The surgery of the breast cancer has dramatically changed,sentinel lymph node(SLN) is one of the aspects.SLN biopsy can precisely predict the status of axillary basin.If the SLN is negative,the patients can spare the unnecessary axillary lymph node dissection(ALND) and reduce the morbidity of the surgery.One of the most important issues with sentinel node biopsy is the intraoperative pathological evaluation of the sentinel nodes.Accurate intraoperative pathological examination of sentinel nodes would enable the selection of candidates for ALND during the initial operation,eliminating the need for second surgery.This article will review the two techniques(touch imprint cytology and frozen section) employed for intraoperative examination of SLN and compare these two methods.And evaluate the role of touch imprint cytology and existing problems in introperative diagnosis of the sentinel lymph nodes and raise the probably ways to improve the sensitivity of touch imprint cytology initially.

Breast calciifcation plays an important role in breast cancer in various areas, such as early-stage diagnosis, recurrence monitoring and prognosis prediction. However, the mechanism of breast calciifcations remains elusive. One proposed mechanism is based on an imbalance between the enhancers and inhibitors of physiological mineralization. Traditionally, the classiifcation of breast calciifcation is based on the assessment of morphology and distribution. These radiology features are closely related to pathology and biological behavior of tumor. However, chemical composition of calciifcations can provide us with more information about tumor status. Calciifcations could be divided into two categories according to chemical composition. Type I (calcium oxalate) is found in benign breast disease, while typeⅡ (hydroxyapatite) is found in proliferative lesions, mostly to be associated with malignancy. Moreover, carbonate concentrations in typeⅡ calciifcations is related to pathology grades. Despite emerging imaging technologies such as digital breast tomosynthesis, they are unable to yield any information on chemical composition of breast calciifcations and thus cannot provide a deifnitive marker for classifying benign and malignant lesions. Recent researches show that using Raman spectroscopy, the chemical information of calcification could be obtained non-invasively and might provide us with a better mode for calciifcation diagnosis in the future.

The correlation between the expression of COX-2 and p53 protein in basal cell carcinoma (BCC) of eyelid and apoptosis was investigated. Specimens of BCC were collected from 40 cases (aged 28-68 y) at the Department of Pathology, Renmin Hospital of Wuhan University, and Department of Pathology, Zhongnan Hospital of Wuhan University during from 1999 to 2006. Five specimens of paracancerous tissues served as control group. Immunohistochemical staining was performed to detect the expression of COX-2 and p53 in the tissues. The average absorbance (A) and the average positive area rate of COX-2 and p53 protein were measured by image analysis. The positive area rate of COX-2 and p53 protein was analyzed by linear correlation analysis. It was found that COX-2 and p53 proteins were highly expressed in BCC of eyelid, and weakly expressed in paracancerous tissues. Image analysis revealed that the expression of COX-2 and p53 proteins in BCC of eyelid was significantly higher than that in paracancerous tissues (P<0.01). Spearman rank correlation analysis demonstrated a positive correlation between the expression of COX-2 and p53 (r=0.113, P=0.421). It was concluded that COX-2 can increase the expression of p53 protein, therefore suppressing apoptosis.
Apoptosis ; Carcinoma, Basal Cell/*metabolism ; Cyclooxygenase 2/*metabolism ; Eyelid Neoplasms/*metabolism ; Tumor Suppressor Protein p53/*metabolism

