OBJECTIVE:To observe the effect of compound glycyrrhizin on patients with chronic type B hepatitis.METH_ ODS:126patients with chronic type B hepatitis were randomly divided into two groups:the control group was administered with common therapy like reducing jaundice and protecting liver;the trial group was administered with compound glycyrrhizin plus the therapy of the control group.Time of therapy for both groups was8wk.RESULTS:The total effective rates for the tri_ al group and the control group were93.6%and33.3%,respectively,and significant differences were noted between groups(P

Objective To investigate the pathogenesis of diagnosis and treatment for delayed gastric emptying(DGE) after pancreaticoduodenectomy(PD).Methods The clinical data of 226 patients admitted between 1983 and 2001 undergoing PD were retrospectively analysed.Results In 226 PD cases DGE was observed in 62 patients(27.4%). Patients with DGE had longer duration of nasogastric tube drainage(21 days vs. 5.6 days).All patients were treated by non-operative methods. The average recovery time was 21 days.Conclusions It is emphasized that DGE has been associated with several factors, including preoperative status of diabetes, bowel obstruction, and jaundice,and postoperative pancreatic fistula, intra-abdominal abscess. Octreotide administration had no relation with the occurrence of DGE.

ObjectiveTo evaluate the potential prognostic factors, and to better define appropriate treatment strategies for patients with phyllodes tumor of the breast. MethodsFourteen patients treated primarily for phyllodes tumor of the breast were reviewed retrospectively.Results The median age was 35 years. According to the histologic criteria of WHO, there were 5 benign cases(36%), 5 borderline cases(36%), and 4 malignant cases(29%). Seven patients underwent local excision, 4 cases did simple mastectomy, and 3 cases did modified radical mastectomy. Follow-up was obtained for 11 cases, with an average of 19 months. One patient died from metastasis 2 years after a modified radical mastectomy. Three patients treated by local excision presented local recurrence.Conclusion The outcome of phyllodes tumor appears to be determined by the biology of the tumor rather than by treatment modality. A wide local excision, with an adequate margin of normal breast tissue is the preferred initial therapy for phyllodes tumor of the breast.

Objective To assess the value of combined detection of enterovirus nucleic acid and antibody in early etiological diagnosis for hand-foot-and-mouth disease ( HFMD).Methods A case-control study was conducted.A total of 1 066 cases of children clinically diagnosed with HFMD from Hangzhou Children′s Hospital were involved into the research group from January to June 2014, consisting of 401 common cases and 665 severe cases; Throat swabs and serum samples from these children underwent combined detection for EV71/CA16/EV of enterovirus nucleic acid by fluorescence quantitative RT-PCR and for EV71/CA16-IgM by ELISA.All data were analyzed with SPSS 16.0.Results The total positive rate of enterovirus nucleic acid EV71/CA16/EV by fluorescence quantitative RT-PCR in the 1 066 cases of children clinically diagnosed with HFMD was 75.52%( 805/1 066 ) ( 95%CI: 72.80%-78.05%).But the total positive rate of combined detection was 91.46%( 975/1 066 ) ( 95%CI:89%.58-93.04%).The total positive rate of combined detection is higher than that of RT-PCR test(χ2 =98.338,P=0.000).The positive rate of EV71 type of combined detection was 64.63%(689/1 066)(95%CI:61.67%-67.49%),which is 15.38%higher than that of RT-PCR test 49.25%(525/1 066)(95%CI:46.21%-52.29%)(χ2 =51.453, P=0.000).In 665 severe cases of HFMD, the total positive rate of combined detection was 96.69%(643/665)(95%CI:94.95%-97.87%), which is higher than that of RT-PCR test 79.25%(527/665)(95%CI:75.92%-82.22%)(χ2 =95.607, P =0.000).In the severe cases, the positive rate of EV71 type of combined detection was 87.52%( 582/665 ) ( 95%CI:84.71%-89.89%) , which is 18.95% higher than that of RT-PCR test 68.57%(456/665) (95%CI:64.87%-72.06%) (χ2 =69.665, P=0.000).In the fatal cases, the positive rate of EV71 type of combined detection was 95.92%(94/98) (95%CI:89.28%-98.68%).Conclusions The combined detection of enterovirus nucleic acid and specific IgM antibody can significantly increase the positive rate of HFMD, especially for severe cases.The combine detection increases both the total positive rate and EV71 positive rate.Thus it has a high potential for becoming a new guidelines for laboratory diagnosis of HFMD.

