New theory, technology and drugs have stinulated clinical research of breast cancer. The typical method for early detection of breast cancer consisted of self examination, clinical breast examination by a health professional and mammography, both fiberoptic ductoscopy and ductal lavage cytology could be effective supplements. Sentinel lymph node biopsy is a potential means of avoiding axillary dissection in women with clinically negative axillary patients without influencing the survival. New drugs and regimes had improved complete response in neoadjuvant setting so as to further treatment. Breast conserving therapy with local excision and radiation is well established as an option in the treatment of localized breast cancer, but social and economic factors of the patients should be considered aside from pathological and clinical factors. It is evident that emphasis on early detection, systemic treatment as well as more limited surgery are the trend of breast cancer treatment today.

In this study, we use retroviral vectors, LXSN (containing internal promoter) and GCEN(containing internal ribosomal entry site,IRES), which cany ?galactosidare gene (LacZ) and neomycin phosphotransferase gene (Neo_R) as double markers, to establish two cell lines, LG-3T3 and GG-3T3. The sensitivities of the two cell lines for detecting replication-competent retroviruses(RCR) in marker rescue test were compared. Our results indicated that both cell lines can be used in marker rescue test, the sentivity of GG-3T3 was 100 times higher than that of LG-3T3.

Objective To investigate the expression of apoptosis-related neuclosome assembly protein-1(NAP-1) gene in related brain region of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP) treated mice and beta-amyloid treated rats. Methods The animal models with central nervous system degeneration were established by consecutive administration of MPTP to C57BL mice and injection of beta-amyloid to brain ventricular of SD rats. The RNA in striatum and substantia nigra of mice and the RNA in cortex and hippocampus of rats were extracted. The levels of NAP-1 mRNA in these samples were estimated by RT-PCR. Results For mice, the expression of NAP-1 were decreased after MPTP treatment in substantia nigra, while its expression showed no significant change in striatum. In contrast, no effect on NAP-1 gene expression by beta-amyloid injection can be detected in cortex and hippocampus of rats. Conclusions The apoptosis of dopaminergic neurons in nigrostriatal pathway after MPTP treatment may be related to the expression of NAP-1 gene. But the mechanism of neurodegeneration after beta-amyloid injection in rats may be different.

Objective To study the epidemiological features of Cryptococcus neoformans and Cryptococcus gattii isolated from clinical samples in Shenzhen and to elucidate the distribution of species,varieties,genotypes and mating types within the strains tested.Methods The strains involved in this study were 55 cryptococcal strains isolated from our clinical samples.The canavanine-glycine bromthymolblue (CGB) culture was performed to distinguish Cryptococcus neoformans from Cryptococcus gattii.The genotype was characterized by polymerase chain reaction (PCR) fingerprinting with primer M13.The Cryptococcus gattii species and varieties of grubii and neoformans together with two opposite mating type α and a were identified by PCR with variety-specific and mating type-specific primers.The GEF1-restriction fragment length polymorphism analysis was conducted to simultaneously determine the genotype and mating types of strains tested.The sequence type of IGS1 region was analyzed for the VG Ⅱ genotype.Results Of the 55 tested cryptococcal strains,52 were Cryptococcus neoformans,all of which were var.grubii,genotype VN Ⅰ and mating type α.The remaining 3 strains were Cryptococcus gattii,among which,one was genotype VG Ⅰ and mating type α,and two were genotype VG Ⅱ and mating type α.The two VGⅡ genotype strains belonged to the sequence type Ⅱ.Conclusions The strains belonging to the Cryptococcus neoformans var.grubii,genotype VN Ⅰ and mating type α predominate in causative pathogens of cryptococcosis in Shenzhen.Cryptococcus gattii accounts for minority of the cryptococcal isolates,and the highly pathogenic VG Ⅱ genotypes in foreign countries are also characterized.The sequence types of IGS1 region of the two VG Ⅱ strains are in accord with VG Ⅱb sub-genotype.

