Objective: To analyze the diagnostic value of ultrasound guided 14 gauge coreneedle biopsy (US-CNB) in breast nodules. Methods: We retrospectively analyzed the pathological results of US-CNB and surgical excision from 373 breast nodules in Peking University International Hospital from Sep 2016 to Nov 2018 to evaluate the accuracy of 14g US-CNB. Results: A total of 349 patients(373 nodules)underwent US-CNB. US-CNB reported 282 benign lesions(75.6%, 282/373), 20 high-risklesions(5.4%, 20/373), and 71 malignant lesions(19.0%, 71/373). For 282 CNB reported benign lesions, the surgical pathology confirmed 235 lesions , 46 for high-risk lesions and 1 for malignant lesion with a concordancy of 83.3%(235/282)and the underestimation rate was 16.7%(47/282). US-CNB identified 20 high-risk lesions. According to surgical results, 15 were high-risk lesions and 5 were malignant lesions with a concordancy of 75% (15/20)and the underestimation rate was 25%(5/20). When it comes to malignant lesions, the excision results showed that 70 were malignant lesions and 1was high-risk lesion with a concordancy of 98.6%(70/71)and the overestimation rate was 1.4%(1/71). The concordance of the histological type , calculated for 50 invasive carcinomas, was 92% (46/50) with a kappa value of 0.77.The concordance of the histological grade could be calculated for 38 invasive ductal carcinomas with the Elston-Elllis Method . It was 89.5% (34/38) with a kappa value of 0.57. Conclusions The pathology result of 14gUS-CNB is in good consistency with surgical excision for breast benign and malignant lesions.

Objective To evaluate the performance of the Sendai Guidelines,Fukuoka Guidelines and Pancreatic Cystic Lesions Management Guidelines (Chinese guidelines) in predicting malignant mucinous pancreatic cystic neoplasms (PCN).Methods A retrospective analysis of 196 patients,who received surgery and were pathologically identified as PCN or intraductal papillary mucinous neoplasms (IPMN),underwent surgical resection in Ruijin Hospital affiliated with Shanghai Jiao Tong University from January 2003 to April 2017 was performed.The differences on clinical and pathological parameters between malignant mucinous and benign mucinous PCN were compared.The accuracy,sensitivity,specificity,positive predictive value (PPV)and negative predictive value (NPV) of the indications for surgery in the Sendai,Fukuoka and Chinese Guidelines in predicting malignant mucinous PCN were calculated.Results Of 196 patients,39 patients (19.9％) were confirmed as malignant tumors and 157 patients (80.1％) were confirmed as benign tumors by pathology.There were significant differences on age,symptoms (abdominal pain,jaundice or pancreatitis),tumor solid composition,pancreatic duct diameter,tumor site,tumor diameter ＞3 cm,and serum CA199 level between malignant and benign patients (all P ＜0.05).But there were no significant differences on gender distribution,tumor diameter,mural nodules and the proportion of mucinous cystic neoplasm (MCN)and intra-ductal papillary mucinous neoplasm (IPMN).165 patients (84.2％) met the Sendai Guidelines,153 patients (78.1％) met the Chinese guideline,and only 61 patients (31.1％) met the Fukuoka Guidelines.All 39 patients with malignant tumors met the indications in Sendai Guidelines and Chinese guidelines,and only 35 patients had the indication for surgery in the Fukuoka Guidelines.The accuracy,sensitivity,specificity,PPV and NPV of the Fukuoka Guidelines for predicting the malignancy were 84.7％,89.7％,83.4％,57.4％ and 97.0％,compared to 35.7％,100％,19.8％,23.6％ and 100％ for the Sendai and 41.8％,100％,27.4％,25.5％ and 100％ for the Chinese guidelines,respectively.Conclusions The performance of the Chinese guideline is slightly better than the Sendai Guidelines,while both of them can lead to a larger number of patients undergoing unnecessary surgical resection.Though the rate of missed diagnosis could reach 10.3％,the Fukuoka Guidelines gets the highest accuracy.

Objective: To summarize the measures and experience of treatment in mass extremely severe burn patients. Methods: The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment. Results: Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients. Conclusions Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.