Objective To observe the effects of cyclovirobuxinum D(Cvb-D)on the myocardium cell apoptosis of myocardial ischemia rats.Methods The rats were given Cvb-D 0.55,1.1 and 2.2 mg/kg orally per day for 21 days respectively.The myocardial ischemia model was induced by isoprenaline intraperitoneal injection.Myocardium tissue was observed under light microscope and end labelling TUNEL method was used to determine the cell apoptosis.Then the average percentage of apoptosis cell was figured out to evaluate the effect of Cyb-D.Results Cvb-D obviously lightened isoprenaline-induced myocardial pathological changes such as turbulence of myocardial fiber,plasmolysis of necrotic cell,inflammatory cell infiltration of necrotic interstitial region.Cvb-D remarkably inhibited myocardium cell apoptosis of myocardial ischemia rats caused by isoprenaline.Conclusion Cvb-D has the action of ameliorating myocardium cell apoptosis caused by myocardial ischemia.

Objective To examine the therapeutic effect of Kummerowia striata (KS) on IgA nephropathy (IgAN) rats.Methods Sixty SD rats were equally randomized into 6 groups after adaptive feeding for 3 days:blank control group,model control group,tripterygium glycosides (TG) group (in the dose of 0.0165 g/kg),and high-,middle-and low-dose KS groups (in the dose of 16.0,8.0,4.0 g/kg respectively).IgAN rat model was established with bovine serum albumin (BSA),lipopolysaccharide (LPS) and carbon tetrachloride.After modeling,rats except those in blank control group received gastric gavage of corresponding drugs for 10 continuous weeks.Levels of 24-hour proteinuria and hematuria in each group were measured,serum levels of total protein (TP),serum albumin (ALB),aspartate aminotransferase (AST),and alanine aminotransferase (ALT) were tested.The pathological changes of renal tissue were observed under light microscope by HE staining.Results Water decoction of KS could significantly decrease the proteinuria and hematuria levels,and reduce renal pathological changes of IgAN model rats.However,water decoction had no effect on indicators of liver function such as TP,ALB,AST,and ALT in IgAN rats.Conclusion KS has certain therapeutic effect on IgAN model rats.

Objective To explore the clinical characteristics,pathology,prognosis and proper treatment of tubular carcinoma of the breast. Methods The clinical data of 11 patients with tubular carcinoma of the breast treated in Peking Union Medical College Hospital were retrospectively analyzed.Results The incidence of tubular carcinoma of the breast account for 0.4% of the total breast cancer cases.Eight out of 11 cases had palpable painless lumps in the breast.Six cases received modified radical mastectomy,among which one patient received modified radical mastectomy of both sides.Four patients underwent breast conservation therapy.Sentinel lymph nodes biopsy was conducted in 2 patients.By immunohistochemistry ER was positive in 6 cases,PR was positive in 7 cases,2 cases were axiilary lymph node positive.Three patients received chemotherapy.Two patients received endocrine therapy(tamoxifen or aromatase inhibitor).Other patients received combined therapy including radiation,endocrine therapy and chemotherapy.All the patients have been followed up from 1 month to 7 years and within the period there is no recurrence,metastasis and death. Conclusion Tubulax carcinoma of the breast is a kind of low malignant tumor.Proper surgery and adjuvant therapy is important to improve survival and the quality of life.

