Objective To discuss the application value of cancer gene c-erbB-2 and its protein products P185 in evaluation of the diagnosis and prognosis of breast cancer with lymph node metastasis,and to explore the relationship between c-erbB-2 expression and tumor pathology classification,relapse.Methods 112 cases with mammary disease were selected as the research subjects.According to different clinical diagnosis,they were divided into breast cancer lymph node metastasis group,breast cancer without metastasis group and mammary gland benign pathological change group.The c-erbB-2 gene and carcinoembryonic antigen(CEA) were detected by immunohistochemical method,enzyme-linked immunosorbent(ELISA) and electrochemical luminescence method.The c-erbB-2 protein(P185)and CEA of the three groups were compared,the sensitivity and specificity of c-erbB-2 expression and CEA in the diagnosis of breast cancer with lymph node metastasis were analyzed.At the same time,the relationship between cerbB-2 expression and tumor pathology classification,relapse was analyzed.Results P185 and CEA index of breast cancer lymph node metastasis group and breast cancer without metastasis group were significantly higher than those of mammary gland benign pathological change group(t =7.093,6.443,9.232,8.508,all P ＜ 0.0 1),and P185 index of breast cancer lymph node metastasis group was significantly higher than without metastasis group (t =2.281,P ＜0.05),and there was no significant difference of CEA between the two breast cancer groups (t =0.406,P ＞ 0.05).The sensitivity of c-erbB-2 expression in dignosis of breast cancer lymph node metastasis had no difference with CEA (x2 =0.632,P ＞ 0.05),but the specificity was significantly higher than CEA(x2 =11.900,P ＜ 0.01).The positive expression rate of c-erbB-2 and tumor pathology classification had no obvious relation:Postoperative recurrence rate of c-erbB-2 positive expression patients was significantly higher than the negative expression patients(x2 =5.141,P ＜0.05).Conclusion c-erbB-2 gene and its protein product has good sensitivity and specificity in the diagnosis of breast cancer lymph node metastasis,and has obvious correlation with postoperative breast cancer recurrence,has important reference value in evaluation of the diagnosis and prognosis of breast cancer.

Objective To explore the clinical diagnosis value of colonoscopy and pathological examination for the etiology of colon and rectum ulcer.Methods 120 patients with colorectal ulcer were examined by colonoscopy and pathological examination,and differential diagnosed.Results The rate of endoscopic diagnosis combined pathological diagnosis for ulcerative colitis,tuberculosis,crohn's disease,amebic,chronic bacterium dysentery were different from the endoscopic diagnosis rate and pathological diagnosis rate,the differences were significant (x2 =12.37,13.58,15.02,17.77,18.39,P ＜ 0.05 ) ; In the nausea lymphoma,colorectal cancer,endoscopic diagnosis combined pathological diagnosis with quite a statistically significant difference between the rate of endoscopic diagnosis( x2 =10.95,11.40,P ＜ 0.05 ).Conclusion For the colorectal ulcer disease,colonoscopy combined pathological examination was an ideal means of inspection.

Objective To evaluate routine ultrasonography combined with virtual touch tissue imagine (VTI) in the diagnosis of thyroid nodules .Methods The aim of the present study was to evaluate clinical value of conventional ultrasound and VTI elastography for thyroid nodules .We selected 36 thyroid nodule cases from 2013 to 2014 of our hospital .Dimensional ultrasound , Color Doppler Flow Imaging ( CDFI ) and Virtual touch tissue imagine (VTI)were used for diagnosis, and postoperative pathology results were compared .Results The conventional ultra-sonic testing had sensitivity 100%, specificity 96.5%, and accuracy 83.3%; The sound palpation tissue imaging (VTI) test had sensitivity 96.1%, specificity 86.2% and accuracy 86.1%.It was statistically significant ( p<0.05).Conclusion Routine two-dimensional ultrasound, Color doppler flow imaging (cdfi) and Virtual touch tis-sue imaging ( VTI) in the diagnosis of benign and malignant thyroid nodules have their own advantages and character -istics.They should be combined in clinical , which can improve diagnostic accuracy in the diagnosis of benign and malignant.

Objective To investigate the knowledge of osteoporosis and its related behavior in middle-aged and elderly people.Methods A total of 1199 residents aged≥45 years in Hangzhou community were investigated by health survey questionnaire of osteoporosis.Results There were statistically significant differences in osteoporosis symptom scores according to ages (aged 45 to 59 years,6.38±2.64; aged 60 to 74 years,5.69±2.83; aged over 75 years,4.43±2.54),and according to education background (middle school or below.4.56± 2.01; secondary school,6.07±2.45; university or higher,8.25±2.69),and according to occupation (mental labour,5.89±3.21;manual labour,4.57 ± 2.36),and residence (city,6.12 ± 3.32 ; countryside,4.34 ± 2.25) (F/t =14.59,26.94,6.29,8.35,respectively,P＜0.01).There were significant differences in types ofexercise between rural and urban population (no exercise or little exercise,30.4％ vs.32.9％; light burden movement,64.4％ vs.53.5％; weight-bearing exercise,5.2％ vs.13.6％; x2 =22.13,P＜0.01).The significant food intake differences were found between rural and urban residents (milk,30.2％ vs.38.3％ sea-food,28.2％ vs.35.7％; bean-products,48.3％ vs.56.1％; fruit,52.6％vs.62.5％; coffee,3.2％ vs.7.4％; x2=8.55,7.77,7.21,19.37,10.14,respectively,all P＜0.01).Conclusions Health education should be individualized based on age,education level and occupation.The elderly and low education groups should be concerned.We should shift the focus of publicity and education to the countryside and enhance the awareness of osteoporosis prevention in order to build a healthy lifestyle.

