Objective To understand the trend of occurrence,diagnosis,and prognosis of breast cancer in the cases treated in Peking Union Medical College Hospital(PUMCH) between 1975 and 2006.Methods A total of 1092 cases of breast cancer treated in the PUMCH from 1975 to 2006 were classified into six groups by time span and reviewed for a comparative study on the parameters of gender,age,menstruation status,tumor size,mumber of positive axillary nodes,pathologic stage,recurrence and metastasis and disease-free survival rate.Results The average age of breast cancer patient has risen from 50.90 to 53.92,while 40-49 year-old group was the largest age group of breast cancer patients,and the percentage of menopause female was the highest.Tumor size has gradually been smaller especially since 2000.The number of positive axillary nodes showed no significant change during the time periods.In all 6 groups,stage-II cases were more frequent,although the percentage of stage-0 and stage-I cases was on the rise,while the percentage of stage-III declined,and that of stage-IV remained stable.In all 6 groups,the 5-year and 10-year disease free survival rate had steadily increased.Conclusions The early diagnostic rate of breast cancer has been improving and subsequently the prognosis has improved as well.

Humans ; Infant ; Male ; Mycobacterium tuberculosis ; Otitis Media ; microbiology ; Tuberculosis

Objective To systematically review the efficacy and safety of Jinlian Qingre Effervescent Tablet (JQET) compared to Ribavirin for acute upper respiratory tract infection in children.Methods CNKJ,CBM,WanFang Data,VIP,PubMed,EM base,Web of science,and Cochrane Library databases were searched from the date of establishment to December 2016 for all randomized controlled trials (RCTs) and quasi-RCT on the use of JQET in children with acute respiratory infections.Meta-analysis by using Rev Man 5.3.Results A total of seven RCTs involving 782 patients were included,while the group of JQET involving 392 patients,Ribavirin involving 390 patients.The results ofmeta-analysis indicated that the efficacy in Jinlianqingre group was superior to that of Ribavirin control group,such as clinical effectiveness [RR=l.26,95％CI=(1.18,1.34),P＜0.000 01],fever subsidence time [MD=-1.54,95％CI (-1.79,-1.30),P＜0.000 01],the time of subsided cough [MD=-1.53,95％CI (-1.79,-1.27),P＜0.000 01],the disappearance time of pharyngalgia [MD=-1.29,95％CI (-1.88,-0.70),P＜0.000 1],and Pharyngeal congestion disappearance time [MD=-2.80,95％CI(-3.11,-2.49),P＜0.000 01].The difference was statistically significant.There were three adverse reactions reported in JQET group.Conclusion JQET is superior to the Ribavirin control group in clinical effectiveness,fever subsidence time,time of subsided cough,disappearance time of pharyngalgia,and pharyngeal congestion disappearance time to treat acute upper respiratory tract infection in children.However,these results should be carefully interpreted,and this conclusion has to be further verified by high quality,large scale RCTs.

To introduce tutorial system for undergraduate in the forensic biology teaching is an important measure of educational reform of forensic medicine.The article presented some schemes and experiences about the practice of tutorial system for undergraduate in the forensic biology department of Kunming Medical College.

