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 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 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 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 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.

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.

Objective To investigate the distribution differences of human papillomavirus(HPV) genotypes in the patients with cervical intraepithelial neoplasia grade Ⅱ/Ⅲ and the patients with cervical cancer. Methods 260 cases of cervical cancer and 280 cases of cervical intraepithelial neoplasia grade Ⅱ /Ⅲ patients who were admitted to our hospital from January 2010 to October 2017 were selected and divided into cancer group and neoplasia group respectively. The HPV infection of patients was detected and typing identification was performed. The distribution differences of HPV genotypes in cancer group and neoplasia group were compared. The differences of genotypes of HPV infection in different types of tissues in cancer group were also compared. Results The negative constituent ratio of HPV infection in cancer group was lower than that in neoplasia group(P＜0. 05), and the constituent ratio of all the high-risk types in single infection was significantly higher than that in the neoplasia group(P＜0. 05). The constituent ratio of all the low-risk types in single infection was significantly similar to that in the neoplasia group(P＞0. 05). The constituent ratio of multiple infections in cancer group was significantly higher than that in neoplasia group(P＜0. 05); the constituent ratios of negative HPV infections and 18 types of single infections in cervical squamous cell carcinoma was much lower than that of cervical adenocarcinoma(P＜0. 05). The constituent ratios of 16 types of HPV and multiple infections in cervical squamous cell carcinoma were much higher than that of cervical adenocarcinoma(P＜0. 05). Conclusion The risk of HPV infection in cervical cancer patients is significantly higher than that of cervical intraepithelial neoplasia grade Ⅱ /Ⅲ, the infection rate of cervical cancer high-risk type HPV is higher, and the risk of multiple infections is also higher. The tissue types of cervical cancer can be determined according to HPV typing.