Objective To explore clinical result of breast carcinoma by improvement radical correction in retention intercostobrachial nerves.Methods The clinical data of breast carcinoma in our hospital were analyzed,which were divided into detection group and control group.Results The operation time,hemorrhage of operation in detection group were lower than control group,the upper limb decreased,skin stabbing pain and relapse rate were higher than control group (P ＜ 0.05 ),the difference were statistically significant.Conclusion The clinical result is obvious,the prognosis is good.It's worthy of clinical application.

Objective To compare the effect of thoracoscopic and laparoscopic surgery with conventional thoracic surgery on esophageal cancer and its influence on pulmonary function. Methods Ninety?four patients with esophageal cancer treated in the Second Affiliated Hospital of Chengdu Medical College from March 2010 to March 2016 were selected and were divided into the control group ( 54 cases) and the study group ( 40 cases) according to operation methods. The control group received traditional thoracotomy. The study group received thoracoscopic and laparoscopic surgery. The operation and pulmonary function indexes were compared. Results The operation time of the patients in the study group was significantly longer than that in the control group ( (218. 1±35. 8) min vs. (192. 3±40. 1) min,t=3. 23,P<0. 05). Intraoperative blood loss of the patients in the study group was significantly less than that in the control group ( (286. 4±83. 5) ml vs. (343. 7 ±96. 7) ml,t=3. 01,P<0. 05) . The number of lymph nodes cleared of the patients was significantly higher in the study group ( (18.0±5.4) node vs. (15.5±4.6) node,t=2.42,P<0.05).Thoracic drainage of the patients in the study group was significantly less than that in the control group ( (650. 3±61. 3) ml vs. (1153. 5 ±133. 7) ml,t=22. 12,P<0. 05). Chest tube pull out time in the study group was significantly earlier than that in the control group ( (5. 1±1. 3) d vs. (8. 0±1. 8) d,t=8. 65,P<0. 05). First exhaust time in the study group was significantly earlier than that in the control group ( (33. 2±6. 7) h vs. (40. 7±7. 3) h,t=5. 10,P<0. 05). Hospital stay in the study group was significantly shorter than that in the control group ( ( 13. 8 ± 2. 8 ) d vs. (18. 2± 3. 6) d, t=6. 42, P<0. 05) . Postoperative complications occurred in 4 cases in the study group, accounting for 10%, significantly lower than that in the control group, 15 cases, 27. 8%, the difference was statistically significant (χ2=4. 50,P<0. 05) . VC,FEV1 and MVV in the study group were significantly higher than those in the control group ( VC:( 81. 5 ± 15. 6 )% vs. ( 42. 3 ± 8. 1 )%;FEV1: ( 85. 7 ± 9. 1 )% vs. ( 43. 6 ±6. 8)%;MVV:(76. 0±8. 9)% vs. (48. 3±7. 6)%,t=15. 83,25. 68,16. 24,P<0. 05). 3?year survival rate of the study group and the control group were 45. 0% (18/40) and 44. 4% (24/54),respectively. There was no significant difference between the two groups (χ2 = 0. 01, P> 0. 05 ) . Conclusion Thoracoscopic and laparoscopic surgery for esophageal cancer has the advantages of small trauma,rapid recovery and low incidence of complications and obvious protective effect on pulmonary function. It is safe and feasible.

