Objective To discuss the treatment mode of mass NBC casualties by field medical unit in NBC environment.Method Field medical unit rehearsed in a simulated NBC environment.Result The procedure for the rehearsal and treatment of field medical unit in NBC environment was determined.The importance of high-tech medical equipment for the obstructed patient flow was made clear.Conclusion High-tech medical equipment should be emphasized on to enhance the treatment capability of field medical unit.

Objective To study the clinical,pathological features and therapeutic method of metastatic triple negative breast cancer (TNBC) and its relationship with disease-free survival.Methods One hundred and thirty-six cases of metastatic TNBC patients who were treated from January 2007 to January 2012 in the Third People''s Hospital of Dalian were selected as research objects.All patients received operation and radiochemotherapy,the clinical,pathological features,therapeutic method,the survival rate within 3,5 years,and the metastasis and survival situation of the patients were analyzed.Results For the patients in clinical stage Ⅲ period,the survival rate within 3,5 years were 45.9%(17/37),37.8%(14/37),respectively,significantly lower than those in stageⅡperiod (89.9%(89/99),73.7%(73/99)),and the differences were statistically significant (χ2=18.459,12.681,P<0.01).The 3-year survival rate of the patients in pathological grade Ⅲ was 64.9%(37/57),5-year survival rate was 43.9%(25/57),significantly lower than those of gradeⅠ(91.7%(22/24),83.3%(20/24)) and grade Ⅱ(85.5%(47/55),76.4%(42/55)),the differences were statistically significant (χ2=14.728,12.450,P<0.05).The 3-year survival rate of radiotherapy group was 81.8%(27/33),significantly higher than that of the non-radiotherapy group (59.1%(13/22)),the difference was statistically significant (χ2=5.468,P<0.05).Lung,liver,brain,bone and supraclavicular lymph nodes were main distant metastasis,the survival time of patients with metastasis was less than 2 years.Conclusion Metastatic TNBC is a special type of breast cancer that is difficult to treat.Breast conserving surgery has certain application value,radiotherapy can only increase the 3 year survival rate.Pathological grade and clinical staging are the main prognostic factors.

Objective: To investigate the effects of rhTNF alone and in combination with antitumor chemicals on Walker-256 cell line in vitro. Methods: the cytotoxic activity in vitro were be examined by MTT method and the flow cytometry(FCM) analysis and alteration of every phase of cell cycle for rhTNF or (and) Adriamycin(ADM) against Walker-256 cell line. Results: rhTNF had a strong activity of antitumor in vitro and good dose-effect relationship(r=0.9811). Compared with negative control group, the effect of rhTNF was significant (P

OBJECTIVE: To investigate the factors affecting shoulder joint functions following artificial humeral head replacement. METHODS: A total of 22 patients with complex fracture of proximal humerus, managed by humeral head replacement in Changhai Hospital of The Second Military Medical University from June 2006 to December 2008 were collected, including 12 males and 10 females, with average age of 67 years (52-86 years). During the procedure, soft tissue damage was minimized, the bone of the tuberosity was reserved as much as possible, appropriate matching size of humerus head prosthesis was selected, and early staging functional rehabilitation was performed. Neer's scoring system was used to evaluate the treatment results after replacement. RESULTS: The 22 patients were followed up for 10-30 months, mean 22.6 months. The shoulder joint functions of 14 cases were recovered more quickly through early post-operative staging rehabilitation, No shoulder joint unstable and stiff occurred. The shoulder joint functions of 8 cases were recovered slowly as they complained pain and did not perform early physical therapy after surgery, shoulder joint of 2 cases presented little unstable and 1 case presented stiff. Only 4 cases of all complained occasionally slight shoulder pain, but could continue daily work. The mean movement ranges of shoulder were as follow: mean flexion for 96°(80°-103°), mean extension for 38° (32°-45°), mean abduction for 86°(80°-110°), mean adduction for 31°(30°-35°), mean external rotation for 32°(30°-37°) and internal rotation for 42° (10°-75°). No vasculardamage, nerve damage, lessening prosthesis or prosthesis dislocation was found in all cases. Based on Neer's scoring system, 5 cases were rated as excellent, 11 as good and 4 as fair, with excellent rate of 82% and case satisfaction rate of 87%. CONCLUSION: In order to recover maximally the shoulder joint functions for post-artificial humeral head replacement, we must try our best to avoid soft tissue damage, reserve the bone of the tuberosity, select appropriate humerus head prosthesis, perform early post-operative staging rehabilitation, as well as maintain a normal retroversion of the prosthesis.

