Objective To develop a novel drainage catheter based on the anatomical structure of the mammary duct and establish a non-invasive treatment protocol for patients with acute high-tension breast milk cyst during lactation.Methods Ten primiparous patients with acute high-tension breast milk cyst during lactation,admitted to the postpartum clinics of three hospitals,were enrolled as study subjects.A novel drainage catheter was prepared using an epidural anesthesia catheter,and intubation was performed to unblock the obstructed mammary ducts.For cases with intubation failure,puncture as-piration was employed.Local cold compresses were applied to the breasts after treatment.Results Out of 10 patients,6 were successfully unblocked(successful group),and 4 failed(failure group).The duration of illness in the successful group was(6.00±0.82)days,which was shorter than that in the failure group[(9.50±1.80)days](P＜0.05).The insertion depth of the catheter in the successful group was(6.42±0.67)cm,which was greater than that in the failure group[(4.00±0.71)cm](P＜0.05).There was no statistically significant difference in cyst diameter between the two groups(P＞0.05).For patients in whom unblocking failed,puncture aspiration was performed,and 3 of them experienced recurrence after the initial puncture.Ultrasound-guided re-puncture aspiration and weaning were performed.One patient with evident inflammatory symptoms was administered systemic antibiotic therapy.After treatment,7 patients resumed lactation,and follow-up results indicated that all 10 patients were cured.Conclusion Acute high-tension breast milk cyst during lactation is rela-tively rare in clinical practice.The novel drainage catheter can achieve non-invasive unblocking of distally obstructed mammary ducts in the lactiferous sinus.The comprehensive treatment protocol can improve the overall cure rate and result in a high rate of resumed lactation post-treatment.

Objective To understand the schistosomiasis epidemic situation among migrant population,so as to assess the potential risk of schistosomiasis transmission in Haining City. Methods Five districts in Haining City were randomly selected to investigate the schistosomiasis endemic situation in migrant population from the schistosomiasis endemic provinces. Results Totally 1207 persons were investigated and four positives were found in serological tests,with the positive rate of 0.33%,but no patients were found in pathologic tests. The positive cases in serological tests were mainly between 31-40 years old,with the pos-itive rate of 1.68%,which was higher than that of other age groups( χ2 = 6.590,P < 0.05). Conclusion The schistosomiasis surveillance work in migrant population still should be strengthened in Haining City.

Objective To evaluate the effects of preventive and control measures on iodine deficiency disorders (IDD) in Hanning City in 2009-2014,we investigated the status of iodine nutrition level and IDD.Methods The wholesale salt was sampled irregularly for salt iodine test yearly in Haining City,Zhejiang Province.In the investigation,a random sampling was carried out as following:in 2009-2011,2 towns were selected from each of the east,west,south,north areas of the city,1 town was selected from the middle area of the city,4 villages were selected from each town,and edible salt samples were collected in 8 households from each village.However,in the year of 2012-2014,only 1 town was selected from 5 areas (east,west,south,north,middle) of the city,still 4 villages were selected from each town,and then edible salt samples were collected in 15 households from each village.A central primary school was selected in each sampled town,at least 40 students aged 8-l0 years old were selected for detection of thyroid volume,and at least 20 of these students' instant urine samples were collected for detecting urinary iodine.Salt iodine was tested using direct titration method,thyroid volume was measured by palpation method;urinary iodine was tested using arsenic cerium catalytic spectrophotometry.Results A total of 339 wholesale salt samples were tested,the median of salt iodine was 25.08-32.64 mg/kg in 2009-2013,and all the sampled wholesale salt samples were found to be qualified.A total of 1 764 household salt samples were collected in 2009-2014,the median of salt iodine was 23.40-28.15 mg/kg,and the consumption rates of qualified iodized salt were all higher than 90％ each year.Monitoring results of 1241 children aged 8-10 years old showed the goiter rates were all equal or lower than 2％,urinary iodine medians were 102.5-210.5 μg/L in 708urine samples,the proportion of urinary iodine under 50 μg/L was less than 20％,while the urinary iodine proportion in appropriate level in 100-＜ 200μg/L rose significantly over the last two years.Conclusions Measures with iodized salt as the principal way have good effects in Haining.However,the government needs to strengthen the regulation of salt industry market in the future to prevent unqualified salt come into the market.