BACKGROUND:The ankle joint is capable of flexion and extension, including plantar flexion and dorsiflexion, to act as a support and a lever. An ankle injury, often accompanied by fracture and ligament injury, seriously threatens the ankle joint function. Previous diagnosis of ankle injury mainly relied on clinical signs and X-ray examination. However, X-ray examination is not accurate enough for ankle injury diagnosis because it cannot clearly diagnose damage to the surrounding ligaments, tendons and other soft tissues except for obvious fractures. Mutlisequence and multiplanar MRI is currently the optimal noninvasive method for high-resolution determination of soft tissue deformations, but little has been reported on the diagnostic accuracy of ankle ligament and tendon injury. OBJECTIVE:To observe the diagnostic value of MRI for ligament and tendon injury of the ankle in its normal position, and during complete plantar flexion and dorsiflexion. METHODS:It is a single-center, prospective, diagnostic trial that wil be completed at the First Hospital of Hebei Medical University, China. Sixty cases were recruited, including 30 cases of normal ankle joint and 30 cases of ankle ligament and tendon injury. MRI scans of the ankle joint in normal position, complete plantar flexion and complete dorsiflexion were performed in al the cases, and the multi-position MRI results were compared. The primary outcome measure is the sensitivity of MRI to ligament and tendon injury of the ankle during complete plantar flexion. The secondary outcomes include the specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of MRI to ligament and tendon injury of the ankle during the complete plantar position as wel as rate of correct diagnosis;specificity and sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio in normal position or during the complete dorsiflexion as wel as rate of correct diagnosis;the morphology of the ankle on the multi-position MRI. This study design was registered at ClinicalTrial.gov (03049423) on February 8, 2017. This study protocol has been approved by the Medical Ethics Committee of Qinghai University Affiliated Hospital of China (approval No. 2015076) and wil be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment was obtained from each volunteer. DISCUSSION:This study aims to determine the rate of correct diagnosis of ankle ligament and tendon injury using the MRI, to clarify the diagnostic value of MRI for ankle ligament and tendon injury, and to provide a quantitative MRI diagnostic standard for developing a reasonable surgical treatment.

Objective: To explore the ethical and juristic signif-icance of hearing with living-related kidney transplantation. Methods: This study involved 18 donors and recipients who received medical e-valuating and informing the related medical risk between Jul.2006 and Jun.2007. Our experience of 18 hearings with living-related kidney transplantation, which comprised members of Human Organ Transplant Te-chnique and Ethics Committee,donors,recipients and their direct rela-tives,was analyzed. Results the 16 hearings were successful, one res-igned donation,and two were controvertible and succeeded after re-ev-aluating. Conclusion:The hearing should have known,voluntary,equitab-le, unclassified and no commercial principle,and endeavour to ensure the medical,ethical and juristic entirety and integrity of living-re-lated kidney transplantation.

BACKGROUNDTo investigate the diagnostic significance of detection of telomerase activity of bronchoalveolar lavage liquid (BALF) in primary lung cancer.

METHODSBALF of 63 patients with lung cancer and 31 patients with non-cancerous pulmonary disease was collected, and telomerase activity was detected with silver-stained TRAP. Brush cytology and BALF cytology were carried out simultaneously.

RESULTSThe positive rate of telomerase was 76.2% (48/63) in lung cancer group, which was higher than 6.5% (2/31) in control group (Chi-square=40.6, P < 0.01). The positive rate was also higher than that of brush cytology (58.7%, 37/63) (Chi-square =3.6, P > 0.05), and higher than that of BALF cytology (14.3%, 9/63) (Chi-square=46.3, P < 0.01). In central type lung cancer group, the positive rate of telomerase was 71.4% (35/49), and higher than that of BALF cytology (12.2%, 6/49) (Chi-square= 35.3 , P < 0.01), but had no significant difference compared to that of brush cytology (61.2%, 30/49) (Chi-square=1.1, P > 0.05). In peripheral-type lung cancer group, the positive rate of telomerase in BALF was 92.9% (13/14), and higher than that of brush cytology (50.0%, 7/14) and that of BALF cytology (21.4%, 3/14).

CONCLUSIONSThe telomerase activity could be detected in the BALF of the primary lung cancer. Hence, detection of telomerase in the BALF of patients may be helpful to diagnose lung cancer.

