To explore the role of Human papillomavirus (HPV) in mammary carcinogenesis, the expression of the HPV-16, iNOS, P53 and hTERT proteins in breast carcinomas and their relationships were investigated. 52 samples of breast cancer and 16 samples of benign breast tumors were assayed using the immunohistochemical SP method for detection of protein expression levels. The expression of HPV-16, iNOS, P53 and hTERT proteins in a mammary carcinoma was 44.2%, 57.7%, 63.5% and 59.6% respectively, which was significantly greater than the corresponding levels in the benign group. The expression of iNOS, P53 and hTERT was correlated with the presence of an HPV-16 infection in a mammary carcinoma (P<0.05). The connection between these events might also involve the iNOS, mutated type P53 and the hTERT protein.

Objective To research the effect of ulinastatin on T-cytoimmunity in patients with infertility undergoing laparoscopic surgery. Methods Forty patients scheduled for receiving laparoscopic surgery were equally randomized into two groups, ulinastatin group (Group U) and control group (Group C). Ulinastatin was given to patients in the Group U at a dose of 20 × 104 U before anesthetic. No ulinastatin was given to patients in the Group C. Patients′venous blood samples for T-lymphocyte subset (CD3+,CD3+CD4+,CD3+CD8+) and CD3+CD4+/ CD3+CD8+ ratio calculation were collected before the surgery (T0) and at 0 h (T1),1st day (T2),3rd day (T3) after the surgery. Results CD3+ had less difference at T1~3 compared with T0 in the Group C but raised obviously at T2~3 in the Group U. CD3+CD4+ were only raised at T3 compared with T0 but raised obviously at T2~3 in the Group U. CD3+CD8+ were raised obviously at T2~3 compared with T0 in the Group C but had less difference in the Group U. CD3+CD4+/CD3+CD8+ had less difference at T1~3 compared with T0 in the Group C but raised obviously at T3 in the Group U. Conclusion The application of ulinastatin in laparoscopic surgery could significantly produce protective effect on T-cytoimmunity.

Objective To investigate the diagnostic value of contrast enhanced ultrasound in breast cancer. Methods Thirty-six cases including 51 typical and 22 atypical breast cancer were examined with injecting contrast agent before operation. The enhanced charaters of perfusion pattern, enhanced level, and modes were observed and reanalyzed when pathology was got. Results There was no statistical meanings in perfusion pattern, enhanced level and mode between typical and atypical breast cancer. They all enhanced like branch or annulus with high lever and there were 3 enhanced modes:"fast in slow out"(48% ,35/73) ,"lastly fast in slow out"(44% ,32/73) and "same in same out"(8% ,6/73). Conclusions The enhanced modes of breast cancer showed "fast in slow out" , "lastly fast in slow out"and "same in same out", enhanced like "branch or annulus" and high level enhanced. Contrast enhanced ultrasound can increase the diagnostic accuracy in the early stage of breast cancer.

Objective To evaluate the application of pure brilliance imaging(PB1) in diagnosis of benign and malignant breast neoplasms. Methods Ninty-seven breast neoplasms were respectively examined by high frequency ultrasound and PBI before operation,then correlated with pathological results. Results The accuracy of high frequency ultrasound for breast neoplasms was 73.2% with the sensitivity 77.8% ,specificity 69.2%. The detectable rate of spiculate margin, halo,calcification were much higher in PBI than those in high frequency ultrasound(P<0.05). And the accuracy,sensitivity and specificity of PBI were 86.6%, 91.1%, 82.6%. Conclusions PBI can significantly increase the detectable rate of ultrasonographie marginal features of breast neoplasms which were also helpful to the differential diagnosis.

