Objective To evaluate the effect of music and mood relaxation training for the anxiety in patients with breast tumor before operation. Methods With case-contrast method, 108 patients with breast tumor (52 patients with intervention, 56 with routine treatment) week assessed continuously. All cases were investigated on their common information, physiological indexes and psychological scales, including State-Trait Anxiety Inventory (STAI-Form Y), Social Support Rating Scale (SSRS) and Eysenck Personality Questionaire (EPQ). Results There were significant statistical difference in systolic pressure and pulse rate between two groups on one day (t =3.114, P ＜0.01) and 30-60 minutes (t =3.03, P=0.01) before the operation. There was remarkable difference for anxiety between two groups and among different interventions periods by Repeated Measures ANOVA analysis (Periods: F=18.61, P ＜0.01; Groups: F =7.001, P ＜0.05). Results of Stepwise regression analysis: The influencing factors on anxiety in patients with breast tumor before operation were trait anxiety, breast-feeding history, family history of breast tumor, age, economy and EPQ-N. Conclusion Relaxation music and mood relaxation training can reduce the level of anxiety and related physiological indexes on patients with breast tumor before operation. The influencing factors on anxiety in patients with breast tumor before operation are multi level factors, such as trait anxiety, breast-feeding history and so on.

Purpose:To assess the effect of surgery combined with intraoperative radiotherapy (IORT) in the treatment of rectal carcinoma.Methods:97 patients with rectal carcinoma underwent IORT with 10～30Gy by 9～16MeV elect ro n beam to the tumor bed and local lymphatic regions. Another 122 patients treate d by surgery alone served as control.Results:Surgery combined w ith IORT did not improve the 5-year survival rate and local recurrence rate in the stage Dukes A patients. IORT have increased the 3-year and the 5-year surv ival rates in the stage Dukes B patients to 19.9%?27.2%, decreased their local recurrence rates to 19%?20.2%(P

Objective To evaluate the diagnostic value of contrast-enhanced CT scans in diagnosis of traumatic splenic rupture. Methods The findings of unenhanced and contrast-enhanced CT scans of 34 cases with traumatic splenic rupture confirmed by operation were retrospectively reviewed. Results Of the 34 patients, the diagnoses of splenic rupture on unenhanced CT scans were certain in 23 patients and uncertain in 6 patients. No abnormalities were found in 5 patients(sensitivity 85.3%, specificity 67.6%). After intravenous administration of contrast material, all of the patients were diagnosed as splenic rupture(sensitivity 100%,specificity 100%).Conclusion Contrast-enhanced CT is important in diagnosis of traumatic splenic rupture and can obviously improve the diagnostic accuracy. It provides reliable information for clinical treatment.

Objective To study the characteristics of granulomatosis with polyangiitis (GPA) accompanied by pneumothorax.Methods We described a case of GPA accompanied by hydropneumothorax who was successfully treated.Relevant literature was also reviewed.Results A total of 25 cases were identified,consisting of 18 males and 7 females [the average age was (44±16)(16-70) years old].The time from disease onset to pneumothorax was 26±51 (0.83-216) weeks.Pneumothorax,hydropneumothorax,pyopneumothorax and hemopneumothorax occurred in 11,5,8 and 1 respectively.Nodules or excavated nodules on chest radiography or CT were seen in 22 cases.Erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were elevated in all cases.Sixteen cases received glucocorticoid and immunosuppressive agents treatment.Sixteen cases received drainage and 7 received open operation.Pseudomonas aeruginosa was the most commonmicrobiology findings.Granulomatosis with active vasculitis,bronchopleural fistula,pleural bleb with intensefibrosis,rupture of subpleural nodule were seen on lung biopsy or autopsy.Nine cases died of infections,respiratory failure,sepsis and respiratory arrest.Conclusion Pneumothorax in GPA can be caused by multiple factors such as rupture of subpleural nodule and with high mortality.Patients always died of infections and respiratory failure.Regular treatment of the underlying disease,apply sensitive antibiotics for infection and reasonable surgical intervention should be considered.

