Particulate matter is one of the important factors that have adverse effects on human health. It is generally known that the fine particles are more toxic than coarse ones, but some researchers have different opinion. Based on the analysis of the opinions, the factors that may influence the adverse effects of particulate matter on human health, including surface characteristics and adsorbed components, were discussed in the present paper. This paper will be helpful for the assessment of the toxicity of particulate matter.

Objective To explore the complications of augmentation mammoplasty by polyacrylamide hydrogel (PAHG) injection and their management.Methods Preoperatively,174 patients underwent breast ultrasound image,and some patients received magnetic resonance imaging (MRI) to ascertain the distribution of injected PAHG.We used the periareolar incision and dissection extended to the subcutaneous tissue,mammary gland,and subgland space.We were able to suck most of the gel by the negative pressure machine and remove the abnormal breast tissue.The secondary breast deformity was repaired with subpectoral placement of silicone mammary implants (48 cases immediately,39 cases secondarily after 3-6 months) according to the individual situation.Results Following-up for 3 to 6 months,most of their symptoms were relieved after removal of the polyacrylamide hydrogel.In the patients who were performed with the implants augmentation mammoplasty,77 cases gained satisfactory results on the shape and texture of the breast (44.3％),and 10 cases were not satisfied with texture of the breast (5.7％).79 cases appeared breast atrophy or flat chest (45.4％).The severe breast deformities occurred in 8 cases (4.6％).Conclusions PAHG should be removed with surgical operation as soon as possible.The open operative technique via periareolar incisions may be a better method for the patients.The breast reconstruction is performed with implants prosthesis for those who are suitable and willing after removal of PAHG.

Objective To explore the methods and significance of section of multiple fibroadeno mas of breast with better incision.Methods From may 2005 to December 2014,21 cases were per formed by removing multiple fibroadenomas of breast with a new incision.Preoperatively,the diag nostic work-up included clinical examination,breast ultrasonography and/or mammography.A new approach,for removing of multiple fibroadenomas of the breast with the incision in periareolar site,was used in our hospital.All palpable breast lumps were excised with this approach through which the fibroadenomas were removed as a whole unit.Then,the breast cavity were irrigated with normal saline solution,and strict haemostasis of the bed was done by electrocautery.If the resulted cavity was larger,interrupted sutures should be performed with the absorbable stitches;otherwise,it was unnecessary.The skin wound was sutured to the deepithelialized area with Vicryl 5-0 (Ethicon).Results There were 21 cases,who underwent surgery using the described technique through which 95 lumps (0.5 cm× 0.5 cm-6.0 cm× 5.0 cm) were removed and included in the study.All patients' resected tumor specimens were pathologically confirmed as fibroadenoma.No major complications were encountered in any of the patients.The incision was well concealed by the dome of the nipple and the areolar pigmented and corrugated skin.Both doctors and patients were satisfied with postoperative aesthetic effect of the incision scar.Conclusions The incision in periareolar site for excision of multiple fibroadenomatas results in minimal scarring and a better appearance than that can be achieved with traditional methods.This technique,which can improve the aesthetic outcome of breast surgery,should be performed when feasible.

Objective To explore the current status of humanistic care among medical students in clinical practice in obstetrics and gynecology department and its related influencing factors and to propose the corresponding countermeasures.Methods Scale of humanistic care quality was used in the survey for clinical practice students in obstetrics and gynecology department.ResultsThe total score rate of human care quality of medical students before clinical teaching were (84.12 ± 9.24)with a scoring rate of 72％.Significant differences were observed in the medical students with different medical professional(P ＜0.05).The total score of humanistic care quality of medical students after clinical teaching were (96.41 ± 1 1.53 ),significant higher than that of before training ( P ＜ 0.05 ).ConclusionHumanistic care quality in medical students needs to be strengthen.Clinical training in obstetrics and gynecology department combined with humanities education has important practical significance to improve the quality of medical students.

Objective To investigate the alteration of NKT cells number in patients with systemic lupus erythematosus (SLE) and its correlation with SLE disease activity.Methods Blood samples were obtained from 30 patients with SLE and 30 healthy control subiects.The number of NKT cells from peripherial blood mononuclear cells (PBMC) were detect by flow cytometry (FCM).Two independent samples t-test and Pearson correlation was used to evaluated the relationship between SLE disease activity and NKT cells.Results Compared with healthy controls [(4.16±0.22)%],lower number of NKT cells were found in SLE group[(2.53±0.33)%](P<0.05).An inverse correlation was observed between the frequency of NKT cells and IgG,anti-dsDNA,SLE disease activity index.Conclusion Reduced proportions of NKT cells observed in patients with SLE and is associated with high SLE disease activity.

Objective To explore the clinical effects and prognostic factors of postoperative radiotherapy for malignant gliomas. Methods From June 1998 to October 2007, seventy-eight cases of malignant gliomas patients were treated with radiotherapy after surgery, including -28 cases received whole brain radiotherapy, 34 cases local field irradiation and 16 cases three-dimensional conformal radiotherapy. Thirty-one cases received chemotherapy which included semustine, semustine plus teniposide and temozolomide. Kaplan-Meier survival analysis and COX regression analysis were used to analyze the prognostic factors. Results The median survival time and 1-, 3-, 5-year survival rate were 16 months, 65.4 %, 32.8 % and 17.9 % for all patients, respectively; 24 months, 72.7 %, 41.5 % and 22.8% for grade 1 patients; 11 months, 47.8 %, 10.9 % and 5.4 % for grade IV patients. Univariate analysis showed the age, Karnofsky, pathologic grade, surgical approach and the time from surgery to radiotherapy were significantly correlated with the survival time (P <0.05). Karnofsky (P =0.000), pathologic grade (P =0.004) and age (P =0.011) were independent prognostic factors in the multivariate analysis. Conclusion Prognosis of the patients with Karnofsky ≥70, age < 50 years and grade Ⅲ is better in malignant gliomas. Postoperative radiotherapy combined with chemotherapy may prolong the survival time.

