Objective In order to deeper understand DCIS,improve the rate of diagnosis and therapeutic efficacy.Methods The clinical data of 123 DCIS treated at the First Affiliated Hospital of China Medical University were retrospectively analyzed in regards to age at onset of disease,clinical features,breast ultrasound examination,mammography examination,pathology,immunohistochemistry examination,and surgical methods.Results(1) The average age at onset was(47.7?9.3) years.(2)The major features on physical examination were breast lump in 79cases,nipple discharge in 19cases,and breast pain with glandular thickening in 30 cases.(3)Among 45 cases that underwent both ultrasound and mammography examination,in 17cases(60%) and 30 cases(66.7%) respectively,might be positive for malignancy,but the difference between the 2 melhods was not significant.With the use of both methods togather,diagmosis of possible malignant lesion was made in 37 cases(82.2%).(4) Sixty-five cases underwent breast ultrasound examination,substantive mass was found in 43 cases(66%),blood flow signals in 41 cases(63%),ductal dilatation in 52 cases(80%) and intraductal spotty strong light beam in 33 cases(50.7%).(5) Fifty-two cases underwent breast mammography examination,which showed sand-like calcification,mass with calcification clusters,localized gland density and breast tumor.(6)The immunohistochemistry examination included estrogen receptor(ER),progesterone receptor(PR),p53 and c-erbB-2,but the rate of positive expressios of those indices showed no significance difference between DCIS and DIS with microvasion(DCIS-MI).(7)Six cases underwent radical mastectomy(of which there were 3 cases of DCIS-MI).Modified radical mastectomy was done in 86 cases,including 59 cases of DCIS,27 cases of DCIS-MI.Lymph node metastasis was found in 2 cases of DCIS,and 5 cases of DCIS-MI.ConclusionsCombined breast ultrasound and mammography can increase the rate of DCIS diagnosis.

Adolescent ; Diagnosis, Differential ; Diverticulum, Stomach ; complications ; diagnosis ; pathology ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; pathology ; Gastroscopy ; Humans ; Male

Objective To investigate the effect of diaphragm training on respiratory function and the activities of daily living after cerebral apoplexy.Methods Seventy-eight patients with post-stroke fatigue were randomly divided into a treatment group and a routine therapy group,each of 39.Both groups were given conventional rehabilitation treatment,while the treatment group was additionally provided with diaphragm muscle training.Before and after 4 weeks of treatment,both groups were evaluated using pulmonary function tests,a fatigue severity scale (FSS),Fugl-Meyer motor function assessment (FMA) and the modified Barthel index (MBI).Results Vital capacity,forced vital capacity,forced vital capacity during the first second,and especially the maximum ventilatory volume of the treatment group were all significantly improved after the treatment.There was also significant improvement in that group's average FSS score,but not in that of the control group.The average FMA and MBI scores for both groups had improved significantly after the intervention,with the average FMA score of the treatment group significantly higher than that of the control group.However,no significant differences in the average MBI score were observed after the treatment.Conclusion Diaphragm training can significantly improve motor function and the daily life of stroke survivors.The mechanism may be related to improved respiratory function and decreased severity of fatigue.

Objective To evaluate the regulatory effect of OX40 co-stimulatory signal on the expression of Foxp3 in inductive regulatory T cells (iTreg) in vitro.Method CD4+ CD25+ naive T cells were isolated from C57BL/6 mouse lymphocyte suspension by MASC CD4+ CD25+ regulatory T cell isolation kit.Inductive Tregs were generated by stimulation of naive T cells in the presence of transforming growth factor beta (TGFβ1),anti-CD3,anti-CD28 and IL-2.The regulatory effect on iTregs was shown by use of OX40 stimulation monoclonal antibody (OX86) or control antibody.Using flow cytometric analysis (FACS),we examined the antibody-based identification of Tregs surface markers CD4 and CD25,along with the intracellular activation marker FoxP3.Results The ratio of CD4+ CD25+ nTregs isolated from mouse lymphatic node was (5.0 ± 0.4)％ vs.(71.8 ± 13.4)％ of TGFβ1-driven iTregs.The ratio of CD4+ CD25+ Tregs was (80.0 ± 1.6) ％ in OX40 stimulation McAb group vs.(86.0 ± 1.4)％ in control antibody group.Furthermore,the expression of Foxp3 was (59.2 ± 0.7) ％ in OX40 stimulation McAb group vs.(70.0 ± 0.8) ％ in control antibody group (P＜0.05).Conclusion TGFβ1-dependent protocol may induce the conversion of naive CD4+ T cells into CD25+ Foxp3+ iTregs.OX40 stimulation can down-regulate the expression of Foxp3 in CD4+ CD25 + iTreg significantly.Thus OX40 molecular may become an attractive target in Tregs-induced transplant tolerance.Further study should be performed to increase the suppressive activity of iTregs through blockade of OX40 signal.