Objective To detect K-ras mutations in plasma by a nano capture probe system , and to explore the diagnostic and prognostic value of this method for patients with pancreatic cancer .Methods The clinical data of 62 patients with pancreatic cancer , 38 patients with benign pancreatic diseases and 31 healthy controls admitted in the Second Affiliated Hospital of Jiaxing Medical College from June 2013 to June 2015 were collected.The diagnosis of all the patients were confirmed by pathology .The DNA were extracted from all plasma samples and were detected for the codon 12 and 13 mutation of K-ras gene by nano capture probe and conventional PCR plus direct sequencing .The correlation of K-ras gene mutation with certain clinical data and the diagnostic and prognostic value in pancreatic cancer were analyzed .Results The K-ras mutation were detected by nano capture probe in 27 pancreatic cancer patients , and the mutation rate was 43.5%(27/62), including 25 cases with codon 12 mutation and 2 cases with codon 13 mutation .The K-ras mutation rate in patients with benign pancreatic diseases was 7.9%(3/38), which were all in codon 12.K-ras mutation was detected in only 17 pancreatic cancer patients by conventional PCR plus direct sequencing , and the mutation rate was 27.4%(17/62), The K-ras mutation rate of benign pancreatic diseases was 5.3%(2/38).The mutation rate detected by nano capture probe was higher than that by conventional PCR , and the difference was statistically significant (P=0.006).K-ras mutation in the plasma of patients with pancreatic cancer was related to TMN stage and liver metastasis , but there was no correlation of the factors such as sex , age, clinical symptoms, tumor size, serum CA19-9 and CEA levels with K-ras mutation.The sensitivity of K-ras gene mutation for diagnosing pancreatic cancer was 43.5%, the specificity was 92.1%, the positive predictive value was 90%, the negative predictive value was 50%, Youden index was 0.356.The 1-year survival rate of patients with K-ras mutation was 44.4%, which was lower than that (71.4%) of patients with wild-type K-ras, and the difference was statistically significant (P<0.05).Conclusions The nano capture probe system could certainly detect K-ras mutation in a small quantity of plasma DNA , and its diagnosis sensitivity for pancreatic cancer is low , but the specificity is relatively high .K-ras mutation in plasma is closely related to the TMN stage and prognosis of pancreatic cancer .

Objective To explore the effect of upgrade of dialysate quality on the microinflammation in maintenance haemodialysis (MHD) patients. Methods Fifty-three MHD patients in Kidney Center of the First Affiliated Hospital,Medical College,Zhejiang University in January 2003 were enrolled in the prospectively study.The main end-points were survival at 8 years or weaning from haemodialysis during 8-year period including death, receiving renal transplantation or transferring to peritoneal dialysis.The endotoxin level of dialysate and patients' serum levels of interleukin-6 (IL-6),tumor necrosis factor α (TNF-α),C reaction protein (CRP),and albumin were recorded during the observation period. Results After the upgrade of water management system,endotoxin level of dialysate obviously decreased [(0.046±0.012) EU/ml vs (0.454±0.002) EU/ml,P＜0.01],and serum IL-6 [(3.947±3.624) ng/L vs (13.779±7.106) ng/L,P=0.036],TNF-α [(7.935±3.864) ng/L vs (12.804±8.017) ng/L,P=0.012] as well as CRP [(0.194±0.149) mg/L vs (0.561 ±0.309) mg/L,P＜0.01] decreased significantly,while serum albumin increased [(41.900±6.803) g/L vs (38.140±7.083) g/L,P=0.042].Hemoglobin level did not change significantly after the system upgrade,however,the dose of erythropoietin decreased [(93.0±12.7) U·kg-1·week-1 vs (131.0±10.1) U·kg-1·week-1,P=0.015]. Conclusions The upgrade of central dialysis fluid delivery and water management system by application of double reverse osmosis,high frequency heat disinfection and endotoxin filter can improve the quality of dialysate.Improvement of dialysate quality can ameliorate the microinflammation state of MHD patients.