Objective To investigate the expression of PES1 in ovarian cancer and its relationship with the vascular endothelial growth factor(VEGF) expression .Methods The expression of PES1 in ovarian cancer tissues and corresponding pericancerous tis-sues was detected with Western blot .Results The expression of PES1 in ovarian cancer tissues was obviously higher than that in the pericancerous tissues .The secretion amounts of VEGF in cell culture fluid of CAOV-3 and ES-2 with transfection of FLAG-PES1 were elevated from (178 .0 ± 11 .8) pg/mL and (309 .5 ± 18 .5) pg/mL to (375 .0 ± 18 .3) pg/mL and (633 .2 ± 25 .7)pg/mL respectively (P<0 .01) ,the secretion amounts of VEGF were also increased(P<0 .01) .The relative VEGF mRNA levels were also raised by 1 .8 times and 2 times respectively (P< 0 .01);Western blot simultaneously showed that the over expression of PES1 could increase the expression of HIF-1αin these two kinds of cells .The luciferase report gene transcriptional activation activity de-tection reveald that PES1 had no direct effect on the VEGF transcription .After cotransfecting HIF-1αSiRNA and FLAG-PES1 to CAOV-3 and ES-2 cells ,Western blot demonstrated that HIF-1αSiRNA could obviously inhibit the increase of HIF-1αexpression induced by PES1 ,at the same time the secretion amounts of VEGF and mRNA level were also supressed .Conclusion The expres-sion of PES1 is obviously up-regulated in ovarian cancer tissues .

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Lymphatic Diseases ; etiology ; pathology ; Male

Bacterial Infections ; diagnosis ; etiology ; therapy ; Brain Injuries ; etiology ; China ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Respiration, Artificial ; adverse effects ; Respiratory Distress Syndrome, Newborn ; diagnosis ; therapy ; Respiratory Insufficiency ; diagnosis ; therapy ; Respiratory Tract Infections ; diagnosis ; etiology ; therapy ; Systemic Inflammatory Response Syndrome ; diagnosis ; therapy ; Ventilators, Mechanical ; adverse effects

Objective To study the clinical characteristics of intrauterine re-adhesions treated by transcervical resection of adhesion (TCRA). Methods Between January 2012 and January 2015, 12 patients with intrauterine re-adhesions after TCRA in other hospitals had fertility requirements , including 10 cases of severe intrauterine adhesions and 2 cases of moderate intrauterine adhesions .In our hospital , the 12 patients underwent laparoscopic exploration and TCRA .After operation the patients were treated with artificial cycle therapy for 3 months and then underwent hysteroscopic examination . Results In the operation, the remaining of 50%endometrium was found in 1 case, the remaining of 30%endometrium was found in 1 case, and the remaining of 20%endometrium in 9 cases.Only petechial and patchy residual endometrial islands were found in 1 case.Uterine dysplasia was found in 3 cases.Re-examinations of hysteroscopy 3 months after surgery showed 4 cases of uterine cavity normal recovery , 6 cases of moderate intrauterine adhesions, and 2 cases of mild intrauterine adhesions .Follow-up for 18-42 months (mean, 28.5 months) in the 12 cases showed 2 cases of term pregnancy and 1 case of spontaneous abortion .The other 9 patients had no pregnancy , 3 of which withdrew the treatment and 6 of which underwent further treatment . Conclusions Patients with intrauterine re-adhesions usually have seriously damaged endometrium and poor recovery .We suggest that TCRA should be completed by experienced professionals to reduce the residual endometrial destruction , so as to improve the treatment outcomes of intrauterine adhesions .

Metformin improves glycemic control mainly due to improved insulin sensitivity.Dipeptidyl peptidase-4(DPP-4) inhibitor,which suppresses degradation of glucagon-like peptide-1 (GLP-1) and maintains the bioactivity of endogenous GLP-1,improves islet dysfunction.Moreover,recent studies suggested that metformin enhanced the biological effect of GLP-1 via different mechanisms and that DPP-4 inhibitor enhanced insulin sensitivity in type 2 diabetes.Therefore,the combination therapy of DPP-4 inhibitor and metformin could simultaneously ameliorate the two major defects of type 2 diabetes and obtain complementary and synergistic benefits for glycemic control.

OBJECTIVE:To provide reference for the construction of suitable evaluation index system for the implementation of National Essential Medicine System in community health service center.METHODS:The frame of evaluation index system was designed by theoretical analysis,literature study and expert interviews methods.Delphi method was used to establish evaluation index system for National Essential Medicine System in Shanghai community health service center.Analytic hierarchy process was adopted to determine the weights of indicators at all levels.RESULTS:The positive coefficients of the two rounds consultations were 88.24％ (15/17) and 86.67％ (13/15).The authority coefficient of structural index,processing index and result index in the first round consultation were 0.68,0.68 and 0.69,respectively,which showed that the authority degree was higher.The coefficient of concordance in the second round consultation was higher than the first round (the indexes of structure,process and result in two rounds consultation were 0.286,0.306,0.193 and 0.345,0.358,0.337,respectively),which indicated the expert opinions were highly consistent.Established evaluation index system consisted of 3 fiust-level indexes,13 second-level indexes and 27 third-level indexes.CONCLUSIONS:The selected experts were representative,the consultation results were reliable,established evaluation index system was rational and the setting of weights was scientific.Also this study was a methodological exploration.