ObjectiveTo discuss the clinical value of ultrasonically activated scalpel(UAS) in breast cancer patients who underwent 2-3 cycles of neo-adjuvant chemotherapy by comparing UAS and electric knives (EI) in modified radical mastectomy. MethodsFrom Jun.2009 to Aug.2011, 52 breast cancer patients taking 2-3 cycles of neo-adjuvant chemotherapy underwent modified radical mastectomy in our hospital. Among them, UAS group included 23 patients, and EI group included 29 patients.The 2 groups were compared in terms of the operation time, intraoperative blood loss, postoperative drainage tube duration, postoperative hospital stay, the number of lymph nodes retrieved, and the volume of subcutaneous hydrops.ResultsBetween the 2 groups, the difference of intraoperative blood loss and postoperative drainage tube duration had statistical significance(P ＜0.01 ).The difference of operation time, hospital stay, and subcutaneous hydrops had statistical significance ( P ＜ 0.05 ).The difference of the number of lymph nodes retrieved had no statistical significance ( P ＞ 0.05 ).ConclusionThere are good curative effects for breast cancer patients undergoing modified radical mastectomy by UAS and axillary lymph node dissection after neo-adjuvant chemotherapy, which is consistent with the conception of fast track surgery.

This paper,starting with sociology,mainly analyzes the factors which affect the college curriculum settings from such aspects as politics and ideology,economy and technology development level,educational thinking and perceptions as well as cultural tradition,which will be useful for reference on college curriculum settings.

Objective To analyze the distribution and drug resistance of Escherichia coli which separated from clinical.Methods Collecting the bacteria specimens to separating and training Escherichia coli,and then screening and monitoring drug susceptibility by The Dark Horse Microbial Analysis System,from January 2010 to July 2011.Results The Escherichia coli 486 strains which separated from clinical,the male 297 cases,female 189 cases,secretion separation 236 strains was the highest rate (48.56％),sputum 165 strains (33.95％),urine 39 strains (8.02％),and the rest of the sample 46 strains (9.47％).ESBLs 198 strains,which resistance in 19 antibiotics were higher than Escherichia coli,and it was multiple antibiotic resistance such as Aminoglycoside,Quinolone etc; Escherichia coli strains were sensitive to imipenem.Conclusion Escherichia coli which separated in surgery,respiratory tract,and urinary had a large proportion,and Resistance of Escherichia coli was serious,we should according to the Drug sensitivity of Escherichia coli,choose reasonable application of antibiotics,especially the ESBLs strains.We should strengthen the resistance testing,to provide reference for clinical rational drug use.

Objective To study the dilution model of the early pregnancy test strip for the quantitative detection of serumβ-hu-man chorionic gonadotropin(β-hCG)level by the Abbot AxSYM detection system and its application.Methods The detection re-sults of serumβ-hCG level in 5 612 outpatients and inpatients of the internal medicine department and the gynecology and obstetrics department during 5 years were retrospectively analyzed.In addtion,234 serum samples from the patients were collected for prelimi-narily determining the serumβ-hCG level by the early regnancy test strip and then the quantitative detection of serumβ-hCG level was detected by the Abbot AxSYM detection system.Results The retrospective analysis showed that 241 cases(4.6%)were low-age pregnant women.The qualitative screening was necessary.The screening model was successfully established.But one thing to note was that the part of serum sample needed to be taken out and put into another tube for determination.Conclusion Establishing the rational and effective dilution interpretation model of early pregnancy test strip for screening serumβ-hCG can bring the econom-ic and time benifits for the routine detection work of the Abbot AxSYM detection system.

With the popularity of heart disease and obesity,as an important part of the integrated management of heart disease,weight gradually attracting attention from all walks of life.This paper summarizes the 2013 to 2016,American College of Cardiology/American Heart Association (ACC/AHA) jointly launched by the obese patients lose weight guide and aimed at overweight or obese patients with the fone management based on the weight of the specific steps,and by the AHA and international diabetes groups put forward the treatment of type 2 diabetes and overweight or obesity surgery.

On June 20,2014 in Washington for a meeting of the heart,a think-tank.As a call to action,the meeting to define the cardiovascular disease~ prevention and control of new mode and method,to help solve the problem of merging high metabolic risk of cardiovascular disease.More than 20 representative groups participate in the discussion and meet the following consensus that metabolic syndrome is a complex pathophysiological state,is a process of gradual change,consisting of a series of known and unknown risk factors,and is associated with the severity of the disease.Treatment is the ideal mode of the metabolic syndrome,before the disease can accurately determine risk,identify the subtypes of disease,and identify the different stages of the disease,in order to better carry out prevention and treatment of cardiovascular disease.This new mode of prevention and control of determination needs establishment of consensus,and sustainable development of this control mode,the mode of authentication,in the future continue to optimize the mode.

