Objective To study the diagnos tic value of mammography, color Dopp ler ultrasound and biopsy in early breast cancer and to evaluate its diagnostic accuracy. Methods 55 patients with breast cancer an d 25 patients with benign breast masses, proved pathologically, were checked by mammogra phy, color Doppler ultrasound and biopsy. Results Mammography demonstrated bre ast cancer in 45 cases, the sensitivity and specificity were 82.0% and 88.0%, re spectively, with the accuracy of 83.8%; Color Doppler ultrasound revealed breas t cancer in 43 cases, the sensitivity, specificity and accuracy were 78.2%, 84 .0% and 80.0%; Biopsy demonstrated breast cancer in 53 cases, the sensitivity, specificity and accuracy were 96.4%, 92.0% and 95.0%. When ultrasound, mammagrap hy and biopsy were combined together, the sensitivity, specificity and accuracy were 98.2%, 96.0% and 97.5%. Conclusion Mammography, color Dopp ler ultrasound combined with biopsy can increase the diagnostic sensitivity and accuracy of ear ly breast cancers.

Objective To determine the mortality and associated risk factors in the patients with diabetic foot ulcers. Methods One hundred and sixty-three patients with diabetic foot ulcers hospitalized from January 2001 to December 2006 were followed up until December 2009. Mortality rates were derived from Kaplan-Meier survival curves. The prognostic factors were evaluated with Cox proportional hazard model. Results Follow-up was successful in 139 out of 163 patients, with a mean follow-up period of(3.71 + 1. 80)years. 55 patients(39 males and 16 females)died during the follow-up. The 5-year mortality was 45.8% and mean survival time was 5.38 years(95% CI 4.87-5.89). The median survival time was 6.83 years. Age, smoking, hypertension, coronary artery disease, and diabetic nephropathy were found to be independent prognostic factors for mortality. Conclusions Diabetic foot ulcers increased the mortality of diabetic patients. Age, smoking, hypertension, coronary artery disease, and diabetic nephropathy were predictive risk factors for mortality.

Objective To study the mini-invasive surgical treatment for cholelithiasis disease in the primary hospital. Methods Laparoseope,duodenoscope and choledochoscope were combined to treat 293 cases with cholelith-iasis which included 2 cases cholecystolithisasis, 131 cases were cholecystolithiasis with secondary choledocholith,28 cases with primary choledocholith,39 cases with calculus of intrahepatic duct,93 cases with calculus of intrahepatic or extrahepatic duct. Results The program had minor trauma, mild suffering, and less operative complications,compared with traditional open operations. Conclusion The combined treatment of laparoscopy, duodenoscopy, choledochoscope and surgery for the cholelithiasis in the primary hospital is feasible, safe and effective.

ObjectiveTo evaluate the clinical efficacy and safety of Baoshen prescription in the treatment of stage Ⅳ diabetic nephropathy （DN） in the patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction， and to explore the mechanism of this prescription delaying the disease progression. MethodsA randomized， controlled， double-blind， multicenter clinical trial was conducted， in which 94 stage Ⅳ DN patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction were randomly assigned into Baoshen prescription and control groups （47 cases）. The treatment lasted for 12 weeks. The primary efficacy indicators were mainly renal function indexes， including urine albumin-to-creatinine ratio （UACR）， 24-hour urine total protein （24 h-UTP）， serum creatinine （SCr）， and estimated glomerular filtration rate （eGFR）. The secondary efficacy indicators were metabolic memory of hyperglycemia， podocyte epithelial-to-mesenchymal transdifferentiation-related indexes， and TCM syndrome score. ResultsAfter 12 weeks of treatment， the Baoshen prescription group showed lowered levels of advanced glycation end products （lgAGEs）， connective tissue growth factor （CTGF）， type Ⅳ collagen （Col-Ⅳ）， receptor of AGEs （RAGE）， urinary fibroblast-specific protein-1 （FSP-1）， UACR， 24 h-UTP， and glycated hemoglobin （HbAlc） （P<0.05）， and an upward trend of miR-21 mRNA. The control group showed elevated levels of SCr and UREA and lowered levels of urinary FSP-1， eGFR， and HbAlc （P<0.05）. After treatment， the Baoshen prescription group had lower levels of lgAGEs， CTGF， urinary FSP-1， SCr， UACR， and 24 h-UTP and higher levels of Col-Ⅳ and eGFR than the control group （P<0.05）. In addition， the Baoshen prescription group showed statistically significant differences in SCr， eGFR， UACR， and 24 h-UTP before and after treatment （P<0.05）. ConclusionBaoshen prescription can effectively improve the renal function， reduce the urinary protein level， and alleviate clinical symptoms in stage Ⅳ DN patients with syndromes of Qi-Yin deficiency and kidney collateral stasis and obstruction. The mechanism may be related to the metabolic memory of hyperglycemia and epithelial-to-mesenchymal transdifferentiation of podocytes.