Objective To discuss the application of microsurgery in the treatment of male infertility.Methods From March 2007 to March 2012,there were totally 853 infertile men received microsurgical treatments in our department.Among them,344 patients with unilateral or bilateral varicocele underwent microsurgical varicocelectomy,60 underwent vasovasostomy (VV) and 192 underwent vastoepidystomy (VE)in microsurgical methods due to obstructive azoospermia.257 non-obstructive azoospermia (NOA) patients were performed microdissection of testicular sperm extraction (MD-TESE),at the same time,pathologic examination was done.Results ①For the varicocele patients,the pre-operative sperm density was (10 ±6) × 106/ml,the progressive sperm percentage was (16 ± 9)％.The post-operative density was (15 ± 8) ×106/ml,the progressive sperm percentage was (28 ± 14)％.The natural pregnant rate was 10.8％ (37/344).②In 60 patients undergone VV,the patent rate was 80.0％ (48/60),the natural pregnant rate was 35.0％ (21/60).In 192 VE patients,the patent rate was 53.1％ (102/192),the natural pregnant rate was 19.8％ (38/192).③In 257 NOA patients,the testicular volume,sperm retrieval rate of MD-TESE was significantly higher than that of conventional testicular sperm extraction (60.3％ vs.38.1％).Conclusion The microsurgery techniques in male infertility treatments could have some advantages such as explicit effects and decreased injuries.

Objective To explore the association of estrogen receptor β expression with different stages and molecular subtypes of invasive breast cancer.Methods The clinicopathologic data of 446 invasive breast cancer cases was retrospectively analyzed.ERβ expression was evaluated by types and stages.Results Of all 446 invasive breast cancer cases,328 (73.5％) were ERβ positive.The ERβ positive rate was 77.9％ (240/308) and 63.8％ (88/138) in ERα + group and ERα-group,respectively.The ERβ expression in breast cancer was positively correlated with ERα (P ＜ 0.01) while it had no correlation with PR,histological grade,HER-2 and Ki-67 (P ＞ 0.05).ERβ expression was not significantly different among different age,tumor size and axillary lymph node groups(all P ＞ 0.05).A total of 418 invasive breast cancer cases were recruited for pathologic stage and NPI analysis,including 168 cases at stage Ⅰ,152 cases at stage Ⅱ and 98 cases at stage Ⅲ.ERβ expression was not significantly different among different stages of breast cancer(P =0.743).Analyzed in these 418 cases,NPI was ＜ 3.4 in 126 cases,3.4-5.4 in 207 cases and ＞ 5.4 in 85 cases.ERβ expression was not significantly different among different NPI group (P =0.644).The ERβ positive rate in Luminal A subtype,Luminal B1 subtype,Luminal B2 subtype,HER-2 subtype and TN subtype was 75.6％ (88/118),75.9％ (110/145),85.2％ (46/54),68.4％ (39/57) and 62.5％ (45/72) respectively.ERβ expression was significantly different between Luminal subtype and non-Luminal subtype (P =0.007).Conclusions ERβ was not differentially expressed among different breast cancer stages and NPI groups.ERβ was differentially expressed in different breast cancer molecular subtypes.

Objective:To analyze the distribution, clinico-pathologic features, and survival status of different subtypes in axillary lymph node-negative invasive breast cancer patients. Methods:In this study, data of 183 patients were included and retrospectively ana-lyzed in terms of age distribution, clinico-pathologic features, disease-free survival (DFS), and overall survival based on different sub-types (luminal, basal-like, and HER-2 over-expression). Results:No significant differences in age, tumor size, and TNM stage was ob-served among different subtypes. The relapse rates of luminal, basal-like, and HER-2 over-expression subtypes were 3.9% (4/102), 20.4% (10/49), and 6.3% (2/32), respectively (P=0.002). The death rates of luminal, basal-like, and HER-2 over-expression subtypes were 2.0%(2/102), 6.1%(3/49), and 3.1%(1/32), respectively (P>0.05). Kaplan-Meier analysis showed that the DFS of basal-like sub-type was much lower compared with that of the luminal and HER-2 over-expression subtypes (P=0.002). Cox analysis showed that the subtype was an independent prognostic indicator (P=0.001). Conclusion:In node-negative invasive breast cancer, no significant differ-ences in age distribution, tumor size, and TNM stage was observed among different subtypes. The basal-like subtype has the worst prog-nosis. Therefore, subtype is an important independent prognostic indicator.