Objective To explore ways for expanding the now-limited coagulation volume of percutaneous microwave coagulation therapy(PMCT) in liver in order to enhance the complete necrosis rate of large hepatic tumors with obviously fewer punctures. Methods Fresh pig livers in vitro and rabbit, pig livers in vivo with and without blood supply were coagulated using the self-designed HM-WIA microwave coagulator to make clear antenna length, microwave power, coagulation time and blood flow influence the microwave volume(MCV).Results The device enlarged the MCV by 3 times using single electrode with an antenna of 36 mm in length along with microwave power of 45-55 W and coagulation time of 15-19 min,the short axis of the coagulation area was 5.6 cm in vitro, 5.3 cm in vivo with no blood supply.The antenna 36 mm in length was proved the best in keeping the finest coagulation shape.The MCV was 2.8 times as large without blood supply as with it (P

Objective To explore the effects of exercise with psychological rehabilitation on motor function of upper limbs for stroke patients with hemiplegia. Methods 34 stroke patients with hemiplegia were divided into treatment group (n=17) and control group (n=17). Both groups were treated with basic medication and exercise while the treatment group received psychological rehabilitation additionally. The motor function of upper limbs was evaluated with Fugl-Meyer assessment (FMA), and activities of daily living was assessed with Barthel index (BI) before and after treatment. Results After treatment, the scores of FMA and BI improved significantly in both groups (P<0.001), and was better in the treatment group than in the control group (P<0.001). Conclusion Exercise with psychological rehabilitation can effectively improve the motor function of upper limbs and activities of daily living for stroke patients with hemiplegia.

Objective To investigate the clinical efficacy of Changqin No. 1 combined with Western therapy for severe traumatic brain injury and its effects on prognosis. Methods Totally 65 cases of severe traumatic brain injury were randomly divided into the treatment group (n=32) and the control group (n=33). The control group was treated with basic Western therapy (dehydration reduction of intracranial pressure, nutrition nerve, scavenging oxygen free radicals, improve cerebral circulation, nutritional support and maintain the internal environment stability, anti-infection, prevention and treatment of complications, hyperbaric oxygen). The treatment group was treated with Changqin No. 1 plus the basis of routine treatment, 1 dosage per day, 2 times stomach tube nasal feeding or blunt, for 14 d. One month after treatment, awake rate, awake time, the incidence of complications and MMSE in both groups were compared. Three months after treatment, the prognosis of two groups were compared by GOS. Results One month after treatment, the awake rate in treatment group was 77.4% (24/31) and 53.1% (17/32) in the control group, with statistical significance (χ2=4.089, P=0.043), and the death rate was 0. The awake time in the treatment group was significantly shorter than that of the control group (t=2.458, P=0.017). The incidence of pulmonary infection in the treatment group was lower than the control group (P=0.001). There was no statistical significance in urinary tract infection, epilepsy, liver and kidney dysfunction rate of the two groups (P>0.05). The number of awake case was 24 in the treatment group and 17 in the control group. The number of normal MMSE cognitive function was 3 in the treatment group and 2 in the control group, and the treatment group was better than the control group (Z=-2.205, P=0.027). Three months after treatment, the good prognosis was 58.08% (18/31) in the treatment group and 28.12%(9/32) in the control group, with statistical significance (χ2=5.763, P=0.016). Conclusion Changqin No. 1 combined with Western basic treatment can help patients with severe traumatic head injury awake early, reduce pulmonary infection complications, and improve the cognitive function of sober patients and improve the prognosis.

Objective To investigate the clinical distribution and antimicrobial resistance characteristics of carbapenem-resistant Acinetobacterbaumannii (CRAB).Methods CRAB isolated from all inpatients in a hospital in January-December 2015 were performed retrospective analysis,antimicrobial susceptibility testing result was analyzed.Results A total of 721 AB strains were detected,231 (32.04%)of which were CRAB,isolation rates of CRAB in quarter 1-4 were 48.99% (73/149),41.98%(68/162),27.39%(63/230),and 15.00%(27/180) respectively,which showed a decreased trend (P<0.001).CRAB mainly came from sputum specimen(n=140, 60.61%),followed by secretion of wound(n=33,14.28%)and urine specimen(n=24,10.39%).CRAB mainly distributed in intensive care unit,accounting for 43.72%(n=101),following by department of neurosurgery(n=37,16.02%),and burn/plastic surgery (n=22,9.52%).Resistance rates of CRAB to ampicillin/sulbactam, gentamicin,levofloxacin, and ciprofloxacin were 85.28% -90.48%,resistance rate to tobramycin was low (19.48%),no strains were found to be resistant to polymyxin B.Conclusion Antimicrobial resistance of CRAB is serious,it is necessary to focus on management of key departments,take scientific prevention and control measures, so as to effectively reduce the incidence of healthcare-associated infection.

