For the patients with early breast cancer,the effects of breast-conserving surgery combined with radiotherapy and radical resection are equal,and the former shows less adverse reactions and better aes-thetic outcome. Because of individual differences and the inherent complexity of tumor,to obtain optimal effects,it is an inevitable trend of making an individual comprehensive therapy,which is a combination of radiotherapy,chemotherapy,endocrine therapy and targeted therapy.

OBJECTIVE To probe the possibility for CQI to raise the passing rate of hand-washing liquid. METHODS From Jul 2007 to Sep 2007,we applicated continuous quality improvement(CQI) in the management of the use of hand-washing liquid. RESULTS The failure rate of hand-washing liquid was decreased markedly (64% in July,36% in August,and in 12%September),and the difference among three months was significant (P

Objective To evaluate the association between hyperglycaemia at admission and in-hospital outcomes in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). Methods Three hundreds and fifty-four patients with AMI and underwent PCI were divided into 3 groups according to the glucose level on admission: group A (n=132), ＜7.80 mmol/L;group B (n=120), 7.80-11.00 mmol/L;group C (n=102), ≥11.00 mmol/L. Results Patients in group C had higher cholesterol, low-density lipoprotein and triglycerides levels than those in group A. Compared with group A, there were higher incidence of multi-vascular diseases and higher corrected TIMI frame count (CTFC) in angiography in group B and group C. Cardiac events and in-hospital mortality in group B and group C were higher than those of group A, while statistical difference was found between group C and group A. Conclusion Elevated admission glucose level in AMI patients with primary PCI is associated with worse prognosis, increased major adverse cardiac events and higher in-hospital mortality.

Objective To discuss the diagnosis value of transrectal ultrasound and transabdominal ultrasound in fat sufferers with bladder tumor.Methods In own control,transabdominal and transrectal ultrasound were used to examine 87 fat patients with suspected bladder tumor.The tumors were confirmed by cystoscope and pathological section.They were divided into 3 groups according to the size:＜10 mm,10-20 mm,and＞20 mm,the detection rates of the tumors and blood flow in tumors,the diagnose accordance rates of the tumor stage of the two methods were analyzed.Results Of the 92 lesions pathologically confirmed to be bladder tumors,the diagnose accordance rate of transabdominal ultrasound was 79.3%,missed diagnosis rate was 1 7.4%,misdiagnosis rate was 3.3%,while the diagnose accordance rate of transrectal ultrasound was 95.6%,misseddiagnosis rate was 4.4%,misdiagnosis rate was 0.There was statistical significance on the detection rate of thetumor and blood flow in tumor of the two methods(P＜0.05).Also there was statistical significance on the diagnosis accordance rate of the tumor staging on Ta,T1,T2(P＜0.05).Conclusions As to detecting bladder tumors in fat sufferers,transreetal ultrasound iS obviously superior to transabdominal ultrasound.

Objective To evaluate the clinical value of CHO-hTSHR cells in detecting thyroid stimulating antibody (TSAb). Methods The cAMP production and TSAb activity were measured and cal-culated by stimulating CHO-hTSHR cell line with IgGs of normal control group and Graves" disease ( GD )group. TSAb positive standard was set to more than the mean + 2SD of TSAb activities in control subjects.The positive percentage of TSAb activity in GD group was calculated. Results The cAMP production and TSAb activities of GD group were higher than those of normal group[( 353. 65±126. 34 ) pmol/L vs (237.21±77. 15)pmol/L, ( 149. 08±53. 26)% vs ( 100±32. 52)%, P <0. 05] . The value that higher than 165% was set to be positive for TSAb. The positive percentage of TSAb in GD group was 50% ( 14/28). Conclusion CHO-hTSHR cell line constructed by our group is suitable for detecting TSAb activity in the sera of patients with GD.

Objective To discuss the value of amplitude integrated electroencephalographic(aEEG) monitoring in early neonatal brain injury and prognosis of asphyxia neonatal.Methods Seventy-two subjects of asphyxia children were divided into mild asphyxia group and severe asphyxia group.We selected 45 cases of full-term healthy children born in our hospital as control group in the same term.All the objects were observed by aEEG monitoring within 6 hours.According to the aEEG results,all the samples were redivided into normal aEEG group,mildly abnormal aEEG group and severely abnormal aEEG group.All subjects were followed-up to observe their physical growth and the nervous system development at one-year-old.Results Incidence of abnormal aEEG in mild asphyxia group and severe asphyxia group was significantly higher than that of control group(x2 =26.996,47.07,P ＜ 0.01,respectively),and incidence of abnormal aEEG in severe asphyxia group was significantly higher than that of mild asphyxia group (x2 =7.76,P ＜ 0.05).There was no significant difference in all subjects about physical development (height and weight) (P ＞ 0.05),all of their mental index and developmental quotient were lower in severely abnormal aEEG group (x2 =13.450,15.285,P ＜ 0.01,respectively).Conclusion aEEG can be used to assess the early neonatal brain injury of asphyxia neonatal,and it can be used to predict the prognosis of neonatal asphyxia based on the abnormal degree of aEEG.