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Objective To compare the clinical effects of dynamic hip screw(DHS),Gamma interlocking intramedullary nail and proximal femoral nail antirotation (PFNA) in the treatment of intertrochanteric femoral fractures in elderly patients.Methods From January 2008 to June 2015,103 elderly patients with intertrochanteric femoral fracture were treated with DHS (DHS group,33 cases),Gamma nails (Gamma group,30 cases),or PFNA (PFNA group,40 cases).By the AO classification,there were 44 cases of type 31-Al,30 cases of type 31-A2 and 29 cases of type 31-A3.The 3 groups were compared in terms of incision length,operation time,intraoperative blood loss,fracture healing time,postoperative weight-bearing time,Harris scoring,and incidence of postoperative complications.Results PFNA group incurred significantly shorter incision length (5.4 ±0.5 cm) and operation time (70.8 ± 16.2 min) than DHS group (12.6 ±2.7 cm and 102.6±17.4min) and Gamma group (7.5±0.8 cmand93.0±35.9 min) (P ＜0.05).The intraoperative blood loss in PFNA group (163.2 ± 60.6 mL) was significantly less than in DHS group (280.5 ±89.8 mL) and in Gamma group (204.9 ±62.2 mL),and that in Gamma group was also significantly less than in DHS group (P ＜ O.05).PFNA group had significantly shorter weight-beating time (11.0 ± 0.8 weeks),fracture healing time(13.6 ± 1.5 weeks) and significantly higher Harris good to excellent rate (92.5％) than DHSgroup (13.3±1.0weeks,15.8 ± 1.2 weeks and 84.8％) and Gamma group (12.5±1.3 weeks,14.2 ± 1.0 weeks and 86.7％) (P ＜ 0.05).The incidence of postoperative complications in DHS group (21.2％)was significantly higher than in Gamma group(10.0％) and in PFNA group (7.5％) (P ＜ 0.05).Conclusions DHS,Gamma nail and PFNA are effective means for the treatment of intertrochanteric femoral fractures in the elderly.Intramedullary fixation,especially by PFNA,shows superiority in the clinical outcomes.

BACKGROUND:Hepatocyte transplantation as an effective method for liver failure has been confirmed by animal models and clinical application.However,limited source and poor proliferation of hepatocyte graft limit its development.Studies have shown that bone marrow mesenchymal stem cells(MSCs)have potentials to differentiate into hepatocyte and bile epithelial celts,with strong proliferation.OBJECTIVE:To explore the therapeutic effect of bone marrow MSCs transplantation on liver failure of New Zealand white rabbits.METHODS:Adult male New Zealand rabbits were treated with D-galactosamine,and 3 mL hepatocyte suspension(1×109/L)was injected into the liver of transplantation group,but the control group was injected with the same volume of culture solution with no bone marrow MSCs.Alanine aminotransferase(ALT)and aspartate aminotransferase(AST)activity was detected 48,72 hours,1,4 weeks following transplantation,and pathological detection was performed at 4 weeks.RESULTS AND CONCLUSION:The liver functional index following transplantation of bone marrow-derived MSCs transplantation was significantly decreased,and ALT and AST activity at 4 weeks was significantly less than the control group(P ＜ 0.05).At 4,the transplantation group displayed disorderly hepatic cord,hepatocyte swollen and degeneration,necrosis,accompanied by bleeding and inflammatory cell infiltration.In addition,the hepatic lobule structure was detectable,and regenerative hepatocyte increased among necrotic hepatocyte;small cells with large ratio of nucleus and cytoplasm at header,central vein and surrouding necrosis focus extended to the liver tissues.

BACKGROUNDIt has been proven that the newborn vessels and adhesion ability are very important characters of malignant tumor cells. Among all the invasion and metastasis factors, integrins seem to be hot spots gradually because of their special construction and function.The aim of this study is to investigate the expression of integrin β1 mRNA and integrin β3 mRNA in squamous cell carcinoma (SCC) of the lung, as well as their correlation with microvascular density (MVD) and biological behaviour of SCC.

METHODSExpression of integrin β1 mRNA, β3 mRNA and CD34 protein was detected in 152 SCC specimens by tissue microarray, in situ hybridization and immunohistochemistry.

RESULTSThe mean MVD was not significantly different between high and low integrin β1 mRNA expression groups (P=0.072), however, it was markedly different between high and low integrin β3 mRNA expression groups (P=0.041). The high expression rate of integrin β1 mRNA and β3 mRNA was closely related to lymphatic metastasis (P=0.018, P=0.011), distant metastasis (P=0.020, P=0.035) and T stage (P=0.025, P=0.015). The survival time of patients with high integrin β1 mRNA and β3 mRNA expression was significantly shorter than that of those with low expression (P=0.034, P=0.021). The survival time of patients with MVD value≥39 was significantly shorter than that of those with MVD value < 39 (P=0.024).

CONCLUSIONSThe results of this study suggest that both of integrin β1 and β3 may be involved in invasion and metastasis of SCC, and that integrin β3 expression correlates with enhanced tumor angiogenesis and integrin β1 expression may be an early event in development of SCC. They may serve as prognostic markers of SCC.

