Objective To investigate the efficacy,side effects and cosmetic effects of breast-conserving operation combined with radiotherapy for patients with breast cancer. Methods Forty-three patients with early stage of breast cancer(n=30 for stage I and n=13 for stage II) were performed extended resection plus axillary lymph node dissection or quadrant resection plus axillary lymph node dissection.After operation,tangential field irradiation was conducted with 50 Gy of X ray,tumor bed was irradiated with additional 10 Gy of electron beam,and supraclavicular field irradiation was also administered with 30 Gy of X ray and 22 Gy of electron beam. Results There was no recurrence during the follow up for 14 to 50 months.The acute side effects of radiotherapy included breast complaints(n=10,grade Ⅰ,23.26%),skin erythema and hyperpigmentation(n=19,grade Ⅰ,44.19%),moist desquamation(n=5,grade Ⅱ,11.63%) and radiation esophagitis(n=4,grade Ⅰ,9.30%),while one patient experienced radiation esophagitis one month after radiotherapy.No such complications as skin fibrosis and necrosis,angiotelectasis,breast and upper extremity edema occurred.The short-term cosmetic effects were satisfactory to 93.02% of all the patients. Conclusion For early stage of breast cancer(stage I and stage Ⅱ),breast-conserving operation combined with radiotherapy may yield satisfactory survival rate and short-term cosmetic effects,as well as low incidences of side effects.

Objective To evaluate the role of arthroscopy in diagnosis and treatment of osteoarthritis of the knee.Methods The data of 108 patients (118 knees) with osteoarthritis of the knee and received arthroscopic surgery were analyzed retrospectively including sign, X-ray and MRI examinations of knee, the average stage in hospital, diagnoses before and after operation, and prognosis.Results Arthroscopic surgery was of benefit to diagnosis and treatment of osteoarthritis of knee. The average stage in hospital was 11±7 days. The following-up of 98 patients showed that 82 patients were excellent, 16 patients good and only 1 patients not up to standard.Conclusion Arthroscopic surgery has following advantages such as less invasive surgery, shorter stage in hospital, good curative effect in the near future.

Objective To study the significance of detecting the mutations of K-ras gene in faecal for diagnosis colorectal carcinoma.Methods 36 cases suffering from colorectal carcinoma,24 cases from colorectal benign diseases and 24 cases from healthy subjects,all cases had been diagnosed by enteroscope. K-ras gene mutation at the codon 12 was detected by PCR-RFLP,DNA was taken from faecal in modified method.Results K-ras mutation rate in colorectal carcinoma was 77.8 %,colorectal benign diseases was 25.0 %,healthy cases was 8.3 %.Conclusion Detecting the mutations of K-ras gene in faecalmay improve the rate of diagnosing colorectal carcinoma.

Objective To survey the scientific research integrity situation of community health care organizations in Yangpu district in Shanghai,meanwhile,provide a reference for scientific research integrity management in any community health care organization.Methods Using the convenience sampling method,we sampled 200 health staff from 4 community health service centers.They were surveyed with uniform questionnaires.Results No dramatically relationship existed in health staff's knowledge about scientific research integrity breach and their age.However,education background,their academic titles,how many times they have learned relative information,publicity about science research integrity would impact their awareness on research integrity.Conclusions There is dramatically discrepancy on the scientific research integrity among these community health staff.

Objective:To evaluate the clinical application of human serum albumin in the inpatients in our hospital to promote its rational use. Methods:Totally 1 183 cases were selected from the inpatients treated with human serum albumin from January to De-cember in 2014, the clinical department, classification of diseases, age distribution and relevant concentration checks of serum albumin in the inpatients were analytically reviewed. Results: Totally 26 clinical departments were involved in the use of human serum albu-min,mainly in the digestive departments and ICU. The elderly patients aged above 65 years accounted for great proportion (47. 68%). In addition, all patients had relevant concentration checks of serum albumin. Conclusion:The patients with digestive diseases tend to have the largest consumption proportion of human serum albumin in our hospital. It is important for physicians to strictly follow the indi-cations of medication in using human serum albumin.

A 65-year-old woman presented with intermittent right hand numbness and elevated serum creatinine for more than 2 months. The histological examination of kidney biopsy showed renal arterioles occlusion and interstitial fibrosis. Pathological abnormality was originally considered as a part of systemic atherosclerosis. Thus, rosuvastatin 20 mg/d, fosinopril 10 mg/d, metoprolol 47.5 mg/d and aspirin 0.1g/d were administrated. No improvement of renal function was seen. Further Congo red staining was applied. Diffuse amorphous eosinophilic substance was deposited in interlobular artery and small arteriolar artery. Combined with the abnormal free light chain (FLC) level and ratio (serum κ 340 mg/L, κ/λ 10.932), the diagnosis of systematic light-chain amyloidosis was confirmed. The patient received 3 courses of chemotherapy regimen as BCD (bortezomib 2 mg d1, 8, 15, 22, cyclophosphamide 0.3 g d1, 8, 15, 22 and dexamethasone 40 mg d1, 8, 15, 22). A hematologic partial response was achieved and serum creatinine decreased to 180 μmol/L.

