Objective To explore the clinical significance of interstitial chemotherapy applied in breast cancer.Methods Sixty breast cancer patients with modified radical mastectomy were divided into treatment group (40 cases) and control group (20 cases) according to whether using fluorouracil implants.The control group was given conventional treatment.In treatment group,distilled water washed the wound after conventional treatment,and fluorouracil implants (0.4 g) was placed below local tumor,between pectoralis major and pectoralis minor,below 0.5 cm axillary vessel.The bone marrow suppression,liver and renal function,gastrointestinal reaction,skin flap necrosis,subcutaeous hydrops,local recurrence were observed in the 2 groups.Results There were no significant differences in the rates of bone marrow suppression,liver and renal function abnormal,skin flap necrosis,subcutaeous hydrops and gastrointestinal reaction between treatment group and control group (P ＞ 0.05).The rate of local recurrence in treatment group was significantly lower than that in control group [0 vs.20.0％ (4/20)],there was statistical difference (P ＜0.05).Conclusion Intraoperative application of fluorouracil implants is safe and effective in modified radical mastectomy of breast cancer.

1. Therty-three adult male rabbits were used for this experiment. The animals were divided into four groups. In the first experimental group, a piece of its own spleenic tissue was implanted to the myocardial surface in each animal after the internal mammary arteries had been ligated bilaterally. Within one to four weeks after the first operation, the animals were subjected to ligation of the circumflex branch of the left coronary artery. Out of 18 animals, 12 survived over 5 days after 2nd operation. In the second experimental group the same procedure was repeated as group 1, except the implantation of the spleenic tissue. Two animals survived out of 5 operated. In the control groups (the 3rd and 4th groups) no operation was performed before ligation of the branches of the coronary artery. In the 3rd group, after the ligation of the ant. descending branch, 3 out 4 animals survived over 5 days, while in the 4th group, after ligation of circumflex branch none survived over 5 days in 6 animals operated. 2. In group 2, X-ray photographs indicate that collateral circulation was established through the anastomosis between pericardial vessels and branches of the coronary artery. 3. The X-ray photographs of the experimental group 1 proved the establishment of collateral circulation between ant. descending branch and circumflex branch of the left coronary artery by the vasculature in the spleenic implantation. 4. As is shown by periodic acid Schiff reaction, (1) in both control groups, the glycogen granules in the area of coronary occlusion were more reduced than in the border area, (2) in the second experimental group the glycogen granules in the area of coronary occlusion have slightly increased in comparison with those in same area in the control group and (3) in the first experimental group the glycogen granules in the area of coronary occlusion were increased more than in the same area in the second group. These changes offer convincing elucidation that in the first and second groups, owing to the production of the intercoronary collateral circulation or the hemodynamic effect, the blood supply to the area of the coronary occlusion was ificreased.

ObjectiveTo explore the effect of psychological intervention on anxiety of patients with motor neuron disease (MND) before stem cell transplantation via lumbar puncture.Methods40 MND patients were randomly divided into the group A and group B with 20 cases in each group. Every patient received anxiety assessment on the day of hospitalization, the day before transplantation as well as the day after transplantation. As to the patients in the group B, psychological intervention was performed before the second time anxiety assessment, while no such intervention to the ones in the group A. Then the assessment was statistically analyzed.ResultsThe patients in each group had anxiety. After psychological intervention, the assessments of the second and the third time of the patients in the group B were better than that of the patients in the group A ( P<0.01).ConclusionPsychological intervention before transplantation can effectively ease the anxiety of patients.

Emphysematous cystitis is a rare inflammation of the bladder, which can be life-threatening in severe cases. A senior gentleman with emphysematous cystitis was recently admitted to our hospital. He got bilateral renal hydronephrosis and bilateral terminal pneumatosis of the ureter. The comorbidity was prostatic hyperplasia and diabetes. After indwelling catheter , glucose levels control and anti-infection treatment for 3 days, the repeated CT showed the gas inside the bladder the end of ureter decreased significantly. The blood routine, urine routine, renal function was better than before. The patient was instructed to continue anti-infection treatment. The above laboratory examination indicators returned to normal after a week's re-examination.

