Breast cancer is a kind of hormone-dependent tumor,the high level of estrogens is an impor-tant risk factor of breast cancer.There is evidence that estrogens through estrogen receptor (ER) signaling pathways and estrogen metabolic products participate in the development and progression of breast cancer.Recentally,studies demonstrated that SDF-1 and its receptor CXCR4 are involved in breast cancer.Estro-gens play an important role in the growth,proliferation and metastasis of breast eaneers through SDF-1/CX-CR4 signaling pathways.These findings may'provide a novel therapeutic target for breast cancer.

Objective To summarize the clinical feature and treatment of 34 cases with closed abdominal trauma and craniocerebral trauma. Methods 34 patients with closed abdominal trauma and craniocerebral trauma were analyzed retrospectively. Results 4 cases died in hospital. Conclusion For the patients with closed abdominal trauma and craniocerebral trauma, shock and acute intracranial hypertension should be dealt with in time. Early diagnosis and operation is important to avoid secondary brain injury and to reduce the death rate.

ObjectiveStromal cell-derived factor -1 (SDF-1 ) is closely related to the biological characteristics of breast cancer. We aimed to explore whether estrogen affected breast cancer by SDF-1. MethodsThe breast cancer cell line MCF-7 and MRC5 were chosen, and divided into three groups: the control group, the estrogen group and the estrogen + estrogen receptor blocker group. Each group was cultured with different physiological concentrations of 17-β estrogen at certain time, and the same alcohol concentration of 17-β estradiol at different time points, and then the enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of SDF-1 in culture medium, and the semi-quantitative reverse transcriptionpolymerase chain reaction (RT -PCR) was used to detect the expression of SDF-1 mRNA in each group.ResultsSDF-1 can be detected in the culture medium of both MCF-7 and MRC5 cell lines. All different concentrations of 17-β estradiol may increase the secretion of SDF-1 in MCF-7 cells. When adding 17-β estradiol to the concentration of 107mol/L, the secretion of SDF-1 reached the peak in 2 hours, which was 6 times and 2.7 times that of control group ( P ＜ 0.01 ). The effect could be ehminated by pure estrogen receptor ICI182,780. In addition, the mRNA expression of SDF-1 was consistent with the SDF-1 protein levels-l07 mol/L group. The expression of SDF-1 mRNA was higher than both that of the control group and the blocking group in 2 hours (P ＜ 0.05 ). ConclusionsIn some breast cancer cell lines, physiological concentrations of estrogen can increase the secretion of SDF- 1, and this effect is mainly achieved through the estrogen receptor. Estrogen can influence the biological characteristics of breast cancer by SDF-1.

Objective To explore the clinical value of combined detection of CA15-3, TSGF, OPN and CA125 in the diagnosis and treatment of breast cancer. Methods The serum specimens from 187 patients with breast cancer (cancer group) were collected, tumor markers CA15-3 and CA125 were detected with electrochemiluminescence method, TSGF was detected with chemocolorimetry, and OPN was detected with enzyme-linked immunosorbent assay. Compared with 50 cases of patients with benign breast disease (control group), The relationship between these marker and clinical stage, recurrence and metastasis of breast cancer were analyzed. Results The serum levels of CA15-3, CA125, TSGF and OPN in cancer group were significantly higher than those in control group (P ＜0.05). Four markers in high clinical stage(Ⅲ and Ⅳ stage)[(83.21±28.67), (89.13±32.34), (278.66±137.23) U/ml and (97.4±11.7) ng/ml, respectively] were higher than those in low stage( Ⅰ and Ⅱ stage) [(60.03±19.35), (58.21±17.56), (155.79±113.11) U/ml and (77.5±10.81) ng/ml,respectively] (P ＜0.05), and those in lymphnode metastasis patients and in recurrence patients were significantly higher than those in corresponding groups (P ＜0.05). The sensitivity and specificity of the combined detection of four tumor markers were 96.3 % (180/187) and 80.0 % (40/50), respectively. The average time of combined detection of serum tumor markers was 2 months ahead of the mammographic features in the recurrence patients with breast cancer. Conclusion The dynamic combined detection of CA15-3, TSGF, OPN and CA125 are better markers for monitoring recurrence and metastasis of breast cancer,which are benefit to early diagnosis and interference.

