Objective · To investigate the expression of androgen receptor (AR) in human breast cancer and its prognostic significance. Methods · A total of 183 female patients with breast cancer were selected. The expression of AR in breast cancer tissues was detected by immunohistochemical staining. The relationship of AR expression with the clinicopathological characteristics was analyzed. Survival analysis of AR gene expression by an online database (Kmplot) was also performed. Results · The positive rate of AR expression was 47.5% and was significantly higher in grade 1 and grade 2 group than that in grade 3 group (57.6% vs 25.0%, P<0.05). Breast cancer patients with estrogen receptor, progesterone receptor and P53 positive expression had significantly increased AR levels (P<0.05). AR expression were significantly higher in patients with luminal type as compared withthose in patients with human epidermal growth factor receptor-2 (HER2) positive and patients with triple negative breast cancer (51.7% vs 31.6%,P<0.05). Kaplan-Meier curves identified that AR gene expression was positively correlated with relapse-free survival, overall survival and distant metastasis-free survivalof breast cancer patients (P<0.05). Conclusion · The breast cancer patients with AR positive expression have a better prognosis, which suggests that inhibitors of AR pathway may be a treatment option for breast cancer.

Literature review of the world on hospital brands, data collection in summary and comparison, and specialist consultancy were used to set the appraisal indicators, while the stratum analysis was used to calculate the weight coefficients of individual indicators, for building the appraisal indicators system for hospital brand effect. In addition, the indicators system and appraisal model were called into play to explore the use of hospital brands, offering scientific references for hospital management.

Objective To investigate clinical features and treatment strategy for pancreatic duct stent displacement complicated with acute pancreatitis.Methods Ten cases of pancreatic duct stent displacement complicated with acute pancreatitis were retrospectively analyzed.All the cases were confirmed by lab examination,X-ray examination,endoscopy and computed tomography (CT) examination.After operation,the clinical symptoms of patients were observed.Time consumed for stent removing and blood amylase level before endoscopic retrograde cholargio-pancreatography (ERCP) and 1st,4th,7th day after ERCP were recorded.Clinical features,the time of stent displacement,time of clinical cure and therapeutic strategy were summarized.Results The average age of the ten cases (four male and six female) was 55.9 years.All the displaced pancreatic duct stents were pancreatic duct stent with side wing,length five to seven cm.Obstruction was observed in one case.The end of the pancreatic duct stent of two cases dislocated at the neck of pancreats,seven cases at the head of pancreas and one at the body of pancreas.Ten cases presented with abdominal pain,seven with nausea and vomiting and one with fever.The average time of the occurrence of pancreatic duct stent displacement was 2.9 months.All the stents were successfully taken out,which of two cases were removed with balloon,seven cases with forcep and one with snare,and the average time duration was 17.7 min.After the stents taken out,pancreatic duct stent was replaced in one case and the left nine cases received nasal-pancreatic drainage treatment.After the operation,no severe complications such as pseudocyst of pancreas,pancreatic abscesses,pancreatic necrosis and gastrointestinal bleeding were observed in all the patients.Average blood amylase level at 1st,4th and 7th day after ERCP was 508 U/L,137 U/L and 86 U/L,respectively.The average time of recovery was 6.7 days,and the average time of keeping the nasal-pancreatic tube was 8.6 days.Conclusions For patients with pancreatic duct stent displacement complicated with acute pancreatitis,it is safe and effective to take out the stent and perform pancreatic duct drainage by ERCP as soon as possible,which could improve the symptoms in a short time.

Objective To investigate the effect of health education for discharged patients, and to explore the reasons and effective countermeasures on the health education. Methods Through the question-naire survey, convenient sampling method was used to evaluate the effect of the hospital health education. The existing problems and corresponding countermeasures taken for continuous improvement were analyzed. SPSS 17.0 statistical software was applied for data processing, the count data was expressed by rate and Statistical methods using chi-square test. Results The hospital health education satisfaction rate rose to 95.21%from 54.17%after intervention, and differences between the two groups was statistically significant (P<0.05). The satisfaction rate of the department of internal medicine, surgery department, and the department of gynaecology and pediatrics was significantly improved than before. Conclusion By improving health education importance, strengthening learning and training of specialized subject knowledge, rationally allo-cating human resources and establishing health education quality control system, the health education for discharged patients was effectively improved with satisfaction.