Objective To investigate the prevalence and clinical characteristics of Sj?gren′s syndrome-interstitial lung disease (SS-ILD). Methods 136 patients with SS were studied. Anti-SSA and Anti-SSB antibodies were measured by Western blot. The inpatients had chest X ray, chest HRCT and pulmonary function examined. Results ①pSS-ILD patients with postive anti-SSA antibody were proned to have interstitial lung disease and the ILD were more severe. ②HRCT showed that sSS-ILD were more severe than that of pSS-ILD. ③Lung capacity of pSS-ILD decreased more frequently than sSS-ILD. sSS-ILD mainly had venti-latory function abnormalities. The lung function impairment of both were dominated by small airways dysfunction and decrease of TLCO. Conclusion SS patients should be examined by HRCT and lung function tests should be performed in the course of the disease to find out and treat ILD.

Objective To investigate the treatment for papillary thyroid carcinoma (PTC) located in the isthmus.Methods 90 patients with PTC located in the isthmus receiving surgery from May 2007 to Dec.2013 were enrolled.Patients' age,muhifocality,capsular invasion,central compartment lymph node metastasis were analyzed and compared with the results of 82 patients who had PTC within the thyroid lobe.Results In patients with PTC located in the isthmus,those with multi foci were older((49.4 ± 9.9)years,P =0.004).Patients with capsular invasion had larger tumor((1.02 ± 0.43) cm,P =0.001).Compared with PTC within the lobe,PTC located in isthmus were more likely to be multifocal (27.8％ vs 14.6％,P =0.036)and capsular invasive(42.2％ vs.19.5％,P =0.001).Central compartment lymph nodes metastasis rate was higher in patients with PTC located in isthmus but no statistical difference was found(53.3％ vs 48.8％,P =0.551).Conclusions PTC located in the isthmus tends to be more aggressive at early stage.Central compartment lymph node metastasis occursearly and can be on both sides.Most patients should receive total thyroidectomy and central compartment lymph node dissection of both sides,but there's no need to dissect lymph node beneath the recurrent laryngeal nerve on the contralateral central compartment.

BACKGROUND:It has been proved that bone marrow mononuclear cel transplantation can obviously improve neurological function of rats with cerebral hemorrhage. OBJECTIVE:To investigate the effects of transplanted bone marrow mononuclear cel s on the neurological function and apoptosis in perihematomal brain tissues fol owing cerebral hemorrhage in a rat model. METHODS:Twenty-four Sprague-Dawley rats were given stereotaxical injection of col agenase IV into the caudate nucleus to establish cerebral hemorrhage models in transplantation group (n=12) and model group (n=12), and then at 6 hours after cerebral hemorrhage, rats in these two groups were administrated 3x1010/L al ograft bone marrow mononuclear cel s and the same amount of PBS, respectively. Another 12 rats were given no interventions as control group. Neurological functions of rats were assessed at 1, 4, 8, 16 days after cerebral hemorrhage;pathological changes of the injury sites were observed at 16 days after transplantation;neuronal apoptosis rates in the perihematomal brain tissue were detected by flow cytometry at 2 and 4 days after transplantation. RESULTS AND CONCLUSION:The modified neurologic severity scores in the transplantation group were significantly lower than those in the model group at 8 and 16 days after cerebral hemorrhage (P<0.05). In the control group, cel s in each layer arranged closely with complete structure, and neurons and glial cel s were in good shape;in the model group, perihematomal brain tissues were loose with intercel ular gap, in which most neurons and glial cel s became necrotic;in the transplantation group, cel s in each layer arranged closely and regularly, and glial cel proliferation occurred. Besides, compared with the model group, the neuronal apoptosis rate in the transplantation group was significantly lower (P<0.05). To conclude, bone marrow mononuclear cel s can significantly enhance the neurological function recovery and reduce neuronal apoptosis in the brain of cerebral hemorrhage rats.