Objective To explore the application value of cone-shaped gastric tube combined with cervical end-to-end anastomosis in thoracoscopic and laparoscopic esophagectomy for esophageal cancer.Methods The retrospective and descriptive study was conducted.The clinical data of 122 patients with esophageal cancer who were admitted to West China Hospital of Sichuan University from December 2016 to December 2017 were collected.There were 89 males and 33 females,aged (61±8)years,with a range from 48 to 81 years.McKeowntype three-incision esophagectomy was performed,and the cone-shaped gastric tube was pulled up to esophagus in left neck for hand-sewn end-to-end anastomosis after the dissection of esophagus and stomach under total thoracoscopy and laparoscopy.Observation indicators:(1) surgical treatment situations;(2) postoperative complications;(3) follow-up.Follow-up using outpatient examination was performed to detect postoperative gastroesophageal reflux,anastomotic stenosis and evaluate anastomotic width at 1,3,6 months and one year postoperatively up to December 2018.Measurement data with normal distribution were represented by Mean±SD.Measurement data with skewed distribution were described by M (P25,P75) or M (range).Count data were expressed by absolute number.Results (1) Surgical treatment situations:122 patients underwent laparocopic McKeown-type three-incision esophagectomy successfully,using cone-shaped gastric tube combined with cervical hand-sewn end-to-end anastomosis as digestive tract reconstruction,with no intraoperative conversion to open surgery.The operation time,cervical anastomosis time,and volume of intraoperative blood loss were (229 ± 49) minutes,(27± 1) minutes,and 50 mL (40 mL,60 mL),respectively.There were 6-8 stations of lymph node dissected,and the number of lymph node dissected were 19 (15,25).Duration of postoperative hospital stay was 10 days (9 days,11 days) in the 122 patients.(2) Postoperative complications:31 of 122 patients had postoperative complications.The primary complications:3 patients with anastomotic fistula were cured by conservative treatment including enteral nutrition through placement of nutritional tube under gastroscope,closed thoracic drainage and anti-infection;6 cases with severe thoracic gastric dilation were cured after gastrointestinal decompression.The secondary complications of 22 patients included 8 cases with hoarseness caused by recurrent laryngeal never injury,5 with arrhythmia,9 with pulmonary infection.They were cured after symptomatic and supportive treatment.No chylothorax occured,and there was no perioperative death.(3) Follow-up:all the 122 patients were followed up for 10-24 months,with a median time of 19 months.During the follow-up,7 cases with anastomotic stenosis including 4 scoring less than grade 2 and 3 scoring more than grade 3 were relieved after dilation through gastroscope.There were 33 of 122 patients without any reflux symptoms,and 89 with reflux symptoms,among which 52 were scored 1,25 were scored 2 and 12 were scored 3.The width of gastroesophageal anastomosis measured by barium radiography at 1 month after operation was (1.2±0.4) cm.Conclusion Coneshaped gastric tube combined with cervical end-to-end anastomosis in digestive tract reconstruction of thoracoscopic and laparoscopic esophagectomy can reduce the incidence of postoperative anastomotic complications and thoracic gastric dilation,and nasogastric tube placement could be abandoned,which demonstrates good safety and universality.

【Objective】 To investigate the management of adverse reactions to blood donation(ARBD) in blood services, so as to promote the surveillance of ARBD and improve the quality of blood donation service in Chongqing. 【Methods】 A questionnaire, involving the staff and facilities in blood donation sites as well as the prevention and treatment, the record and report, the following up and data related to ARBD was developed by Chongqing Society of Blood Transfusion in February 2019, and was issued to 18 blood services(1 blood center and its sub-center, 6 central blood stations and 11 hospital blood banks) in the Chongqing via email. The questionnaire was filled in and submitted before March 31 by management personnel participating in the investigation, and the data was collected, collated, revised and analyzed by Excel 2011. 【Results】 A total 19 questionnaires were collected, with the valid rate at 100%(19/19). 78.95%(15/19) of the blood services met the requirements of medical personnel allocation(>6 medical staff) when the number of daily blood collection was more than 60, and 100%(19/19)met the requirements of medical personnel allocation(2 to 6 medical staff) when the number of daily blood collection was less than 60. 89.47%(17/19) of the blood services were equipped with epinephrine hydrochloride, and 84.21%(16/19) with dexamethasone(an anti-allergic drug). There were significant differences in the allocation of other types of drugs. 100.00%(19/19) of the blood services formulated prevention and treatment measures concerning ARBD. In 2019, the incidence of ARBD in Chongqing was reported to be 0.54%(1 958 / 359 871), with the highestas [1.35%(223/16 543)] in subcenters and the lowest [0.32%(179/56 299)] in central blood centers (P<0.05). There was statistical significances in the incidences of ARBD reported by different blood stations(P<0.05). 【Conclusion】 The monitoring and management of ARBD among blood services in Chongqing should be further standardized in terms of staffing allocation, emergency drugs allocation and reporting, so as to gradually realize regional homogenization and ensure blood safety.