OBJECTIVETo investigate the clinicopathological features and prognosis of primary squamous cell carcinoma of the breast and to improve the diagnosis, treatment and prognosis of this disease.

METHODSThe clinicopathological data of 22 patients with primary squamous cell carcinoma of the breast treated in our hospital between January 1985 and January 2011 were retrospectively reviewed. The correlation between age, tumor size, axillary node status, treatment modality and prognosis was statistically analyzed.

RESULTSAll the 22 patients were female and their median age was 56 years.The average tumor diameter was 3.6 cm.The diagnosis was confirmed by histopathology. The positive rates of expression of ER, PR and HER-2 of the breast cancers were 9. 1%, 9. 1% and 33. 3%, respectively. In follow-up visits, recurrence or metastasis was found in 5 patients and they all died of it. The median overall survival of the 22 patients was 60 months and their overall 5-year survival rate was 73.6%. Univariate analysis showed that the tumor maximum diameter (P = 0.024) and axillary lymph node status (P = 0.022) were impact factors, while menopause, chemotherapy and radiotherapy were not. Cox multivariate analysis showed that the tumor size (P = 0.021) and axillary lymph node status (P = 0.037) were independent prognostic factors for primary squamous cell carcinoma of the breast.

CONCLUSIONSPrimary squamous cell carcinoma of the breast is a rare entity and lack of specific clinical features. Axillary node status is an independent prognostic factor.

Analysis of Variance ; Axilla ; Breast Neoplasms ; metabolism ; mortality ; pathology ; Carcinoma, Squamous Cell ; metabolism ; mortality ; pathology ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Survival Rate ; Tumor Burden

Objective:To improve the recognition, appropriate diagnosis, and treatment of breast cancer in women aged 25 years or less through their clinicopathological features, diagnosis, treatment, and prognosis. Methods:The clinicopathological data from 77 patients with breast cancer treated in our hospital between January 1995 and January 2010 were retrospectively reviewed. The correla-tion between age, lactation, tumor size, axillary node status, surgical approach, pathological stage, indicators of immunohistochemistry treatment modality, and prognosis was analyzed using statistical software. Results:All patients were female, and their average age was 22.94 ± 1.94 years. The diagnosis depended on pathological examination. In the follow-up visits, recurrence or metastasis was found in 27 patients, of which 18 died . The median overall survival was 39 months, and the median progression-free survival was 36 months. The 3 year overall survival rates of stagesⅠ,Ⅱ,Ⅲ, andⅣwere 100%, 92.44%, 59.97%, and 0, respectively. The 5 year overall sur-vival rates of the four stages were 100%, 86.84%, 59.97%, and 0, respectively. Univariate factor analysis showed that tumor size, axil-lary lymph node status, surgical approach, pathological stage, and estrogen receptor were impact factors, whereas lactation, progester-one receptor, human epidermal growth factor receptor-2, p53, molecular subtyping, chemotherapy, and radiotherapy were not. Cox mul-tivariate analysis showed that axillary lymph node status was an independent prognostic factor for breast cancer in women aged 25 years or less. Conclusion:Breast cancer in young women is rare and has unique characteristics in biological behaviors, diagnosis, prognosis, and other factors. Axillary lymph node status was an independent prognostic factor. The crucial factors in the treatment were diagnosis and on time and early-stage treatment.

Objective To explore the roles of bacterial infection in the pathogenesis and progression of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Methods The clinical data of 604 patients with ALI or ARDS hospitalized from April 1991 to March 2001 were analyzed. Results (1) The cause of direct lung injury was predominantly ascribed to lung infection, whereas indirect lung injury was due to sepsis. (2) The gram positive cocci (50.76%) and gram negative bacilli (40.15%) in the isolated pathogenic bacteria from patients were approximately similar. Furthermore, Staphylococcus aureus and Pseudomonas aeruginosa were the first and second pathogenic bacteria, respectively. (3) The incidences of ALI and ARDS in infected patients significantly increased with the grade elevation of systemic inflammatory response syndrome (SIRS) ( P

The paper introduces and summarizes the teaching purpose and content project,implementation and effect of the optional course in Excel and medical data analysis.