Objective To investigate the lifestyles of internet addiction disorders and explore the relationship between lifestyles and internet addiction among Chinese adolescents.Methods In this cross-sectional stratified cluster sampling study,Demographic Information Questionnaire,Chinese Adolescent Lifestyles Scale (CALS)and Young's Internet Addiction Test were applied.Results (1) Adolescents with internet addiction were 275,accounting for 11.20％.Boys(15.45％) addicted the internet more than girls(7.48％).The prevalence rate of IAD was higher in students from urban(13.55％) than that in students from rural area(9.67％).The ratio of IAD was the highest in junior school students (14.01％),the second in university students (13.84％),the third in senior high school students(9.66％),and the lowest in primary school students(7.67％) (P＜0.01).(2) The internet addicts scored significantly lower on sleep,study habits,physical exercise,interpersonal relationship and coping style,compared to the normal group(P＜0.01).(3) Sleep status,study habits,physical exercise,interpersonal relationship and coping style were negatively correlated with internet addiction (r=-0.193,r=-0.319,r=-0.175,r=-0.225,r=-0.105,P＜0.01).(4)Multiple logistic regression analysis indicated learning habits and interpersonal relationship had negative predictive effects on internet addiction; whereas,the coping style showed a weak positive prediction effect on Internet addiction.Conclusion Internet addict teenagers have poor lifestyles which should be suggested to start the good behavior habit and insist on a healthy lifestyle to prevent the internet addiction disorder.

Objective To develop a scale of the executive functional status for adolescents.Methods Regarding to the structure and the conception of executive function and the results of interviews to several adolescents,a preliminary inventory including 37 items was developed.The investigation sample consisted of 1722 students from 2 provinces in China by stratified sampling,and the the internal consistency,conduct validity and criterion validity were assessed by exploratory factor analysis.Results The revised scale including 21 items was consisted of three factors:inhibition control,cognitive flexibility,working memory,which explained 45.39％ of the total variance.The factor loading ranged from 0.499 to 0.727.The Cronbach alpha ranged from 0.786-0.897 for the scale and its three factors.Factor structure fitted actual data and its fit indices were x2=530.44,df=186,RESMA =0.053,GFI =0.93,AGFI =0.91,NFI =0.96,CFI =0.97.Conclusion It shows that the reliability and validity of the scale meet the standard of the psychometrics,and it can be suitable for evaluating the functional status of execution of Chinese adolescent.

Objective To investigate the impacting factors on the professional identity of railway young workers and the relationship of the professional identity and subjective well-being.Methods The sample consisting of 5 762 young workers was selected from railway enterprises by stratified and random sampling according to the proportion.Occupational professional identity Scale and Index of Well-being,Index of General Affect Scale were used.The affect of the variable,such as sex,age,working years,educational background and income on professional identity were studied.Moreover,the relationship between professional identity and subjective well-being was reported.Results (1) Professional identity ascended witb the increase of ages,and there was significance between three groups(F=6.667,P＜0.05).(2)Professional identity ascended with the increase of length of service (F=5.147,P＜0.01),but it dropped at the point of 9-12 years.(3) The professional identity of workers with bachelor degree was higher than that with junior college education background.and there was significance between three groups (F=3.538,P＜0.05).(4)The workers who had more than 3 500 RMB monthly salary was regarded on the top in professional identity,while those whose monthly salary were under 2 500 RMB was in the lowest level (F=42.275,P＜0.01).(5)The result of linear regression indicated that the degree of professional identity can forecast the degree of subjective well-being(R =0.534,P＜0.01).Conclusion The professional identity of railway young works was affected by their ages,the length of service,the educational degree and salary,The professional identity can forecast subjective well-being.

Objective To develop and test the reliability and validity of the dual-systems of self-control scale for children (DSSCSC).Methods The scale was developed based on previous studies and the theoretical framework of the dual system.Totally 1493 families from 5 provinces were recruited.Participants were asked to complete the DSSCSC.Item analysis was conducted to identify valid items.Then the construct validity of the scale was tested through exploratory and confirmatory factor analysis(EFA & CFA).Finally the reliability and criterion validity of the scale was examined.Results The scale was consisted of 23 items with 5 factors-planning,impulsivity,distractibility,persistence,and poor delay of gratification.They explained 50.46％ of the total variance.Besides,the CFA resuhs demonstrated a satisfactory construct validity of the scale (RMSEA =0.044,NFI =0.95,NNFI=0.97,CFI=0.97).The scores of DSSCSC and its subscales were significantly correlated with the TSCRS scores.The Cronbach' s α coefficients of the total scale was 0.855,and 5 subscales were 0.813,0.803,0.582,0.608,and 0.620 respectively.Conclusion The DSSCSC with 5 factors has a good reliability and validity,demonstrating it a valid tool to measure the children' s self-control in China.

