Objective To retrospectively study the value of ultrasonography in diagnosing breast lymphoma and compare with mammography and MRI. Methods Imaging characteristics of 26 patients who were pathologically comfirmed as breast lymphoma were reviewed, including ultrasonography,mammography and MRI, and compare the diagnostic accuracy among the three. Results Twenty-four patients underwent ultrasonography and 32 lesions were found, with longest diameters averaged 30 mm.Tumors were mostly hypoechoic or very hypoechoic (81.3％), some were lobular (25.0％) or oval (21.9 ％ ) in shape, the margins were most frequently circumcribed (62. 5 ％ ), and a few tumors showed an echogenic boundary (18.8 ％ ). Color Doppler imaging showed hypervascularity in most tumors (59.4 ％ ).Ninteen patients undewent mammography, 15 solitary lesions were identified in 12 patients, asymmetric density in five,punctate calcification in one,and no abnormality in one. Eleven lesions were identified in MRI of 10 patients, 10 lesions showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images, and heterogeneous enhancement after contrast. The diagnostic accuracy of ultrasonography,mammography and MRI was 83％, 52％ and 100％, respectively. Conclusions The sonograms of breast lymphoma have some distinct features, the combination of ultrasonography and MRI might benefit the diagnosis of breast lymphoma.

Objective To study ultrasound features of breast cancer before and after neoadjuvant chemotherapy,and its correlation with histopathology. Methods One hundred and nine patients with breast cancer underwent paclitaxel plus carboplatin neoadjuvant chemotherapy, the change of the primary lesions and axillary lymph nodes were studied by ultrasound,and compared with histopathology. Results Seventeen patients achieved complete remission under ultrasound, the rest measurable lesions became significantly shortened in maximum diameter [ ( 22.46 ± 11.50) mm vs (34. 71 ± 13.67) mm, P ＜ 0. 001 ], and showed decrease both in longitudinal-transverse ratio (0. 80 ± 0. 23 vs 0. 86 ± 0. 22, P ＞0. 05) and grades of blood flow (0. 51 ± 0.80 vs 1.23± 1.05, P ＜0. 001 ). 44. 83% (44/92) of metastatic axillary lymph nodes disapeared after treatment. Comparing with histopathology, the sensitivity and specificity of ultrasound assessing complete remission were 57. 89 % ( 11 / 19) and 93.33 % (84/90), respectively. The moderate concord between ultrasound with histopathology might be attributed to the pathologic change of breast tissue and stroma after treatment, nevertheless grades of blood flow might be more meaningful. Conclusions Ultrasound assessment of neoadjuvant chemotherapeutic response might be of reference value,and studying corresponding ultrasonic manifestation of different kinds of pathological changes would help with better evaluation.

Objective To explore propofol dosage difference between in morning and at after-noon undergoing gynecological clinic short operation.Methods One thousands and nine hundred fifty eight female patients,aged 1 6-50 yr,of ASA physical status Ior II,undergoing gynecology clinic short operation,according to the operation time,were divided into two groups,Group morning (8:30-1 1:30,n =1047)and group afternoon (14:00-1 7:00,n =91 1).Each patient was intravenously injected fentanyl 0.01 μg/kg,and then propofol 2.5 mg/kg.When the observer’s assessment of alertness/se-dation (OAA/S)scores reached 0 score,the operation began.If the body moved,the surgery was stopped and 25 mg propofol was intravenously injected quickly.After 10 seconds observation,if the body movement existed,25 mg more propofol was performed,until the movement disappeared.Re-cord patients’year,height,weight,body mass index,and the heart beat,blood pressure of pre-op-eration,the number of times of cervix uteri expansion per vagina,the history of labor per vagina,the total dosage of propofol and the time length of sedation.Results The dosage of group afternoon (1 52.1 6±65.90)mg was higher than group morning’s (135.69±37.67)mg (P <0.05).There was no significant difference of time lengths of sedation between the two groups.Additional use of propofol in the afternoon group 387 (42.5%)was higher than group morning’s 1 99 (23.5%)(P <0.05).Conclusion In gynecological clinic short operation,the propofol dosage in afternoon was higher than that in the morning group.But the sedation time length in afternoon was not longer than that in the morning.

