Objective To investigate the feasibility of laparoscopic extirpation for mammary multiple fibroadenoma. Methods A total of 12 patients with multiple fibroadenoma that were diagnosed by ultrasonography and fine needle aspiration were enrolled in this study. Through an axillary small incision, the air was inflated into the retromammary space, which had been obtusely separated to build a surgical space. Then, 58 fibroadenomas were resected under a laparoscope. Frozen-section examination was carried out during the operation. Results All the masses of the 12 patients were laparoscopically extirpated successfully, without operative complications. The operation time was 40-150 minutes with a mean of 80 minutes. One month after the operation, the shape of the breast looked well and the sensation of the nipple remained normal. During a 1- to 36-month follow-up (mean 18.5 months), none of the patients had scars on the breast or tumor recurrence. All of them were satisfied with the cosmetic results. Conclusion Laparoscopic extirpation of mammary multiple fibroadenoma through the retromammary space is safe and feasible.

Objective:To compare transvaginal ultrasonography and hysteroscopy in diagnosis of intrauterine adhesions.Methods: One hundred and one cases of infertile women were treated by transvaginal ultrasound and hysteroscopy.Results: One hundred and one cases of infertility by hysteroscopy diagnosis of 87 cases of intrauterine adhesions, transvaginal ultrasound 68 cases of intrauterine adhesions, 78.16% sensitivity, sensitivity and different degree of intrauterine adhesions without significant difference. The diagnosis coincidence rate of intrauterine adhesions was consistent with transvaginal ultrasonography and hysteroscopy.Conclusion: In the clinical diagnosis and treatment of intrauterine adhesions, transvaginal sonography has the value of irreplaceable hysteroscopy. Vaginal ultrasonography can be used as the first choice for intrauterine adhesions.

Atrial fibrillation (AF) is one of the common arrhythmias. Catheter radiofrequency ablation is a only effective therapeutic method of AF currently. Contact force sensing catheter like SMART TOUCH can real time monitoring the pressure of catheter tip, which can help operators to understand the contact force between atrial and ablation points, and guide the atrial fibrillation ablation. It is significantly improved the effectiveness and safety of the atrial fibrillation. This article will focus on the current situation of radiofrequency ablation for AF by contact force catheter, in order to provide guidance for clinical work.

Objective To investigate expression of TPS, VEGF of beast cancer patients and relationship with clinical pathological.Methods 68 cases of breast cancer were selected as experiment group, 36 cases with breast fibroma were selected as control group.TPS and VEGF were detected by elisa of patients before and after treatment.Serum TPS and VEGF levels and TNM staging were compared after operation.Results TPS and VEGF of the experiment group were higher than control group(P<0.05).TPS and VEGF of experiment group after operation were higher than before operation.TPS and VEGF increased with the grade of tumor, but there was no significance between grade Ⅰ and 0.The expression of VEGF in tumor diameter≤2 cm group was significantly lower than >2 cm group(P<0.05).TPS and VEGF of axillary lymph node metastasis group and axillary lymph node metastasis had significant difference(P<0.05).The concentration of TPS was significantly higher than that of estrogen and progesteronepositive group in estrogen receptor negative, progesterone receptor negative (P<0.05).Conclusion TPS, VEGF levels in the serum of breast cancer patients showed high expression, the expression of TPS, VEGF levels related to axillary lymph node metastasis, estrogen receptor, progesterone receptor.

Objective To investigate effect of anthracyclines of VEGF-C, VEGFR-3, ER and E-cadherin in serum of patients with breast cancer.Methods 43 patients with breast cancer were selected and randomly divided into experimental group and control group, 40 cases in each group.According to the experimental program based on the treatment, serum VEGF-C, VEGFR-3 levels and breast tissue ER and E-cadherin were detected after the end of the treatment.Results Compared with the control group, VEGF-C, VEGFR-3 levels of the experiment group were lower( P<0.05),ER level was lower(P<0.05) and E-cadherin level was higher(P<0.05).Conclusion the ER, VEGFR-3 and VEGF-C levels in breast cancer patients can significantly decrease the E-cadherin level, and it has a guiding significance for clinical.

