Breast Neoplasms ; therapy ; Consensus ; Female ; Humans ; Neoadjuvant Therapy

Objective To discuss the application of allowable total error (Tea) and allowable imprecision derived from biological variation in routine chemistry external quality assessment ( EQA) and internal quality control (IQC) and set up quality specifications of routine chemistry in our country.Methods Data of test items including K,Na,CI,Ca,P,Glu,Urea,UA,Cre,Alb,TP,TC,TG,AST,ALT,Tbil,ALP,AMY,CK,LDH,Fe,Mg,Cu,Zn and GGT was collected and evaluated by a nationwide EQA.At the same time the coefficients of variation (CVs) of these test items during the month were acquired from the IQC reports of each laboratory and then the results were analyzed.Results Percent of pass was different in these test items based on Tea derived from biological variation in EQA results.Except for items of CI,Mg,Cu and Zn,about 80％ of participant laboratories could achieve the minimum performance of biological variation.About 80％ of participant laboratories could achieve the desired performance of biological variation for K,P,Glu,Urea,UA,Cre,TC,TG,ALT,AST,Tbil,AMY,CK,LDH,Fe and GGT.About 80％ of participant laboratories could achieve the optimum performance of biological variation for Urea,UA,TC,TG,ALT,AST,Tbil,C K,and GGT.And the IQC results showed that acceptable percents of different items based on three allowable imprecision were different.More than 80％ of participant laboratories could achieve the minimum allowable imprecision for K,P,Glu,Urea,UA,TC,TG,ALT,AST,Tbil,AMY,CK,LDH,Dbil,Fe,GGT,the desirable imprecision for P,Urea,UA,TG,ALT,AST,Tbil,CK,Dbil,Fe,GGT and the optimum imprecision for TG,ALT,CK,Dbil,Fe.Conclusions The quality specifications derived from biological variation can be as evaluation criteria for EQA and IQC in order to know the detection ability of each laboratory more completely and objectively,set up quality specifications derived from allowable total error and allowable imprecision in routine chemistry and to provide basis for mutual recognition of routine chemistry test results.

OBJECTIVE:To observe the efficacy and safety of Compound yimucao oral liquid combined with oxytocin in the prevention of postpartum hemorrhage and promotion of uterine involution for puerpera of vaginal delivery. METHODS:240 preg-nants with natural childbirth of vaginal delivery were randomly divided into control group and observation group. Control group was injected oxytocin 20 U in buttock after delivery. Observation group was additionally treated with Compound yimucao oral liquid 20 ml,tid for consecutive 2 weeks. Postpartum vaginal bleeding,uterine involution and incidence of adverse reactions in 2 groups were observed. RESULTS:Compared with control group,postpartum hemorrhage volume after delivery 2-24 h,incidence of post-partum hemorrhage,uterus size,uterine hemorrhage and lochia duration in postpartum 42 d in observation group were significantly better than control group,the differences were statistically significant(P<0.05);there were no significant differences in the hemor-rhage postpartum volume after delivery 1 h and 1-2 h and fundal height in postpartum 42 d in 2 groups(P>0.05). There were no fever,rash,nausea and other obvious adverse reactions in 2 groups. CONCLUSIONS:Compound yimucao oral liquid combined with oxytocin can obviously decrease the postpartum bleeding and promote uterine involution,with good safety.

Objective To evaluate the clinical effect of transcatheter closure with Amplatzer duct occluder offers in infants with patent ductus arteriosus(PDA).Methods Thirty-seven PDA infants underwent transcatheter closure of PDA at(8.7 ? 3.3)months and weight of(8.6 ? 3.5)kg.A lateral view aortogram was made to determine the morphology and the narrowest diameter of the ductus and selected the size of the device.Occluder was implanted using the anterograde venous approach.Follow-up evaluations were made with chest X-ray and echocardiogram at 24 hours and 1,6 and 12 months after implantation.Results The narrowest diameter of the ducts measured by angiographically was(3.3 ? 1.5)mm.Ninteen patients(54.29%) achieved immediate complete occlusion.On color Doppler the closure rates at 1 month after implant were 34 cases(97.14%).No residual shunt exsisted in all implanted patients at 6 and 12 months follow-up.Procedure time at(57 ? 43)minutes and fluoroscopy time(23.0?14.9)minutes.Conclusions Percutaneous PDA closure with the Amplatzer duct occluder decice is an safety and effective method for the treatment of PDA in infants,but caution shall be exercised to the anatomic characteristics in the infant age group in solving clinical complications.