To study the pharmacokinetics characteristic of loganin, ferulic acid and stilbene glucoside in rat plasma after oral administration of Bushen Tongluo formula. The plasma samples were treated by using liquid-liquid extraction technique, the concentrations were determined by HPLC-UV. Johnson spherigel C18 column (4.6 mm x 250 mm, 5 μm) was adopted and eluted with the of mobile phase of methanol-water containing 0.01% glacial acetic acid in a gradient mode, with the flow rate at 1.0 mL x min(-1), column temperature at 30 degrees C and injection volume of 10 μL. According to the findings, loganin was determined at 235 nm, ferulic acid and stilbene glucoside were determined at 320 nm, with the sample size of 10 μL. The pharmacokinetic parameters of loganin, ferulic acid and stilbene glucoside were calculated by DAS 2. 0 software as follows: C(max) was (0.369 ± 0.042), (0.387 ± 0.071), (0.233 ± 0.044) mg x L(-1); t(max) was (0.226 ± 0.022), (0.282 ± 0.031), (0.233 ± 0.044) h; t(½β) was (6.89 ± 0.20), (10.73 ± 0.11), (6.93 ± 0.09) h; AUC(0-∞) was (1.91 ± 0.36), (3.22 ± 0.52), (1.52 ± 0.33) mg x h x L(-1); AUCO(0-t) was (1.62 ± 0.33), (2.58 ± 0.43), (1.30 ± 0.30) mg x h x L(-1); CL was (20.2 ± 4.0), (1.39 ± 0.23), (31.7 ± 6.9) L x h(-1) x kg(-1), respectively. The results showed that after the oral administration with Bushen Tongluo formula, loganin, ferulic acid and stilbene glucoside showed concentration-time curves in conformity with the two compartment model, with a rapid absorption, loganin and stilbene glucoside was excreted at a moderate speed, and ferulic acid was excreted slowly (but with the highest bioavailability). Bushen Tongluo formula can main maintain plasma concentration with three administrations everyday and so is suitable to be made into common oral preparation.
Administration, Oral ; Animals ; Biological Availability ; Coumaric Acids ; administration & dosage ; blood ; pharmacokinetics ; Drugs, Chinese Herbal ; administration & dosage ; analysis ; pharmacokinetics ; Glucosides ; administration & dosage ; blood ; pharmacokinetics ; Iridoids ; administration & dosage ; blood ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley ; Stilbenes ; administration & dosage ; blood ; pharmacokinetics

Objective To investigate the effects of sevoflurane postconditioning on cardiomyocyte apoptosis during myocardial ischemia-repeffusion (I/R) in rats.Methods Forty-five healthy male Wistar rats weighing 250-280 g were randomly divided into 3 groups ( n =15 each):group sham operation ( group S) ; group I/R and group sevoflurane postconditioning (group Spo).The animals were anesthetized with intraperitoneal 3％ pentobarbital 45 mg/kg,tracheally intubated and mechanically ventilated.Myocardial I/R was produced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 120 min reperfusion in groups I/R and Spo.In group Spo the animals inhaled 2.5％ sevoflurane for 5 min starting from 1 min before reperfusion was started.The animals were sacrificed at the end of 120 min reperfusion.Their hearts were removed for measurement of infarct size and the area at risk and determination of apoptotic index (the number of apoptotic cells/the total number of cells) and Bcl-2 and Bax protein and mRNA expression.Results Sevoflurane postconditioning significantly reduced infarct size in group Spo as compared with group I/R.There was no significant difference in area at risk between groups I/R and Spo.Myocardial I/R significantly increased the apoptotic index,Bcl-2 and Bax protein and mRNA expression in group I/R as compared with group S.Sevoflurane postconditioning significantly decreased apoptotic index and Bax protein and mRNA expression but increased Bcl-2 protein and mRNA expression in group Spo as compared with group I/R.Conclusion Sevoflurane postconditioning attenuates myocardial I/R injury by redncing myocardial apoptosis,up-regulating Bcl-2 expression and down-regulating Bax expression.

