Objective To investigate clinical characteristics of the multi-center breast DCIS (ductal carcinoma in situ), in order to improve the rate of early diagnosis. Methods Clinical data of 23 multi-center breast DCIS patients admitted and operated on from September 2003 to February 2009 at our department were retrospectively reviewed. Results There were 4 cases associated with nipple discharge,and 18 cases with preoperative negative physical examination (78%). In the preoperative examination within 6 months, the positive rate of mammography was 90% mainly characterized by the existence of diffuse and multiple small calcifications. The positive rate of MRI was 25%, B ultrasound had no positive findings. The patients that were confirmed multi-center breast DCIS by intraoperative frozen section examination received mastectomy and ipsilateral axillary L1, L2 lymph node dissection. Conclusion The diffuse and multiple small calcification is one of early clinical characteristics of multi-center breast DCIS. Although the disease has a wide range of lesion, it still is an early tumor, and has a favourite prognosis after comprehensive treatment.

Child ; Child, Preschool ; Humans ; Sleep Apnea, Obstructive

Objective To study cervical central group (VI region) lymph node metastasis with papillary thyroid microcarcinoma and correlative influencing factors.Methods Clinical data of 215 papillary thyroid microcarcinoma patients undergoing surgery between Jan 2007 and Jan 2011 were analyzed retrospectively.Results All patients accepted bilateral thyroidectomy and bilateral cervical central group lymph node dissection.The total incidence of cervical central group lymph node metastasis was 36.7％ (79/215).Factors relating to cervical central group lymph node metastasis rate were:age (with one year elder,the likelyhood of lymph node metastasis was 0.935 times lesser),gender (the ratio of female to male was 0.202),the number of foci and the sum of the diameters of all lesions.Conclusions Patients with papillary thyroid microcarcinoma may suffer from lymph node metastasis of the cervical central group,and lymph node metastasis rate increases significantly in young or male patients,and when the lesions were multifocal or the sum of the tumor diameter ＞ 0.5 cm.

Child ; Choristoma ; Humans ; Male ; Neck ; pathology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Thymus Gland ; pathology ; Thymus Neoplasms

OBJECTIVETo explore the effects of sacral canal injection on nerve root local inflammatory factors in rat model with lumbar disc herniation, in order to identify its mechanism of treatment.

METHODSForty-eight male SD rats were randomly divided into sham operation group(group A), model group (group B), Chinese medicine group(group C) and western medicine group(group D). There were 12 rats in each group. The model of lumbar disc herniation was established using compression and inflammatory stimulation in group B, C, D. All rats were given epidural catheterization and group A and B with physiological saline (1 ml/kg), group C with mixed liquor of 2% lidocaine and compound Danshen injections and physiological saline (2:2: 16) and group D with mixed liquor of 2% lidocaine and triamcinolone acetonide injection and physiological saline (2:2:16), once a week for a total of three treatments. Four rats were killed every 1 week after injection for once, and the inflammatory factors of tumor necrosis factor (TNF-alpha), prostaglandin E2 (PGE2), interleukin-l (IL-1) and interleukin-6 (IL-6) were detected by ELISA method.

RESULTSThe levels of TNF-alpha, PGE2, IL-1 and IL-6 in compressed nerve tissues in group B were increased than those of group A (P < 0.01). The levels of PGE2, IL-1 and IL-6 in group C and D were decreased than those of group B, and group D was much less(P<0.05). There was no significant difference in level of TNF-alpha among group B, C, D (P > 0.05).

CONCLUSIONCompound compression with inflammatory stimulation can lead to massive release of inflammatory mediators, such as TNF-alpha, PGE2, IL-1 and IL-6. Both injection with compound Danshen injections and triamcinolone acetonide injections by sacral canal can reduce the levels of part inflammatory mediators (PGE2, IL-1 and IL-6), and the effect of Glucocorticoid is better than Danshen (P < 0.05).

Animals ; Dinoprostone ; analysis ; Disease Models, Animal ; Injections ; Interleukin-1 ; analysis ; Interleukin-6 ; analysis ; Intervertebral Disc Displacement ; drug therapy ; immunology ; Lumbar Vertebrae ; Male ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; Spinal Nerve Roots ; immunology ; Triamcinolone Acetonide ; administration & dosage ; Tumor Necrosis Factor-alpha ; analysis

