Objective To summarize the experience of mammotome minimally invasive biopsy in detection of early breast cancer.Methods 1000 cases with breast lesions underwent minimally invasive surgery under imaging guided mammotome.Results By intraoperative frozen section,10 cases of early breast cancer was found,with 3 millimetre as the minimum lesion diameter,among whom 4 cases were intraductal carcinoma,5 cases were infiltrating ductal carcinoma,and 1 case was mixed carcinoma.Axillary lymph node metastasis was found in only 1 case.Conclusions Non-palpable small lesions cant be ignored.Ultrasound-guided mammotome minimally invasive surgery can accurately position and specifically diagnose non-palpable small lesions or multiple lesions,as well as suspicious malignant lesions.Benign lesions can be directly resected by uhrasound-guided mammotome minimally invasive surgery,which is of great value in detection of early breast cancer.

The performance appraisal (PA) system establishment in scientific research institutes on traditional Chi-nese medicine (TCM) plays an important role in the management of TCM research work, which can set up both well-defined guidance and favorable appraisal regimen for scientific researchers, so that leads to the accomplishment of the scientific objectives. However, current PA system establishment has fallen seriously behind the real demand in most TCM research institutes. As a result, there is a serious lack of a mature, efficient, standardized, propagable PA system in TCM research field. In this paper, we tried to discuss the current situation and key issues in building modern PA system in TCM research institutes. The PA system development in scientific research institutes on TCM was pointed out. The PA system should be based on existed referenced similar platforms, with full consideration on professional features and Chinese culture. The PA system establishment should be with most science, systematicness, objectivity, and guidance. The PA system should also be established to evaluate the scientific researchers equitably, guide the scientific trend, provide proper institute, and promote scientific research.

As the urgent need of both clinic and research,the identification of hypertonia subtypes is becoming more and more important. Hypertonia assessment tool is a standardized discriminative measure with good reliability and validity. Hypertonia assessment tool can identify paediatric hypertonia subtypes. For its easily learning,it can be easily generalized in clinician.

Objective To explore the clinical and echocardiographic characteristics of primary malignant pericardial mesothelioma (PPM).Methods Cases of PPM with description of echocardiographic presentations from China mainland were searched from database during 1981 to 2015.Data about the clinical and echocardiographic features of the patients were collected.Results A total of 122 patients were included for analysis.It involved mainly middle-aged [(39.9 ± 14.7)years] and male patients (79,64.8％).The most common echocardiographic demonstration was pericardial effusion (74.6％) with were mostly bloody (97.7％),followed by pericardial masses (36.9％) and pericardial thickening (18.0％).The echocardiographic diagnostic accordance rate was about 26.2％.Conclusions The most common presentation of PPM on echocardiogram is massive pericardial effusion.Echocardiography is of great value in screening and assessment of PPM.The definitive diagnosis is made by histopathological examination.

Objective To observe the anti-fibrosis therapeutic effect and mechanism of Qingshen granule for treatment of patients with chronic renal failure (CRF) accompanied by damp-heat syndrome.Methods Sixty-eight patients with CRF accompanied by damp-heat syndrome were randomly divided into a control group and a observation group, and the study was completed only in 61 patients, 31 in the control group and 30 in the observation group. Thirty subjects having taken physical health examination were assigned in a healthy control group. All the patients in both treatment groups were treated with conventional western medical therapy and traditional Chinese medicine (TCM) retention enema, and for patients in observation group, Qingshen granule was given additionally, 1 bag (10 g) thrice a day taken orally. The therapeutic course was 8 weeks. The clinical therapeutic effect, the levels of serum creatinine (SCr), the glomerular filtration rate (eGFR), serum interleukin-17 (IL-17), collagen type Ⅲ (Col-Ⅲ) and nuclear factor-κB p65 (NF-κB p65) in peripheral blood mononuclear cells (PBMC) were measured before and after treatment in the two treatment groups, and the above results were compared with those in healthy control group.Results Clinically, the total effective rates of the disease and of the TCM syndrome in observation group were significantly higher than those in the control group (86.67% vs. 58.06%, 83.33% vs. 45.16%, bothP < 0.01). In the observation group, the level of SCr was obviously lower, and the level of eGFR was markedly higher after treatment, and compared with the control group, the changes in above data after treatment in observation group were more significant [SCr (μmol/L): 250.62±164.97 vs. 393.72±183.64, eGFR (mL·min-1·1.73 m-2): 33.42±17.24 vs. 39.72±23.85, bothP < 0.05]. After treatment, the levels of serum IL-17, Col-Ⅲ and NF-κB p65 in PBMC were obviously lowered in both treatment groups compared with those before treatment, the therapeutic effect in observation group being superior to that in the control group [IL-17 (ng/L): 17.47±8.87 vs. 25.51±16.69, Col-Ⅲ (μg/L): 17.06±8.76 vs. 23.77±10.44, NF-κB p65 (μg/L): 0.58±0.34 vs. 0.83±0.30, allP < 0.05].Conclusion The Qingshen granule can ameliorate the clinical symptoms, improve renal function, decrease the levels of serum IL-17, Col-Ⅲ and NF-κB p65 in PBMC, intervene renal fibrosis in patients with CRF and damp-heat syndrome, ultimately delaying the progress of CRF.

