Purpose:To explore the value of predicting the axillary lymph node(ALN) metastases statu s by sentinel lymph node biopsy(SLNB) with methylene blue subcantaneously inject ion in the breast cancer patient and to provide the scientific basis for selecti ve axillary lymph node dissection(ALND) in breast cancer.Methods :1% methylene blue 2ml was subcantaneously injected at 4 sites of the skin over the tumor in each of 64 patients with breast cancer. Most of these were staged as T 1-2 N 0M 0, and a few were T 3N 0M 0. All patients underwent a S LNB 5 minutes after injection, followed by various ways of radical operation. Pa thohistological examination was assessed in all of SLN which included a frozen s ection intra-operation and a paraffin section after operation, and all other no n-SLN had a paraffin section.Results:The successful detection rate of SLN was 85.9%(55/64), and the accuracy of predi cting ALN metastases was 96.4%(53/55). The sensitivity was 90.9%(20/22), the sp ecificity was 100%(33/33), and the false-negative rate was 9.1%(2/22). The pred ictive value of a positive test and of a negative test were respectively 100%(22 /22) and 94.3%(33/35). In the resected SLN and non-SLN the metastases rates wer e respectively 29.4% and 8.3%(? 2=41.493, P

PURPOSE To discuss induction and relation of synchronous multiple primary cancer to adenoma of large intestines. METHODS Continuous observation of resectable and pathologically proved cancer of large intestines of 166 cases. RESULTS We discovered 8 cases (4. 8%) of synchronous multiple primary cancer of large interstines. 43 cases of single primary cancer of concomitant adenoma (27. 7%). The 4 cases of synchronous cancer had merged adenoma (50%). The 4 cases of synchronous cancer had concomitant adenoma of 14 sites. Of these 2 cases had neoplastic change in 3 sites. The rate of neoplastic change was 50% concomitant adenoma. In the whole group, of the 18 cancer sites, 8 nidi were less than 3cm. CONCLUSION Synchronous cancer of large intestines is not rare, and is related to malignant change of adenomas. complete colonoscopy is an important means to improve diagnostic rate.

Objective To observe and analyze the clinical effect of dexmedetomidine combined with sufentanil in the treatment of ICU mechanical ventilation. Methods 80 cases of critically ill patients treated by mechanical ventilation in our hospital ICU from February 2014 to March 2015 were randomly divided into study group and control group (n=40), the study group was treated with dexmedetomidine and sufentanil combined drug treatment, the control group was treated with sufentanil and midazolam combined drug treatment. The sedative effect and analgesic effect of the two groups were compared at different time points after the administration. Results At each time point after medication, there was no significant difference with the score of SAS between study group and control group; The BPS scores of respiratory compliance, upper limb and facial expression of the study group were lower than those of the control group, the difference was statistically significant; the incidence of adverse reaction in the study group was 7.5% (3/40), which was significantly lower than that of the control group 22.5% (9/40), the difference was statistically significant (P<0.05); There were no significant differences in MAP, SpO2 and HR between the two groups before treatment; After treatment, the indexes of MAP, SpO2 and HR in the two groups at different time points and after extubation were significantly different from those before treatment (P<0.05), The difference of MAP, SpO2 and HR between the two groups at each time point after treatment and after extubation were statistically significant (P<0.05). Conclusion The combination of dexmedetomidine and sufentanil for ICU mechanical ventilation has a good sedative and analgesic effect, and is worthy of clinical practice, and it is worthy of clinical practice.