Purpose To investigate the significance of PET/CT in differential diagnosis of incidental thyroid benign or malignant lesions with high fluorodeoxyglucose (FDG) uptake.Materials and Methods Forty cases with focal high FDG uptake lesion in thyroid accidently detected by PET/CT were retrospectively collected. The subjects were dived into physiological uptake group (n=18), benign lesion group (n=16) and malignant lesion group (n=6) according to the pathology or follow-up examinations. The average SUVmax of different groups was analyzed, and ROC curve was used todetect benign or malignant lesions.Results The average SUVmax was 3.7±1.1 in physiological uptake group, 4.9±2.3 in benign lesion group and 9.5±4.8 in malignant lesion group. Significant difference was noticed among the three groups. The average SUVmax in malignant lesion group was higher than that of the other two groups with statistical difference (P<005). No significant difference was observed between physiological uptake group and benign lesion group (P>0.05). ROC analysis showed that the sensitivity and specificity for thyroid malignant tumor were 100.0% and 87.2% at SUVmax of 8.5.Conclusion18F-FDG PET/CT plays an important role in differentiating benign lesions of thyroid from malignance, but it is not helpful to identify benign lesions from physiologic uptake.

Objective This study seeks to use a meta-analytical approach to quantitatively assess the results of applying the problem-based learning(PBL) teaching model and the traditional lecture-based learning(LBL)teaching model to basic medical courses in undergraduate medical edu-cation. Methods The CNKI and VIP databases were electronically searched to retrieve randomised controlled trial studies that examined the use of PBL methods for basic medical courses in under-graduate medical education. In these studies PBL teaching model was used in experiment group and LBL teaching model was used in control group. Pass rate or test scores was used to evaluate the effect of learning. The retrieved documents ranged from the time that each database was first constructed to December 2012. After two researchers performed literature screening independently, data extraction, and quality assessment procedures in strict accordance with the inclusion and exclusion criteria of this study, the Stata 11.0 software package was utilized to conduct the meta-analysis. Results This meta-analysis examined 28 studies that included a total of 3703 subjects. The modified Jadad scores of 20 studies(71.4%) were less than 4, and those of 8 studies(28.6%) were more than or equal to 4. The meta-analysis revealed that compared with the traditional teaching model, the PBL teaching model did not produce improved examination passing rates for a course [relative risk(RR):1.05, 95%confidence interval(CI):(0.99, 1.10), P=0.098] but could improve examination scores for a course [standardized mean difference (SMD): 0.73, 95% CI: (0.51, 0.96), P<0.001]. Conclusion For basic medical courses in undergraduate medical education, compared to LBL teaching, PBL teaching can improve students' test scores but cannot improve students' pass rate. PBL used in basic medical courses has di-versified forms and lacks unified criterion, so there is still a long way to go for the appli-cation of PBL.

Aim To investigate the effects of ginsenoside(GS) on phosphorylation of tau protein,microtubule,cellular apoptosis and its related factors in cellular model of Alzheimer disease(AD) induced by the protein phosphatase 1 and 2A inhibitor okadaic acid(OA).Methods The human neuroblastoma cell line SK-N-SH cells were cultured with GS for 24 h,the culture medium was changed,and then incubated with OA 10 nmol?L-1 for 6 h.The changes of cell morphology were observed by inverted microscope.The laser confocal microscopy was used to observe the microtubule changes.Western blot was applied to determine the expression of phosphorylation of tau protein,and apoptosis-regulating factors Bcl-2,Bax and Caspase-3.The changes of apoptotic cells were observed by TUNEL method.Results The normal SK-N-SH cells spread well.OA-treated cells showed that the cell axons and the microtubules were broken and decreased under the inverted microscope and laser confocal microscope.Preincubation of GS demonstrated the significantly protective effects against the morphologic damage induced by OA.In OA-treated group,the phosphorylation of tau protein at Ser-199/202 and Ser-404 sites was higher than that in normal group,and the non-phosphorylation of tau protein at the same sites was lower;Incubation of GS at the dose of 50 mg?L-1 and 100 mg?L-1 with the cells decreased the phosphorylation of tau protein Ser-199/202 and Ser-404 sites.GS group at the dose of 50 mg?L-1 and 100 mg?L-1 decreased the expression of at non-phosphorylation of tau protein at the Ser202 site.The apoptotic cells were not found in normal group.The number of apoptotic cells were obviously increased.the expression of Bax and caspase-3 significantly enhanced,and Bcl-2 expression decreased in the OA-treated model group.GS significantly decreased the apoptotic cell number of nerve cells,inhibited the expression of Bax and caspase-3.Conclusion GS can protect the nerve cells from pathological change induced by OA.Maybe because it can inhibit the hyperphosphorylation of tau protein and protect the nerve cells from apoptosis,thus GS may have potential to treat Alzheimer disease.

