Objective:To analyze the reasons of misdiagnosed cases in the intraoperative frozen pathological diagnosis of breast disease and explore effective measures and practices for targeted and standardized quality control.Methods:A retrospective analysis was conducted on 2 421 cases of breast intraoperative frozen pathological examination performed at Renmin Hospital of Wuhan University from Apr. 2020 to Dec. 2021. The results of intraoperative frozen pathological examination were compared with postoperative pathological results to calculate the overall concordance rate and misdiagnosis rate. Pathological classification and causative analysis were performed for misdiagnosed cases. Standardized management was implemented to address the identified issues, and an analysis was conducted on 2248 cases from Feb. 2022 to Nov. 2023 to compare the overall concordance rate and misdiagnosis rate before and after management.Results:The comparison between intraoperative rapid frozen pathology diagnosis and postoperative paraffin pathology diagnosis showed that among the 2 421 breast specimens, there were 2 377 cases (98.18%) with concordant results and 44 cases of misdiagnosis, resulting in a misdiagnosis rate of 1.82%. The pathological types of 44 misdiagnosed cases were analyzed, among which 10 cases were lymph node metastatic carcinoma, 5 were lobar tumors, 3 were intraductal papillary tumors, 7 were carcinoma in situ and common hyperplasia each, and 4 were carcinoma in situ, sclerosing adenopathy, and other invasive carcinoma each. Through the analysis of causes, it was found that poor slide quality, the need for immunohistochemistry assistance, careless slide reading, missed critical lesions, and other factors contributed to misdiagnosis, with variations in the causes of misdiagnosis among different pathological types. After implementing standardized management, the overall concordance rate significantly improved (98.93%) and the misdiagnosis rate significantly decreased (1.07%) .Conclusions:Intraoperative frozen pathological diagnosis is of great significance in the treatment of breast diseases. The targeted standardized quality control can help early detection and solve problems, reduce the differences between different doctors and technicians, and improve the accuracy of intraoperative frozen pathological diagnosis.

Objective:To analyze the reasons of misdiagnosed cases in the intraoperative frozen pathological diagnosis of breast disease and explore effective measures and practices for targeted and standardized quality control.Methods:A retrospective analysis was conducted on 2 421 cases of breast intraoperative frozen pathological examination performed at Renmin Hospital of Wuhan University from Apr. 2020 to Dec. 2021. The results of intraoperative frozen pathological examination were compared with postoperative pathological results to calculate the overall concordance rate and misdiagnosis rate. Pathological classification and causative analysis were performed for misdiagnosed cases. Standardized management was implemented to address the identified issues, and an analysis was conducted on 2248 cases from Feb. 2022 to Nov. 2023 to compare the overall concordance rate and misdiagnosis rate before and after management.Results:The comparison between intraoperative rapid frozen pathology diagnosis and postoperative paraffin pathology diagnosis showed that among the 2 421 breast specimens, there were 2 377 cases (98.18%) with concordant results and 44 cases of misdiagnosis, resulting in a misdiagnosis rate of 1.82%. The pathological types of 44 misdiagnosed cases were analyzed, among which 10 cases were lymph node metastatic carcinoma, 5 were lobar tumors, 3 were intraductal papillary tumors, 7 were carcinoma in situ and common hyperplasia each, and 4 were carcinoma in situ, sclerosing adenopathy, and other invasive carcinoma each. Through the analysis of causes, it was found that poor slide quality, the need for immunohistochemistry assistance, careless slide reading, missed critical lesions, and other factors contributed to misdiagnosis, with variations in the causes of misdiagnosis among different pathological types. After implementing standardized management, the overall concordance rate significantly improved (98.93%) and the misdiagnosis rate significantly decreased (1.07%) .Conclusions:Intraoperative frozen pathological diagnosis is of great significance in the treatment of breast diseases. The targeted standardized quality control can help early detection and solve problems, reduce the differences between different doctors and technicians, and improve the accuracy of intraoperative frozen pathological diagnosis.