BACKGROUND: Polymorphism of exon 5 +3953C/T of interleukin-1β (IL-1β) gene is found in some studies. This gene polymorphism is related to stomach cancer, rheumatism, arthritis and other diseases. However, what is the distribution property of genotype of IL-1β gene in Guangxi Zhuang population? OBJECTIVE: To observe the distribution of the polymorphism of exon 5 +3953C/T of 1L-1β gene in Chinese Guangxi Zhuang population and Han population, and compare its distribution with Caucasians and African white people.DESIGN: Contrast observation.SETTING: Department of Histology and Embryology,Youjiang Medical College for Nationalities.PARTICIPANTS: Persons who received the health examination in the Affiliated Hospital of Youjiang Medical College for Nationalities were recruited in the experiment. Among them, 155 were Zhuang nationality, including 80 male and 75 female, aged (37) years, and 195 were Han na tionality, including 100 male and 95 female, aged (38) years. Blood relationship was not found among them,and informed consents were obtained from all the participants.METHODS: This experiment was carried out in the Experimental Center for Medical Sciences,Guangxi Medical University from June 2003 to May 2005. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to detect the polymorphism of exon 5 +3953C/T of IL-1β gene in Guangxi Zhuang population (n=155) and Han population (n=195).Genotype and allele frequency of IL-1β gene of healthy population were directly calculated with counting method, and they were compared between Caucasians and African white people combining with literatures.MAIN OUTCOME MEASURES: Comparison of genotype frequency and allele taking frequency of IL-1β gene (+3953) among different ethnic populations.RESULTS: Subjects who received healthy examination including 155 Guangxi Zhuang nationality and 195 Chinese Han nationality participated in result analysis. ①The frequencies of genotypes and allele of IL-1β gene (+3953C/T) were close between Guangxi Zhuang population and Han nationality (Frequency of genotype CC,CT TT and allele C and T of Zhuang population was 94.8％,5.2％,0,97.4％,2.6％,respectively,and that of Han population was 93.3％,6.7％,0,96.7％,3.3％,respectively,P＞0.05).②There were significant differences in genotype distribution and allele taking frequency of IL-1β gene between Caucasians,African white people and Guangxi Zhuang population,Han population (Frequency of genotype CC,CT TT and allele C and T of Caucasians was 52.2％,43.9％,3.9％,74.1％,25.9％,respectively,and that of African white people was 60.4％,33.2％,6.4％,76.4％,23.6％, respectively, P＜0.01).CONCLUSION: The distribution of polymorphism of exon 5 +3953C/T of IL-1β gene is close between Guangxi Zhuang population and Han population,but significant difference exists in comparison with Caucasians and African white people.

Acupuncture Therapy ; Analgesia ; Animals ; Brain Chemistry ; Morphine ; pharmacology ; Opium ; analogs & derivatives ; antagonists & inhibitors ; Rats

ObjectiveTo explore the diagnosis and surgical treatment techniques for the patients with primary presacral tumor.Methods Data from 31 patients with primary presacral tumor admitted into our Department for Surgery from Jan. 1999 to Jar. 2009 were retrospectively analyzed.All patients underwent surgical treatment,among them,10 received per-sacroiliac or per-perineum approaches to remove the tumors,18 receivedper-abdomentumorectomy, and3receivedcombinedper-peritoneumandper-perineum tumorectomy.Results Patients visited the doctor while exhibiting the compression symptoms by the the tumors.Final diagnosis could be reached with the help of rectal touch,B-mode ultrasound,computerized tomography,or magnetic resonance imaging.Complete resection was performed in 28 patients.Partial resection was performed in 3 patients.Fractionated resection was successfully performed in 2 patients with chronic infection or sinus tract.ConclusionThe primary presacral tumor should be surgically resected once final diagnosised and without surgical contraindications.Pelvic plexus should be preserved and presacral hemorrhage should be prevented.The tumor should be resected as complete as possible.

BACKGROUND: Based on the multi-directional differentiation potential,the combined application of proper biological materials and growth factor can repair tissue defect.OBJECTIVE: To observe the growth characteristics of rabbit bone marrow-derived mesenchymal stem cells and their osteogenic potential under the induced condition.DESIGN: A single sample experiment.SETTING: The Department of Histology and Embryology of Youjiang Medical College for Nationalities; the Affiliated Hospital of Youjiang Medical College for Nationalities.MATERIALS: This experiment was conducted at the Department of Histology and Embryology of Youjiang Medical College for Nationalities in June 2004. Male new Zealand rabbits, with a body mass of 2.0 to 2.5 kg,were provided.METHODS: Rabbit bone marrow tissue was extracted. After gradient centrifugation, adherent cells were kept for cell passage. Culture medium was used for inducing culture of osteoblast when the passage was stable (50 mL/L of Dulbecco modified culture medium of bovine serum containing 10 mmol/L of β-sodium glycerophosphate, 10 nmol/L of dexamethasone, 50 mg/L of vitamine C). The culture medium was changed every other day. Osteogenic characteristics of the bone marrow-derived mensenchymal stem cells were observed under an inverted microscope after alkaline phosphatase immunohistological staining, osteonectin and osteopontin immunocytochemical staining.MAIN OUTCOME MEASURES: ① Morphological observation of bone marrow-derived mesenchymal stem cells; ② Osteogenic characteristics of bone marrow-derived mesenchymal stem cells.RESULTS: ① Morphological observation of bone marrow-derived mensenchymal stem cells: Primary rabbit bone marrow-derived mesenchymal stem cells could cover the Petri dish fully in 7 or8 days and could passage stably. Generative cells began to passage in 5 or 6 days. ② Osteogenic characteristics of bone marrow-derived mensenchymal stem cells:Alkaline phosphatase immunohistochemical staining showed a lot of brown particles in the kytoplasm, but no colored cells were found in the control group. Osteonectin and osteopontin immunohistochemical detection found that the nucleus was light blue and a lot of brown particles appeared in the kytoplasm, presenting obvious strong positive, but no brown particles appeared in the control group.CONCLUSION: After combined induced culture with dexamethasone, vitamine C and β-sodiumglycerophosphate, rabbit bone marrow mensenchymal stem cells showed the morphological and biological characteristics of osteoblasts with osteoblastic activity, and were able to supply autologous seed cells for constructing in vitro tissue engineered bone in a short period of time.