Objective To evaluate the clinical application and safety of CT-guided transthoracic cutting needle lung biopsy in diagnosing diffuse lung diseases. Methods By using automatic biopsy gun (14 & 16 gauge), CT-guided transthoracic cutting needle lung biopsy was performed in 29 cases with diffuse lung diseases. The samples obtained were sent for pathological and immunohistochemical examination. The sampling successful rate, the diagnostic accuracy and the occurrence of complications were analyzed. Results Technical success rate was 100%, and large size of sample enough for pathological and immunohistochemical examination was obtained in all 29 cases. Definite pathological diagnosis could be made in 25 cases, with the positive diagnostic rate of 82.8%. The main complications included pneumothorax and pulmonary hemorrhage. The symptoms in most cases were not severe and disappeared within one week after the treatment. Conclusion For the diagnosis of diffuse lung diseases, CT-guided transthoracic cutting needle lung biopsy is a safe, easy, effective and reliable method with high successful rate, high diagnostic value and fewer complications, in these respects this technique is superior to transbronchial lung biopsy, open lung biopsy and video-assisted thoracoscopic lung biopsy. Therefore, this technique should be popularized in clinical practice.

Objective:To investigate the role of clinical pharmacists in the process of chemotherapy for a patient with intracranial glioma. Methods:Usage and dosage of antitumor drugs, drug interactions, adverse drug reactions and medication education after dis-charged as the breakthrough points, clinical pharmacists and clinicians explored options for the patient treatment and adjusted the medi-cation timely according to the condition. Results:There were no serious adverse drug reactions in the adjusted therapeutic regimen and the treatment results of the patient were satisfactory. Conclusion:Clinical pharmacists provide pharmaceutical care can play an impor-tant role in improving the safety and effectiveness of drug use.

Objective To investigate the X ray radiation protective measure during interventional procedure.Methods The X ray radiation dose at 1,2,3 meters from the X ray tube in front of and in the near of lead glass,plumbic suit were measured in 101 cases interventional procedure.The data were analyzed and evaluated.Results The shielding efficacy was 95% by the lead glass and plumbic suit double protection,the X ray radiation was reduced markedly.The X ray radiation attenuation was swift with the distance increasing.The X ray radiation attenuation was 53.8% from 1 meter to 2 meter,and 81% to 3 meter.The X ray radiation received by medical personnel increased significantly with the fluoroscopy and subtraction time adding.Conclusion The X ray radiation protection should be carried out from shielding protection,distance protection and radiation time reducing;That can reduce the damage of radiation to keep the operator healthy.

Objective To evaluate the efficacy of a self-expandable metal stent coated with autologous endothelial progenitor cells(EPCs)for prevention of restenosis in transjugular intrahepatic portosystemic shunt(TIPS)in a swiue model.Methods EPCs were coated on the metal stents using fibrin gel before TIPS procedure.TIPS was performed in 15 young adult pigs,using an autologous EPC-seeded stent(treatment group,n=9)or a conventional bare metal stent(control group,n=6).All pigs were sacrificed at 2 weeks after TIPS procedure.Portography was performed immediately before the euthanasia.Gross and microscopic pathological exams and immunohistochemical exams of the TIPS track specimens were performed.Fisher test and t test were used to analyse the data.Results TIPS was performed successfully in all the 15 swine.On day 14 of follow-up,direct portography and necropsy demonstrated that 5 shunts remained patent,2 shunts stenosed,and the remaining 2 shunts occluded in the treatment group(n=9);while 5 shunts were occluded and one shunt was stenotic in the control group(n=6).The patency rate was 56%vs 0(P=0.03)between the two groups.Histological analyses showed a greater pseudo-intimal hyperplasia in the TIPS track of the control group than that of the treatment group(pseudointimal thickness at hepatic vein,hepatic parenchyma and portal vein site was(1.2±0.4),(1.3±0.5),(1.5±0.4)mmvs(1.0±0.6),(0.9±0.5),(1.0±0.4)mm respectively(P＜0.05).Conclusion The EPC-coated metal stent is feasibly constructed in vitro and improves the patency in TIPS in a porcine model.

ObjectiveTo explore the therapeutic effects and value of endoscopic variceal ligation and tissue glue injection therapy in esophageal and gastric fundal varices.Methods184 patients with severe esophageal varices underwent endoscopic variceal ligation treatment,and 32 cases of those accompanied with gastric fundal varices were treated with tissue glue injection therapy.All patients were followed-up for 6-months to observe the therapeutic effects and complication of endoscopic variceal ligation and tissue glue injection therapy.ResultsThe effective rate of endoscopic variceal ligation in severe esophageal varices was 71.74 ％ ( 132/184 ),the rate of acute hemostasis was 95.00％(57/60)and the rate of complication was 2.17 ％ (4/184).The effective rate of tissue glue injection in gastric fundal varices was 100％ (32/32) and the rate of complication was 21.88％ (7/32) (7 cases with refractory ulcers in injection site,2 of refractory ulcers cases with bleeding).There was no perforation and severe infection complications.ConclusionEndoscopic variceal ligation and tissue glue injection therapy have good therapeutic effects in esophageal and gastric fundal varices.