eosinophils from bronchoalveolar lavage fluid in asthmatic guinea pig.Realgar induced the apoptosis of eosinophils is one of the causeses for asthmatic treatment.

Objective To observe the effect of comfort levels in patients during long-term video electroencephalographic(VEEG) monitoring on the monitoring effect. Methods A total of 168 patients with consecutive epilepsy were observed about the Bruggrmann comfort scale(BCS) and artifacts of VEEG during VEEG monitoring. Pearson′s correlation coefficient was used to evaluate a possible correlation between BCS and artifacts. Results The average single score before VEEG, including psychological comfort, social comfort, comfortable environment and overall comfort was (2.87±1.04), (2.63±0.98), (2.40± 1.25), (2.84 ± 0.90), (2.69 ± 1.07) points, which was (2.06 ± 1.38), (1.66 ± 1.40), (1.89 ± 0.57), (1.83 ± 1.24), (1.86 ± 1.19) points after VEEG. There was significant difference between 2 groups (t=4.011-6.353, P<0.05). The overall comfort score and the average single project blinks or eye movement artifacts, physical artifacts, chewing or swallowing artifacts and electrocardiogram artifacts were negatively correlated (r=-0.843--0.585, all P < 0.05), which would reduce the number of these artifacts when increased; there was no correlation (r=-0.204,-0.158, P>0.05) between the average single score of comfort and sweating, skin artifacts, and electrocardiogram artifact. Conclusions There is a significant negative correlation between patient's BCS and the occurrence of artifacts during VEEG monitoring. Comfort evaluation and comfort care before monitoring has great significance in raising the long-term VEEG monitoring accuracy.

Objective To evaluate the role of p38 mitogen-activated protein kinase (p38MAPK) in the spinal cord in the development of persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR) and the relationship with Toll-like receptor 4 (TLR4).Methods One hundred and twenty male SpragueDawley rats,weighing 200-250 g,aged 2 months,in which intrathecal catheters were successfully implanted,were randomly divided into 5 groups (n =24 each) using a random number table:sham operation group (group S),SMIR group,SMIR + dimethyl sulfoxide (DMSO) group (group DMSO),SMIR + p38MAPK inhibitor SB203580 group (group SB203580) and SMIR + TLR4 small interference RNA (siRNA) group (group TLR4siRNA).The rats were anesthetized with intraperitoneal chloral hydrate 400 mg/kg.The skin and superficial muscle of the medial thigh were incised and a small pair of retractors inserted.This tissue was retracted for 1 h causing potential stretch of the saphenous nerve.2％ DMSO 10 μl and SB203580 5 μg were injected intrathecally at 30 min before operation and 1-12 days after operation in DMSO and SB203580 groups,respectively.TLR4siRNA 2 μg was administered intrathecally at 1 day before operation and 1-12 days after operation once a day in group TLR4siRNA.Mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) was measured at 1 day before operation and 1,3,7,12 and 22 days after operation.Four rats in each group were sacrificed after measurement of MWT at each time point,and the L4-6 segments of the spinal cord were obtained for detection of the expression of phosphorylated p38MAPK (p-p38MAPK) by Western blot analysis.Results Compared with group S,MWT was significantly decreased after operation,and the expression of p-p38MAPK was up-regulated after operation in SMIR and DMSO groups.Compared with group SMIR,MWT was significantly increased after operation,and the expression of p-p38MAPK was down-regulated after operation in SB203580 and TLR4siRNA groups,and no significant changes in MWT and p-p38MAPK expression were found at each time point in group DMSO.Conclusion TLR4-triggered activation of p38MAPK in spinal cord is involved in the development of SMIR-evoked persistent postoperative pain in rats.

Objective To investigate the value of copy number variation analysis based on next-generation sequencing (NGS-CNVA) in the genetic analysis of missed abortion chorionic villi. Methods From August 2012 to May 2014, chorionic villi from 74 cases of missed abortion at 6-13 gestational weeks in Haidian Maternal and Child Health Hospital were collected and analyzed by karyotype analysis and NGS-CNVA. The results of the two methods were compared. Results (1) Karyotype analysis was carried out for the villi from the 74 missed abortion patients. Thirty cases were euploid, 26 cases were aneuploid, while 18 cases had structural abnormalities. The resolution of the karyotyping was 320 bands and the average report time was 22 days. (2) All of the 74 samples obtained NGS-CNVA results and the report time was 7-10 days. (3) The NGS-CNVA results of 56 cases were consistent with karyotype. Among them, 28 cases (28/56, 50%) had no copy number variants (CNV), and 19 cases (19/56, 34%)had CNV between 1 Mb and 10 Mb. 9 cases (9/56,16%) had CNV≥10 Mb found by NGS-CNVA, but not found by karyotyping. (4) According to the results of NGS-CNVA, karyotype were reviewed. The reviewed results found 7 cases with CNV<10 Mb and 3 cases with CNV≥10 Mb in 30 cases which got normal karyotype results at the first analysis. (5) Among the 18 cases of structural abnormalities, 6 cases were Robertsonian translocation. Sequencing technology could confirm the specific area of chromosome deletion/duplication in 8 cases, but could not locate them. Conclusions NGS-CNVA has lower failure rate, higher resolution, lower specimen requirement and shorter report time than karyotype analysis when used for the genetic analysis of missed chorionic villi . NGS-CNVA could be a useful genetic analysis method for the missed abortion villi.

Objective To carry out a molecular screening of Chinese common deafness gene mutations in Chinese pregnant women group,so as to expatiate on the content,provide molecular epidemiological data,reduce the birth rate and provide a theoretical basis to the deaf children. Methods The molecular detection was done to the pregnant women underwent normal antenatal care in our hospital,using gene chips to screen the four com?mon deaf genes(GJB2,GJB3,SLC26A4 and mitochondrial 12S rRNA)in China;then,the newborn infants carrying mutations were treated with the hearing screening,using the methods of Otoacoustic Emissions(OAE)and Brainstem Auditory Evoked Potentials(BAEP),and the husbands of mutation carrying pregnant women were adopted molecular testing of the deaf susceptibility genes in order to investigate the correlation of the rate of pregnant women carrying the mutant genes and newborn infants deafness. Results Totally 2 067 cases of pregnant women were accepted to do the molecular screening,there were 110 cases of deafness mutations detected(5.320%),in which GJB2 gene(67 cases),GJB3 gene(6 cases), SLC26A4gene(33 cases),mitochondrial 12SrRNAgene(4 cases)mutation detection rates were 3.240%,0.290%,1.600%and 0.190%,respec?tively;especially:GJB2gene 235 del C,GJB2gene 299 del AT double mutant 1 case;GJB2gene 299 del AT,GJB3gene 538 C>T double mutant 1 case;GJB2 gene 235 del C,SLC26A4 gene IVS7?2 A>G double mutant 1 case. About 108 cases children newborn accepted to do the hearing screening,in which 3 cases had problems with the left ear,3 cases with the right ear,and 4 cases with the double ears. Conclusion The use of ge?netic deafness gene chip to do the molecular diagnostics in pregnant women can be convenient,fast and efficient for prenatal diagnosis of deafness, which provides a theoretical basis and good method for reducing the birth rate of deaf children and should be popularized more widely.