Objective To observe and discuss the effect of the traditional Chinese drug complex prescription ShensuⅡfrom Xintong Changluo therapeutic principle on renal interstitial fibrosis (RIF) and transforming growth factor-β1 (TGF-β1) expresssion in focal segmental glomerulosclerosis (FSGS) model rats. Methods Forty-eight healthy male SD rats were randomly divided into control group (n=12) and modeling group (n=36). Rats of modeling group were injected by doxorubicin hydrochoride for FSGS model. Rats of modeling group were sub-divided into model group, benazepril group and TCM group randomly. In 12 weeks, TCM group was given by intragastric administration of ShensuⅡ(3.5 g/100 g), benazepril group was given by intragastric administration of benazepril suspension (0.33 mg/100 g), control group and model group were given by intragastric administration of same volume of saline. HE/Masson staining was used to observe changes of tubulointerstitial pathomorphology. The degree of injury and fibrosis was measured. The expressions of fibronectin (FN) and TGF-β1 were detected by immunohistochemical SP method. Results The process of renal interstitial fibrosis was slower in FSGS rats of TCM group. Renal interstitial pathological index was 1.51 ± 0.80 in TCM group, which was lower than that of model group (2.18 ± 0.38) and benazepril group (1.79 ± 0.24). The index of renal interstitial fibrosis was 2.39 ± 0.13 in TCM group, which was lower than that of model group (3.11 ± 0.25) and benazepril group (2.80 ± 0.41). The relative expression of FN in renal interstitial was 14.19 ± 3.06 in TCM group, which was lower than that of model group (21.25 ± 3.31) and benazepril group (18.51±2.29). The relative expression of TGF-β1 in renal interstitial was 2.64±0.21 in TCM group, which was lower than that of model group (6.02 ± 0.12) and benazepril group (3.79 ± 0.46). All the differences were statistically significant (P<0.05). Conclusion Xintong Changluo complex prescription ShensuⅡcan reduce the process of renal interstitial fibrosis in FSGS model rats, which may be related with the inhibiting expression of TGF-β1.

Objective To provide rationales for preventing and treating dyslipidemia by understanding the current status of lipids and related metabolic factors.Methods A total of 2 590 permanent residents aged ≥ 18 years were selected by random cluster sampling from three urbanized communities of Sijiqing Street.And the rate of abnormal lipid metabolism was calculated for different ages and genders.Spearman's correlation analyses were conducted for the levels of total cholesterol (TC),total triglyceride (TG),low density lipoprotein-cholesterol (LDL-C),high density lipoprotein-cholesterol (HDL-C),body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting plasma glucose (FPG),glycated hemoglobin (HbA 1 c) and uric acid (UA) levels.Both x2 test and logisic regression were employed to examine the correlations between dyslipidemia and overweight/obesity,hypertension,hyperglycemia and hyperuricemia.Results ① The total rate of abnormal lipid metabolism was 60.0％ (1 554/2 590) with a standardized rate of 57.2％.High TC rate was 42.9％ (1 111/2 590) with a standardized rate of 40.5％.And the edge incremental rate was 31.7％ (822/ 2 590),the standardized rate 30.5％,the incremental rate 11.2％ (289/2 590) and the standardized rate 10.0％.High TG rate was 33.0％ (855/2 590) with a standardized rate of 30.7％.And the edge incremental rate was 15.3％ (397/2 590),the standardized rate 14.3％,the incremental rate 17.7％ (458/2 590) and the standardized rate 16.4％.High LDL-C rate was 30.4％ (787/2 590) with a standardized rate of 28.4％.And the edge incremental rate was 22.9％ (594/2 590),the standardized rate 21.7％,the incremental rate 7.5％ (193/2 590) and the standardized rate 6.7％.Low HDL-C rate was 12.6％ (327/2 590) with a standardized rate of 12.8％.The rates of high TC,high TG,high LDL-C,low HDL-C and abnormal lipid metabolism among gender showed no statistically significant difference (P ＞ 0.05);② For both males & females,high TC rate,high TG rate,high LDL-C rate and total rate of abnormal lipid metabolism increased with age (P ＜ 0.01) while low HDL-C rate did not change with age (P ＞ 0.05);③Spearman's correlation analysis showed that the levels of TC,TG and LDL-C were positively correlated with BMI,WC,SBP,DBP,FBG,HbA1C and UA (all P ＜0.01) while the level of HDL-C had negative correlations with BMI,WC,SBP,DBP,FBG,HbA1 c,and UA (all P ＜ 0.05);④The total rate of abnormal lipid metabolism and various types of abnormal lipid metabolism increased with a rising level of BMI in the upward trend (trend test P ＜ 0.01),various types of abnormal lipid metabolism rate between different groups (elevated & non-elevated) of blood pressure,glucose and uric acid also were statistically significant (all P ＜ 0.05);⑤ Non-conditional logistic regression analysis showed that,after adjusting for age and gender,overweight or obesity and hypertension were risk factors of high TC and high LDL-C;overweight or obesity,hyperuricemia was a risk factor for low HDL-C;overweight or obesity,hypertension,hyperglycemia and hyperuricemia were risk factors for high TG and total abnormal blood lipid.Conclusions Urbanized community groups have a high rate of dyslipidemia.And abnormal lipid metabolism is affected by overweight or obesity,hypertension,hyperglycemia and hyperuricemia.The target population should be regularly monitored and comprehensively controlled.