Objective: To analyze the sensory processing characteristics among preschoolers with mental health problems in Nanshan District, Shenzhen. Methods: Random cluster sampling was used to select kindergartens for psychological screening from March to June 2018. The Strengths and Difficulties Questionnaire (SDQ) and the Simplified Sensory Questionnaire (SSP) were used to evaluate 6 365 preschool children. Results: A total of 15.15% preschoolers were detected with abnormal results. The SSP scores of preschoolers with emotional symptoms/conduct problems/prosocial behaviors were lower than normal preschoolers’(P<0.01). Among the preschoolers with hyperactivity-inattention, taste/smell sensitivity (F=12.45)/underresponsive/seeks sensation(F=102.44), auditory filtering(F=93.51), low energy/weak(F=13.33), visual/auditory sensitivity (F=4.32) scores were lower than normal preschoolers’(P<0.05), the scores of tactile sensitivity movement sensitivity were no statistical difference with normal preschoolers’. Among the preschoolers with peer problem, taste/smell sensitivity(F=5.86), tactile sensitivity(F=6.05), movement sensitivity(F=4.70), auditory filtering(F=17.32), low energy/weak (F=9.56), visual/auditory sensitivity (F=4.16) scores were lower than normal preschoolers’ (P<0.05), and the scores of under-esponsive/seeks sensation were no statistical difference with normal pre-schoolers’. Prosocial behavior and tactile (r=0.30), under-responsive/seeks sensation(r=0.37), auditory filtering(r=0.37), low energy/weak (r=0.31) were positive associated(P<0.01). Emotional symptoms were negatively associated with lack of energy/weakness(r=-0.33, P<0.01). Conclusion Mental health problems are related to sensory processing ability in preschoolers. Preschoolers with mental health problems have weak sensory processing ability. Clinicians and occupational therapists should pay attention to evaluation and intervention of sensory processing ability in preschoolers with mental health problems.

OBJECTIVETo investigate the way of revascularization of donator's trachea wrapped in united muscle flap.

METHODSUsing fiberoptic bronchoscopy, histopathology and microangiography, we evaluated the tracheal mucosal blood flow, the survival rate, the percentage of patency, and the graft viability of autograft tracheas with varying lengths wrapped in one-sided sternocephalic muscle flap and two-sided sternohyoid-sternothyroid muscle flap and autograft tracheas with the length of 5 rings without wrapped in muscle flap in 32 dogs.

RESULTSIn the tracheal autograft wrapped in the united muscle flap group with a length less than 4 centimeters, the submucosal blood flow of graft could be detected by laser blood flowmetry one week after transplantation, and it reached 60% of the normal, which had no significant difference between the place near the site of anastomosis and the middle part of the graft. Dense vessels could be found to grow from the wrapped muscles into the autografted trachea by microangiography. Histopathological examination demonstrated that the structure of the autograft was the same as what it originally was. the inner surface of the autograft was covered with pseudostratified columnar ciliary epithelia, and no necrotic tracheal cartilages were found. Every autograft could survive over long time. However, at 1 week, most mucous membrane in the middle part of the graft with length over 4 cm was in gray or in pale; hyperemia, edema, and haemorrhage were found near the site of anastomosis. Mucosal blood flow measured by laser blood flowmetry in the middle part of the graft was significantly less than that near the site of anastomosis. Malacia, dissolution or granulation hyperplasia occurred in midportion of the major grafts shortly after transplanatation. As for those autografted trachea without wrapping in muscles flap, mucous membranes turned black one week after the transplantation and all dogs died of graft necrosis later.

CONCLUSIONOne-sided sternocephalic muscle flap and two-sided sternohyoid-sternothyroid muscle flap can provide blood for the graft and the grafted trachea can survive for a long time.

Animals ; Bronchoscopy ; Dogs ; Female ; Male ; Neck ; Surgical Flaps ; Survival Rate ; Trachea ; blood supply ; pathology ; transplantation ; Transplantation, Autologous

Objective To analyze the risk factors of multi-drug resistant organism (MDRO) infection after liver transplantation. Methods The clinical data of 77 recipients undergoing liver transplantation were retrospectively analyzed. According to the incidence of MDRO infection, all recipients were divided into the non-MDRO infection group (n=51) and MDRO infection group (n=26). The infection rate and strain distribution of MDRO in liver transplant recipients were summarized. The risk factors of MDRO infection in liver transplant recipients were identified. Clinical prognosis of all recipients was statistically compared between two groups. Results The infection rate of MDRO after liver transplantation was 34% (26/77), mainly carbapenem-resistant MDRO infection. The main sites of infection included lung, abdominal cavity and incision. Univariate analysis showed that postoperative tracheal intubation ≥48 h, length of intensive care unit (ICU) stay ≥72 h, length of hospital stay ≥30 d, re-operation, continuous renal replacement therapy (CRRT) and tacrolimus (Tac) blood concentration ≥15 ng/mL were the risk factors for MDRO infection after liver transplantation. Cox regression analysis indicated that postoperative tracheal intubation≥48 h, re-operation, CRRT and Tac blood concentration ≥15 ng/mL were the independent risk factors for MDRO infection after liver transplantation. The fatality in the MDRO infection group was significantly higher than that in the non-MDRO infection group [31%(8/26) vs. 10%(5/51), P=0.01]. Conclusions Postoperative tracheal intubation ≥48 h, re-operation, CRRT and Tac blood concentration ≥15 ng/mL may increase the risk of MDRO infection after liver transplantation and affect clinical prognosis of the recipients.