BACKGROUND:To reduce the amount of bleeding and the amount of hemoglobin after total knee replacement has been a key project in the clinical research in the division of bone and joint. Currently, ice therapy has been widely used in the clinic for tissue sweling and pain due to various physical and chemical factors. OBJECTIVE:To investigate the risk factors of postoperative hemoglobin after total knee replacement and discuss the effects of ice intervention. METHODS: 240 patients with osteoarthritis based on the random draw principles were equaly divided into the treatment group and the control group. The general information, disease status, diagnosis and treatment and prognosis of the two groups were investigated. Al patients were actively subjected to artificial total knee replacement. On the basis of the treatment in the control group, the treatment group received ice intervention at 2 hours after replacement for 7 consecutive days. RESULTS AND CONCLUSION:The postoperative hemoglobin decrease occurred in 34 patients, with the incidence of 14.2% among 240 patients at 7 days after replacement. Multivariate logistic regression analysis results showed that age, no ice treatment, body mass index were the main risk factors for hemoglobin decrease after total knee replacement (P < 0.05). Compared with the control group, the postoperative hemoglobin values of the treatment group were significantly higher (P < 0.05). Hemoglobin decrease values, total blood loss, blood transfusion rate, blood transfusion amount, and pain score at 3 and 7 days after replacement were significantly lower in the treatment group than in the control group (P < 0.05). The knee function excelent and good rate was 96.7% in the treatment group, and 95.8% in the control group, which showed no significant difference (P > 0.05). Results verify that clinical application of total knee replacement facilitated the knee recovery in patients with osteoarthritis, but hemoglobin decrease and bleeding existed. Active ice intervention can reduce the risk and relieve postoperative pain.

Objective To investigate the therapeutic effect of endoscopic plastic stent and metal stent placement in relieving obstructive jaundice in patients with pancreatic cancer,and to analyse the cost effectiveness.Methods A retrospective review was performed on the clinical data of 102 pancreatic cancer patients with obstructive jaundice in General Hospital of Northern Theater Command between January 2013 to January 2014.The patients were divided into plastic stent group (n =26) and metal stent group (n =76)based on the type of biliary stent placed under endoscopy.The complication and short-term therapeutic effect were compared between two groups.The number of endoscopic stent placement,treatment interval,hospitalization cost and median survival time were recorded.Results The levels of alanine aminotransferase (ALT) and total bilirubin (TBiL) in the two groups 5-7 days after endotherapy were significantly lower than those before treatment,but the difference was not statistically significant between the two groups (P ＜0.05).No severe complication was observed.The average number of treatments in the metal stent group was significantly lower than that in the plastic stent group (1.7 times vs 2.9 times),and the treatment interval was significantly longer[(271.7 ± 42.3) d vs (113.4 ± 38.2) d].The difference above between these two groups was statistically significant (P＜0.05).However,there was no significant difference on the average total hospitalization cost (84227.2 yuan vs 86906.8 yuan) or median survival time (15.6 months vs 13.1 months)between these two groups.Conclusions Primary placement of metal biliary stents for obstructive jaundice in adult patients with metastatic pancreatic carcinoma was cost-effective than plastic stents,and their effects were comparable.

Objective The present research aimed to explore the relationship of serum CA19-9,CEA,CA125 and sICAM-1 concentration with the diagnosis valuation and tumor metastasis of pancreatic cancer.Methods Ninety pancreatic cancer patients in First Affiliated Hospital of Hebei North University from January 2014 to December 2016 were enrolled in this study.The concentrations of serum CA19-9,CEA,CA125 and sICAM-1 were assayed in different stage of pancreatic cancer patients.The concentrations of these parameters were also detected in metastasis patients and non-metastasis patients.In the same period,90 cases of health examination as contrd group.Measurement data were represented as ~ ± s.Comparison between groups was analyed using t test.single-factor analysis of variance (ANOVA) was used for comparison among groups,and the resuhs were compared by F test.The correlation analysis was performed by spearman method.Results The results showed that CA19-9/ β-actin (control group and Ⅰ / Ⅱ / Ⅲ/Ⅳ stage pancreatic cancer were 0.25 ± 0.03,0.27 ± 0.04,0.31 ± 0.06,0.38 ± 0.09,0.68 ± 0.10,respectively),CEA/β-actin (control group and Ⅰ / Ⅱ / Ⅲ/Ⅳ stage pancreatic cancer were 0.29 ±0.07,0.34 ±0.08,0.47 ±0.09,0.58 ±0.12,0.68 ±0.14,respectively),CA125/β-actin(control group and Ⅰ/Ⅱ/Ⅲ/Ⅳ stage pancreatic cancer were 0.31 ±0.05,0.36 ±0.07,0.55 ±0.13,0.58 ±0.14,0.63 ± 0.14,respectively),sICAM-1/β-actin (control group and Ⅰ/Ⅱ/ Ⅲ /Ⅳ stage pancreatic cancer were 0.34 ± 0.05,0.36 ± 0.08,0.41 ± 0.08,0.49 ± 0.10,0.58 ± 0.12,respectively) were higher in pancreatic cancer than control(P ＜0.05).The tumor metastasis group was higher than tumor un-metastasis group CA19-9/β-actin(un-metastasis group and metastasis group was 0.36 ± 0.09,0.58 ± 0.12),CEA/β-actin (un-metastasis group and metastasis group was 0.42 ± 0.09,0.61 ± 0.14),CA125/β-actin (un-metastasis group and metastasis group was 0.48 ± 0.09,0.60 ± 0.14),sICAM-1/β-actin (un-metastasis group and metastasis group was 0.42 ±0.09,0.52 ± 0.10) (P ＜ 0.05).The results showed that CA19-9,CEA,CA125 and sICAM-1 concentrations are positively (r value were 0.832,0.698,0.748 and 0.845) with the metastasis of pancreatic cancer patients while negatively with the prognosis (r value were-0.867,-0.832,-0.916 and-0.908) and clinical stage (r value were-0.815,-0.896,-0.798,and0.912) of pancreatic cancer patients.Conclusion CA19-9,CEA,CA125 and sICAM-1 concentrations are positively related with the metastasis of pancreatic cancer patients while negatively with the clinical stage and prognosis of pancreatic cancer patients.