Objective:To study the mechnism of mild hypothermia during cerebral resuscitation. Method:Fourteen dogs were anaesthetized with ketamine and fentanyl and were divided randomly into three groups. Four dogs as nonischemic control(group A).recived general care for 24 hours after operation without cardiac arrest. The other ten dogs underwant a 18-minute cardiac arrest.were resuscitated with standard CPR.and supported by intensive care for 24 hours,then divided into two groups. Five dogs were treated with routine cerebral resuscitation measures (RCRM) (group B):five dogs were treated with RCRM and mild hypothermia started 10 min after CPR and mantained at 34 C?0.5 C for 12 hours (group C). At the end of experiment,the parietal cerebral cortex was obtained to detect the expression of heat shock proteins with immunohistochemical technique and to observe the change of histomorphology. Result: The pathologic change in group C was more obviously mitigated than that in group B. The HSP70-LI positive neuronal density and grey values in group B and C were more significantly increased than those in group A (P

Objective An interaction network among PD-1-ligands and other proteins were built to add deeper understanding of PD-1 signal pathway and to supply the theoretical data on the clinical application study of PD-1 and its ligands.Methods Searching the literature about PD-1 and its ligands in the PubMed,the result of which would be used to summarize the proteins that had been reported to have interactions with PD-1 and its ligands,and then,quadratic search would be performed on these proteins.Finally,the software Cytoscape would be used to build and analyze the interaction network and verified by PCR.Results There were 122 and 126 nodes in the PD-1/PD-L1 network and PD-1/PD-L2 network respectively.These proteins were involved in TCR signal path-way,cell adhesion,JAK-STAT signal pathway and interaction between cytokines.Meanwhile,a perspective that PD-L1 may influ-ence on CXCR4 through JAK-STAT pathway based on the network which had been supported by qPCR.Conclusion The bioinfor-matics suggested that there are differences between the mechanism of PD-1/PD-L1 and PD-1/PD-L2.Additionally,the method, which was based on the literature mining and bioinformatics,is good to put the biological literature to rational utilization and to pro-vide guidance for experiments.

Objective To discuss MRI characteristics of dysplastic gangliocytoma of the cerebellum.Methods MRI manifesta-tions of 13 cases with dysplastic gangliocytoma of the cerebellum verified by operation and pathology were analyzed retrospectively. Results All of 13 cases were located in the cerebellar hemisphere and vermis.The lesions presented striated pattern of iso-intensity signal and hypo-intensity signal on T1-weighted images.The sign of tiger stripes was the feature in dysplastic gangliocytoma on T2-weighted and FLAIR images.All of the tumors showed slightly striated enhancement after intravenous administration of contrast agent.The mass effects of dysplastic gangliocytoma of the cerebellum along with the forth ventricle and brain stem oppressed were seen in all cases.NAA was mildly reduced on magnetic resonance spectroscopy (MRS)in 7 cases of dysplastic gangliocytoma of the cerebellum.Conclusion There are distinctive manifestations in MRI images for dysplastic gangliocytoma of the cerebellum,which has crucial diagnostic value before operation.

