Sentinel lymph node biopsy(SLNB)can predict the status of axillary basin and precisely stage the patients with breast cancer.It can also release the patients whose sentinel lymph node(SLN)is negative from the unnecessary axillary lymph node dissection(ALND)and relieve the complication of the surgery.To standardize the pathologic examination and to make the best use of the molecular biology technique will help to diagnose the micrometastasis accurately.But the prognostic and therapeutic significance of the SLN microme tastasis of breast cancer remaias controversial.

Objective To investigate,the significance of serum high-sensitivity C-reactive protein (hs-CRP) concentration in subjects with various glucose tolerance and study the role of hs-CRP in patients of impaired glucose tolerance (IGT) and diabetes mellitus.Method All subjects in the study underwent oral glucose tolerance test (OGTT).Determination of serum hs-CRP levels in normal glucose tolerance(NGT),IGT and type 2 diabetes mellitus (T2DM) patients were made by immunologic projective turbidimetry method.Results The levels of serum hs-CRP were (1.57 + 0.46) mg/L in NGT patients,(2.84 ±0.48) mg/L in IGT patients,and(4.18± 0.76) mg/L in T2DM patients.The levels of serum hs-CRP were positively correlated with body mass index,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,OGTr 2 hPG,triglyceride,and total cholesterol.ConclusionsInflammation has already existed not only in T2DM patients but also in subjects with IGT.Inflammation might participate in the oeeurrance and development of T2DM.hs-CRP as an inflammator factor can be used to predict and monitor T2DM.

OBJECTIVE To investigate species and drug resistance of pathogenic fungi from patients with urogenital candidiasis.METHODS The fungi were cultured with general method,isolated and identified with CHRO-Magar medium and API20C AUX stripes.Drug sensitive test was tested by M-27-A broth microdilution method recommendated.RESULTS In 331 pathogenic fungi,C.albicans was the most frequent species,followed by C.glabrata and C.parapsilosis.The resistant rate in the female patients was:to itraconazole 3.24%,fluconazole 4.32%,nystatin 4.86%, amphotericin B 6.49%,miconazole 16.76%,ketoconazole 17.84%,and to econazole 28.6%,and that in the male patients was:to nystatin 4.11%,itraconazole 5.48%,fluconazole 8.22%,amphotericin B 10.27%,ketoconazole 17.81%,econazole 23.29% and to miconazole 26.71%.CONCLUSIONS In order to guide clinically the selection of reasonable antifungals,species identification and sensitive test should also be stressed.

Objective To explore the diagnosing value of serum 1,5-anhydroglucitol(1,5-AG)for gestational diabetes mellitus(GDM)by determining 1,5-AG in pregnant women with different glucose tolerance status.Methods The levels of serum 1,5-AG,fasting plasma glucose(FPG),1 hour plasma glucose(1hPG)and glycosylated hemoglobin(HbA1c)were determined in 30 cases GDM(GDM group),32 cases gestational impair glucose tolerance(GIGT group)and 43 cases gestational normal glucose tolerance (GNGT group).Results The level of serum 1,5-AG in GDM group[(11.69 ± 3.92)mg/L]was obviously lower than that in GIGT group[(20.93 ± 3.43)mg/L]and GNGT group[(27.83 ± 4.03)mg/L](P ＜ 0.01),GIGT group was obviously lower than that in GNGT group(P ＜0.05).The level of serum 1,5-AG had significantly negative correlation with FPG,1hPG and HbA1c respectively(P＜ 0.01).Conclusion The level of serum 1,5-AG has significantly correlation with glucose tolerance,1,5-AG can be used as useful indicator in the diagnosis of GDM.

Objective To explore the value of serum 1,5-AG in the diagnosis of diabetes mellitus by applying the method of pyranose oxidase (PROD). Methods 1,5-AG,FPG、2hPG and HbA_1c were determined in 50 case of DM,100 case of IGT and 30 control subject. ROC curve was applied to evaluate the diagnostic efficiency of 1,5-AG,FPG and HbA_1c for DM. Results Serum 1,5-AG was obviously lower in the diabetes than in IGT and controls(P＜0.01). Compared with controls, IGT patients had lower serum 1,5-AG(P＜0.05).1,5-AG level had significantly negative correlation with FPG,2hPG and HbA_1c respectively. The area under the ROC curve of 1,5-AG,FPG and HbA_1c are 0.948、0.921、0.817,respectively. Conclusions 1,5-AG level shows significantly correlation with glucose tolerance. Serum 1,5-AG measurement could be used as useful indicator in the screening of diabetes mellitus as well as in the monitoring of glycemic control.

Objective:To establish the content standards of Cortex Magnoliae Officinalis with ginger mix frying by determing the change of total content of magnolol and honokiol in Cortex Magnoliae Officinalis before and after ginger mix frying. Methods: The total content of magnolol and honokiol in Cortex Magnoliae Officinalis before and after ginger mix frying were determined by HPLC according to the determination method of Cortex Magnoliae Officinalis in China Pharmacopeia (2000). Results: There was 13-14% decrease in total content of magnolol and honokiol of Cortex Magnoliae Officinalis after ginger mix frying. Conclusions: It is suggested that the total content of magnolol and honokiol of Cortex Magnoliae Officinalis after ginger mix frying shouldn't lower than 1.6%.