Objective The objective of this study was to investigate the underlying causes of catheter rupture in implantable venous assess ports among 4 paediatric patients and to summarise nursing experiences.Methods A total of 319 implantations of venous assess port were admitted in the Department of Paediatric Surgery of our hospital from March 2011 to January 2023,with an incidence rate of catheter fracture at 1.3%(4 cases).The ruptured catheters in all 4 paediatric patients were successfully retrieved via surgery.The reasons for catheter rupture as well as the methods for identification were analysed and summarised.Results In Case 1,a catheter rupture was located at 6 cm from the port and the ruptured catheter was not displaced.In Case 2,a linear crack was observed at 7 cm from the base of port without visible sign of catheter rupture,however,a leakage was observed from the crack when fluid was injected.In Case 3,the location of catheter rupture was identified at 11 cm from the port and again there was no evidence of displacement.However for Case 4,a catheter rupture occurred at just 1 cm away from the base of port,with a displacement along right atrium-right pulmonary artery-right inferior pulmonary artery.The causes of catheter rupture were attributed to frequent and prolonged neck and upper extremity activities in Cases 1,3 and 4,as well as an inappropriate handling of catheter in Case 2.After removal of the catheter,Cases 1,2 and 4 were kept in hospital for treatment of original illnesses,while Case 3 was discharged the day after the removal of catheter.Conclusion Catheter rupture is an extremely serious complication.It is imperative for healthcare personnel to adhere to standardised procedures and maintenance protocols,together with comprehensive health education to both parents and children.Early detection of an abnormality followed by prompt handling is crucial in ensuring the safety usage of an implantable venous assess port in paediatric patients.

Objective To explore the experience of the double guide wires technology in the difficult ERCP examinations.Methods There were 776 difficult ERCP patients.701 cases with difficult cannulation of the bile duct had been inserted another guide wire into the upper left corner of the duodenal papilla after retained pancreatic guide wire.75 cases with difficult cannulation of the pancreatic duct had been inserted another guide wire into the right vertical direction of the duodenal papilla after retained a guide wire into the commom bile.Results 697cases(99.4%)with difficult cannulation of the bile duct were examined successfully at first time;74 cases(98.7%)with difficult cannulation of the pancreatic duct were examined successfully at first time.Conclusion Double guide wires technology is easy to use.The method of retaining a guide wire into the duct which was cannulated easily may increases the achievement ratio of cannulation into another duct.The check time was shortened significantly.

Objective To study the value of CA19-9,s-ULBP2 and Dkk1 in the diagnosis of pancreatic cancer and the correlation. Methods From January 2016 to May 2017,56 patients with pancreatic cancer in our hospital were selected,45 healthy subjectsand 33 patients with benign pancreatic diseaseswere enrolled in this study.The differences of serum CA19-9,Dkk1 and s-ULBP2 expression and their relationship with clinicopatholog-ical parameters were compared between the three groups. The diagnostic value of CA19-9,s-ULBP2,Dkk1 and joint detection was analyzed.Results The serum levels of CA19-9,s-ULBP2 and Dkk1 in patients with pancreat-ic cancer were significantly higher than those in the benign pancreatic disease group and the healthy control group (P<0.05).CA19-9 and s-ULBP2 are related to TNM staging and histological differentiation,and CA19-9 is also related to tumor location.Joint test was higher than any of the individual indicators.Conclusion CA19-9,s-ULBP2 and Dkk1 are closely related to pancreatic cancer,and the combined detection of the three can improve the diag-nostic accuracy of pancreatic cancer.