Objective To explore the multi-modal MRI characteristics of breast cancers in dense breasts.Methods 120 patients with breast cancer shown on mammography underwent breast MRI,which were solitary and confirmed by pathological examination. According to the BI-RADS classification of breast,the 120 cases were divided into two groups including dense type breast and non-dense type one.The differences in morphological features,ADC values (b=1 000 s/mm2 )and time-signal intensity curve (TIC)of the lesions between two groups were analyzed and compared.Statistical analysis was performed using SPSS1 6.0.Results The breast cancers in dense breast were vulnerable to have a spiculated margin (44/68 in the dense breast group vs.1 6/52 in the non-dense breast group,P =0.000).The size of the lesion in dense breast (1.83 ±0.98)cm was bigger than that in non-dense breast (1.40±0.46)cm (P =0.005).The non-mass-like enhancement of the lesion in dense breast was much more than that in non-dense breast (P =0.000).In addition,the average ADC values of the lesion in dense breast (0.89±0.12)×10 -3 mm2/s were lower than in non-dense breast (0.95±0.10)×10 -3 mm2/s(P =0.01 6).Conclusion The breast cancer in the dense breast has different MRI findings in comparison with non-dense breast.

Objective To analyze the endemic situation of schistosomiasis after its interruption of transmission in Xiuzhou District,Jiaxing City,Zhejiang Province,so as to provide the references for future surveillance work. Methods The data of schistosomiasis and Oncomelania hupensis snails in Xiuzhou District were collected and analyzed statistically. Results From 1994 to 2015,totally 975 village?times were investigated for O. hupensis snails,and the accumulated area of 4 385.31 hm2 was surveyed. Twenty former snail sites were reoccurring,with an area of 32.61 hm2. An area of 57.71 hm2 was supplied with snail eradication measures. Totally 11 941 snails were dissected and no schistosome infected snails were found. The serum and stool tests were performed to 221 794 and 3 731 residents respectively,and no local infection cases but four imported cases were found. Conclusion The endemic situation of schistosomiasis in Xiuzhou District is stable after the transmission was interrupt?ed. However,there are imported schistosomiasis cases,and therefore,the prevention of imported infection source is the focus of surveillance work.

Tamsulosin hydrochloride is widely used for the treatment of lower urinary tract symptoms of benign prostatic hyperplasia ,requiring long-term medication .It reduces adverse reactions of hypotension and dizziness by rapid absorption from oral intake .The sustained-release (SR) formulation is recommended for clinical application .Currently in domestic and foreign market,SRproductsmainlyincludeSRcapsulesandSRtablets,likeFlomaxR○ andHarnalR○ .Thedomesticmarketmainlyuses the originally developed Harnal R○ SR capsules .In accordance with the drug′s potential market ,more and more SR studies have been done .This article reviews the research progress of tamsulosin hydrochloride sustained-release preparation .

Objective To prepare an occupation well-being scale for nurses, and test its reliability and validity. Methods After literature review and semi-structured interviews, the item pool of the occupation well-being scale for nurses was created based on theory of structure of the subjective well-being. After group discussion, and evaluation by the specialists, a pilot scale was obtained. A total of 350 clinical nurses were selected by using stratified sampling method, and their occupation well-being were surveyed by the scale. The data were used to assess the reliability and validity of the scale. Results The occupation well-being scale for nurses had 3 dimensions, including 8 exploring factors. The values of Cronbach Alpha and the split half reliability coefficient of the total scale, endogenous exogenous satisfaction, satisfaction of nurses occupation happiness were all larger than 0.9, which meaned the internal consistency was good. In the emotion dimension, the value of Cronbach Alpha and the split half reliability coefficient were less than 0.7, which meant the internal consistency was not so good. The reliability coefficient of repeated measurement of the whole scale and each dimension were greater than 0.7, suggesting the external consistency of the scale was good. The content validity index of 3 dimensions were all larger than 0.9,and the cumulative ex-planatory variables were all larger than 55%. Conclusion The occupation well-being scale for nurses proposed in this study has good reliability and validity, and can be used to evaluate the occupation well-being of the nurses.