Objective To explore the effect of practicing Chinese gymnastic Qigong-Yijinjing on the infrared radiant track along meridian course (IRRTM)of Ren Meridian stimulated by moxibustion on CV-8 among dysmenorrhea patients.Methods Twenty dysmenorrhea undergraduate patients were recruied and practiced Chinese gymnastic Qigong-Yijinjing for 3 months.The numbers of patients of mild,moderate and severe symptoms were collected before and after the intervention.The effects of IRRTM stimulated by moxibustion on CV-8 were compared before and after practicing Chinese Gymnastic Qigong-Yijinjing.Results After practicing Chinese Gymnastic Qigong-Yijinjing,symptoms of 15 patients (including 11 with moderate dysmenorrhea and 4 with severe dysmenorrheal)were relieved to different extent.After the practice,all IRRTM of Ren Meridian turn to be more continuous,clear and regular either the Ren Meridian was stimulated with moxibustion or not.The average surface temperature along Ren Meridian rose significantly after the practicing.The conduction time to achieve the best states of IRRTM along Ren Meridian significantly shortened compared to before the intervention.Conclusion Chinese Gymnastic Qigong-Yijinjing can effectively enhance the transmission of IRRTM along Ren Meridian on dysmenorrhea patients,and may have a positive effect on dysmenorrhea treatment.

Objective To study the features of anatomical delamination of the posterior renal fascia in CT images.Methods Clinical datas and CT images of 85 patients with acute pancreatitis were collected,the anatomical delamination features of the adult posterior renal fascia were observed and recorded.Results (1) 23 cases showed anatomical delamination of the left posterior renal fascia, 9 cases showed anatomical delamination of the right posterior renal fascia, and 8 cases showed anatomical delamination of bilateral posterior renal fascia.(2) The features of anatomical delamination of the posterior renal fascia were detected in the whole posterior renal fascia or in the lateral part of the posterior renal fascia.Anatomical delamination was detected in the whole left posterior renal fascia in 6 cases, and was detected in the lateral part of the left posterior renal fascia in 17 cases.Anatomical delamination was detected in the whole right posterior renal fascia in 4 cases and in the lateral part of the right posterior renal fascia in 5 cases.Anatomical delamination of the whole part in the bilateral posterior renal fascia were detected in 4 cases and pure delamination of the lateral part in the both sides were 4 cases.Conclusion CT images can show the anatomical delamination of the posterior renal fascia which has two types.The anatomical delamination of bilateral posterior renal fascia is not always the same.

Objective To explore short-term effect of tonsillotomy on children′s obstructive sleep apnea hypopnea syndrome (OSAHS) with tonsil hypertrophy by Ellman double-frequency radio-frequency machine .Methods Totally 30 cases children′s OS-AHS with tonsil hypertrophy were had tonsillotomy by Ellman double-frequency radio-frequency machine .They were compared with 30 cases children′s OSAHS with tonsil hypertrophy by traditional tonsillectomy .Short-term effect of tonsillotomy were ana-lyzed by wound bleeding ,operation time ,postoperative pain ,difficulty eating ,PSG testing ,immune function ,growth and develop-ment .Results Postoperative symptom in 1 weeks and 6 months ,compared with the traditional tonsillectomy ,30 cases of OSAHS patients were found that there were less bleeding ,shorter operative time ,mild postoperative pain ,no difficulty in feeding ,improving sleep-disordered breathing ,no decline in immune function ,good growth and development .Conclusion Short-term effect of tonsillot-omy on children′s OSAHS with tonsil hypertrophy is good by Ellman double-frequency radio-frequency machine ,it is a minimally invasive ,safe and effective surgical method children OSA HS .

Objective To analyze the difference of dosimetry and evaluate clinical efficacy and acute toxicity reaction between RapidArc and fixed gantry angle dynamic intensity modulated radiotherapy (IMRT) in advanced cervical carcinoma.Methods A total of 43 patients with locally advanced cervical cancer were studied,including 22 patients treated with RapidArc and 21 patients with IMRT.All plans were prescribed 50.4 Gy in 28 fractions.The conformity index and homogeneity index of the targets,the monitor units(MUs) and delivery time were compared.Incidence of acute intestinal and bladder side effects and rates of efficacy were calculated.Results The conformity index of RapidArc was better compared to IMRT.The V40 and V50 of bladder and V30,V40 and V50 of rectum planned by RapidArc was significantly lower than that by IMRT(t =-2.386,-2.397,P ＜0.05;t =-5.525,-2.883,-2.686,P ＜0.05).The mean dose of femoral head planned by RapidArc was also significantly lower (t =-2.395,P ＜ 0.05).For RapidArc,mean MU and treatment time were reduced by 53.15％,and 62.14％,respectively.There was no difference in the incidence of acute intestinal and bladder toxicity and rates of complete remission and efficacy between the two groups.Conclusions In dosimetric analysis,RapidArc showed advantage in protecting organs at risk and reducing treatment time in radical radiotherapy for locally advanced cervical carcinoma.