Objective To investigate the relationship of c erbB2 with endocrine therapy and prognosis, to investigate the rapid and effective method to detect c erbB2 alteration in breast carcinoma(BC).Metheds Semi quantitative PCR was used to detect the amplification of c erbB2, and immunohistochemistry was used to detect the expression of protein of c erbB2. 58 cases of BC were followed up .Results There was significant relationship between c erbB2 protein overexpression and gene amplification(P

Objective To discuss the influent factors and managements of lower urinary tract injury caused by tension-free vaginal tape (TVT) procedure. Methods From Mar.2001 to Feb.2011,609stress urinary incontinence (SUI) patients were trested by TVT.Lower urinary tract injury appeared in 39 cases (6.4％),which age from 39 to 78 years (average age 52.7 ± 18.3).The history of disease was 2 to 12 years.Preoperative SUI types were 12 cases of Ⅱ type SUI,22 cases of Ⅱ/Ⅲ type SUI and 5 cases of Ⅲ type SUI.The patients who had low urinary tract injury were retrospective analyzed to figure out the causes and influent factors,and recorded the treatments and follow-ups. Results 39 patients (6.4％) suffered from low urinary tract injury,including 36 oases (5.9％) of bladder perforation and 3 cases of urethral injury.In these 39 patients,34 (87.2％) patients had history of pelvic surgeries,including 18 (52.9％) cases of total hysterectomy,9 (26.5％) cases of cesarean section delivery,4 (11.8％) cases of hysteromyomectomia and 3 (8.8％) cases of ovarian surgery.All of the 36 bladder peeroration patients were re-punctured and the catheter was kept for 4 - 5 d.Three urethral injury patients were re-punctured after the urethral rupture was sutured and the catheter was kept for 2 weeks.All the 39 patients were cured and discharged.No urinary fistula,infection or other postoperative complications occurred. Conclusions The history of pelvic surgery may be an important risk factor of the lower urinary tract injury,which should pay attention.If the bladder perforation occurred,re-puncture should be taken by adjust the direction.If there was a urethral injury,the re-puncture should be taken after the suturing of the urethral rupture.

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.

Objectives To evaluate the clinical value of neoadjuvant chemotherapy (NACT) in the treatment of local advanced cervical cancer. Methods We searched the clinical trials on the treatment of local advanced cervical cancer with NACT followed by surgery versus initial surgery on English and Chinese published literatures from the main medical data resources (MEDLINE, PUBMED, ELSEVIER ScienceDirect, CNKI). The data about positive pelvic nodes, interstitial infiltration, vascular invasion, positive surgical margin, 3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year OS, 5-year DFS were extracted from these papers, and a meta-analysis was applied. Result The hazard ratio (HR) of positive pelvic nodes on NACT group versus control group was 0. 54(95% CI 0. 33 ～0. 86), HR of interstitial infiltration was 0. 45(95% CI 0. 24 ～0. 86), HR of vascular invasion was 0. 25(95% CI 0. 16 ～0. 38), all differences were statistically significant. And HR of positive surgical margin was 0. 45 ( 95% CI 0. 21 ～0. 99), P = 0. 05, which indicated the difference was not statistically significant. And there were also no significant difference on the HR of 3-year OS, 3-year DFS, 5-year OS and 5-year DFS, and their RR were 1.18(95% CI 0. 84 ～ 1.66) ,1.31 (95% CI 0. 96 ～ 1.78) ,0. 89(95% CI 0. 68 ～ 1.15) ,and 0. 99(95% CI 0. 71 ～ 1.93) respectively. Conclusion For local advanced cervical cancer, NACT could reduce pathological risk factors but it did not improve the survival.

In order to train the clinical ophthalmic seven-year students to further comprehend their professional knowledge and further stimulate their imagination and creation ability, we developed several steps to promote these students' patent designing ability. These steps include: trained targets selection, theoretical knowledge training, clinical practice training, comprehensive quality control, et al. In the implementation of the concrete steps, we put emphasis on the elements such as step by step training, the high quality computer assisted mapping and the internationally compatible contents, et al., and encouraged the students to propose the assumption of solving the problems in the clinical and sci-entific research. And the stimulation mechanism and medical humanity were infiltrated all the while.