Objective To investigate the clinical effect and safety of spleen-preserving surgery by microwave tissue coagulation (MTC) therapy.Methods Retrospectively analyzed the clinical data of 45 cases undergoing spleen retaining surgery by MTC therapy (observation group) and comparative study was used on another 45 cases experiencing splenectomy (comparative group),clinical effect and complications were compared.All cases were patients from Jan.2010 to Jun.2013.Results All cases were cured.Hospitalization of observation group is obviously shorter than that of comparative group(P =0.007).The rate of complication in observation group(4.44％) is lower than that in comparative group (20.00％),but the time and amount of bleeding in operation of observation group is much more than that of comparative group.Conclusion MTC can effectively guarantee patients safety,shorten hospital stay,and be worthy of popularization.

Background and purpose:Along with the development of diagnosis and treatment technology, the disease free survival and overall survival of breast cancer have been extended. In order to improve the quality of life after mastectomy, more and more breast reconstructions were applied in breast cancer patients. We retrospectively reviewed 118 cases of free abdominal lfaps for breast reconstruction performed in Fudan University Shanghai Cancer Center. Clinical outcomes, reconstructive techniques and experiences are discussed. Methods:From November, 2006 to June, 2013, we used free abdominal lfaps to perform 118 cases of breast reconstruction on 117 female patients after mastectomy. We observed the surgery, complications and safety of this technic. Results:We performed 118 cases of lfaps based on deep inferior epigastric vessels. The average operation time was 7.72 h. The average time of ischemia was 78.74min. The average anastomosis time was 60.83min. The average number of perforators included in the lfap was 3. The internal thoracic vessels were preferred recipient vessels. Ten cases of vessel crisis occurred and 6 of them were venous thrombosis and 4 cases were venous kink. Seven of them were salvaged, and the other 3 failed, the success rate was 97.46%. Postoperative infection rate was 7.00%. Abdominal bulge occurred in 3.50%of patients. None of the patients developed abdominal hernia. The median interval between surgery and the ifrst cycle of adjuvant chemotherapy was 19 days. The median follow-up time was 12 months. One case of distant metastasis, but no local recurrence was observed. Conclusion: Although free abdominal flap breast reconstruction requires complicated microsurgical techniques, and the learning curve does exist, free abdominal lfap breast reconstruction has a high success rate with oncological safety and few complications.

BACKGROUND:The treatment difficulties of thoracolumbar angular kyphosis surgery are:low correction rate, hard to rebuild sagittal plane, easily induce neurological complications, postoperative loss of balance, high incidence of pseudarthrosis and postoperative loss of correction degree.
OBJECTIVE:To explore the safety and efficacy of modified posterior vertebral column resection osteotomy and bilateral pedicle screw combined with echelon tight closure spinal cord technique and implant fixation for severe spinal angular kyphosis.
METHODS:A total of 87 severe spinal angular kyphosis patients, 36 males and 51 females, who were treated in the Department of Orthopedics, the 306 Hospital of Chinese PLA from January 2006 to December 2013, were enrol ed in this study. They underwent posterior vertebral column resection, bilateral pedicle screw combined with echelon tight closure spinal cord, and implant fixation. Kyphosis, spinal sagittal imbalance, offset rate towards trunk side, operation time and intraoperative blood loss were observed before and after treatment.
RESULTS AND CONCLUSION:The preoperative average kyphosis was 90.1° (31°-138°). The postoperative average kyphosis was 27.9° (15°-57°). The improvement rate was 76%. The improvement rate of trunk sagittal offset was 76%. Intraoperative blood loss was 800-3 000 mL, and average blood loss was 2 300 mL. The operation time was 5-7 hours, averagely 5.9 hours. Before treatment, two patients affected neurologic symptoms in double lower extremity, and their Frankel classification was grade C and became grade E after treatment. Al patients were fol owed up for 9-57 months. Bony fusion was achieved in al patients. No complications of spinal cord injury appeared, and no orthopedic angle missing occurred. These results indicate that during posterior vertebral column resection for treating severe angular stiffness of the thoracic kyphosis, blood vessels could be maintained greatly. Blood vessel injury-induced ischemic changes in spinal cord and ischemic reperfusion injury could be avoided. To reduce hemorrhage and to keep effective blood volume in patients with low body mass are effective for early recovery after treatment. Bilateral pedicle screw combined with echelon tight closure spinal cord technique greatly protected spinal cord cells against injury. We should pay attention to the protection and loose of nerve root to avoid postoperative nerve root irritation. Sufficient bone fusion ensures kyphosis correction, avoids spine lateral offset, and plays a key role in spinal function and postoperative orthopedic effect.

Objective: To evaluate the relationship between bolus volume and hyoid displacement in dysphagia patients with nasopharyngeal carcinoma after radiation therapy. Methods: Twenty-three nasopharyngeal carcinoma patients with dysphagia were recruited and their swallowing of 3, 5, 10 and 20ml of liquid food was studied fluoroscopically. The vertical and horizontal displacement of the hyoid as well as its time in motion were measured, and the relationship between the bolus volume, hyoid displacement and time in motion time was evaluated. Results: The largest vertical displacement of the hyoid (1.01±0.65cm) was observed when swallowing a 10ml bolus. The hyoid showed the smallest average horizontal displacement (0.39±0.34cm), when swallowing a 3ml bolus. The average motion time of the hyoid was (2.11±0.65) seconds. It was shorter when swallowing a 10 or 20ml bolus than when dealing with a smaller one. Hyoid motion time was negatively correlated with the horizontal displacement of the hyoid bone, and the volume of a swallow was negatively correlated with the hyoid motion time but positively correlated with the penetration-aspiration scale score. Conclusion Bolus volume affects hyoid displacement and hyoid motion time in nasopharyngeal carcinoma patients with dysphagia after radiation therapy. For patients with a penetration-aspiration scale score of 5 or less, the optimum bolus volume is 5 to 10ml.