Objective To investigate whether black cohosh could be improve patients with breast cancer treated chemotherapy like-menopausal symptoms through a non-estrogen pathway.Methods We selected 120 patients with breast cancer dianosised and treated chemotherapy from January 2012 to June 2013 in four Affiliated Hospital of Harbin Medical,which were female patients,20-51 years,preoperative menopause,menstrual regularly,postoperative chemotherapy timely and regularly,and Kupperman score ≥ 15 points.All patients were randomized,double-blind divided into two groups,the experimental group was treated with medication Li Fumin Black Cohosh Extract,40 mg once daily,the other one was treated with placebo,40mg once a day.After 12 weeks,all patients were checked by estrogen hormones,gynecological ultrasound,the ultrasound of the other breast,Kupperman score,Then we make an assessment with those.Results During the experimental group and the control group,estrogen and endometrial thickness were within normal range,and there are not statistically significant difference between before and after medicine(P ＞ 0.05).What's more,before and after medication,the experimental group and the control group were not found new breast lumps.After taking medicine,the Kupperman score of experimental group was significantly lower than before treatment,the difference was statistically significant (P ＜0.05); however,there was not statistically significant difference between before and after medicine for the Kupperman score in control group(P ＞ 0.05).In experimental group,there are 5 cases of patients,which Kupperman is more 15 points,but lower than the score before taking medicine.Conclusions Black cohosh could improve like-menopausal symptoms of patients with breast cancer treated chemotherapy through a non-estrogen pathway,regardless of estrogen-receptor positive or negative,which has a good effection.

Objective To investigate the relationship between abnormalities of maternal serum markers in Down syndrome screening in second trimester and adverse pregnancy outcome.Methods Totally,1935 pregnant women were screened for Down syndrome with maternal serum tri marker with time-resolved fluorescence assay,including alpha fetoprotein (AFP),free β-human chorionic gonadotropin (β-hCG) and unconjugated estriol (uE3),between 15 and 20+6 gestational weeks at Peking Union Hospital from January 1,2009 to January 31,2011,and were followed up till delivery.The relationship between incidence of adverse pregnancy outcomes and women with normal or abnormal levels of serum markers in Down syndrome screening was investigated.T-test or Chi-square test were applied for statistical comparison.Results (1) Among the 1935 pregnant women,normal levels of serum markers were found in 1255(normal group) and 680 were abnormal(abnormal group),in which 577 with only one abnormal serum marker,89 with two and 14 with three abnormal serum markers.According to the serum marker level,the 577 women with one abnormal serum marker were further divided into five groups,including high AFP group (n=17),low AFP group (n=114),high β-hCG group (n=242),low β-hCG group (n=139) and low uE3 group (n=65).The birth weight of infants in lower AFP group and the gestational age at delivery in low β-hCG group were greater than those in normal group [(61.3±9.1) kg vs (59.5±8.3) kg,(272.6±11.8) d vs (274.4±10.1) d,t=2.21 and 1.99,both P＜0.01].(2) The incidence of adverse pregnancy outcome in normal group was 42.8％(537/1255),while comparing with the abnormal group(43.7％,297/680),no statistical significance was shown (RR =1.02,P =0.71).While comparing with the normal group,the incidences of placenta previa [25.5％ (32/1255) vs 2/17,RR=4.61,P＜0.05] and abnormal placental morphology were higher in high AFP group [4.1％ (51/1255) vs 5/17,RR=7.24,P＜ 0.05],the incidence of gestational diabetes mellitus (GDM) was higher in low AFP group [8.1％ (101/1255) vs 14.4％(16/114),RR=1.74,P＜0.05],the incidence of placenta and membrane retention was higher in high β-hCG group [3.5％ (44/1255) vs 6.2％(15/242),RR=1.77,P＜0.05],the incidence of pre-eclampsia was higher in low β-hCG group [1.7％ (21/1255) vs 6.5％ (9/ 139),RR=3.87,P＜0.05].(3) There were 89 women with two abnormal serum markers.Comparing with the normal group,the incidences of small for gestional age (SGA) infants,oligohydramnios,abruptio placenta were higher in women with low AFP but high β-hCG [SGA infants:6.9％(2/29) vs 1.8％(22/1255),RR=3.94; oligohydramnios:20.7％(6/29) vs 6.4％(80/ 1255),RR=3.24; both P＜0.05],the incidences of oligohydramnios was higher in women with both low AFP and low uE3[3/14 vs 6.4％(80/1255),RR=3.36,P＜0.05],the incidence of premature birth and GDM were higher in women with both low β-hCG and low uE3 [premature birth:2/6 vs 4.3％(54/1255),RR=7.75; GDM:3/6 vs 8.0％ (101/1255),RR=6.21; both P＜0.05].(4) There were 14 women with three abnormal serum markers.The relationship between adverse outcome and abnormal serum markers did not show any statistical significance.Conclusions The abnormality of serum markers of Down syndrome screening is closely related to adverse pregnancy outcomes,and women with abnormal serum markers should be carefully monitored during pregnancy.