Objective To construct recombinant adenovirns containing small interfering RNA (siRNA) targeting human VEGF-C mRNA,then to study the inhibitory effects of adenovirus-mediated VEGF-C siRNA on growth and lymphangiogenesis of human colon cancer in BABL/c nude mice model.Methods In vitro:the specific siRNA sequence targeting human VEGF-C mRNA was selected.The homologous double-strand DNA was designed and synthesized.After such DNA was inserted into pDC316-EGFP-U6 by BamHI and HindⅢ,pDC316-VEGF-C siRNA-EGFP-U6 was obtained,then it was co-transfected into 293 cells with the hone plasmid pBHGF35.After generated by homologous recombination,Ad5F35-VEGF-C siRNA-EGFP-U6 was obtained,and it was packaged and amplified in 293 cells.The human colon cancer model was established in nude mice by hypo-injection LoVo cells.They were divided randomly into four groups (n=6):adenovirus,virus without target gene,single siRNA and PBS control group.Injecting intervention intra-tumorly in each groups,calculating the tumors volume and drawing the growth curve,calculating micro-vascular density (MVD) and micro-lymphatic density (LVD) by staining respectively of the lymphatic and vascular with anti-LYVE-1 monoclonal antibody and anti-CD<,34> monoclonal antibody were completed.Results Adenovirus group tumor sizes were smaller than other groups.The LVD were 8.47±2.1 and 17.35±4.7 (P<0.05) in adenovirns group and the PBS control group.The MVD were 22.65±6.04 and 23.19±7.63 (P>0.05) in adenovims group and the PBS control group respectively.Conclusion The adenovirus-mediated VEGF-C siRNA can significantly inhibit the growth and lymphangiogenesis of human colon cancer in nude mice model,hut have no effect on microangium vessels growth.

This article first elaborates the connotation of research integrity,and analyzes the causes of the problems,then enumerates the typical examples of research misconduct.Based on those analyses,we explored possible solutions to prevent such problems.Relevant departments should consummate relevant law and regulations to improve the system,to avoid the emergence of research integrity problems,guarantee high quality of research.

Objective To explore the advantages of the technique of bile duct mini-incision (BDM) for stone removal in choledocholithiasis,and to further clarify the indications for T tube insertion during surgery.Methods 85 BDM operations were performed.The use of MRCP (Magnetic resonance cholangiopancreatography),Advantage Workstation AW4.2 0.7sdc software,choledochoscopic imaging system and illustrations were used to study the applicability of the BDM technique in stone removal.Results The width of common bile duct (CBD) was usually over 8 mm in the patients with choledocholithiasis,and the width was related to the number and size of the stones.In the patients who had a CBD width of over 11mm (n 16),the MRCP stone imaging area (MRCP-SIA) was significantly larger when compared with that [(148±67)mm2 vs.(47±31)mm2,P＜0.05] in the patients (n=14) with CBD width of less than 11 mm.T tube insertion for secondary choledochoscopic examination should be performed when the stones were non drifting,multiple,and closely related to the lower part of CBD indicating difficulty in complete stone removal.Conclusions Unnecessary T tube insertion could be avoided by the BDM technique for stone removal which was especially suitable for patients with early diagnosis of choledocholithiasis.T tube insertion should only be performed in patients with difficulty in complete stone removal and in other complicated situations.

Objective To evaluate the effectiveness of urgent surgical correction for infra-cardiac total anomalous pulmonary venous drainage (TAPVD) in infants and children. Methods From July 2000 to April 2009, seventeen patients with infra-cardiac type of total anomalous pulmonary venous connection received surgical correction in our department. The age of patients ranged from 15 days to 3.7 months at admission, 9 patients ( 52.9 % ) were younger than 1 month of age. The mean body weight was (4.10 ±0.95) kg and was less than 5 kg in 15 patients (88.2%). Deep hypothermic circulatory arrest (DHCA) without cerebral perfusion was used in 13 patients (76%), and continuous hypothermic low-flow perfusion was used in4 (24%). Incisions on the left atrium and pulmonary veins were sutured without tension, and the width of the anastomosis was 2.5 to 4.0 cm. Results Urgent operations were performed in all patients and no early death occurred during surgery.Mean bypass time was 121.9 minutes ( ranging from 70 to 277 minutes) and mean aortic cross-clamp time was 44 minutes ( ranging from 30 to 74 minutes). 6 neonates had delayed wound closure after surgery and 4 had obvious pulmonary edema. Inhalation of nitric oxide was given to 5 cases for the management of significant postoperative pulmonary hypertension, while peritoneal dialysis was performed in 2 cases with temporary renal failure. Transient atrioventricular block of grade 3 occurred in 2patients and acute renal failure occurred in 2 cases. All patients were uneventfully discharged. The mean ventilation time was 45 h (ranging from 12 to 430 h). Mean duration in ICUs and hospitals were 15 days ( ranging from 4 to 40 days) and 22. 5days ( ranging from 10 to 42 days), respectively. During the period of follow up, one patient presented with pulmonary venous obstruction and recurrent pulmonary infection with increased flow speed at the site of anastomosis, pulmonary hypertension and tricuspid regurgitation on echocardiogram. No improvement was observed in the patient spite of medical treatment and he was lost during follow up one year after operation. 16 patients received postoperative follow up for 1 month to 9 years, mean (51.8 ± 35.0) months. Echocardiography, chest radiography, and ECG were performed during this period. As a result, most children had good cardiac function, with sinus rhythm on ECG and apparently reduced pulmonary congestion on radiography.No obstructive pulmonary venous return was observed on echocardiography. Most patients had good cardiac functions. Conclusion Corrective operation for infra-cardiac TAPVC on urgent basis may provide favorite outcomes. The prognosis is associated with the size of anastomosis between the pulmonary vein and left atrium, as large anastomosis may prevent the obstruction of pulmonary venous retum.