OBJECTIVE: To summarize the biocharacteristics, separation and purification as well as the culture technique of bone marrow mesenchymal stem cell, which has the potentiality of multiple cellular differentiations, locatedinduced differentiation of bone and cartilage, cellular carrying tray and application in bone tissue engineering.DATA SOURCES: Relative articles were retrieved through Medline database according to the key words of "mesenchymal stem cell, tissue engineer" in English between January 1990 and December 2004. Meanwhile,relative articles were also retrieved in Chinese journal full-text database and Wanfang database with the same key words in Chinese between January 1994 and December 2004.STUDY SELECTION: Articles were retrieved first to select those references which were related to the aspects of biology, isolation and culture of mesenchymal stem cell in tissue engineering. Representative and lated references were included; however, researches on non-bone tissue engineering and repetitive studies were excluded. The rest of articles were looked up for their full text.DATA EXTRACTION: There were 78 articles on mesenchymal stem cell in tissue engineering. Among them, 31 papers were included; the otherbut 47 papers including 13 articles of similar contents and 34 studies on nonbone tissue engineering were excluded.DATA SYNTHESIS: Mesenchymal stem cell mainly existed in bone marrow and could differentiated into multiple tissue cells and increase in vitro.① There were three methods for separation, purification and culture of mesenchymal stem cells: density gradient centrifugation, flow cytometry and adherent screening method. Other scholars obtained cell strain of mesenchymal stem cell through single-cell cloning technique, but this way was more difficult to obtain multiple seed cells. At present, density gradient centrifugation was widely used. ② Mesenchymal stem cell could differentiate into bone cells and cartilae cells through adding inductor into eligible culture medium. Ideal scaffolds could carry and retain the vitality of cells, support rapid endogeny of vessels and be benefit for observing new bone formation under X ray. New bone might be absorbed and replaced in bone rebuilding and form or increase conductive bridging of host bone. Functions of differentiated cells could be maintained by the interaction between scaffolds surface and cells, and the histocompatibility was well. ③ Mesenchymal stem cell was an kind of ideal target cells for gene therapy. It could shift growth factor or cytokine and express foreign protein after multiple desintegration in vitro. It was successful in bone tissue engineering.CONCLUSION: Modern tissue engineering which is presented by stem cells develops quickly at present, but tissue engineering of mesenchymal stem cell starts just now. Bone marrow mesenchymal stem cell is characterized by easily materializing, potentiality of multiple tissue differentiation, stable genetic background, non-rejection in implant button and high proliferation. All properties determine that it will be a useful thing in cell and gene therapy as well as tissue engineering.

Objective To study the D gene polymorphism of Rh-negative blood group in Kunming resident population with PCR technology for gene typing,and to establish and perfect PCR detecting method for RhD gene.Method 46 samples of Rh-negative blood samples were collected and PCR amplification with exon-SSP had been done firstly.The samples of D gene part existing were screened,then PCR amplifying by intron-SSP had been conducted.The PCR amplification production with intron-SSP was used to DNA sequence.Results Among 46 Rh-negative samples,the number of D gene lost intacfly was 29;the complete existing one with all exons was 12.The sequencing results were that 2 samples of only containing D10 were RhD-CE(3-9)-D and the sample with only D4 and D6 was the newly discovered variant allele RhD-CE(2-3,5,7-9)-D.RhD ? was not found in our study.Conclusion(1)There is high frequency of RhD-CE(3-9)-D in Kunming area.(2)A new variant allele of RhD-CE(2-3,5,7-9)-D is first found in Kunming area.

Objective To investigate the efficacy of esomeprazole (Esomeprazole) and flupentixol and melitracen (Deanxit) in treatment of non-erosive gastroesophageal reflux disease (NERD) with depression and anxiety.Methods The diagnosis of NERD was based on the results of esorneprazole scale (reflux diagnostic ques- tionnaires,RDQ) and endoscopy,the degree and frequency of symptoms were graded and scored.Hamilton de- pression scale was used to evaluate depression and anxiety status.Sixty-three patients were randomly divided into group A (esomeprazole 20 mg qd),B (Deanxit 1 tab qd),C (esomeprazole 20 mg qd and Deanxit 1 tab qd) with each group 21 patients,and treated for four weeks.The efficacy was evaluated by the symptom scores.Results There were some effects of esomeprazole or Deanxit alone on the improvement of symptoms of NERD.Although the effect of Deanxit was not as good as esomeprazole,there was not difference for relieving heartburn and sub- sternal pain between two groups in time point of each week after treatment (P＞0.05).esomeprazole was better for relieving acid regurgitation than Deanxit (P＜0.01).Combined treatment of esomeprazole with Deanxit was better and faster for relieving the symptoms of NERD than esomeprazole or Deanxit alone (relieving rate 81% in group C,23.8% in group A and 14.3% in group B,P＜0.01).The total efficacy rate of group C (100%) was higher than that of group A (80.9%) or group B (61.9%,P＜0.01),but there were not difference of relieving rate and total efficacy rate between group A and B (P＞0.05).Conclusions There was better efficacy of com- bined treatment of esomeprazole and low-dose Deanxit in treating NERD with depression and anxiety.These re- sults suggest that depression and anxiety have some effects on the pathogenesis and progress of NERD.