OBJECTIVE:To investigate the effects and safety of Compound xuelian burning wound ointment in the treatment ofⅡdegree deep burn. METHODS:Using consubstantial control method,2 burn wounds(Ⅱdegree deep burn,about 10 cm×10 cm) selected from symmetric or adjacent part of extremities in 80 patients withⅡdegree deep burn were divided into treatment area and control area. Treatment area was given Compound xuelian burning wound ointment,and control area was given Sulfadiazine silver cream. Healing time,degree of pain due to dressing change,the amount of infiltration liquid,wound infection rate,the incidence of scar formation and the incidence of ADR were observed. RESULTS:The healing time of wound in treatment area was signifi-cantly shorter than in control group [(18.7±3.6)d vs.(23.8±3.1)d],with statistical significance(P<0.05). During treatment,the proportion of patients suffering from acute pain and severe pain due to dressing change in treatment area,the amount of infiltration liquid and the incidence of scar formation were significantly lower or less than in control area;the proportion of patients suffering from mild pain due to dressing change in treatment area was significantly higher than in control area,with statistical significance (P<0.05). There was no statistical significance in the proportion of patients suffering from moderate pain and indolence due to dressing change,the incidence of wound infection between treatment area and control area(P>0.05). No obvious ADR was found in 80 patients. CONCLUSIONS:Compound xuelian burning wound ointment in the treatment of Ⅱdegree deep burn can relieve the degree of pain due to dressing change,control the amount of infiltration liquid,promote wound healing and reduce the occurrence of scar with good safety.

0.05).There were more complaints of postoperative pain and discomfort after LASEK procedure.No severe vision threatening complications in these two groups were found.Conclusion:Both LASIK and LASEK are safe and effective in treating eyes with severe myopia.

ObjectivesTo investigate the effects of 5-aza-2-deoxycytidine(5-Aza-dC),a methylation inhibitor,on the expression and methylation of tissue factor pathway Inhibitor (TFPI-2) gene in PANC1 cell line of pancreatic cancer.MethodsPANC1 cell lines were treated with different dosages of 5-Aza-dC ( 1× 10-7,5 × 10-7,1× 10 -6 mol/L).The status of TFPI-2 methylafion and expressions of TFPI-2 mRNA and protein were determined by MSP,RT-PCR,and Western blot.Results TFPI-2 gene CpG island was completely methylated,and there was no expression of TFPI-2 mRNA and protein without 5-Aza-dC treatment.After treatment with different dosages of 5-Aza-dC( 1 × 10-7,5 × 10 -7,1 × 10-6 mol/L),TFPI-2 gene CpG hypermethylation was reversed from incomplete methylated to complete non-methylated.The relative expressions of TFPI-2 mRNA were 0.211± 0.087,O.327 ± 0.068,0.609 ± 0.017; and the relative expressions of TFPI-2 protein were O.429 ± O.121,O.675 ± O.044,1.132 ± O.124 in a dose-dependent manner ( P ＜0.05 ).ConclusionsThe hypermethylatien of promoter region may be the primary reason for TFPI-2 gene expression down-rogtdation and inactivation.5-Aza-dC may reverse the hypermethylation of TFPI-2 gene,and induce the m-expression of TFPI-2 mRNA and protein.

Objective To investigate the methods of nursing safety management for indwelling catheters. Methods The nursing safety management measures included the establishment of three-level monitoring network of safety management for indwelling catheters,standardization of 25 kinds of catheter identification cards,formulation of prevention procedure and reporting system of catheter extrusion,design of catheter management handbook,organization of training and examination on the relative skills for nurses. Results Nurses' safety awareness of indwelling catheters was strengthened. And nurses could distinguish different catheters promptly and provide efficacious and safe nursing services. There was no nursing error,nursing dispute and patient complaints towards nursing care of indwelling catheters. Conclusion The implementation of nursing safety management for indwelling catheters can ensure medical and nursing safety,and promote the continuous improvement of quality of nursing.