Objective:To explore whether interactive learning mode can improve learning ability of medical students.Methods:From September 2017 to January 2018, there were 266 medical undergraduate interns of Grade 2014 in the department of pediatrics of the First Affiliated Hospital of Xi'an Jiaotong University. Interactive approach mode was used in pediatric probation teaching of hematological disease. And the questionnaire and final exam grade were used to evaluate the effect of interactive approach in pediatric clinical practice teaching and understand students' satisfaction with interactive learning. The test results were compared with those of 146 Grade 2013 students, who studied in the same period of 2016 and adopted traditional teaching methods. Data were analyzed using SPSS 19.0 software.Results:In the questionnaire survey, the interactive approach mode was believed to improve the learning enthusiasm by 95.8% (230/240) students, improve the ability of language expression by 97.5% (234/240) students, promote the knowledge understanding and memory by 93.3% (224/240) students, and enhance the ability of self-study and by 90.9% (218/240) students. Additionally, the mode was believed to facilitate the ability of analyzing and resolving problems by 94.2% (226/240) students, and enhance the ability of information technology, such as information retrieval ability, PPT production ability, by 96.2% (231/240) students. Moreover, the test results of students using interactive approach model mode were significantly higher than those using traditional teaching mode ( P<0.01). In the questionnaire survey, there were 92.5% (222/240) students accepting interactive approach mode. Conclusion:The teaching mode of interactive approach can improve the learning enthusiasm and learning ability of medical students, which is worthy of popularization and application in the probationary courses.

Objective To explore the effects of different intrauterine adhesion (IUA) classification systems on predicting the IUA prognosis.Methods One hundred cases were selected as the subjects in present study from those diagnosed with IUA and underwent surgery in Zhujiang Hospital of Southern Medical University from Jan.2010 to Jan.2017,and were followed up for two years.According to the actual situation,all patients were scored by March,AFS,ESGE and Chinese classification for comparing the effects of different IUA classification systems on predicting the pregnancy rate,live birth rate and effective rate within 2 years after surgery.Results ESGE classification had a good effect on predicting the postoperative live birth rate and effective rate,and a certain predictive effect on pregnant rate,with the area under curve (AUC) of 0.722,0.754 and 0.635,respectively.March classification had a certain effect on predicting the postoperative live birth rate and effective rate with AUC of 0.635,0.754,respectively,but had a poor effect on predicting pregnant rate.AFS classification and China classification had poor effect on predicting the IUA prognosis.Conclusion ESGE classification system is better than the other systems including March,AFS and Chinese classification,on predicting the IUA prognosis,but further verification in large sample size is still required.

Objective To investigate the effect of estrogen on the fibrosis process of intrauterine adhesions and the expression of forkhead box F2 (FoxF2).Methods Primary human endometrial stromal cells (HESCs) were obtained by separation with 0.2％ collagenase Ⅰ digestion-mesh filtration-differential adherence,and identified by immunocytochemistry.HESCs affected with 10ng/ml transforming growth factor β1 (TGF-β1) for 48 hours.HESCs in model group were affected with 0,10-6,10-8,10-10 and 10-12mol/L estrogen,the expressions of smooth muscle actin alpha (α-SMA),Collagen I (COL Ⅰ) and FoxF2 were detected by quantitative PCR (qPCR) and Western blotting.Results HESCs with high purity and good activity were obtained by using 0.2％ collagenase Ⅰ digestion-mesh filtration-differential adherence separation method.Immunocytochemistry showed positive vimentin and negative cytokeratin 18 in HESCs.The results of qPCR and Western blotting showed that the mRNA and protein expression levels of α-SMA,COL Ⅰ and FoxF2 were higher in model group than in control group (P＜0.05),the model was built successfully.qPCR revealed that the mRNA expression levels ofα-SMA,COL Ⅰ and FoxF2 were significantly lower in 10-6,10-8 and 10-10mol/L estrogen groups than in model group (P＞0.05 in 10-10mol/L estrogen group,P＜0.05 in other groups),while in 10-12mol/L estradiol group,the expression levels of FoxF2 mRNA significantly decreased (P＜0.05),and of α-SMA and COL Ⅰ mRNA increased,but no significant difference were found (P＞0.05).Compared with the model group,the protein expression levels of α-SMA,COL Ⅰ and FoxF2 in 10-6,10-8 and 10 10mol/L estrogen groups decreased,but no significant difference was found (P＜0.05),while in 10-12mol/L estradiol group,the expression levels ofα-SMA protein increased (P＞0.05),and of COL Ⅰ and FoxF2 proteins decreased (P＜0.05).Conclusions The expression of FoxF2 in intrauterine adhesions is increased.Estrogen can reverse the fibrosis process of intrauterine adhesions in a certain range and inhibit the expression of FoxF2.