Objective To provide patients with appropriate and useful health education, improve the self-management of patients with neurogenic bladder and reduce the incidence of complications, through understanding health education requirement of clean intermittent catheterization in patients with neurogenic bladder. Methods The health education requirement of clean intermittent catheterization of 59 patients with neurogenic bladder were investigated by self-designed questionnaire. Results They extremely lacked the knowledge of clean intermittent catheterization. The mean score of health education requirement was 4.05 (5 as total score), and they had strongly request on the relevant knowledge, especially for dietary guidance, observation and prevention of complications, current bladder condition. The form of health education should be diversified, especially for expert lectures. Conclusion It is necessary for nurses to conduct health education on clean intermittent catheterization for paitents with neurogenic bladder, at the same time more pertinence is needed.

Objective To analyze the possible risk factors of esophageal stenosis after endoscopic mucosal resection (EMR). Methods From January 2008 to December 2009, a total of 219 procedures of esophageal EMR were performed to resect early esophageal squamous carcinoma and its precancerous lesions,and esophageal stenosis was observed in 9 cases. Data of these 9 patients ( stenosis group) were collected and compared with those of patients without stenosis ( control group, n = 202, 8 patients were excluded because of being diagnosed as squamous carcinoma with submucosal infiltration after EMR and being transfered to surgery). Results There was no significant difference between two groups in regard of gender, age, location of the lesion, length of the lesion or pathological diagnosis after EMR, while the rate of patients with mucosal defect larger than 3/4 circumference in stenosis group ( 8/9, 88.9% ) was significantly higher than that in control group (9/202, 4. 5%, P ＜ 0. 01 ). Conclusion In EMR for early esophageal squamous carcinoma and its precancerous lesions, post-EMR mucosal defect larger than 3/4 circumference is a risk factor for esophageal stenosis.

Objective To explore the value of three-dimensional DSA (3D-DSA) in displaying the location of the origin of uterine artery.Methods A total of 90 female patients underwent uterine artery (UA) embolization were enrolled.The bilateral internal iliac artery catheterization were performed by 3D-DSA,then the images were reconstructed in every 5 degree interval to choose the optimum range of viewing angle.The origination and the degree of the origin artery and UA were calculated.The distance between the origin of UA and superior glutea artery which was identified as the locating point was measured.Results Bilateral and contralateral oblique position of ＞30°-60°were the optimal projection positions of UA.Totally 64.44％ (116/180) of UA originated from the anterior trunk of internal iliac artery,18.33％ (33/180) originated from the inferior gluteal trunk,9.44 ％ (17 / 180) originated from the internal pundenal artery,5.56 ％ (10 / 180) originated from internal iliac artery,and 2.22％ (4/180) originated from the superior gluteal artery;10.56％ (19/180) of the angle of the origin artery and UA were 0-30°,38.89％ (70/180) were ＞30°-60°,41.11％ (74/180) were ＞60°-90°,4.44％ (8/180) were＞90°-120°,2.78％ (5/180) were＞120°-150°,2.22％ (4/180) were＞150°-180°.Distance between the origin of UA and superior gluteal artery was 3.04-18.31 mm,average was (11.71±4.28)mm.Conclusion 3D-DSA can clearly display the origination,viewing angle and the distance away from superior gluteal artery.

Biological mass spectrometry has been developed for the largE-scale protein identification. The successful identification of protein in proteomic study is based on an effective match of MS data to the sequence in database. Because of the diversity and heterogeneity of protein modification, the experimental data obtained by mass spectrometry does not match the theoretical value sometimes, which makes about 90 percent or more of the tandem mass spectra not be effectively identified. This has become one of the most important technique issues to be resolved in current proteome research. The N-terminal cyclization of peptides, as one of a variety of modification introduced in sample preparation, has been preliminarily studied in this work. The result showed that N-terminal cyclization occurred at the most of the glutamine(Q) or carbamoylmethyl-cysteine(CAM_C) residues and the reaction is often incomplete or partial, both types of peptides could often exist in its respective state at the same time, and the behavior of modified peptides in revered phase chromatography is also changed. The success rate of protein identification could be obviously improved if adding the N-terminal cyclization modification in the database searching. These results will be very helpful in the mass spectrometric data analysis of proteomic study.

OBJECTIVETo explore the feasibility of urethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate in the treatment of hypospadias.

METHODSForty-eight patients with hypospadias (18 of the coronal type, 21 the penile type, 8 the penoscrotal type and 1 the perineal type) underwent urethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate. The surgical effects were observed by following up the patients for 3-27 months.

RESULTSOne-stage surgical success was achieved in 44 of the cases, with satisfactory functional and cosmetic results but no complications. Two cases developed urinary fistula and another 2 urethral stricture, but all cured by the second surgery.