Objective To evaluate the effectiveness of an activity of nutrition science experience on nutrition and food safety cog-nition among primary and secondary school students .Methods With stratified cluster sampling ,students of grade 5 and 6 in one primary school and students of grade 1 and 2 in one middle school in Chongqing were selected ,and randomly divided into interven-tion group(n= 501) and control group(n= 522) .Only conducted the activity in the intervention group .Baseline data of all the students were investigated before the intervention .Effect evaluation was performed instantly in the intervention group and control group ,and a follow-up survey carried out in the intervention group after 9 months(n= 472) .Results The nutrition knowledge scores of instant intervention group were 9 .03 ± 2 .75 and 14 .70 ± 3 .28 before and after intervention respectively (U=29 .78 ,P<0 .01);the knowledge scores of the nine months later intervention group were 12 .35 ± 2 .89 ,which were lower than instant interven-tion group(U=12 .40 ,P<0 .01) ,but higher than before intervention(U=18 .04 ,P<0 .01) .The food safety scores of instant inter-vention group ,which were higher than control group ,nine months later intervention group and before intervention(P<0 .01) .Con-clusion It is feasible and effective to conduct a nutrition science experience among primary and secondary school students .

Objective To explore the association between folic acid supplementation during periconcerptional period and congenital heart disease in newborns to provide scientific evidence for making intervening measures.Methods Using stratified random cluster sampling,a total of 30 counties were sampled from Shaanxi Province.A questionnaire survey was conducted among childbearing-aged women pregnant between January 2010 and November 2013.All of the included women had definite pregnancy outcomes and had signed the consent form.Logistic regression was performed to investigate the association between folic acid supplementation during pregnancy and congenital heart disease in newborns.Results In total,28 354 questionnaires were available for analysis.The overall prevalence of congenital heart disease among live-birth neonates in the present study was 7.3‰.The percentage of childbearing-age women who had taken folic acid supplementation during pregnancy was 64.4％,while only 17.2％ of them took folic acid according to the specification.Taking folic acid regularly during pregnancy was associated with a lower risk of congenital heart disease among the newborns (OR 0.502,95％ CI:0.279 0.902).The multiple-factor analysis results also showed that taking folic acid regularly during periconcerptional period could reduce the risk of congenital heart disease (adjusted OR=0.512,P=0.046) when we controlled the family background factors,mother factors and exposure risk factors during pregnancy.However,no association was found between irregularly taking folic acid during periconcerptional period and the risk of congenital heart disease.Conclusion Taking folic acid according to the specification during periconcerptional period (taking folic acid during 3 months before pregnancy to 3 months after pregnancy with a daily dose of 0.4mg for more than 90 days) may prevent congenital heart disease of newborns.

Objective To analyze the effect of special risk exposures during periconception period on birth defects of newborns.Methods From Jul.to Dec.2013,the multi-stage stratified random sampling method was adopted.Women of childbearing age between 15 and 49 who were pregnant during 2010 to 2013 in Shaanxi Province were selected as study subjects for investigation on special risk factors exposed during periconception period.The Logistic regression model was adopted to analyze the association between newborns' birth defects and special risk exposures.Results The study included 30 010 women of childbearing age and 29 550 newborns with 572 (193.57/ 10 000) cases of birth defects.After adjusting for demographic factors,the risk factors for birth defects were drinking [OR=2.29,95％ CI (1.22,4.29)] and passive smoking [OR=1.25,95％ CI (1.02,1.53)] during periconception.There was a higher risk of birth defects when exposure to medicine [OR =1.64,95％ CI (1.04,2.61)],pesticides [OR =2.41,95％ CI (1.09,5.35)],biological risk factors [OR-1.64,95％ CI (1.05,2.56)],physical risk factors [OR=1.15,95％ CI (1.13,2.34)] and chemical risk factors [OR =2.36,95％ CI (1.36,4.11)] 3 months both before and after pregnancy.Similarly,after adjusting for demographic factors and behaviors,we found that birth defects were related to antibiotics,salicylates,and antitussive,which could increase the risk of birth defects (P＜0.05).Conclusion Exposure to passive smoking and drinking during periconception and exposure to medicines and pesticides,as well as biological,physical and chemical risk factors 3 months before and after pregnancy could increase the risk of birth defects in newborns.

Objective To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) guided with endoscopic ultrasonography (EUS) for rectal neuroendocrine neoplasms(NENs).Methods A retrospective analysis was performed on 58 patients with rectal ENEs who underwent ESD from January 2011 to December 2015 in JiangSu Province Hospital.Manifestations of EUS, clinicopathological characteristics, proliferation activity grade, complete resection rate, complications and follow-up results of lesion were studied.Results Those treated by ESD included 58 patients with 64 lesions of rectal NENs.EUS results showed that 3 lesions originated from mucosa, 3 from muscularis mucosa and 58 from submucosa.A total of 34 lesions located within 5 cm from anus, 26 in 6-10 cm from anus and 4 more than 10 cm from anus.All 64 lesions were successfully treated by ESD.The mean maximum diameter of the lesions was 0.8 cm(0.2-3.5 cm), and the mean procedure time was 31 min(10-60 min).The complete resection rate was 93.8% (60/64).There were 4 patients with positive basal surgical margin, and two of them underwent additional surgery and two others were treated with argon plasma coagulation after rejecting surgery and ESD.Histological examination determined that 59 lesions were pathologic grade 1(G1) and 5 were pathologic grade 2(G2).Delayed bleeding occurred in 4 cases after ESD,which was managed by medicine in 1 case and endoscopic treatment in 3 cases.No perforation occurred after ESD.During a mean follow-up period of 22.9 months(3-48 months), no lymph node metastasis or distant metastasis was observed.Conclusion EUS is able to distinguish the origin of rectal NENs and aid determining the range and depth of ESD.ESD appears to be a safe, feasible and effective procedure for providing accurate histopathologica1 evaluations as well as curative treatments for rectal NENs limited to submucosa.