Objective To compare the difference and effectiveness between Tetra-ataxiametry and Berg balance scale (BBS) in predicting the risk for fall in the elderly inpatients.Methods A total of 401 elderly inpatients were randomly selected using convenience sampling in a class III grade A hospital. Tetra-ataxiametry and BBS were used to monitor the risk for falls of elderly patients in two groups: group with or without fall histories.Results Fall histories were set as the standard. The area ratios under receiver operating characteristic (ROC) of Tetra-ataxiametry fall index (FI) and BBS were 0.762 and 0.705. Youden index showed that the predicted value, the sensibility and the specificity of Tetra-ataxiametry FI were 41, 80.5% and 60.2%; while those for BBS were 46, 67.1% and 65.8%. No statistically significant difference in the area under the curve (AUC) between Tetra-ataxiametry and BBS was observed(P=0.0587).Conclusions There is no statistically significant difference in predicting the risk for fall in the elderly inpatients between Tetra-ataxiametry and BBS, suggesting that Tetra-ataxiametry can replace BBS to evaluate the fall risk, and is better than BBS, since Tetra-ataxiametry has higher sensitivity in objective data provision, body weight and BMI (body mass index).

Objective To investigate the vaginal flora in patients with recurrent vulvovaginal candidiasis (RVVC).Methods Vaginal swabs were collected at different time points from 6 RVVC patients and 5 healthy women of child-bearing age.The dynamic changes,microbiota composition,alpha diversity and beta diversity in the two groups were assessed by analyzing the 16S rRNA V4 hypervariable region amplified from the total genomic DNA from the swabs.Results Lactobacillus was the predominant species in healthy women with similar proportions of Liners and L.crispatus;small proportions of Gardnerella,Prevotella and other genus were also detected.In some healthy women,the vaginal flora showed a high relative abundance of anaerobic bacteria such as Gardnerella,Prevotella,Atopobium,Sneathia.Compared with the healthy women,patients with RVVC showed a significantly reduced diversity of vaginal flora,where Liners was the predominant species and the content of L.crispatus decreased significantly.In healthy women,the vaginal flora fluctuated with the menstrual cycle,and the fluctuation was the most prominent during menstruation;the dominant species either alternated regularly or maintain an absolute superiority in the menstrual cycle.The vaginal flora showed attenuated fluctuation in women with RVVC,were highly conserved within the menstrual cycle,and maintained a similar composition in the episodes and intermittent periods.Conclusion The vaginal flora of RVVC patients do not undergo regular variations with the menstrual cycle and shows a similar composition between the episodes and intermittent periods.Promoting the production of L.iners or inhibiting the colonization of L.crispatus to restore the composition of the vaginal flora may help in the treatment of RVVC.