CONCLUSIONUrethroplasty with transection of the urethral orifice and preservation and lengthening of the urethral plate is a simple, safe and effective surgical procedure for the treatment of hypospadias.

Adolescent ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Urethra ; surgery ; Urologic Surgical Procedures ; methods

Objective To treat hematospermia by ureteroscopy and investigate its application value for the treatment of hematospermia.Methods Nineteen patients with persistent hematospermia, TRUS,seminal vesicle MRI or CT were examined to exclude seminal vesicle tumor, tuberculosis, prostatic occupancy and preoperative prostatic fluid and drug sensitivity.Transurethral 4.5 - 6 F ureteroscopy entered through the microscopic seminal vesicle, wash of the old blood, reserved perfusion with Quinolones, and the lithoclasty on the seminal stones by holmium laser, resection of small polypi.Results The ureteroscopy was successful in 18 (95%) cases for bilateral seminal vesicle, wash and drug reserved perfusion, and one case was also successful seminal vesicle microscopy on the affected side; five cases with the seminal stones by olmium laser, three cases with small polypi by resection.The averse duration of the procedure was 35 10 -75) min.There were no compliocations during or after the operation.In 18 cases at 6 - 12 months follow-up the hematospermia and symptoms of hematospermia disappeared fully after 90 d.There was recurrence in one case which improved with anti-inflammaotry treatment.Conclusions Ureteroscopic treatment for persistent hematospermia by 4.5 - 6 F ureteroscopy through the seminal vesicle is effective and safe method and results in a micro-wound.

Objective To investigate the correlation between mammographic features in BIGRADS 3,4 and the corresponding histological findings.Methods 442 patients with 46 9 lesions categorized as 3 ,4 in BIGRADS on mammography from July 20 1 3 to February 20 1 5 were retrospectively analyzed.The correlation between mammographic features and histological findings was statistically analyzed.Results Among the 469 lesions,130 lesions were categorized as BIGRADS 3,with 13 pathologically confirmed malignant lesions and 117 benign lesions.There were 3 3 9 lesions in BIGRADS 4,with 9 8 malignant lesions and 241 benign lesions.There were statistical differences between benign and malignant lesions (P＜0.05)in mass morphology,mass margin,calcification morphology,calcification distribution,architectural distortion,asymmetries and axillary adenopthy.There were no statistically significant differences (P＞0.05 )in breast composition, mass density or location.The logistic regression analysis with above mentioned significance indexs showed that the F value was 4.3 1 1 , with the significance probability (P＜0.001 ).The mass shape,the edge of the mass,the calcification shape,the calcification distribution,the structure distortion,the asymmetrical compact shadow,and the axillary lymph node enlargement were all correlated with the benign and malignant of the tumors.Conclusion The mammographic features of BIGRADS category 3 and 4 including the mass morphology, margin,calcification morphology,calcification distrubution,architectural distortion,asymmetries,and axillary adenopthy could help us to improve the accuracy diagnoses between benign and malignant lesions.

Objective:To analyze the distribution and drug sensitivity of pathogens in bronchoalveolar lavage fluid(BALF)of children with severe community acquired pneumonia(CAP)in Qingdao from 2018 to 2020.Methods:The clinical data of 482 children with severe CAP in Qingdao admitted to Women and Children′s Hospital of Qingdao University were collected.BALF was collected by bronchoscopy for detection of bacteria and mycoplasma.Results:(1)Bacterial infection was detected in 139 cases(27.84%), mycoplasma infection in 119 cases(24.69%), and virus infection in 141 cases(29.25%). (2)The detection rates of bacteria and virus infection in the 1-12 months old group were higher.The detection rate of mycoplasma pneumoniae was the highest in the group over 5 years old.(3)A total of 139 strains were positive in bacterial culture of lavage fluid under bronchoscope: 55 strains(39.57%) of gram-negative bacilli and 84 strains(60.43%) of gram-positive cocci.Streptococcus pneumoniae was the most common gram-positive bacteria.Haemophilus influenzae was the most common gram-negative strain.(4)Streptococcus pneumoniae and Staphylococcus aureus were highly sensitive to amoxicillin clavulanate potassium, vancomycin and linezolid.The resistance rate to erythromycin was high(100%). (5)Haemophilus influenzae, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae were highly sensitive to meropenem and cefoperazone sulbactam.They were highly resistant to amoxicillin, ampicillin and cefuroxime(>80%).Conclusion:Severe CAP in Qingdao area is mainly caused by virus and bacteria within 1 year old.Mycoplasma pneumoniae infection is the main cause of children over 5 years old.Respiratory syncytial virus, adenovirus and parainfluenza virus are main causes of virus infection.Streptococcus pneumoniae and haemophilus influenzae are the main pathogens, which are more sensitive to vancomycin, linezolid, meropenem and cefoperazone sulbactam, but resistant to erythromycin and amoxicillin.