Objective:To observe the changes of metabolic intensity value of points on the face before and after needling bilateral Hegu (LI 4) in healthy people and provide scientific basis for association between Hegu (LI 4) and face/mouth. Methods:A total of 45 healthy college students were selected in this study. Using medical thermography and Pennes bio-heat transfer model, the infrared thermograph images on the face before and after needling bilateral Hegu (LI 4) were collected to observe the distribution of metabolic intensity value on the face before acupuncture and changes in these values after needling bilateral Hegu (LI 4). Results:Before acupuncture, Cuanzhu (BL 2) had the maximal metabolic intensity value. Its mean value was (0.71±0.23) W. Quanliao (SI 18) had the minimal metabolic intensity value. There were no left-right statistical significances in metabolic intensity values. After needling bilateral Hegu (LI 4), the metabolic intensity values of most points on the face were increased. Kouheliao (LI 19) obtained the maximal increase: 0.35 W on average; and Yangbai (GB 14) obtained the minimal increase: 0.08 W on average. Conclusion:Points on both sides in healthy people have good symmetry in metabolic intensity value. After needling bilateral Hegu (LI 4), the metabolic intensity values of points on the face were increased, especially points around the lips, which accords with the pathway of the Large Intestine Meridian on the head and face. This provided some scientific foundation for the association between Hegu (LI 4) and face/mouth.

Objective To explore the probability to unify the scores of different neuropsychological scales under the guideline of item response theory (IRT).Methods Two hundred and three old individuals with a mean age of (80.86±9.52) years were enrolled in this study,including 101 normal individuals and 102 patients with mild cognitive impairment (MCI).The data of cognitive ability assessed using MoCA and MMSE scales were collected and analyzed according to IRT with Stata 14.0 software.The population,qualitative data,and scaled data were analyzed by Hybrid model,2PL model,and GRM model,respectively.Finally,model fitting was conducted in these data.We used test characteristic curves(TCC)to calculate corresponding theta values of the scores of MMSE and MoCA,and draw cartograms after fitting the model.Results The data of MoCA and MMSE conformed to the characteristics of unidimension.The scores of MoCA and MMSE were 26.37 ±2.63 and 29.06±1.32,respectively,in the normal group,and those were 21.57±3.47 and 26.62± 2.89,respectively,in the MCI group.The Log likelihood for the fitting model of MoCA and MMSE was-1 670.9012 and-773.9797,respectively.The TCC indicated that the score of MoCA was lower than that of MMSE at the same level of theta value.The TCC of the two scales were both steep at first,and then became flat.In evaluating the cognition ability,the MoCA score was more precise than MMSE score,and MMSE score was easier to show ceiling effect than MoCA score.Conclusions Under the guideline of item response theory,we can unify the scores of two scales in order to make the scores of two scales fit with each other and be in common use during study and research.

Type Ⅰ sialidosis is a neurosomatic disorder related to the storage of lysosomal and induced by shortage of neuraminidase. It is an autosomal recessive disorder, maybe heterogeneous in its onset, clinical manifestations and prognosis. A case of type Ⅰ sialidosis with a missense mutation in the α-N-acetyl-neuraminidase (NEU1) gene is reported. The patient was characterized by reduced visual acuity, ataxia and subcortical myoclonus. Although the macular cherry red spots were not detected in the male patient, his bilateral visual evoked potential showed severely prolonged latencies of P100, which was consistent with continuous decline of his visions. Finally, he was treated with carbamazepine and clonazepam with moderate improvement in the symptom of myoclonus. In order to make the definite diagnosis, the importance of a clinical history integrating all the patient′s clinical manifestations and the mutation in NEU1 gene was highlighted. Regardless of being an uncommon disorder, the burden for those patients with sialidosis was significant. Therefore, this diagnosis in the relevant setting should always be considered.