Objective To explore the effects of nerve growth factor (NGF) and low frequency electricity stimulus on the configurations of skeletal muscle cells and the change of muscle fibre types in the denervated skeletal muscle separately.Methods The denervated rat model was established and model animals were injected with the NGF and given the stimulus (frequency=2 Hz) about 30 days. The configurations and the change of muscle fibre types were observed by immunohistochemistry and image analysis.Results The muscle fibre was in chaos and the boundary was not obvious among cells in the denervated rats; the muscle fibre of the denervated rats with NGF injection and low frequency electricity stimulus was more regular and the boundary of cells was clearer, the cells number was more than those of the denervated rats. Compared to normal rats, the proportion of Ⅰ muscle fibre in the denervated rats increased ( P<0.05), whereas the proportion of Ⅱ muscle fibre decreased ( P<0.05); it had no significant differences of the two types of muscle fibre between the denervated rats with NGF injection, low frequency electricity stimulus and the denervated rats ( P<0.05).Conclusion NGF injection and low frequency electricity stimulus can make the configurations of denervated muscle to better.

OBJECTIVETo observe the neurological protective effects of progesterone (PROG) on focal cerebral ischemia/reperfusion injury in rats and to explore its possible mechanism.

METHODSOne handred and twenty male SD rats were divided into three groups randomly: sham-operated group, middle cerebral artery occlusion ( MCAO ) group and PROG + MCAO group( n = 40). The right temporary MCAO model was established by the line-embolism method. The PROG + MCAO group rats were according to 8 mg/kg intraperitoneal injection PROG, after that 30 min, the rats were suffered ischemia/reperfusion. After rats were suffered ischemia for 2 h and reperfusion 0, 24, 48, 72 h stress, the nervous functional defect degree were evaluated by longe scoring, and the expression of two-pore domain K channel 3 (TASK3) mRNA in brain tissue were detected by the real-time PCR.

RESULTSPROG (8 mg/kg) could significantly reduced the nervous functional defect degree in rats after ischemia/reperfusion 24, 48, 72 h (P < 0.05). The results of real-time PCR showed that the TASK3 mRNA expression in the brain tissue at all time points significantly decreased in MCAO group compared with sham-operated group (P < 0.05). However, compared with MCAO group, the expression of TASK3 mRNA in brain tissue at all time points dramatically increased in PROG + MCAO group (P < 0.05).

CONCLUSIONPROG can improve the nervous functional defect degree after focal cerebral ischemia/reperfusion injury in rats, and the mechanism might be associated with up-regulating the expression of TASK3 mRNA in brain tissue.

Animals ; Brain ; drug effects ; pathology ; Brain Ischemia ; drug therapy ; Infarction, Middle Cerebral Artery ; Male ; Neuroprotective Agents ; pharmacology ; Potassium Channels, Tandem Pore Domain ; metabolism ; Progesterone ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Reperfusion Injury ; drug therapy

AIM: To evaluate the safety, efficacy and stability of posterior chamber phakic intraocular lens ( ICL ) implanation and clear lens extraction for the correction of high myopia.
METHODS: The study enrolled 56 cases ( 100 eyes ) of high myopia. Group I comprised 32 cases ( 58 eyes ) receiving ICL implantation and Group II comprised 24 cases (42 eyes) undergoing clear lens extraction. In this study, we evaluated the two groups of subject's the visual and refractive results, intraocular pressure ( IOP ) , endothelial cell density ( ECD ) , anterior chamber depth ( ACD) , lens transparency, the surgical complications as well as visual adverse symptoms before and after surgery.
RESULTS: The postoperative subjects in group I and group II were followed, uncorrected vision acuity ( UCVA)>0. 5 were 69. 0% in group I and 71. 4% in group II after 3mo. UCVA>0. 5 were 72. 4% in group I and 73. 8% in group II after 1a. Predictability of the manifest spherical equivalent refraction within±1. 00D was achieved in 62. 1%of eyes in group I and 57. 1% in group II after 1a. The central vault of the ICL ( distance from posterior surface of ICL to the crystalline lens ) measured with anterior segment optical coherence tomography ( AS-OCT ) was 0. 35-0. 54 (0. 40±0. 16) mm. Twelve point one percent of eyes in group I and 7. 1% of eyes in group II had transient mild increase in IOP. Here were statistically significant differences between preoperative and postoperative ECD (P<0. 001 ). Complications of surgery: 1 eye had ICL spontaneous rotation, 2 eyes had anterior subcapsular cataract, 4 eyes noticed halos around lights at night in group I. Three eyes had posterior capsule mild opacification, 3 eyes noticed halos around lights at night, 12 eyes had difficulty in near vision in group II.
CONCLUSION: ICL implantation and clear lens extraction are effective, safe and predictable surgical option for the management of high myopia. No severe complications occurred, but its long time effect and safety still need more time to prove.