Objective To investigate the prediction of maternal HBV transmission by breast milk of postpartum women with chronic HBV infection.Methods HBV DNA levels in serum and breast milk weredetected by fluorescent quantitative polymerase chain reaction in 64 postpartum women with chronic HBV infection.HBV DNA≥1.0×103copies/ml was defined as positive,and correlation analysis was conducted.Results HBV DNA positive rate was 78.1%and 62.5%in serum and breast milk respectively,with a HBV DNA range of 1.05×103～3.87 ×104copies/ml in breast milk.When HBV DNA in serum was 1.0×105～1.0×107copies/ml,the HBV DNA positive rate in breast milk reached to 94.9%;however,when HBV DNA in serum was 1.0×103～1.0×104copies/ml,the positive rate in breast milk was only 18.2%.Conclusion The HBV DNA positive rate of breast milk in postpartum women with chronic HBV infection is correlated with the HBV DNA levels in serum;and breast-feeding should be avoided for postpartum women with HBV DNA≥1.0×105copies/ml in the serum.So serum HBV DNA detection is necessary in antenatal care for women with chronic HBV infection.

Objective:To explore the effectiveness of patient participation and Internet plus in fall prevention management strategies of elderly inpatients and analyze the causes of falls, so as to provide a basis for continuous improvement in fall prevention to investigate their continuous improvement.Methods:A pre- and post-control study was conducted. Totally 8 480 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2020 to 31 May 2021 in Chenzhou NO. 1 People′s Hospital were selected by convenient sampling as the control group, and 8 662 elderly inpatients hospitalized in the Department of Internal Medicine from 1 June 2021 to 31 May 2022 were in the experimental group. The routine fall prevention measures were used in the control group, and on this basis, the experimental group formulated and implemented fall prevention management strategies involving patients based on the patient participation framework "informing, participating, empowering, cooperating, and electronic information support" and introduced Internet plus. Then the differences between the two groups in terms of the incidence of falls and the satisfaction rate of nursing care were compared.Results:The experimental group included 8 662 cases (5 110 males and 3 552 females) with (73.96 ± 8.78) years old, while the control group included 8 480 cases (4 918 males and 3 562 females) with (74.11 ± 8.59) years old. The incidence of falls in experimental group (0.092%, 8/8 662) was lower than that in control group (0.224%, 19/8 480), and the difference was statistically significant ( χ 2=4.71, P<0.05); the nursing care satisfaction rate of experimental group (98.880%, 8 565/8 662) was higher than that of control group (96.450%, 8 179/8 480), and the difference also was statistically significant ( χ 2=106.50, P<0.01); the analysis of the fall causes of the patients revealed that the toilet squatting commode was an important hidden risk of falls in elderly patients. Conclusions:Fall prevention management strategies based on patient participation can reduce the incidence of falls in elderly patients and improve the satisfaction rate of nursing care. Patient participation introduced "Internet plus" can prevent patient falls. The root causes of patient falls will continue to change, and care managers should continually track real-time changes in the root causes of falls to identify problems, develop and adjust prevention strategies accordingly, and pay attention to the importance of infrastructure in the safety of older patients.

Objective:To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography (QCT) and the differences of bone mineral density (BMD) in different regions of in Chinese adult males.Methods:Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast, North, East, South, Central and Southwest of China from January 2018 to December 2019 were selected. And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system (Mindways Software, Inc.). The mean BMD values and their decline rates were calculated at an age interval of 10 years, and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results:A total of 50 682 males with a mean age of (50.22±12.79) years (ranged 20 to 98 years) were included in this study. The peak BMD of (173.11±28.56) mg/cm 3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age. Before the age of 70 years, the BMD was relatively higher in males in South China, and it was lower in Central China and Southwest China, and it was intermediate in Northeast, North and East of China, with statistically significant differences. There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China. The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92% over the lifetime, and it declined obviouslyin the 40-49 age group. The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%, with the highest prevalence in Southwest China and Central China (14.72% and 13.87%, respectively) and the lowest in North China and South China (8.53% and 7.71%, respectively). Conclusions:A reference of lumbar spine BMD values for healthy males in China based on QCT is established. BMD values were highest in South China and Lowest in Central China.