Background: Hypoalbuminemia adversely affects the clinical outcomes of various cancers. The purpose of this study was to estimate the prognostic value of hypoalbuminemia 3–5 weeks after treatment in patients with metastatic renal cell carcinoma (mRCC) who received sorafenib or sunitinib as first-line treatment. Methods: In this single-center, retrospective study, we assessed the progression-free survival (PFS) and overall sur-vival (OS) of 184 mRCC patients who received first-line sorafenib or sunitinib treatment. PFS and OS were compared between patients with post-treatment hypoalbuminemia (post-treatment albumin level <36.4 g/L) and those with normal post-treatment albumin level (albumin level ≥36.4 g/L). The Memorial Sloan Kettering Cancer Center (MSKCC)risk model stratified mRCC patients into three risk categories. Prognostic values of all patient characteristics including MSKCC risk category were determined by using univariate and multivariate Cox regression models. Prognostic value was further determined using the Harrell concordance index and receiver operating characteristic curve analysis. Results: The median PFS and OS of the 184 patients were 11 months (95% confidence interval [CI] 9–12 months) and 23 months (95% CI 19–33 months), respectively. Patients with post-treatment hypoalbuminemia had significantly shorter median PFS (6 months [95% CI 5–7 months]) and OS (11 months [95% CI 9–15 months]) than patients who had normal post-treatment albumin levels (PFS: 12 months [95% CI 11–16 months], P < 0.001; OS: 31 months [95% CI 24–42 months], P < 0.001), respectively. Multivariate analysis showed that post-treatment hypoalbuminemia was an independent predictor of PFS (hazard ratio [HR], 2.113; 95% CI 1.390–3.212; P < 0.001) and OS (HR, 2.388; 95% CI 1.591–3.585; P < 0.001). Post-treatment hypoalbuminemia could also be combined with the MSKCC risk category for better prediction about OS. The model that included post-treatment hypoalbuminemia and MSKCC risk category improved the predictive accuracy for PFS and OS (c-index: 0.68 and 0.73, respectively) compared with the basic MSKCC risk model (c-index: 0.67 and 0.70, respectively). The prognostic values for PFS and OS of the integrated MSKCC risk model involving post-treatment hypoalbuminemia were significantly more accurate than the basic MSKCC risk model using likelihood ratio analysis (both P < 0.001). Conclusions: Post-treatment hypoalbuminemia can be considered an independent prognostic factor for patients with mRCC who undergo first-line treatment with tyrosine kinase inhibitors. Additionally, integrating post-treatment serum albumin level into the basic MSKCC risk model can improve the accuracy of this model in predicting patient overall survival and progression-free survival.

Objective To evaluate the values of bilateral inferior petrosal sinus sampling ( BIPSS),high dosage dexamethasone suppression test (HDDST) and pituitary image in the differential diagnosis of ACTH-dependent Cushing's syndrome. Methods Totally 87 patients with confirmed pathological diagnosis were recruited in the study.All received the procedure of BLPSS,HDDST,and pituitary MRI with dynamic enhancement.The diagnostic performances of three differential diagnosis methods in ACTH-dependent Cushing's syndrome were evaluated.Results Seventy-eight patients were diagnosed as cases of pituitary ACTH adenoma,and the remaining 9 were confirmed cases of ectopic ACTH syndrome due to the thymic carcinoid.The sensitivity and specificity of HDDST,pituitary MRI,and BIPSS for the diagnosis of ACTH-dependent Cushing's syndrome were 82.1％ and 100％,79.5％ and 44.4％,92.3％ and 100％,respectively.In Cushing's disease,the diagnostic accuracy was 83.9％ with HDDST,77.0％with pituitary MRI,and93.1％ with BIPSS.In those patients with Cushing's disease,the coincidence of lateralization was 83.9％ with BIPSS and 64.5％ with MRII.Conclusion BIPSS was better than the other two methods in differential diagnosis of ACTH-dependent Cushing's syndrome.Compared with the pituitary MRI,the concordant rate of BIPSS in lateralization of the tumor is higher,and it is more reliable.