The main ingredients of Ophiopogonjaponicas include steroidal saponins,flavonoids,polysaccharides,and so on,but the research on polysaccharides is relatively less.This particle will mainly review the chemical composition,analytical methods,and pharmacological effects of Ophiopogon polysaccharides.The Ophiopogon polysaccharides contain a variety of substances,such as MDG-1,Md-1,Md-2,OJP-1,etc;The main analysis methods were sulfuric acid method,phenol-sulfuric acid method,3,5-dinitrosalicylic acid (DNS) colorimetric method,and near-infrared spectroscopy combined with partial least squares regression method.Ophiopogon polysaccharides can effectively improve the cardiovascular system diseases,with antihypoxia,anti-inflammatory,antitumor,anti-oxidation,and other pharmacological effects.

Objective To investigate the manifestations of esophageal motility disorders and evaluate the association between them and dysphagia, laboratory tests and other accessory examinations in patients with Sj(o)gren's syndrome (SS). Methods Esophageal manometry was performed in 31 patients with SS and 18 healthy volunteers by the step pull-through method. Results Decreased upper esophageal sphincter pressure was detected in 19 of the 31 patients (61%) with SS, while 4 of 18 (22%) in controls. The frequency was significantly higher in patients than in healthy controls (P=0.008). Fifteen of 31 patients (48%) showed various patterns of esophageal dysfunction including ineffective esophageal motility in 6 patients, nutcracker esophagus in 3 patients and nonspecific dysmotility in 6 patients. No major differences were found in esophageal parameters (peak amplitude, wave duration and velocity) when comparing primary SS with secondary SS. These esophageal abnormalities were not correlated with clinical manifestations, laboratory examinations and other auxiliary examinations. Conclusion Patients with SS may have esophageal motility disorders, which can presents with different patterns.

Objective: Lymph node metastasis (LNM) often occurs in cN0 papillary thyroid microcarcinoma (PTMC). The risk factors for lymph node metastasis, especially for high-volume metastasis, were investigated in this study. Methods: The medical records of 1,268 consecutive PTMC patients admitted in the Peking Union Medical College Hospital from 2013 to 2014 were reviewed. Their clinical and pathological features were collected. Univariate and multivariate analyses were performed to identify the risk factors for LNM/highvolume LNM. Results: Of the 1,268 patients, 416 patients (32.8％) and 43 (3.4％) had LNM and high-volume LNM, respectively. According to the univariate analysis results for the risk factors of LNM, male (42.22％ vs. 30.26％, P<0.01), <40 years (<40 years, 48.39％; 40-59 years, 27.62％; ≥60 years 22.45％, P<0.03), multifocality (41.00％ vs. 29.03％, P<0.01), without chronic thyroiditis (36.44％ vs. 20.62％,P<0.01), tumor size >0.5 cm (35.77％ vs. 23.05％, P<0.01) were associated with LNM. Meanwhile, according to the multivariate analysis results, male, multifocality, and tumor size >0.5 cm are independent risk factors for LNM (OR=1.516, 1.743, and 1.788, respectively, all P<0.05). The protective factors for LNM are 40-59 years, ≥60 years, and chronic thyroiditis (OR 0.388, 0.301, and 0.472, respectively,all P<0.05). In the univariate analysis of risk factors for high-volume LNM, the results indicated that being male (6.30％ vs. 2.61％, P= 0.005), <40 years (<40 years, 7.62％; 40-59 years, 2.05％; ≥60 years 0, P<0.001), and tumor size >0.5 cm (4.01％ vs. 1.36％, P=0.027) are associated with high-volume LNM. In multivariate analysis, the results suggest that being male is an independent risk factor for LNM (OR=2.383, P=0.002), whereas age of 40-59 years is a protective factor for LNM (OR=0.270, P<0.001). Conclusion: Lymph node metastasis often ocucrs in cN0 PTMC, whereas high-volume LNM is rare. Being male and <40 years old are risk factors for both LNM and highvolume LNM.