ObjectiveTo evaluate a second endoscopy for prevention of delayed bleeding after ESD.MethodsData of 67 patients with gastric epithelial neoplasms undergoing ESD from May to November 2011 were reviewed.The median age was 63 ( 31 ～ 84) years.All patients were followed up by endoscopy on the first and the third day after ESD.ResultsOf 67 lesions,5 were located at cardia,6 at gastric body,3 at fundus,35 at antrum,16 at gastric angle,and 2 at residual stomach.The mean maximum diameter of the lesions was 3.73±4 1.24 (2.0 ～ 7.0) cm.There were no intraoperative complications.Post-ESD delayed bleeding was detected by endoscopy in 6 (9.0％ ) patients,with 5 on the third day and 1 on the fourth day.Forrest grading showed 2 cases of Ⅰ b,and 4 of Ⅱ b.All 6 cases were cured by endoscopy.The incidence of postoperative bleeding was far more than that evaluated based on the patients' clinical manifestations only.But therapeutic effect and saffety were the same according to the follow-up results.ConclusionIncidence of post-ESD bleeding is high,but there are no symptoms or severe consequences,so a second endoscopy after gastric ESD may contribute little to the prevention of delayed bleeding.

Objective To analyze the risk factors for postoperative stricture after endoscopic submucosal dissection (ESD) for early stage esophageal cancer.Methods The data of 362 patients with early esophageal cancer treated by ESD from January 2007 to February 2012 were reviewed to investigate the risk factors of postoperative stricture.Results Esophageal stricture after ESD occurred in 42 patients (11.6％)with a mean time from ESD to stricture of (58.5 ± 12.3) days.The rates of mild,median and severe stricture were 16.7％ (7/42),38.1％ (16/42) and 45.2％ (19/42),respectively.Multivariate analysis revealed that lesion range ＞ 3/4 esophageal circumference (odds ration [OR]:44.2 ; 95％ confidence interval [CI]:4.4-443.6) and tumor invasion beyond m2 (OR:14.2; 95 ％ CI:2.7-74.2) were independent risk factors.Stricture level was related to lesion's circumferential extension (relational coefficient (φ) =0.47,P ＜ 0.05) and tumor invasion depth (relational coefficient (φ) =0.647,P ＜ 0.05).Conclusion Circumferential extension and invasion depth of early esophageal cancer were independent risk factors for post-ESD esophageal stricture and related with the degree of stricture.

ObjectiveTo investigate the managements of complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA).MethodsData of 119 EA patients who underwent POEM from October 2010 to July 2011 were collected.Complications during and after POEM and during follow-up were analyzed.Results Complications during operation included bleeding in 19 patients ( 16.0％ ),mucosa rupture in 9 (7.6％),mediastinal and subcutaneous emphysema in 27 (22.7％ ) and pneumothorax in 3 (2.5％ ).Complications occurred at the night of procedure included pain in 43 (36.1％ ) patients and pneumothorax in 7 ( 5.9％ ).Postoperative complications included asymptomatic pneumothorax in 23 patients (19.3％),delayed hemorrhage in 1(0.8％),pleural effusion in 58 (48.7％ ),minor pulmonary inflammation or segmental atelectasis in 59 (49.6％),emphysema of mediasti-na and subcutaneous tissue in 76 (63.9％ ),and gas under diaphragm or aeroperitoneum in 47 (39.5％ ).Complications during follow-up included one case of dysphagia caused by stricture of mucosa and one case of dehiscence at the tunnel entry with food retention.No POEM-correlated death occurred.All the complications were cured by conservative treatments.No additional surgery was needed.ConclusionMain complications as emphysema of mediastina and subcutaneous tissue,pneumothorax,aeroperitoneum and bleeding during and after POEM can be treated timely and effectively with conservative treatment.