Objective To explore the effect of electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS) on somatosensory evoked potential (SEP) of the upper extremity in healthy subjects. Methods From October, 2015 to April, 2016, ten healthy young volunteers were selected. Each of the subjects was randomly treated with electroacupuncture and TEAS. Before and after treatment, the latency and amplitude of N20 and N9 of SEP were detected. Results After electroacupuncture, the latency of N20 prolonged in the stimulated side (Z=-2.620, P<0.01); the latency of N9 prolonged (Z=-2.454, P<0.05), and the amplitude of N9 decreased (Z=-2.330, P<0.05) in the non-stimulated side. After TEAS, the latencies of N9 both in the stimulated side and the non-stimulated side prolonged (Z>2.695, P<0.01). There was no significant difference in the D-value of latency and amplitude of N20 and N9 in both two sides between two treatments (Z<1.817, P>0.05). Conclusion Both electroacupuncture and TEAS could affect the latency and amplitude of N20 and N9, and no difference was found between two treatments.

Objective To investigate the vaginal flora in patients with recurrent vulvovaginal candidiasis (RVVC).Methods Vaginal swabs were collected at different time points from 6 RVVC patients and 5 healthy women of child-bearing age.The dynamic changes,microbiota composition,alpha diversity and beta diversity in the two groups were assessed by analyzing the 16S rRNA V4 hypervariable region amplified from the total genomic DNA from the swabs.Results Lactobacillus was the predominant species in healthy women with similar proportions of Liners and L.crispatus;small proportions of Gardnerella,Prevotella and other genus were also detected.In some healthy women,the vaginal flora showed a high relative abundance of anaerobic bacteria such as Gardnerella,Prevotella,Atopobium,Sneathia.Compared with the healthy women,patients with RVVC showed a significantly reduced diversity of vaginal flora,where Liners was the predominant species and the content of L.crispatus decreased significantly.In healthy women,the vaginal flora fluctuated with the menstrual cycle,and the fluctuation was the most prominent during menstruation;the dominant species either alternated regularly or maintain an absolute superiority in the menstrual cycle.The vaginal flora showed attenuated fluctuation in women with RVVC,were highly conserved within the menstrual cycle,and maintained a similar composition in the episodes and intermittent periods.Conclusion The vaginal flora of RVVC patients do not undergo regular variations with the menstrual cycle and shows a similar composition between the episodes and intermittent periods.Promoting the production of L.iners or inhibiting the colonization of L.crispatus to restore the composition of the vaginal flora may help in the treatment of RVVC.

Objective To investigate the effects of functional electrical stimulation (FES) on motor function and on the expression, proliferation, migration and differentiation of endogenous neural stem cells in the subventricular zone (SVZ) after cerebral ischemia.Methods Middle cerebral artery occlusion (MCAO) was used to induce a model of cerebral ischemia in 108 rats using the modified Zea-Longa method of intraluminal filament occlusion.They were then randomly divided into an FES group, a placebo stimulation group and a control group with 36 cases in each.Superficial FES electrodes were pasted on the paralyzed forelimbs of the rats in the first two groups, though FES treatment was administered only to the FES group beginning on the 3rd day after the MCAO operation.The stimulation was designed to produce extension of the wrist and digits of the paralyzed forelimb.Before, and after 1,3, 7 and 14 days of the treatment, the neurological deficit was evaluated using modified neurological severity scoring (mNSS).BrdU +/GFAP+, BrdU+/DCX+ and BrdU+/NeuN + cells in the SVZ were detected using immunofluorescence technique.Results After 7 and 14 days of treatment, the average motor function of the rats in the FES group had improved significantly when compared with the averages of the other two groups.Compared with the other two groups, the average number of BrdU +/GFAP+ positive cells in the ischemic SVZ was also significantly greater in the FES group after 7 and 14 days of treatment.After 14 days, BrdU +/Dcx + positive cells in the FES group had also increased significantly more,but only a few BrdU +/NeuN + cells had appeared in any of the three groups.Conclusion FES can improve motor function after cerebral ischemia, and promote proliferation and differentiation of neural stem cells in the SVZ.