OBJECTIVE:To investigate the effects and the mechanisms of cornel iridoid glycoside(CIG)on antiapoptosis in cellular model of alzheimer disease(AD)induced by the protein phosphatase inhibitor okadaic acid(OA).METHODS:The human neuroblastoma cell line SK-N-SH cells were preincubated with CIG for 24 h,and then incubated with OA 10 nmol for 6 h.The changes of apoptotic cells were observed by TUNEL method.Western blotting was used to determine the expression of apoptosis-regulating factors Bcl-2,Bcl-2 related X protein(Bax)and Caspase-3.RESULTS:The normal SK-N-SH cells spread well and no apoptotic cells appeared.In OA-treated model group,the number of apoptotic cells increased significantly,the expressions of Bax and Caspase-3 increased significantly,but Bcl-2 expression decreased significantly.In CIG(100 and 200 ?g?mL-1)-treated group,the number of apoptotic cells decreased significantly as compared with OA-treated model group,and the expressions of Bax and Caspase-3 decreased significantly whereas Bcl-2 expression increased significantly.CONCLUSION:CIG can inhibit the apoptosis of nerve cells through affecting apoptosis-regulating factors,suggesting its potential as a therapy for AD.

Precision medicine pointed out the future direction for medicine,providing new opportunities for the development of TCM,putting forward higher requirements and encountering severe challenges of the quality research of TCM.In view of the core connotation of precision medicine and the characteristics of TCM,we presented the precision connotation of quality based on the basic attributes,the clinical application and function characteristics of TCM in accordance with the thinking mode and method of the transformation research.In this article,we indicated the research approach for the scientific evaluation and effective control of quality based on the precise cognition of TCM.

Objective To explore the relationship between infant feeding practices and infants growth,especially the weight gain for length in the first 6 months of life. Methods Two-hundred healthy full-term singlet normal birth weight 5 - 6 months old infants and their main care givers were recruited in Kongjiang community health service center in Shanghai. The questionnaires included infants feeding pattern, feeding environment and care givers feeding behaviors, and were completed on-site by investigators. The birth weight was obtained. The weight and length of infants at 6 months were measured. Results There were 70/200 (35.0%) infants overweight (BMI for age Z score>+1) at 6 months. There were more overweight boys than girls (40.0% vs. 30.9%, x2 = 1.798, P = 0.180). Compared with normal weight infants, the overweight infants had same birth weight (3.30 ± 0.35 kg vs. 3.35 ± 0.32 kg, t =1.010, P = 0.314) and same length at 6 months (67.64 ± 2.10 cm vs. 67.91 ± 1.97 cm, t=- 0.896, P = 0.371). However, the overweight infants gained much more weight for length in the first six months of life. At 6 months, the weight and BMI of overweight infants was significantly higher than that of normal weight infants (9.16 ± 0.67 vs. 7.94 ±0.64, t = 12.324, P < 0.01;19.86 ± 1.24 vs. 17.41 ± 0.80, t = 14.953, P < 0.01). The rates of exclusive breastfeeding for at least four months, continued breastfeeding at six months, complementary food consistency, and complementary feeding frequency, were not significantly differenct between overweight and normal weight infants (x2 =0.723 - 2.701, P > 0.05). The grandparents played an important role in infants feeding in Shanghai. There were 39.0% infants fed only by grandparents, and 23.0% infants fed jointly by grandparents and parents (x2 = 0.175, P > 0.05).The care givers' educational level and knowledge of feeding skill were similar in overweight and normal weight infants (x2 = 0.446, t = 0.949, P > 0.05). However, the overweight infants were fed more quickly than normal weight infants (Z = 2.753, P < 0.01), and there was less language communication between care givers and overweight infants during feeding (Z = 2.932, P < 0.01). In overweight infants, the overfeeding behaviors of care givers were positively correlated with BAZ (r = 0.281, P < 0.05). Conclusions Overweight in early life is associated with some particular infants feeding behaviors of care givers in Shanghai. The long term effect of more rapid weight gain for length in the first 6 months of life on the risk of childhood obesity warranted to be further followed and researched.