Objective To determine the prevalence of microembolic signals (MES) by using transcranial Doppler (TCD) and to assess their association with neuropsychiatric systemic lupus erythematosus (NPSLE) and clinical presentations in patients with systemic lupus erythematosus (SLE).Methods Forty-four patients with SLE underwent TCD for 30 min were included for MES detection and their clinical information were recorded.In addition to the frequency of patients with MES,patients with MES were followed-up for sixmonth.Mann-Whitney U test and Fisher exact test were applied to investigate the clinical characteristics.Results There were 4 patients with history of NPSLE and the occurrence times were from 8 to 120 month before our study.There were 4 patients had the abnormal neuropsychiatric symptom during our study period.MES were detected in 5/44 patients (11％) with mean 17.6 per 30 min.MES were more prone to be detected in patients with higher systemic lupus erythematosus disease activity index (SLEDAI) score [16(12.5,19) vs 8(5,10),U=14.5,P=0.001],shorter course of disease [1(0.1,48.5) vs 26(13,55),U=38,P=0.028] and neuropsychiatric symptoms [3 vs 1,P=0.003].Conclusion MES may be detected in SLE patients.MES is associated with higher disease activity,shorter course of disease and NPSLE.TCD microemboli detection may be a noninvasive method to evaluate NPSLE patients.

OBJECTIVETo evaluate the accuracy of sentinel lymph node biopsy (SLNB) to predict the axillary lymph node status in breast cancer patients and its clinical significance.

METHODSSeventy patients with clinical TNM status T(1 - 2)N(0)M(0) underwent sentinel lymph node biopsy using Tc-99m sulfur colloid radiotracer and gamma probe, which was followed by standard axillary dissection. SLNB was compared with standard axillary dissection for its ability to reflect the final pathological status of the axillary nodes. The SLNs that were tumor negative in conventional HE staining were further evaluated using immunohistochemical stains for CK8, CK19 and KP-1 antibodies.

RESULTSThe sentinel lymph node (SLN) was successfully identified in 67 (95.7%) out of 70 patients. The number of sentinel nodes harvested ranged from 1 to 5 (average 1.6). The nonsentinel nodes ranged from 5 to 20 (average 12.3). Of the 67 patients, 29 (43.3%) had histologically positive axillary lymph nodes. SLN was positive in 24 patients with metastasis (35.8%), and in 7 patients without metastasis (10.4%). In 5 patients, SLN was negative for tumor with positive nodes. The accuracy of sentinel lymph node biopsy to predict the axillary lymph node status was 92.5% and the false negative rate was 7.5%. For tumors with diameter less than or equal to 2 cm, the accuracy was 100%. 65 SLNs that were negative for HE stain were also non-reactive to immunostain for CK8 and CK19 antibody.

CONCLUSIONSSLNB can accurately predict the axillary lymph node status in most of breast cancer patients. The accuracy is about 100% in patients with T(1) lesions. Immunohistochemical staining at the same level of HE stain can not increase the detection of lymph node micrometastasis.

Adult ; Aged ; Aged, 80 and over ; Axilla ; Breast Neoplasms ; pathology ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Sentinel Lymph Node Biopsy

Objective To discuss the clinical effect of perioperative bundle of care for patients with advanced hepatocellular carcinoma (HCC) who are receiving CT-guided percutaneous minimally-invasive argon-helium knife cryoablation.Methods A total of 30 HCC patients,who underwent percutaneous argonhelium knife cryoablation,were enrolled in this study.Perioperative measures based on the concept of bundle of care were implemented,which included training of nursing team members,perfect preoperative psychological nursing,dietary guidance,preoperative routine preparations,effective intraoperative guidance and close observation of the patient's condition,postoperative activity guidance,prevention and observation of complications,etc.Results All 30 advanced HCC patients could actively cooperate with physicians for the performance of percutaneous argon helium cryoablation.After the treatment,two patients developed nausea and vomiting and one patient developed chills and fever,which were improved after symptomatic treatment.All the 30 patients recovered well during the perioperative period and were discharged from hospital smoothly.Conclusion Perioperative bundle of care can help patients restore the surgical damage as soon as possible,reduce the pain and improve the quality of life.