Objective To investigate the incidence of attention deficit hyperactivity disorder (ADHD)symptoms among 3-10-year-old children and its relationship with sleep.Methods Taking gender,grade (junior in kindergarten to third grade),and region(urban and rural areas) as stratification variable,1 535 children aged 3 to 10 years old were selected by random in six areas nationwide.ADHD Rating Scale-Ⅳ-Parent Version and Pittsburgh Sleep Quality Index were adopted to investigate ADHD symptoms and sleep of these children.Results 24.95％ of the investigated children had ADHD symptoms.Boys scored higher than girls in all indicators(boys:Inattention (IA):(9.21±3.75),Hyperactivity-Impulsivity (HI):(8.62± 3.87),Total:(17.82±7.01),girls:IA:(8.16±3.77),HI:(7.32±3.76),Total:(15.48±6.98)) while girls had higher incidence of ADHD symptoms than boys (girls:IA:16.19％,HI:27.02％,Total:32.51％,boys:IA:11.70％,HI:8.19％,Total:17.43％).Peak incidence occured in children aged 7-9 (7 years old group:IA:18.22％,HI:21.93 ％,Total:38.66％,8 years old group:IA:20.66％,HI:23.25 ％,Total:38.01％,9 years old group:IA:18.22％,HI:33.78％,Total:32.00％).Rural children had higher incidence of ADHD symptoms than urban children(rural children:IA:18.37％,HI:18.37％,Total:29.48％,urban children:IA:10.47％,HI:15.12％,Total:21.40％).Logistic regression results showed that sleep quality,sleep disorder and daily dysfunction can predict the incidence of ADHD symptoms to a certain degree.Conclusion The incidence of ADHD symptoms appear to be high in children evaluating by ADHD Rating Scale-Ⅳ-Parent Version.More attention should be paid to girls and rural children' s ADHD symptoms.7-9 years old children have the highest incidence of ADHD symptoms.The more problems in daytime dysfunction,sleep disorders and bedtime,the more ADHD symptoms will be observed.

Objective To explore the expression of glutathione-S-transferase-π(GST-π),P-glycoprotein (P-gp),topoisomerase Ⅱ (Topo Ⅱ) and thymidylate synthase (TS) in gastric adenocarcinoma tissues and the clinical significance.Methods Envision method of immunohistochemistry was used to detect the expression of GST-π,P-gp,Topo Ⅱ and TS in sample of 64 gastric adenocarcinoma tissues and 12 normal gastric mucosas,and their corresponding clinical data were comprehensive analyzed.Results The expression positive rates of GST-π,P-gp,Topo Ⅱand TS were respectively 76.6 ％(49/64),64.1％ (41/64),84.4 ％ (50/64) and 53.1％ (34/64),that were all higher than in gastric mucosa [8.3 ％ (1/12),8.3 ％(1/12),16.7 ％ (2/12),0],the differences were statistically significant respectively (P ＜ 0.01).Their positive expression rates were closely relevant to the degree of differentiation (P ＜ 0.05),but not to the patients' gender,age,tumour size,clinical staging,invasive depth and lymph node metastasis (P ＞ 0.05).The expressions of GST-π,P-gp and TS in high and middle differentiation adenocarcinoma were high.er than in low differentiation,but the expression of Topo Ⅱ in high and middle differentiation adenocarcinoma was lower than in low differentiation (P ＜ 0.05).Conclusion GST-π,P-gp,Topo Ⅱ and TS are over-expressed in gastric adenocarcinoma,which is related to the multidrug resistance of gastric adenocarcinoma.The joint detection of the expression of GST-π,P-gp,Topo Ⅱ and TS in gastric adenocarcinoma can be looked as an important symbol for guiding its chemotherapy drug and prognosis.

Objective To explore the current situation of basic psychological needs satisfaction (BPNS) and the relationship between index of well-being and BPNS among young workers in China.Methods The samples consisting of 5972 young workers were selected by stratified and random sampling according to the proportion.The Chinese vision of the Basic Needs Satisfaction in General Scale and the Index of Well-being Scale were used.Results The overall situation of BPNS of young workers (4.36 ± 0.71) was good,satisfied state of relatedness need (SSRN,4.70 ± 1.05) was the highest,satisfied state of autonomy need (SSAN,3.96 ± 1.21) and blocked state of autonomy need (BSAN,4.08 ± 1.17) were lower,blocked state of relatedness need (BSRN,3.20 ± 1.26) was the lowest; education and income had interaction on SSRN (F0.05(6.5948) =4.068,P ＜ 0.01)while there was no difference between gender on all of the dimensions.Pearson correlation analysis showed that all the dimensions of BPNS were significantly related to the index of well-being;and linear regression analysis showed that SSAN,SSRN and BSAN could forecast the index of well-being (adjR2 =0.339),β =0.457,0.186,-0.102 respectively.Conclusion The overall situation of BPNS of young workers is good ; and adjustment of SSAN,SSRN and BSAN could improve the index of well-being of young workers.