Objective To investigate the role of miR-223 in the pathogenesis of acute gouty inflammation.Methods The subjects were divided into 3 groups:65 acute gout patients (AG),50 inter-critical gout patients (IG),and 45 healthy controls (HC).The peripheral blood mononuclear cells (PBMCs) and the clinical laboratory parameters were all collected.The expression of miR-223 in the PBMCs was detected using realtime fluorescent quantitative polymerase chain reaction (RT-qPCR) (TaqMan probe).The PBMCs of 5 healthy people were stimulated with monosodium urate (MSU) (100 μg/ml) for 12 h,and then,miR-223,NLRP3 mRNA and IL-1β production were all measured using RT-qPCR and ELISA respectively.All data were analyzed by SPSS 17.0 statistical software,Wilcoxon rank sum test,t test and Spearman's correlations analysis were used for statistical analysis.Results ① The expression of miR-223 in AG and IG groups was both significantly decreased than that in the HC group (8±17 vs 26±76,P＜0.05;9±17 vs 26±76,P＜0.05;respectively),AG group was significantly decreased than that in the IG group [8(17) vs 9(17),Z=11.387,P＜0.01].② After stimulated with MSU in healthy controls,IL-1β production and NLRP3 mRNA were both significantly increased [(86±5) pg/ml vs (13±6) pg/ml,t=21.042,P＜0.01;5.2±0.4 vs 1.2±0.4,t=14.640,P＜0.01;respectively],while the expression of miR-223 was significantly decreased (0.34±0.20 vs 1.05±0.24,t=-5.164,P＜0.01).Conclusion The data suggests that miR-223 might be involved in the patho-genesis of spontaneous regulation,but further study is needed to discover the exact mechanism.

Objectives To investigate the expression of B lymphocyte stimulator (BLyS) and its receptor BAFF-R(a receptor of B-cell activator factor, belonging to the TNF family) in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE), and to explore their clinical significance. Methods The patients were separated into active group (n = 28) and inactive group (n = 24) according to the SLE disease activity index (SLEDAI). The mRNA and protein expression of BLyS and its receptor BAFF-R were measured by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western-blot in PBMCs from the patients and 21 healthy volunteers. The relationship between the expression of BLyS and BAFF-R and SLEDAI was analyzed. Results In the case of the expression of mRNA and protein of BLyS and BAFF-R, the patients had a higher level than the healthy controls (P 0.05). Conclusions These findings indicate that BLyS and its receptor BAFF-R might be involved in the pathogenesis of SLE. Also, BLyS expression level might be a new parameter for the evaluation of SLE disease activity and therapeutic effect.

Objective To assess the impact of radiation on superior epigastric vessel pedicled transverse rectus abdominal myocutaneous (TRAM) for breast reconstruction.Methods Female breast cancer patients were divided into 4 groups:group A (immediate breast reconstruction + radiation therapy,123 cases),group B (immediate breast reconstruction,262 cases),group C (radiation therapy + delayed breast reconstruction,34 cases),group D (delayed breast reconstruction,53 cases) from June 2009 to June 2012 at Department of Breast Oncology,Tianjin Medical University.Patient demographics,operative details,radiation therapy details,postoperative complications,patient-centered evaluation of aesthetic and psychological outcomes were assessed.Results The average follow-up duration was 24.98 ± 6.99 months.2.5％ patients developed delayed wound healing postoperatively.Fat necrosis and flap contracture were seen in 7.0％ and 3.6％ of all patients,respectively.Irradiated patients had a significant statistical difference in cancer staging,involved lymph nodes,tissue invasion and neoadjuvant chemotherapy (P ＜ 0.05).No significant statistical differences were observed in post-operative early complications,but in advanced stage complications.There was no significantly statistical difference in breast aesthetic outcome before and after radiation therapy within four groups.Conclusions For breast reconstruction patients,those without postoperative radiotherapy were suggested immediate breast reconstruction,and those with postoperative radiotherapy were proposed to accomplish breast reconstruction after postoperative radiotherapy.

Objective To determine the effect of lipoxins (LX) A4 and its agonist (BML-111) on the survival of RAW264.7 macrophage cells and TLR4/NF-κB signaling pathway. Methods RAW264.7 cells were treated with different concentrations of LPS, then the effect of LX A4 and BML-111 on the survival rate of these cells was observed. Cytotoxicity were detected by CCK-8 method and RT-PCR was used to detect the TLR4 and TRAF6 mRNA. The protein levels of TLR4 and pNF-κB p65 in RAW264.7 were determined by Western Blot. Results The survival rates of macrophage treated with LPS for 6 h in 1 000 ng/mL LPS in LX A4 group and BML-111 group were significantly higher than that in control group (P < 0.05). In the present of LPS, the TLR4 mRNA levels in RAW264.7 cells from LX A4 group and BML-111 group were significantly higher than those in the corresponding non-LPS groups. And the TRAF6 mRNA levels in each LPS stimulation group were higher than those in the corresponding non-LPS groups (P<0.05), while the protein level of TRAF6 in LX A4 and BML-111 groups were significantly lower than that in control group (P < 0.05). Stimulated with LPS, the protein levels of pNF-κB p65 in the LX A4 group and BML-111 group were all significantly lower than that in control group (P<0.05), and pNF-κB p65 expression level in control group was also significantly higher than the corresponding non-LPS groups (P < 0.05). Meanwhile, no significant difference was found between LX A4 and BML-111 group (P > 0.05). Conclusion LX A4 and BML-111 could inhibit the cytotoxicity of LPS on the RAW264.7 macrophage cells through the inhibition of the activation of TLR4/NF-κB signaling pathway, then reduce the inflammation. And this stable BML-111 may appear as another promising treatment for IBD disease.

There are a lot of feasibility studies, using sentinel lymph node biopsy SLNB instead of Alex lymph node dissection (ALND), having got a conseusus that SLNB is a safe and useful method in the treatment of breast cancer. But in clinical practice, there are much false negative rate (FNR) which need to be carefully dealt with for SLNB. In order to diminish the FNR, how many nodes should be the perfect number to lower the FNR? If positive detection was found in the SLN, should ALND always be needed? And when micro metastasis was found in the post operation HE staining? Does it need further treatment? We make a review to discuss those matters.

0.05).After the EN,the level of blood total protein,albumin and prealbumin significantly increased(P