Objective To investigate the developmental characters of neural stem cells(NSCs) in occipital of cortex from human fetal brain at different age.Methods Ninety cases of embryoes at gestational age 16-32 weeks and by induction of labor with water bag were collected for determining distribution,shapes,growth modes and the number of NSCs in the occipital of cortex with immunohisto- chemical method under light microscope.Results It was noted that NSCs existed in the occipital of cortex from human fetal brain at different ages.NSCs mainly distributed in layers of cone cells and inner granule cells.NSCs existed in the occipital of cortex of different fetal age included middling round cells,NSCs had enations from 0 to 1.Nucli were larger than plasm.Each NSC had nucleoli from 2-4 and rarefaction chromatin.Most of NSCs distributed in three growth modes including crowd,cluster and clone,occasionally with a single growth mode among other nerve cells.There were no differences including distribution,shapes,growth modes and the number of NSCs in the occipital of cortex between groups,but,NSCs gradually decreased with increasing of age.Conclusion NSCs exists in the occipital of cortex from different gestational age,and the number of NSCs decreases with increasing of age.

To study the stimulation effect to the growth of Bifidobac te rium sp. A04, 4 kinds of oligosaccharide, 8 kinds of Chinese traditional medi cine and 4 kinds of food raw materials were used. The results indicates that so ya bean oligosaccharide is the most effective (P

Adenoma ; pathology ; Brain Neoplasms ; secondary ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Pituitary Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Reoperation ; Synaptophysin ; metabolism ; Temporal Lobe ; pathology

OBJECTIVETo establish a clinical data based practical diagnostic model for Chinese medicine syndrome differentiation in patients with chronic hepatitis B (CHB), by way of seeking a combination of symptoms, signs and laboratory criteria associated with the typical syndromes of the disease.

METHODSA syndromatologic and laboratory investigation on 88 symptoms, 20 signs, and 14 laboratory indexes, was conducted in 1004 CHB patients. The clinical data of typical syndromes were selected and analyzed using Logistic regression analysis, decision tree and Bayesian network analysis in combination to establish a diagnostic model for effectively identifying the typical syndromes in CHB.

RESULTSThe most typical syndromes revealed in the 1004 CHB patients were the Gan-dan damp-heat syndrome (340 patients, accounting for 33.86%) and the Gan-stagnancy with Pi-deficiency syndrome (366 patients, 36.45%). Based on the clinical data from patients with the two syndromes, 16 symptoms/signs and 3 laboratory indicators, provided with statistical significance, were selected using Logistic regression analysis. Then, a diagnostic model for differential the two syndromes, which was proved to have an accurate diagnosic rate of 74.36%, was formed by decision tree method. It was found that white tongue coating, light red tongue, yellow sclera, eye dryness, blood levels of alanine aminotransferase and HBeAg appeared to be the effective combination of indexes that may be helpful to differentiate the two syndromes. And the significance of the above-mentioned indexes was also verified by a Bayesian network approach.

CONCLUSIONA decision tree model for diagnosing the two typical syndromes in CHB patients, the Gan-dan damp-heat syndrome and the Gan-stagnancy with Pi-deficiency syndrome, was established, which could be helpful for shifting the diagnosis of syndrome from experience-based to the data-model-based form, to make the syndrome diagnosis more objectively.

Adult ; Decision Trees ; Diagnosis, Differential ; Female ; Hepatitis B, Chronic ; diagnosis ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Yin Deficiency ; diagnosis ; Young Adult

OBJECTIVETo retrospectivly compare the clinical efficacy of dynamic hip screw (DHS) with proximal femoral nail anti-rotation (PFNA) for the treatment of unstable intertrochanteric fractures in the elderly.

METHODSTotally 92 elderly patients with unstable intertrochanteric fractures were treated with DHS [including 27 males and 23 females with a mean age of (72.5 +/- 5.3) years old] and PFNA [including 22 males and 20 females with a mean age of (72.8 +/- 5.8) years old] from August 2008 to August 2012. The data of operation time,blood loss (obvious and hidden blood loss), bedridden time, down load time, postoperative complications and Harris hip function score were recorded and compared.

RESULTSBoth of two groups were followed-up for 10 to 18 months with an average of 13.5 months. PFNA was implanted with a significantly smaller incision and shorter clinical healing time, less blood loss,while hidden blood loss were more. Postoperative complications, therapeutic effects and Harris score in PFNA group were better than that of DHS group.

CONCLUSIONFor treatment of senile patients with unstable intertrochanteric fractures, PFNA was superior to DHS in reducing complication rates, recovering hip joint, while DHS could reduce perioperative blood loss in treating type II a, II b and III fracture.

Aged ; Aged, 80 and over ; Bone Nails ; Bone Screws ; Case-Control Studies ; Female ; Femur ; surgery ; Fracture Fixation, Internal ; instrumentation ; Hip Fractures ; surgery ; Humans ; Internal Fixators ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome