Objective To determine the relationship of ultrasonographic features and the expression of estrogen receptor(ER)in infiltrating duetal carcinoma(IDC)and infiltrating lobular carcinoma(ILC)of breast. Methods 118 patients with breast cancer were evaluated by ultrasonography.Ultra sonographic features in- cluded spiculate margin,posterior shadowing,microcalcifications,axillary lymphnodes metastasis,pre-and post-menopause and size of breast tumor.Scanning was performed before operation.The mastectomy speci- mens were stained with immunohistochemistry,and the expression of ER was measured.Results The expres- sion of ER was significantly correlated with spiculate margin and posterior shadowing in IDC and ILC(P0.05).Conclusion The biologic behavior and prognosis of breast IDC and ILC can be assessed according to ultrasonographic features to some extent.

Objective To establish dried blood spot determination for quantitative analysis of creatine phosphokinase (CK) activity; To analyze the correlation of CK value between serum detection and dried spot determination, and set up a 'cut-off point' for screening of pathologically high CK values in dried blood spot determination. MethodsA total of 100 samples were analyzed quantitatively with two methods (serum detection and dried blood spot determination) for CK activity. The correlation of the two methods was studied. The ' cut-off point' for screening of pathologically high CK in dried blood spot determination was calculated with receiver operating characteristic curve (ROC curve). ResultsOf the 100 samples, 50 were normal and other 50 were abnormal when the 'cut-off point' was set at serum CK of 170 IU/L. There was a positive correlation in CK values between serum detection and dried blood spot determination (r = 0.764, P < 0.01). However, the values measured with the two methods could not be interchanged. The sensitivity and the specificity were 90% when the 'cut-off point' was set at 150 lUlL. The sensitivity and the specificity were 70% and 72%, respectively, when the 'cut-off point' was set at 400 IU/L. ConclusionsThere was a good correlation in CK activity between serum detection and dried blood spot determination. 400 IU/L could be suggested as the 'cut-off point' for detecting pathologically high CK in dried blood spot determination.

Foods derived from plants are thought to be devoid of vitamin B12. We have found that some fermented foods contained microbiologically active vitamin B12 components.In order to ascertain the amount of physiological active vitamin B12, we have established a bioautographic area quantitative method of determination of vitamin B12. The procedure is described briefly as follows:The extract of fermented soybean food sample is spotted on a filter paper strip. The Paper is developed with a mixture of secbutanol-water-ammonia water- 5 % potassium cyanide (100: 50: 1: 0.5) using descending technique. After developing for 24-72 hours, the strip is taken out and dried in air. It is then put on the surface of nutrient agar containing E. coli 44110 and 2,3,5,-triphenyl tetrazolium chloride. After incubation, the area of spot of growth is measured and the amount of vitamin B12 in the sample is calculated.Two types of fermented soybean food samples were assayed by the above procedure, mean values of vitamin B12 content are: fermented soybean curd with strong smell contains 0.97 ?g/100g sample, fermented soybean curd contains 0.41 ?g/100g sample. Compared with animal foods, both types of fermented soybean foods may be considered as good source of vitamin B12.

Bnip3,a kind of mitochondrion apoptosis gene,belongs to the Bcl-2 gene family and BH3-only subfamily.It is one of the downstream response factors of hypoxia inducible factor (HIF).Bnip3 can induce cell apoptosis and autophagy under the oxygen deficit condition.Many studies show that Bnip3 is closely related to the occurrence,development and treatment of tumors.Molecular targeting treatment aimed at Bnip3 combined with chemoradiotherapy has preferable application foreground in tumor therapy.

Objective To evaluate the effect of management by objective implementation in neurology department nurse training.Methods Divided the nursing students into the experimental group and the control group according to their student ID,there were 100cases in each group.Routine training was used in the control group,while the training based-on management by objective was used in the experimental group.Compared the intervention effects between the two groups.Results The scores of theory,skills and the comprehensive performance in the experimental group was significant higher than that of in the control group respectively,P＜0.01.The excellent rate of theory and skills in the experimental group was 57.95％ (2 434/4 200) and 49.74％ (1 691/4 200),which was significant higher than those of in the control group [28.62％ (1 202/3 400) and 21.91％ (745/3 400)],P＜0.01.The intervention measures had increased the theoretical scores 21.011 times,OR=21.011,95％CI 9.752-45.269,increased the skills scores 14.625 times,OR=14.625,95％ CI7.032-30.416,increased the comprehensive performance 23.993 times,OR=23.993,95％CI1.085-51.934.Conclusion The implementation of management by objective on nurse training can improve the trainee's theory and professional knowledge,the nursing skill can be improved also.So the comprehensive training effect is higher than before.

Objective To investigate the role of endoplasmic reticulum stress in lung ischemiareperfusion (I/R) injury in rats.Methods Fifty-six healthy male Sprague-Dawley rats,weighing 250-320 g,were randomly divided into 2 groups using a random number table:sham operation group (group S,n=16) and I/R group (n=40).Lung I/R was induced by clamping the left hilum of lung for 60 min followed by reperfusion.Before ischemia (T0) and at 0,1,2 and 4 h (T4) of reperfusion,PaO2 and PaCO2 were recorded.The rats were sacrificed,and lungs were removed for examination of pathological changes.Wet/dry lung weight ratio (W/D ratio) was calculated.The expression of molecular chaperones of 78-kDa glucose-regulated protein (GRP78) and C/EBP homologous protein (CHOP) protein and mRNA was detected in lung tissues using Western blot and real-time PCR,respectively.Results Compared with group S,PaO2was significantly decreased,PaCO2 and W/D ratio were increased,and the expression of GRP78 and CHOP protein and mRNA was up-regulated during reperfusion,and the pathological changes of lungs were found in group I/R.With the prolongation of reperfusion,the pathological changes of lungs were gradually aggravated,and the expression of GRP78 and CHOP protein and mRNA was gradually up-regulated in group I/R.Conclusion Excessive endoplasmic reticulum stress may be one of the pathophysiological mechanisms of lung I/R injury in rats.

ObjectiveTo investigate the context-sensitive half-times of etomidate. Methods Twenty patients ( ASA Ⅰ - Ⅱ ) underwent selective thoracic operation were divided into 2 groups by random digits table with 10 cases each,the patients were allocated to receive either continuous infusion etomidate 10μg/(kg·min) for 1 h(Gl group) or continuous infusion etomidate 10 μg/(kg·min) for 2 h(G2 group) of maintenance anesthesia. The samples were collected at the following time points: 1 min before stop infusion,2,5, 10,15,20,30,40,50 and 60 min after stop infusion. The plasma concentrations of etomidate were measured by high-performance liquid chromatography and the changes of the context-sensitive half-times of etomidate were calculated. ResultsThe context-sensitive half-times of etomidate was ( 17.1 ± 13.1 )min in G1 group and (21.7 ± 15.1 ) min in G2 group. There was no significant difference between two groups (P＞0.05). ConclusionThe context-sensitive half-times of etomidate is short and its pharmacokinetic profile is suitable for continuous infusion.

The objective of this paper is to build a real-time and highly efficient platform for medical information in wartime.The different characteristics of the wartime medical information are analyzed.Based on the hospital information system,and centering on rescue timeliness,continuity,and quality as well as the coordination of medical service command,a wartime medical information platform is designed,which is significant to the medical work in wartime.

Objective To investigate the effect of emulsified isoflurane preconditioning on focal cerebral ischemia-reperfusion (I/R) injury in rats and the mechanism. Methods Fifty-six healthy male adult SD rats weighing 250-280 g were randomly divided into 4 groups (n = 14): group Ⅰ sham operation (group S); group Ⅱfocal cerebral I/R; group Ⅲ emulsified isoflurane preconditioning and group Ⅳ fat emulsion preconditioning. Focal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) using a nylon thread with rounded tip inserted into internal carotid artery and advanced cranially until resistance was met. MCAO was maintained for 2 h followed by 24 h reperfusion. In group Ⅲ and Ⅳ 8% emulsified isoflurane 7.5 ml/kg and 3% fat emulsion 7.5 ml/kg were injected intraperitoneally at 24 h before MCAO respectively. Neurologic outcome was evaluated at 24 h of reperfusion and scored (0 = no deficit, 4 = unable to crawl, loss of consciousness). The animals were then killed and brains removed. The infarct size was assessed. The apoptotic cells were detected by TUNEL and calculated. The expression of Bax, Bcl-2, cytochrome C and caspase-3 protein was detected by immunohistochemical staining. Results The neurologic deficit scores were significantly lower in emulsified isoflurane preconditioning group than in I/R group. Preconditioning with emulsified isoflurane significantly decreased the infarct size and the number of apoptotic cells and increased the expression of Bcl-2 protein and inhibited the expression of Bax, cytochrome C and caspace-3 protein. Conclusion Emulsified iscflurane preconditioning can protect the brain from focal cerebral I/R by increasing Bcl-2 protein expression and decreasing Bax protein expression, and reducing cytochrome C release from mitochondria, caspase-3 activation and neuronal apoptosis.