Objective To compare the air permeability,water absorption and water locking properties of two different foam dressings,thus to provide theoretical and experimental evidence to alternative optimization for acute and chronic wound.Methods Five Mepilex foam dressings(group 1) and PermaFoam Comfort dressings(group 2) each was selected.Simulated wound exudation was made by NaCl and CaCl·H2O.The water-absorbing rate of dressings at post immersion 24 h (PIH),the water-absorbing speed of dressings at post immersion 1,5,10,20 min,the diffusion diameter of exudation dripped on the surface of dressings for 5 min,the beaker filled with exudation was sealed tightly by dressing for 24 h,and the weight was gotten before and after 24 h.Statistical analysis was performed.Results (1) The water-absorbing rate:the group 1(616±19)% was significantly higher than (313±13)% of the group 2 (t=29.137,P<0.01);(2) The water-absorbing speed:the group 1 (119.68±2.59)g·s-1·m-2,(24.39±0.62)g·s-1·m-2,(12.33±0.29)g·s-1·m-2,(12.33±0.29)g·s-1·m-2 were significantly higher than those of the group 2[(65.85±4.37)g·s-1·m-2,(13.82±1.03)g·s-1·m-2,(7.16±0.41)g·s-1·m-2,(3.66±0.12)g·s-1·m-2,t=23.704,t=19.708,22.947,31.764,all P<0.01];(3) The water holding capacity:the group 1 (5.66±0.15)cm was significantly higher than (2.2±0.12)cm of the group 2,(t=39.089,P<0.01);(4) The air permeability:there was no statistically significant difference between the two groups(t=0.189,P>0.05).Conclusion The Mepilex foam dressing is more suitable for the early stage of acute wound with large exudation in short time,while the PermaFoam Comfort dressings is better for chronic wound or the later period of acute with less exudation in a relative slow seepage velocity.

Objective To discuss the effect of operations for comminuted patella fractures with cable cerclage and revised tension band. Method Retrospective study of clinical effects of 120 patella fractures cases which used cable(cable group,55 cases) or NT-PC (NT-PC group,65 cases) to internal fix.Results At 10 to 38 ( 19.50 ± 1.15 ) months follow-up, all cured well in 12 weeks. Compared with the operative time, the amount of blood loss, length of hospitalization, time for cure, the incidence of complications,there were no significant differences between two groups (P ＞ 0.05 ). The B (o)stman score of cable group [(27.0 ±0.2) scores] was better than that of NT-PC group [(25.1 ±0.6) scores](P＜0.05). Conclusion Using cable cerclage and revised tension band to internal fix for comminuted patella fractures,the operations are facile and the results are satisfactory.

Objective Digital PCR ( dPCR ) was established to detect plasma epidermal growth factor receptor (EGFR) T790M mutation of non-small cell lung cancer (NSCLC) patients and was evaluated in terms of analytical performance and clinical application significance.Methods The specific primers and probes for EGFR T790M mutation and wildtype were designed to establish dPCR platform.Limit of blank, sensitivity and linearity of dPCR were evaluated by the detection of plasmids with different concentrations to set up optimal reporting system and reanalyzing process.The mutation of EGFR T790M in plasma and tissue samples from 10 patients with advanced NSCLC resistant to EGFR-TKI therapy who were enrolled in Zhongshan Hospital Fudan University from January 2014 to October 2015 were analyzed by dPCR and amplification refractory ( ARMS) , respectively.The consistency was evaluated between dPCR and ARMS by Chi-square test.The correlation of T790M abundance detected by dPCR between plasma and tissue samples was also analyzed by Peasrson correlation analysis.Results Limit of blank and sensitivity of dPCR was 10 copies and 0.01%, respectively.dPCR was evaluated as linear in the range of 0.01%-100%( Y=1.226X-3.984,R2 =0.999 ).The consistency between dPCR and ARMS of tissue samples was good ( kappa=0.80), while the positive rates of plasma T790M detected by dPCR was significantly higher than ARMS (50%vs 20%,P<0.05).It was found that T790M abundance detected by dPCR was highly correlated between lung cancer tissue and plasma ( R =0.923, P <0.05 ) using Pearson correlation analysis. Conclusions A new method of dPCR with high sensitivity and absolute quantification is established for the detection of EGFR T790M mutation in plasma from advanced NSCLC patients, which brings tumor liquid biopsy into real.It has the ability to provide the most direct and valuable guidance for clinicians to make decision on EGFR tyrosine kinase inhibitors therapy in patients with advanced NSCLC resistant to EGFR-TKI.