Objective To study the radiological appearance and pathological features of breast phyllodes tumors(PTs), and to enhance the knowledge of the tumor.Methods Clinical and imaging findings were reviewed retrospectively in 65 women with PTs confirmed by surgical pathology.61 patients had preoperative MRI and/or sonography, and 44 had preoperative mammography.Then these findings were compared with the pathological results.Results (1)The percentages of benign, borderline and malignant PTs were 32.3%(21/65), 43.1%(28/65) and 24.6%(16/65), respectively,and the mean maximum diameters of these lesions were (4.75±2.62) cm, (5.37±3.11) cm and (4.96±3.82) cm, respectively.There were no statistical difference in lesion''s size among these three types(F=0.247,P=0.782).(2)On the mammograms of these 44 PTs(including 16 cases of benign type, 18 cases of borderline and 10 cases of malignant type), the appearances of radiolucent halo and calcification among these three types showed statistically significant differences(both P<0.05).(3)On the sonography of these 61 PTs(including 19 cases of benign type, 26 cases of borderline and 16 cases of malignant type), the shape among these three types showed statistically significant difference(P<0.05).(4)On the MRI of these 61 PTs(including 21 cases of benign type, 24 cases of borderline and 16 cases of malignant type), internal hypointense septations on T2WI and time intensity curves showed statistically significant differences among these three types(both P<0.05).Conclusion Some radiological appearances of PTs can be used to help determine the histologic subtypes of breast PTs preoperatively.

Objective To evaluate local moderate hypothermia technology on acute brain hemorrhage cases.Methods 100 patients of cerebral hemorrhage were randomly divided into two groups(moderate hypothermia groupand control group). The moderate hypothermia group was 50 cases treated with moderate hypothermia after routine treatment,the control group was 50 cases with routine treatment. The two groups were assessed after treatment for 21 days. Results The group treated via moderate hypothermia therapy showed the nerve function damages relatively lower than the control group(P < 0.05), and the surviving probability and curative ratio were significant higher than the control group(P< 0.05 ). Conclusion The local moderate hypothermia therapy for acute cerebral hemorrhage patient in clinical can significantly improve the never cell function and reduce mortality and disablement.

Objective To evaluate the feasibility, efficacy and safety of new nano material occluder of single rivet type (left-disk with no-hub) in treating ventricular septal defect (VSD) in order to provide experimental basis for clinical application. Methods A total of 26 healthy adult dogs were selected for this study . Under thoracotomy , VSD model was established through fluoroscopically-guided percutaneous puncturing of the right ventricular free wall. The models were randomly and equally divided into the study group(n=13, using nano material VSD occluder) and the control group(n=13, using double-hub nitinol occluder). Every two dogs from each group were sacrificed each time at one, 2, and 3 months after percutaneous closure of VSD with corresponding occluder, the tissue samples were collected and sent for gross examination as well as for the optical and electronic microscopy study;the blood concentration of nickel ion was also determined. The state of endothelialization after implantation of the new type occluder was evaluated, and the complications such as residual shunt and superficial thrombus formation were recorded. The results were analyzed. Results By open chest operation with small incision and percutaneous puncturing of the right ventricular free wall, VSD model was successfully established in all 26 dogs. The success rate of the implantation of the VSD occluder in the study group was 100%, while it was 91.7% in the control group. One, 2, 3 and 6 months after the implantation, the heart specimens of 25 dogs were removed and gross examination showed that neither occluder displacement nor alloy wire fracture occurred in both groups. No thrombus formation or vegetation attached on the disk surface was observed. One month after the procedure , in the study group the bilateral disk surfaces of the occluder were covered with thin layer transparent tissue , which were proved to be composed of the fibrous tissue and endothelial cells through pathologic and electronic microscopy study. Six months after implantation, the superficial tissue of the occluder became further thickened and the occluder edge became fused with the surrounding heart tissue. Conclusion The design of the new VSD nano materials occluder, which has a left-disk with no hub, is very scientific. Compared with double-hub nitinol occluder, the new device can shorten the time of complete endothelialization and effectively occlude the VSD. Therefore, this new nano material occluder has promising prospect in clinical application.