Objective To investigate the risk factors and preventive measures for acute epidural hematoma after posterior thoracic spine surgery.Methods A retrospective study of 14 patients who developed acute epidural hematoma after thoracic spine surgery from May 2002 to May 2012 was conducted.There were 6 males and 8 females,aged from 41 to 69 years (average,61.2 years).There were 10 cases of thoracic spinal canal stenosis,3 cases of thoracic spinal meningioma,and 1 case of thoracic metastasis.About 3-14 h (average,6.6 h) after posterior thoracic spine surgery,the neurological deterioration was found,and according to the American Spinal Injury Association (ASIA) classification,there were 5 cases of grade A and 9 cases of grade B.The neurological function before evacuation of hematoma was compared with that after evacuation of hematoma and that at final follow-up.The correlations between hematoma compression time,neurological improvement rate and neurological function before evacuation of hematoma were statistically analyzed.Results After evacuation of hematoma,the ASIA classification of 14 patients was as follows:grade B in 1 case,grade C in 2 cases,grade D in 4 cases,and grade E in 7 cases.The hematoma compression time of 3 patients with grade B or C was more than 10 hours.Obvious difference of neurological function was found before and after evacuation of hematoma.The neurological improvement rate was 63.7％±23.3％ after evacuation of hematoma,which was negatively correlated with hematoma compression time and positively correlated with preoperative neurological function.The neurological function before evacuation of hematoma was significantly different from that at final follow-up.The neurological improvement rate was 86.97％±17.58％ at final follow-up,which was negatively correlated with hematoma compression time and positively correlated with preoperative neurological function.Conclusion The acute epidural hematoma after thoracic spine surgery could cause severe neurological deterioration.The neurological improvement was negatively correlated with hematoma compression time.Evacuation of hematoma must be done as soon as possible once progressive neurological deterioration is found.

ED are correlated with the severity of CAD in a degree.

Objective To estimate the effect of sun protection education on the severity and treatment of polymorphous light eruption (PLE).Methods Sixty-two patients with PLE were enrolled in this study,and randomly assigned into the control group (n =31) and intervention group (n =31) by using a random number table.Routine therapy was provided to all the subjects at their visits.The intervention group attended two lectures on sun protection at the beginning of spring and summer,and was given an education manual after each lecture.All the subjects completed a face to face interview and a questionnaire on the severity and therapy of PLE at the baseline and 12 months after enrollment.SPSS 11.5 software was used for data processing.Rank sum test,t test and chi-square test were carried out to assess the differences in the severity and treatment of PLE between the control group and intervention group as well as between pre-and post-intervention.Results The patients receiving sun protection education showed a significant decrease in the severity of PLE,including the number of months affected by PLE (t =4.611,P ＜ 0.01),number of PLE episodes (t =3.569,P ＜ 0.01),frequency of facial involvement (Z =2.369,P ＜ 0.05) and the time taken for lesions to appear after sun exposure (Z =2.650,P ＜0.01) in the year after enrollment compared with that before enrollment.Significant differences were also observed between the intervention group and control group in the number of months affected by PLE (t =3.679,P ＜ 0.01),number of PLE episodes (t =2.995,P ＜ 0.05),frequency of facial involvement (Z =2.169,P ＜ 0.05),the time taken for lesions to appear after sun exposure (Z =2.169,P ＜ 0.05) in the year after enrollment.The percentage of patients applying highly potent topical glucocorticosteroids (x2 =10.928,P ＜ 0.01)and administrating antihistamines (x2 =18.723,P ＜ 0.01) as well as the cumulative time of treatment with oral antihistamines (Z =2.656,P ＜ 0.01) were significantly reduced in the intervention group in the year after enrollment than in that before enrollment.Further more,a marked decrease was found in the percentage of patients applying topical highly potent glucocorticosteroids (x2 =4.521,P ＜ 0.05) and administrating antihistamines (x2 =10.949,P ＜0.01) as well as the cumulative time of treatment with oral antihistamines (Z =3.353,P ＜ 0.01).Conclusions Sun protection education through lectures and manuals appears to be an efficient adjuvant for the relief of PLE severity as well as for the reduction in the use of antihistamines and glucocorticosteroids,suggesting that dermatologists should pay more attention to sun protection education in the treatment of photosensitive diseases.

A set of teaching methods have been explored and practiced in this paper, which include paying attention to knowledge originating process teaching, enhancing thought training, constructing microbiology knowledge system, concerning reality, following the advanced achievement during the microbiology class teaching process, in order to improve teaching quality overall, cultivate students’ innovative ability.