Objective To investigate the effect of fructose-1,6-diphosphate (FDP) pretreatment on myocardial connexin 43 (Cx43) in a rat model of acute myocardial ischemia.Methods Thirty-six male Sprague Dawley rats (aged 8-12 weeks and weighing 220-280 g) were randomly divided into three groups (n =12 each):sham operation group (group S),ischemia group (group Ⅰ) and FDP + ischemia group (group F).The animals were anesthetized with intraperitoneal injection of 10％ chloral hydrate 40 mg/100 g,then tracheostomized and mechanically ventilated.Acute myocardial ischemia was induced by occlusion of the left anterior descending coronary artery for 30 minutes.Myocardial ischemia was verified by elevation of the S-T segment on echocardiogram (EGG).In group F,FDP 100 mg/kg was injected intravenously 10 minutes before ischemia.The hearts were removed after 30 minutes of myocardial ischemia.The myocardial infarct size (IS) and area at risk (AAR) were measured and the IS/AAR ratio was calculated.The expression of myocardial Cx43 protein was determined by immunohistochemestry and analysis of mean optical density.Results The severities of arrhythmia were significantly higher in groups F and I than in group S,while lower in group F than in group Ⅰ (P＜ 0.05).The IS/AAR ratio was significantly lower in group F than in group Ⅰ.The myocardial Cx43 protein expression was down-regulated in group Ⅰ and group F as compared with group S,and was significantly lower in group Ⅰ than in group F.Conclusion FDP pretreatment can protect myocardium against acute ischemia by up-regulation of myocardial Cx43 expression.

Objective To evaluate the effects of sulforaphane preconditioning on cognitive dysfunction induced by sevoflurane anesthesia in aged rats.Methods Thirty Sprague-Dawley rats,aged 22 months,weighing 380-560 g,were randomly divided into 3 groups (n =10 each) using a random number table:control group,sevoflurane group (Sev group),and sulforaphane group (Sul group).In group Sul,sulforaphane25 mg/kg was administered by oral gavage once a day for 7 consecutive days,while the equal volume of distilled water was given instead of sulforaphane in Sev and C groups.Groups Sev and Sul inhaled 3％ sevoflurane in oxygen (2.5 L/min) and group C inhaled air (100 min/d) for 5 consecutive days starting from the end of gavage.At 24 h after sevoflurane inhalation,cognitive function was detected using Morris water maze and open field tests.The escape latency,frequency of crossing the original platform,the number of crossing the grid,the number of standing on the back legs and the time the animals spent in the central square were recorded.Results Compared with group C,the frequency of crossing the original platform,the number of crossing the grid,and the number of standing on the back legs were significantly reduced,the time the animals spent in the central square and escape latency on 1st day were prolonged and no significant changes were found in the escape latency on 2nd-4th days in group Sev.Compared with group Sev,the frequency of crossing the original platform,the number of crossing the grid,and the number of standing on the back legs were significantly increased,and the time the animals spent in the central square and escape latency on 1st day were shortened.Conclusion Sulforaphane preconditioning can improve the cognitive dysfunction induced by sevoflurane anesthesia in aged rats.