Objective To investigate the effect of psychological stress on serum iron concentration of SD rats and its mechanism. Method SD rats were randomly divided into four groups: control group (CG), psychological stress 1w group (PG 1w) and 2w group (PG-2w), and psychological stress 2w with 1w free group (PG 2w-1w). The animal model of stress was tested for 1w, 2w, and 2w with 1w free from stress. The iron concentration of serum, liver, spleen and the expression of liver hepcidin were detected by atomic absorption spectrometry and Western blot respectively. Result (1) Compared with control group, serum iron concentration of rats under stress decreased. (2) Free of psychological stress 1w later, serum iron concentration was not significantly changed. (3) Iron concentration of liver and spleen was increased significantly compared with control group, and the expression of liver hepcidin was also increased. Conclusion Psychological stress may cause serum iron of rats to decrease obviously, and it was restored after 1w free from psychological stress. The mechanism is supposed to be increase of iron storage in liver and spleen by hepcidin in rats under psychological stress.

Objective To explore the indications and attention points in one-stage thyroidectomy and bilateral neck dissection for thyroid carcinoma.Methods The clinical and pathological data of 68 thyroid carcinoma patients treated with one-stage thyroidectomy and bilateral neck dissection from Jan 1990 to Dec 2005 were reviewed retrospectively.Results There was no operative death in this series.Of the 68 patients,60 had bilateral and 4 had unilateral positive lymph nodes;4 had negative lymph nodes.The metastatic rate of patients who had unilateral thyroid cancer with contralateral cervical enlarged lymph nodes,bilateral thyroid cancer with unilateral cervical lymph nodes and isthmus cancer with lymph nodes was 100%(7/7),90%(9/10) and 66.67%(4/6) respectively.Postoperative complications include 7 cases of facial and flap edema,2 headache,5 postoperative hoarseness,7 temporary hypoparathyroidism,1 permanent hypoparathyroidism,1 left chylus fistula,and 3 unilateral accessory nerve injury.Conclusions The patients with unilateral thyroid cancer and enlarged contralateral neck lymph nodes,with bilateral thyroid cancer and unilateral cervical lymph nodes,and with isthmus cancer and enlarged lymph nodes are high-risk patient of bilateral neck metastasis,and should be treated with one stage thyroidectomy and bilateral cervical lymph node dissection.The procedure is safe,no serious postoperative complications occurred,and the survival rate and life quality can be improved.

Purpose Liver fibrosis is the common pathological process of cirrhosis developed by chronic liver disease.This study aims to explore the application of microvascular change in assessing the liver fibrosis induced by bile duct ligation based on X-ray phasecontrast computed tomography (PCCT).Materials and Methods Ten rats were equally divided into the group of bile duct ligation-induced liver fibrosis and the control group at random.Then ten excised liver tissues were imaged at beamline BL13W1 of Shanghai Synchrotron Radiation Facility in China.After the imaging studies,the liver samples were stained with Sirius red and immunostained with antibodies against cytokeratin 19 (CK19).The microvasculature in livers was reconstructed via PCCT,and the correlation analysis on microvascular density and the proportion of fibrosis area was performed.Results The microvasculature including blood vessels,dilated bile ducts and ductular proliferation were clearly revealed by PCCT technology.Moreover,the 3D microvascular density and proportion of fibrosis area in the liver fibrosis group increased significantly compared with those in the control group (P＜0.01),and the correlation between them was obvious (r=0.812,P＜0.01).Conclusion Microvascular 3D characteristics of liver fibrosis are well demonstrated by PCCT,and 3D microvascular density is significantly correlated with the proportion of fibrosis area.Those findings indicate that microvascular change is closely related to the degree of liver fibrosis induced by bile duct ligation,and thus it provides a novel means to assess the severity of liver fibrosis through microvascular change.

Objective To establish a carotid siphon aneurysm model in dogs in order to test the mechanical features of a newly-designed Willis covered stent-graft and to investigate the histological reaction of the stent-implanted vessel during a follow-up period of 12 months.Methods Twenty-four saccular sidewall aneurysms were surgically created in twelve dogs(group A)and 12 carotid siphon aneurysms in another twelve dogs(group B).A Willis stent-graft was implanted in each aneurysm.Angiography was performed immediately after the procedure and 1,3,6 and 12 months after the implantation to investigate the aneurysm isolation,endoleak,stent angulation,and the patency or restenosis of the parent artery.Light and scanning electronic microscopy were used to identify aneurysmai sac thrombi,intima hyperplasia and endothelial progress of the stent-loaded arterial segment.Results In group B,postoperative immediate angiography demonstrated that two aneurysms had mild endoleak and three stents became angulated.Follow-up exam 12 months after the procedure revealed that all previous endoleaks disappeared,one parent artery became occluded and three parent arteries developed mild stenosis(＜50%).In group A.occlusion of parent artery was seen in one and mild stenosis(＜50%)in 2 cases.Electronic microscopy revealed new intima formation in all stents,and all aneurysmal sacs were filled with thrombi.In group B.the endothelialization process was not completed until 12 months after the stent implantation,and a marked correlation existed between endothelial cell arrangement and the hemodynamic orientation.Conclusion It is feasible to treat carotid-siphon aneurysm in dog with a Willis stent-graft.The complete endothelialization of the covered stent in tortuous vessel takes longer time than that in rather straight vessel.