Objective To preliminarily investigate the clinical value of serum procalciton as a noninvasive marker in disease activity assessment in inflammatory bowel disease (IBD).Methods From January 2014 to June 2016,clinical data of 107 IBD patients were collected,including biological inflammatory parameters of peripheral blood such as serum procalcitonin levels,C-reactive protein (CRP) levels,erythrocyte sedimentation rate (ESR) and platelet count,clinical disease activity scores and endoscopic activity scores.The serum level of procalcitonin was measured using the traditional electrochemiluminescence immunoassay (ECL) method.The accuracy of diagnosis was analyzed by receiver operating characteristic (ROC) analysis.Kruskal-Wallis test and Spearman's rank correlation were performed for comparison between groups and correlation analysis.Results In the 60 patients with Crohn's disease (CD),the median serum level of procalcitonin of patients in active phase was higher than that of patients in remission phase (0.066 mg/L,0.047 mg/L to 0.168 rng/L vs 0.033 mg/L,0.024 mg/L to 0.044 mg/L),the median serum level of procalcitonin of patients in moderate to severe active phase was higher than that of patients in mild phase (0.112 mg/L,0.062 mg/L to 0.234 mg/L vs 0.046 mg/L,0.040 mg/L to 0.054 mg/L),and the differences were statistically significant (Z=4.883 and 3.326,both P＜0.01).There was a positive correlation between serum procalcitonin level and CRP,ESR,platelet count,plateletcrit,Crohn's disease activity index (CDAI) and Crohn's disease endoscopic index of severity (CDEIS) (r=0.494,0.387,0.339,0.328,0.736 and 0.689,all P＜0.05).The sensitivity and specificity of serum procalcitonin level ≥ 0.055 mg/L in predicting moderate to severe active CD were 85.0％ and 88.9％,respectively.The area under ROC curve (AUC) value of the combination of procalcitonin and CRP in diagnosing moderate to severe active CD was 0.905 (95 ％CI 0.827 to 0.982).In the 47 patients with ulcerative colitis (UC),the median serum procalcitonin level of patients in moderate to severe active phase was higher than those of patients in mild active phase and remission phase (0.059 mg/L,0.033 mg/L to 0.100 mg/L;0.030 mg/L,0.020 mg/L to 0.048 mg/L;0.030 mg/L,0.021 mg/L to 0.057 mg/L),and the differences were statistically significant (Z=2.056 and 2.783,P=0.040 and 0.005).Serum procalcitonin level was positively correlated with Mayo score,CRP level and Baron score (r=0.468,0.573 and 0.347,all P＜0.05).The specificity of serum procalcitonin level ≥0.065 mg/L in predicting moderate to severe active ulcerative colitis diagnosis was high but the sensitivity was low.Conclusion Serum procalcitonin may be of value in indicating the disease activity and severity.

Objective To introduce and investigate internal-fixtion with outboard proximal tibia anatomic plates through cut of anterolateral aspect of the leg.Methods 56 cases fracture of proximal tibia were fixed with outboard proximal tibia anatomic plates.Results All cases were followed up ranging from 5～18 months,with an average of 9 months.The excellent and good rate was 94.6% on Merchant grading system.Conclusions Internal-fixtion with outboard proximal tibia anatomic plates for the fracture of proximal tibia is an effective and reliable operation.

Objective To further improve level of severe chest trauma care in the elderly pa-tients. Methods A retrospective study was done on data of 148 elderly patients (≥65 years with se-vere chest trauma (AIS≥3 points) (elderly group) treated in Chongqing Emergency Medical Center from June 1995 to May 2005. A total of 1669 patients at age less than 65 years and with AIS≥3 points were set as control group in the same research period (control group). Results The main injury mechanism was blunt trauma, which aceouted for 83.8% (124/148) in elderly group, higher than 69.3% (1 157/ 1 669) in control group (P < 0. 01). The injury causes were mainly traffic accidents, slip and fall from a height. Traffic accidents and slip accounted for 66.2% (98/148) and 14.9% (22/148) respectively, which was significantly higher than 50.6% (845/1 669) and 3.1% (52/1 669) respectively in control group (P < 0. 01). There was no statistical difference upon ISS, RTS, GCS and prehospital time between both groups (all P value > 0.05). The fatality rate and indicence rate of complication in the elerly group were 15.5% (23/148) and 25.7% (38/148), which was significantly higher than 6.5% (108/1 669) and 10.4% (174/1 669) respectively in control group (P <0.01). The fatality rate in elderly group with complications was significantly higher than that in control group (51.7% vs 26.7%) (P < 0.01), while those without complications showed no statistical difference between two groups (6.7% :3.5%) (P >0. 05). Conclusions The patient' s age and complications are relative independent factors to es-timate the trauma care outcome. To raise risk awareness and strengthen the management of complications and supportive treatments for organ function are key to improve survival rate of the elderly patients with se-vere chest trauma.