Objective To apply the percutaneous endoscopic gastrostomy (PEG) for deglutition disorders of the elderly. Methods 32 elderlypatients with deglutition disorders accepted PEG were reviewed. They accepted post-operative enteral nutrition and were followed upmonthly with their weight, body mass index and mini-nutritional assessment (MNA). Results 2 cases presented skin infection of stoma, nomore complications happened. Their weight, body mass index and MNA improved significantly 3 months after treatment (P<0.05). ConclusionPEG is an effective treatment for the elderly deglutition disorders.

Upper limb dysfunction can severely threaten the quality of life of the patients with breast cancer after mastectomy. This paper reviewed the researches on its pathogenesis, diagnosis, treatment, prevention and so on in the last 10 years. Early rehabilitation is very important for upper limb dysfunction after mastectomy.

Objective To compare the incidence of limb dysfunction, sensory disturbance and lymphedema after different treatment methods in breast cancer patients, and evaluate the clinically relevant factors of limb dysfunction. Methods According to the different processing operation of axillary lymph nodes, 235 patients with breast cancer during 2005 to 2012 were divided into axillary lymph node dissection group in Mastoscopy (group A, n=120) and routine axillary lymph node dissection group (group B, n=115). The flexion, extension, abduction, adduction activity of the ipsilateral shoulder were compared with the contralateral, and the circumference of the up-and-down 15 cm of both upper limbs olecroanon were measured. The incidence of limb dysfunction of the patients was followed up in 6 months, 1 year and 2 years. Results There was no significant difference in limb activity and sensory disturbance between 2 groups 6 months, 1 year and 2 years after operation (P>0.05), the incidence of limb lymphedema was higher in group B than in group A (P<0.05). Radiotherapy was related with limb lymphedema in both groups (P<0.05). Conclusion Compared with the conventional axillary lymph node dissection, endoscopic axillary lymph node dissection can reduce the incidence of limb lymphedema after operation, but there was no significant difference in the limb activity and sensory disturbance between 2 groups. Postoperative radiotherapy is a risk to increase the occurrence of limb lymphedema.

Objective To investigate the stapled trans-anal rectal resection (STARR) and Altemeir's resection for rectum prolapse in spinalcord injury (SCI) patients. Methods Anus bowel disease of 260 SCI patients were investigated, 21 cases with rectum prolapse who wereinvalid for nonoperative treatment chose Altemeir's resection or STARR depending on the degree of rectum prolapse. They were recorded ac- cording to International Spinal Cord Injury Bowel Function Based and Extension Set before and 12 months after operation. Results 85 SCIpatients were with rectum prolapse (32.7%), 21 patients complicated with constipation and mixed hemorrhoid, 19 with rectal mucous membraneprolapse (<7 cm), 4 with rectal internal mucous intussusception, 2 were completely rectum prolapse (≥7 cm). Rectum prolapse of Ⅰdegree was found in 13 cases, Ⅱ in 5 cases, and Ⅲ in 3 cases. Patients with Ⅰ or Ⅱ degrees rectum prolapse accepted STARR, those withⅢ degrees accepted Altemeir's resection. No serious complication was found. Self-report of intestinal dysfunction affecting the quality oflife during the 12 months after operation significantly decreased (P<0.01), so as the need of drawing out defecate with hands (P<0.01), theusage of liner, plug, or antidiarrheal (P<0.001). The symptom such as endless defecate feeling, abdominal distension, abdominal pain, abdominaldiscomfort were significantly alleviated (P<0.05). Conclusion STARR and Altemeir's resection are both safe and effective operationfor rectum prolapse in SCI patients.