Objective To discuss the imaging features of parietal bones atrophy,and to improve the understanding of this disease. Methods Clinical and imaging data of 8 patients with parietal bones atrophy were analyzed retrospectively.Age ranged 66-90 years with median age 76 years.CT scans were performed in all cases,and CT enhanced examination in 1 case.MRI examination were performed in 3 cases,in which MRI enhanced examination in 2 cases.Imaging characteristics were analyzed along with a review of the current literature.Results Bilateral parietal sympathetic involvements were found in 4 cases,unilateral parietal involvement in 4 cases,in which the left parietal bone was found in 2 cases and the right side in other 2 cases.The lesions ranged from 2.4 cm to 7.1 cm.On CT and MRI images,the external table of the parietal bones showed symmetrical impression,the diploe revealed thinner and the inner table was intact,which presented"Step change".Two of these patients were followed up,in which 1 case become severe atrophy,and the other case was no significant change.Nothing was showed in the relative scalp and soft tissue.Conclusion According to different degrees of thinning of parietal bones,combined with specific age,symmetrical parietal bone impression should be considered.

Objective:To investigate the effects of external application of Sanying Plaster on the size of thyroid nodules and the states of depression and anxiety in patients with benign thyroid nodules.Methods:A randomized controlled trial was conducted. A total of 120 patients with benign thyroid nodules from the outpatient clinic of the Department of Thyroid Diseases at Shanghai Traditional Chinese Medicine Hospital from June to December 2022 were selected as the subjects of the study. They were divided into two groups using the random number table method, with 60 patients in each group. The control group received lifestyle intervention treatment, while the treatment group received Sanying Ointment in addition to the treatment of the control group. Both groups were treated for 3 months. TCM syndrome scores were measured before and after treatment; the maximum diameter of thyroid nodules was measured using a color Doppler ultrasound transverse section; the quality of life was assessed using the short form 36 (SF-36); the degree of anxiety and depression was evaluated using the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS); adverse reactions during the treatment period were recorded, and the clinical efficacy was evaluated.Results:During the treatment period, 4 cases in the treatment group and 3 cases in the control group did not complete the treatment. Finally, 56 cases in the treatment group and 57 cases in the control group entered the efficacy evaluation. The total effective rate of the treatment group was 71.4% (40/56), and that of the control group was 14.0% (8/57), with a statistically significant difference between the two groups ( χ2=26.82, P<0.001). After treatment, the TCM syndrome score of the treatment group (10.02±3.65 vs. 16.65±3.44, t=-10.24) was lower than that of the control group ( P<0.001); the maximum diameter of thyroid nodules [11.00 (4.65, 19.93) mm vs. 15.00 (7.15, 28.50) mm, Z=-2.43] was lower than that of the control group ( P<0.05); the SF-36 score [121.83 (117.00, 130.00) vs. 114.42 (104.25, 127.50), Z=-2.62] was higher than that of the control group ( P<0.01); the SDS (46.72±4.59 vs. 57.02±5.99, t=14.80) and SAS (42.25±5.72 vs. 50.60±7.12, t=10.04) scores were lower than those in the control group ( P<0.001). The incidence of adverse reactions during the treatment period in the treatment group was 3.5% (2/57), and no adverse reactions occurred in the control group. Conclusion:The external application of Sanying Ointment helps to reduce the size of thyroid nodules in patients with benign thyroid nodules, improve the quality of life and anxiety and depression, and increase clinical efficacy with good safety.