Objective To investigate the effects of recombinant adeno-associated virus-mediated myostatin propeptide (MPRO) on uptake and oxidation of glucose,and glycogen synthesis in C2C12 myotubes,as well as the associated molecular mechanism.Methods Mature C2C12 myotubes were assigned to the following 6 groups:control,insulin,green fluorescent protein (GFP),insulin + GFP,MPRO,and insulin + MPRO groups.Glucose uptake,glucose oxidation,and glycogen synthesis were detected by counting radioactivity of 14CO2 or 14C labeled glycogen derived from 2-deoxy-[1-14 C] glucose.The activity of insulin signal pathway was evaluated by Western blot.Results Compared with control group,glucose uptake and glycogen synthesis were significantly increased in insulin and insulin+GFP groups,and further increased in insulin+MPRO group as compared with insulin alone(all P＜ O.05).However,MPRO and insulin had no effect on glucose oxidation.The phosphorylations of insulin receptor (IR) β,insulin receptor substrate 1 (IRS-1),protein kinase B (Akt),glycogen synthase kinase-3 β (GSK-3β),and the expressions of phosphatidylinositol 3-kinase (PI3K) and glucose transporter 4 (Glut4) in membrane were significantly increased in insulin and insulin+GFP groups compared with control group(all P＜0.05),and were further increased after MPRO transfection (all P ＜ 0.05).Conclusion MPRO may increase insulin-stimulated glucose uptake and glycogen synthesis in C2C12 cells by activating the IRS/PI3K/Akt signal pathway.

OBJECTIVE: To explore the application of the Dexmedetomidine utend drug induced sleep endoscopy. METHOD: Forty-four OSAHS patients diagnosed by PSG randomly were divided into group A (Dexmedetomidine group) and group B (Propofol group), each group of 22 cases. Group A: pump the Dexmedetomidine (1 microg/kg) over 15 minutes. Once the patient reached a satisfactory level of sedation, the electronic nasopharyngoscope was introduced into the nasal cavity group B: the propofol (2 mg/kg) was intravenous injected, use the same exmination after the object patients falling asleep. If not, double the injection dose of the two group. Observe and record the patient vital signs, EEG and sleep time, and handle the complications. RESULT: The study was successfully completed both in group A and B. Mean arterial pressure (MAP) in group B was lower than group A during the examination significantly (P < 0.05). The time falling to sleep in two groups were (13.4 +/- 2.5) min and (6.6 +/- 1.2) min, and the time in group A was much longer than that in group B. The lowest oxygen saturation during the examination in two groups were 0.835 +/- 0.096 and 0.691 +/- 0.095, and the difference was statistically significant. There was no incidence of adverse reactions in two groups. CONCLUSION Compared with propofol, Dexmedetomidine is a safer sleep-inducing drug, and it can be used for clinical sleep endoscopy.
Adult ; Dexmedetomidine ; therapeutic use ; Endoscopy ; Feasibility Studies ; Female ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Male ; Middle Aged ; Propofol ; therapeutic use ; Sleep

Objective To identify the patterns of airway collapse in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by dexmedetomidine induced sleep endoscopy.Methods Forty-five obstructive sleep apnea patients diagnosed by polysomnography were given dexmedetomidine intravenously.Once the patient was sedated in dorsal position,the electronic nasopharyngoscope was inserted transnasally and positioned on five levels of the upper airway sequentially (velum,oropharyngeal lateral wall,tongue base,epiglottis and larynx) to observe and document the collapse.Each level should be observed no less than three apneas.The degree of airway narrowing was calculated by using the ImageTool.No obstruction was defined when the degree of airway narrowing ＜ 50％,and complete obstruction when≥75％.Results In 45 patients with OSAHS,1 case showed no obstruction on any level,6 cases demonstrated obstructions on single level only,and 38 cases demonstrated complete obstructions on multilevel,including 17 cases with complete obstructions on two levels,15 cases complete obstructions on three levels,and 6 cases complete obstructions on four levels.The patterns of collapse found in the trial were:① circumferential stricture by velum collapse was found in 43 patients,and 41 cases showed complete obstructions; ② the side wall of oropharynx all collapsed in a lateral configuration,and 32 cases showed complete obstructions on this level; ③anteroposterior wallowing tongue base was common,11 cases showed partial obstructions on level of tongue base,and 10 cases complete; ④ epiglottic collapses occurred in lateral configuration folding as V shape; in anteroposterior configuration,epiglottis met posterior wall of the pharynx due to wallowing tongue base; the server soften epiglottis obstructed the entrance of the larynx,while the mild soften epiglottis and the collapsed side wall of pharynx came into being obstructions in concentric configuration; ⑤the arytenoid area and aryepiglottic fold mucosa inwardly covered the glottis when the obstruction occurred in the larynx.Conclusions The patterns of hypopharynx obstructions in OSAHS patients are multifarious.Lateral oropharyngeal wall,epiglottic and tone base collapse play an important role in the obstructions.The laryngeal obstruction can also be observed.

Objective To investigate the correlations between young nurses ’ job satisfaction and subjective well-being.Methods We selected 135 young nurses as the samples, used the general well-being scale, MMSS satisfaction scale to do the questionnaire survey and analyzed the correlations between them.Results The overall score of young nurses’ job satisfaction was (2.83 ±0.42) at the low level.Job satisfaction was positive correlated with subjective well-being ( P<0.01).Young nurses’ job satisfaction was positive correlated with subjective well-being (r =0.445,P <0.01).The influencing factors of subjective well-being included four aspects:work had been praised and recognized, the relationship with coworkers, the work of control and chance to participate in decision-making and scheduling satisfaction (R2 =0.981,F=1 677.18,P<0.01).Conclusions We should create a nursing career development opportunities for young nurses, and enhance spiritual incentive, managers’ understanding and support, respect and trust, team cooperation, self actualization and so on.Thus we can effectively promote their job satisfaction of nursing, so as to improve the subjective well-being.