Objective To study the clinical significance and changes of serum cardiac troponin I (CTnI) levels in children's viral encephalitis merged with myocarditis or myocardium injury.Methods CTnI and myocardium zymogram levels were detected in 40 children with viral encephalitis and other 40 children as the controls by means of ELISA.Results CTnI and myocardium zymogram levels in viral encephalitis were significantly higher than those in controls(P

Objective To understand the correlations between HIV-1 subtypes and changes in CD4+T cell count over time in patients with different subtypes of HIV-1 infection.Methods A total of 94 patients who were diagnosed with HIV-1 infection in Nanjing and received at least twice CD4+T cell counting test before antiretroviral therapy (ART) were recruited in this study.Descriptive analysis was used to present the rates of CD4+T cell decline for different HIV-1 subtypes.Logistic regression analysis and nonparametric test were conducted to investigate the factors responsible for CD4+T cell decline and to analyze the correlations between the rates of CD4+T cell decline and HIV-1 subtypes.Results The median monthly rate of CD4+T cell decline was-2.20 [interquartile range (IQR):-11.36-2.13] cell/μl.Of all patients,25.5% (24/94) had a significant decline (≥30%) in CD4+T cell count.Compared with the patients infected with CRF01_AE,those infected with CRF07_BC (OR=0.28,95%CI: 1.7-6.5) or other subtypes (OR=0.16,95%CI: 1.0-2.9) had a lower risk of significant decline in CD4+T cell count.In addition,results of the nonparametric test showed that the patients infected with CRF01_AE (M=-21.54,IQR:-30.97——11.92 cell/μl) had a faster CD4+T cell loss than those infected with CRF07_BC (M=-11.26,IQR:-14.06——5.63 cell/μl) (P=0.033).Conclusion HIV-1 subtype is associated with the rate of CD4+T cell decline.It is important to monitor the changes in CD4+T cell count in patients infected with CRF01_AE and to carry out timely ART.

Objective To investigate the value of new microvascular pattern of contrast-enhanced ultrasonography (CEUS) in the diagnosis of peripheral lung lesion.Methods A total of 72 peripheral lung lesions which had been proved by clinical and pathology results underwent conventional ultrasound,CEUS and new microvascular pattern examination.Two independent readers (Reader 1 and Reader 2) blindly and retrospectively analysised and classified the characteristic of microvascular patterns respectively,and Kappa test was used for evaluating the concordance between the two readers.The diagnosis accuracy of CEUS was calculated,and the CEUS diagnostic scores were compared with conventional ultrasound.Results 16 benign lesions and 56 malignant lesions were enrolled in this study.The microvascular patterns in benign lesions included branch enhancement(43.8 ％,31.3％),point and patchy enhancement (18.8％,25.0％) and rim-like enhancement (18.8％,18.8％).The microvascular patterns in malignant lesions included vascular enhancement (46.4％,57.1％),cotton enhancement (26.8％,25.0％) and dead wood enhancement (19.6％,8.9％).There was significant difference between benign and malignant lesions.Kappa result showed that the two readers had a good diagnosis concordance(Kappa=0.759,P =0.000).According to the different types of microvascular pattern,the diagnostic accuracy,sensitivity,and specificity rates of two readers were 92.9％,91.1％;81.3％,75.0％ and 90.3％,87.5％,respectively.Before CEUS,59.7％ and 68.1％ of lesions were diagnosed as 3 by two readers respectively,while only 1.4％ and 6.9％ of lesions were diagnosed as 3 after CEUS.Further analysis demonstrated that there was significant difference in the microvascular pattern between squamous carcinoma and adenocarcinoma,and also between squamous carcinoma and small cell lung carcinoma.Conclusions Contrast-enhanced ultrasound could significantly increase the differential diagnosis of peripheral lung lesions.New microvascular pattern helped to display patterns of vascular perfusion.of peripheral lung lesions,and provide new diagnostic clue for differential diagnosis.