Objective To investigate the effect of sevoflurane anaesthesia on the cognitive function and phosphorylation of tau protein in hippocampal neurons in amyloid precursor protein (APP) transgenic mice.Methods Male APP gene mutation mice,weighing 18-22 g and aged 8-12 weeks,were used in this study.Forty-four APP positive mice were randomly divided into two groups:sevoflurane group (group AS,n =28) and control group (group AC,n =16).And other forty-four APP negative mice were randomly divided into two groups:sevoflurane group (group S,n =28) and control group (group C,n =16).The animals in groups S and AS inhaled 3％ sevoflurane for 4 hours.While in groups C and AC,the animals inhaled pure oxygen for 4 hours.Morris water maze was performed 24 hours after sevoflurane or pure oxygen inhalation.The phosphorylation of tau protein at Ser262 and Ser396 sites was detected by Western blotting on 1 day after pure oxygen inhalation in groups AC and C,and on 1,3 and 7 days after sevoflurane inhalation in groups AS and S.Results Compared with group C,the escape latency was significantly prolonged and the duration of staying at the original platform quadrant was shortened in groups S and AC,and the phosphorylation of tau protein at Ser262 site in group S and phosphorylation of tau protein at Ser262 and Ser396 sites in group AS were increased (P ＜ 0.05).Compared with group S,the escape latency was significantly prolonged,the duration of staying at the original platform quadrant was shortened,and the phosphorylation of tau protein at Ser262 and Ser396 sites was increased in group AS (P ＜ 0.05).Compared with group AC,the escape latency was significantly prolonged,the duration of staying at the original platform quadrant was shortened,and the phosphorylation of tau protein at Ser262 and Ser396 sites was increased in group AS (P＜0.05).Conclusion Sevoflurane anesthesia can aggravate the impairment of cognitive function in APP positive mice and the increase in the phosphorylation of tau protein at Ser262 and Ser396 sites is involved in the mechanism.

Objective To evaluate the efficacy of a two-step infusion therapy with meropenem against noso-comial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmonary disease.Methods 112 elderly patients with nosocomial multi-drug resistant Pseudomonas aeruginosa infections and chronic obstructive pulmonary disease were randomized into two groups:two-step infusion therapy group ( rapid first-step infusion in 30 minutes and slow second-step infusion in 2.5 hours) and traditional 30 minutes infusion therapy group.The antibiotic clinical efficacy and bacteriological efficacy were observed between two groups .Results The clinical efficacy of observation group and control group were 82.2%(46/56) vs 57.1%(32/56).The difference was statistically significant(χ2 =10.185,P<0.05);The bacteriological efficacy of observation group and control group were 75.0%(42/56) vs 46.4%(26/56),The difference was statistically significant (χ2 =10.265,P<0.05). Conclusion The clinical efficacy and bacteriological efficacy of two-step infusion therapy with meropenem against nosocomial multi-drug resistant Pseudomonas aeruginosa infections in elderly patients with chronic obstructive pulmo -nary disease were superior to the traditional therapy .

Objective To analyze the clinicopathological features and prognosis of patients with occult breast cancer ( OBC) , as well as to explore the best treatment .Methods The clinical data of 72 patients with OBC confirmed by pathology were retrospectively analyzed , while 320 cases with other kind of breast cancer were the control group .Results Axillary mass was the first sign of the 72 patients with OBC.The diagnosis rate of MRI was higher than mammary graphy ( 71.4% vs 53.5%) .The difference had statistical significance (χ2 =11.876, P=0.001) .The characteristics of OBC with axillary lymph node metastasis was mainly moderately or low differenti -ated, usually with diffuse infiltrative cancer cells , flaky, like large Apocrine cells.Compared with the control group, the positive rate of CK7, CK20 and TTF-1 had no statistical differences (χ2 =0.058, P=0.810).The posi-tive rate of ER and PR was 46.7% and 36.7%, lower than the control group (χ2 =4.535, P=0.033).Clinical stage, operating method and the number of lymph node metastasis may be the independent factors influencing prog -nosis.Conclusions Axillary mass is the first symptom of OBC .To combine MRI with immunohistochemistry is helpful in diagnosis and differential diagnosis of the disease .The positive rate of ER and PR for OBC patients is low.Modified radical mastectomy combined with adjuvant therapy may be the better choice .