Objective To investigate the diagnosis and treatment of splenic space occupying lesions associated with comorbidity.Methods The clinical data of 5 patients from Jiangyin People' s Hospital and 9 patients from Wuxi People's Hospital from January 2002 to June 2012 were retrospectively analyzed.All the patients suffered from splenic space occupying lesions associated with comorbidity.Splenectomy or multi-visceral resection were selected according to the results of preoperative B sonography and computed tomography examination.Chemotherapy regimes were selected based on postoperative pathological examination.All the patients were followed up till June 2013.Results The symptoms of patients with splenic space occupying lesions were non-specific.The first symptoms of 4 patients were discomfort or distending pain of left upper abdomen,and the other 10patients had no symptoms.The coincidence rate of preoperative diagnosis was 10/14,and the coincidence rate of preoperative diagnosis for patients with malignant tumors was 2/5.Fourteen patients received preoperative B ultra-sonography,and 9 were definitively diagnosed.Nine patients received computed tomography,and 7 were definitively diagnosed.Of the 14 patients,right ovarian cancer,bilateral ovarian cancer and sigmoid colon cancer were correlated with solitary splenic metastasis,and the main lesions of the other 11 patients were not correlated with splenic space occupying lesions.The main lesions of patients with left colon carcinoma,type 2 diabetes and vascular tumor of the spleen,patients with renal carcinoma and splenic sclerosing hemangioma,and patients with hypertension,cholecystolithiasis and splenic lymphangioma were diagnosed simultaneously with the splenic space occupying lesions,and the main lesions of theother 11 patients were diagnosed separately with the splenic space occupying lesions.Ten patients underwent simple splenectomy and 4 patients received multi-visceral resection.Chemotherapy regimens were selected according to the type of main lesions for 5 patients who were diagnosed by pathological examinations.All the patients were recovered smoothly with no occurrence of severe infections.Two patients with splenic sarcoma had tumor metastasis at postoperative 6 months and 1 year,respectively.One patient with right ovarian cancer and solitary splenic metastasis had transverse colonic metastasis at postoperative 3 years.One patient with bilateral ovarian cancer and solitary splenic metastasis had peritoneal metastasis at postoperative 2 years.One patient with sigmoid colon cancer and solitary splenic metastasis died of peritoneal tumor recurrence at postoperative 4 years.One patient with left colon carcinoma,type 2diabetes and vascular tumor of the spleen survived for 6 years and was still sound and well.The other 9 patients with benign disease survived within the period of follow-up.Conclusions The definitive diagnosis for patients with splenic space occupying disease associated with comorbidity depends on the preoperative imaging examination and postoperative pathological examination.Surgical treatment is safe when operative contraindications are excluded.The prognosis of patients is determined by the progress of main lesions and the character of splenic space occupying lesions.

Objective To study the academic level of randomized control trials(RCTs)published from 2004 to 2009 in Chinese Journal of Hepatobiliary Surgery.Methods Published work about RCTs in 72 issues of Chinese Journal of Hepatobiliary Surgery was searched by finding relevant articles published during 2004-2009.Correlated indexes including literature received time, literature publishing time, the total number of citations, number of citations in Chinese, number of citations in English, research funding situations, the number of authors, article affiliations in all RCTs, together with single(or multiple)center study situation, positive conclusions, the starting time, the end time,and number of patients recruited in clinical RCTs were extracted for aggregate analysis.Results During the past six years, a total of 135 articles of RCT were published in Chinese Journal of Hepatobiliary Surgery, accounting for 8.7% in all clinical studies.The average number of RCTs in each issue was 1.88.The average time for publishing time delay was 450 days.The total number of citations in RCTs was 1252 and the average number of RCTs for citations was 9.3.53 RCT studies were financed, accounting for 39% of the total number of research papers.Beijing Friendship Hospital attached to the Capital University of Medical Sciences had published 8 papers of RCT and it is the institution of publishing the largest number of such papers in the journal.The number of multi-center study for RCTs was one and all RCT studies had significant conclusions.The average research duraton in RCTs was 45 months.The total number of patients in 33 clinical RCTs was 2705 and the average number of patients recruited in each RCT was 82.Conclusion Chinese Journal of Hepatobiliary Surgery put emphasis on the strongest evidence and the most valuable RCT researches that have great significance in the field of domestic hepatobiliary surgery for clinical treatment and experimental research.