With the increasing incidence of osteoporosis, osteoporotic vertebral compression fracture (OVCF) has become a common disease in the elderly. Relevant researches have indicated that percutaneous vertebroplasty (PVP) has become the main treatment for painful osteoporotic vertebral compression fractures. In aspect of perioperative nursing care for PVP, both domestic and foreign scholars have published a large number of research reports, indicating that perioperative nursing intervention can alleviate the pain, reduce the incidence of complications, improve the quality of life of patients, and promote rehabilitation. This article aims to make a comprehensive review about the perioperative nursing care for patients with osteoporotic vertebral compression fractures who are receiving PVP so as to provide reference for clinical nursing staff in the implementation of nursing intervention. (J Intervent Radiol, 2018, 27:290-293)

Objective: Analysis of the effect of triggering receptor-1 expressed on myeloid cells (TREM-1) in nonalcoholic fatty liver disease (NAFLD) and the mechanism. Methods: The oleic acid-treated HepG2 cells were divided into model group, overexpression group, interference group A, interference group B and negative control group. The mouse model of NAFLD was generated and randomly divided into (nuclear factor-κB) NF-κB inhibition group, protein kinase B (AKT) inhibition group, knockout group A, knockout group B and control group. The expression of inflammatory factors and TREM-1 in liver tissue was detected by PCR, and fat accumulation was detected by oil red O staining. Western blotting was used to detect the expression of TREM-1 and signaling pathway proteins, and HE staining was used to detect liver tissue changes. Results: TREM-1 was up-regulated in liver tissue of NAFLD mice [(0.936±0.127) vs. (0.432±0.105)] and in oleic acid-treated HepG2 cells. In oleic acid-treated HepG2 cells, overexpression of TREM-1 increased inflammatory factor expression and increased lipid droplets; inhibition of TREM-1 expression decreased inflammatory factor expression, and lipid droplets decreased. Knockout of TREM-1 and inhibition of NF-κB in NAFLD mice reduced hepatocyte inflammatory factor expression and reduced liver damage; knockout of TREM-1 and inhibition of AKT reduced liver tissue lipids and drops accumulate. Conclusions The overexpression of TREM-1 in NAFLD mice liver tissue can regulate inflammatory factor expression and lipid droplets through NF-κB and AKT signal pathway. TREM-1 might be a potential therapeutic target of NAFLD.

Objective    To evaluate the efficacy of a combination of beating-heart minimally invasive approach and leaflets augmentation technique treating severe tricuspid regurgitation (TR) after cardiac surgery. Methods    From January 2015 to August 2017, patients undergoing reoperative tricuspid valve repair (TVP) with minimally invasive approach and leaflets augmentation were enrolled. Cardiopulmonary bypass (CPB) was established via femoral vessels and the procedures were performed on beating heart with normothermic CPB. A bovine pericardial patch was sutured to leaflets to augment the native anterior and posterior leaflets. Other repair techniques, such as ring implantation and leaflet mobilization, were also applied as needed. Results    A total of 28 patients (mean age 55.6±10.1 years, 5 males, 23 females) were enrolled. One patient was converted to median sternotomy due to pleural cavity adhesion. Twenty-seven patients underwent totally endoscopic TVP with leaflets augmentation. No patients was transferred to tricuspid valve replacement. Two patients died in hospital. All patients were followed up for 7.4±5.0 months and there was no late death and reoperation. Regurgitation area was converted from 20.7±10.1 cm2 to 3.3±3.3 cm2 after TVP according to the latest echocardiography (P<0.001). Conclusion    Minimally TVP with leaflets augmentation is effective in treating severe isolated TR after primary cardiac surgery. It can significantly increase success rate of tricuspid valvuloplasty and decrease the surgical trauma.