Objective To determine the sites of action of propofol and isoflurane on somatosensory pathway using median nerve somatosensory evoked potential(MnSSEP) .Methods Twenty-six ASA I - II patients aged 20-50 yrs were randomly divided into two groups: I propofol group( n = 13) and H isoflurane group( n = 13) .In propofol group patients received propofol infusion at a rate of 10 mg?kg-1?h-1 .Oxygen was administered via mask and respiration was assisted or controlled to maintain SpO2 at 96%-100% and PETCO2 at 35-45 mm Hg. The propofol infusion was continued until the patient failed to respond to verbal command. Six minutes later if the patient was still breathing spontaneously, the rate of propofol infusion was increased to 20-40 mg?kg-1?h-1 . In isoflurane group anesthesia was induced with propofol 2 mg ? kg-1 and intubation was facilitated by succinylcholine and anesthesia was maintained with isoflurane inhalation and intermittent iv boluses of vecuronium. The end-tidal isoflurane concentration was maintained at 0.5,1.0 and 1.5 MAC. Each concentration was maintained for 15 minutes. MAP, HR, SpO2,PCTCO2, T0(naso-pharyngeal) and BIS were continuously monitored. MnSSEP( Viking IV D type) was measured and recorded before induction of anesthesia(baseline) and in propofol group when patients became unconscious and apneic; in isoflurane group when end-tidal isoflurane reached 0.5,1.0 and 1.5 MAC.Results In group I there was no change in both latencies and amplitudes of N9 and N13'.With increasing infusion rate, propofol gradually prolonged the latencies and decreased the amplitudes of N60, P45, N35, N20 and P25 waves. In isoflurane group there was no change in the latencies and amplitudes of N9. There was no change in the latencies of N13', but the amplitudes decreased at 1.0 and 1.5 MAC. With increasing concentration, isoflurane gradually prolonged the latencies and decreased the amplitudes of P45, N60, N35, N20 and P25 waves. At 1.5 MAC the inter-peak latencies between N13'-N20 and N13'-P25 were prolonged. Conclusions The sites of action of different infusion rates of propofol and different concentrations of isoflurane are different on somatosensory pathway. The higher the doses, more widespread are the sites of action.

The diffuse large B cell lymphoma (DLBCL) is the most common adult non-hodgkin lymphoma.At present,rituximab in combination with CHOP program has significantly improved the prognosis of DLBCL,and about 50％ of the DLBCL can be cured.However,due to the heterogeneity of the tumor,the refractory and relapsed DLBCL is still lack of effective treatment methods.With the application of gene expression profile (GEP) and the thorough research of the activation of lymphoma cells signal way,a lot of potential therapeutic targets have been found.

Objective To analyze the mental health status and personality characteristic of hyperplasia of breast,so as to provide sound scientific basis for enhancing the quality of life of those patients.Methods Assessments were made by using Symptoms Checklist 90 (SCL-90)and 16 Personality Factor Questionnaire (16-PF) for the mammary gland hyperplasia patients and the normal,and data were analyzed with SAS 9.2.Results (1)Significant differences were found in the scores of somatization,compulsion,sensitivity,depression,terror and paranoid between the byperplasia of breast and heahhy subjects.(2)Multivariate and unconditional Logistic regression analysis revealed that the protective factor of psychosomatic symptoms is the warmth stability and perfectionism which factor regression coefficient was negative; the risk factor of psychosomatic symptoms was the dominance,suspicion,apprehension and tension which factor regression coefficient was negative.Conclusions There are various psychological problems which affected by personality characteristic in the patients with breast hyperplasia,treatment should be optimized based on the personality characteristics of patients with breast hyperplasia,including changing negative attribution model,disseminating preventive knowledge,and finally improve the mental health condition of patients with breast hyperplasia.

MicroRNA-451 (miR-451) is significantly lowly expressed in glioma,gastric cancer,colorectal cancer,liver cancer and other tumor tissues.Upregulation of miR-451 can significantly inhibit tumor cell proliferation,invasion and metastasis as well as increasing tumor cell apoptosis and improving radiotherapy and chemotherapy sensitivity and other biological effects.