ObjectiveTo explore the value of intraoperative contrast-enhanced ultrasonography in distinguishing gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues,and grading cerebral gliomas.MethodsIntraoperative contrast-enhanced ultrasonic imaging in 80 patients diagnosed cerebral gliomas were studied retrospectively.The blood perfusion patterns of gliomas,peritumorous cerebral edema and peripheral normal cerebral tissues were observed closely after contrast and parameters were recorded.ResultsAfter contrast-enhanced ultrasound,peripheral normal cerebral tissues showed homogeneous enhancement,the tumor tissues and peritumorous cerebral edema of high-grade gliomas (HGG) showed high enhancement,but peritumorous cerebral edema of low-grade gliomas (LGG) showed nearly homogeneous enhancement.Absolute peak intensity(API) of the tumor tissues were higher than those of peripheral normal cerebral tissues and peritumorous cerebral edema ( P ＜0.05).Time to peak (TTP) of the tumor tissues in HGG were shorter than those of peripheral normal cerebral tissues and peritumorous cerebral edema ( P ＜ 0.05).TTP of the tumor tissues in LGG compared with those of peripheral normal cerebral tissues and peritumorous cerebral edema,two groups had no statistical significance ( P ＞ 0.05).ConclusionsIntraoperative contrast-enhanced ultrasonography can reflect the boundary of the brain edema,which is useful to guide surgical resection effectively and helpful to grade cerebral gliomas.

Objective To evaluate spleen autotransplantation with lower esophagus transection for the treatment of portal hypertension by three-dimensional dynamic contrast-enhanced magnetic resonance angiography (3D-DCE MRA). Methods Twenty-eight patients were randomly divided into study group undergoing splenic autotransplantation and cardia-esophageal devascularization plus lower esophagus transection and control group without splenic transplantation. The cross section area, blood velocity and blood flow of main portal vein (MPV) were measured by 3D-DCE MRA, and the blood flow, collateral circulation of transplanted spleen were assessed. Results The cross section areas (cm ) of MPV of the two groups decreased postoperatively ( study group 1. 80 ? 0. 69 vs. 1. 20 ? 0. 73 , t = 13.96, P = 0. 00; control group 1. 78 ? 0. 43 vs. 1. 29 ? 0. 57, t = 11. 38, P = 0. 00). The mean blood velocity ( cm/s) of MPV decreased postoperatively (study group 9. 85 ? 0. 09 vs. 7. 06 ? 1. 98, t = 18. 98 , P = 0. 00; control group 10. 01 ?0. 43 vs. 8. 19 ?2. 44, t =22. 32, P =0. 00) in the two groups, and the mean blood velocity ' of MPV in study group was lower postoperatively than that in control group ( t = - 8. 02, P = 0. 00 ) . The mean blood flow (ml/s) of MPV decreased postoperatively (study group 15. 05 ? 2. 43 vs. 10. 52 ? 2. 55, 1 = 16.93, P=0. 00; control group 14. 81 ?2. 29 vs. 11.58 ?2. 96, t = 15. 90, P=0. 00) , and the mean blood flow of MPV in study group was lower postoperatively than that in control group (t = - 2. 73, P = 0. 02). Extensive collateral circulation developed around the transplanted spleen. Conclusions 3D-DCE MRA clearly shows the autotransplantated spleen and portal hemodynamics. It is an important non-invasive way to evaluate the result of the procedures.

ObjectiveTo investigate the misdiagnostic reason and treatment of the syndrom of splenic flexure of colon(SSFC). MethodsThe clonical data of 21 patients with SSFC admitted from May 1993 to May 2001 were retrospectively analysed. ResultsThese patients aged from 51 to 88 years old with a median age of 67.8years.Clinical manifestalion was repetitive stomach pain, abdominal distension, constipation, etc. Double contrast radiology of colon demonstrated that too high fixation site of colon of splenic flexure, volvulus of colon of splenic flexure, and displacement of colon usually occurred together with transverse or sigmoid colon redundant.All of them were cured by cololysis of colon of splenic flexure, redundant partial colectomy and managing other companying diseases.Postoperative pathological diagnoses were chronic colitis.Followed up was done for 6 months to 6 years, all of them released from primary symptoms. ConclusionsThe main misdiagnostic reason of SSFC is less understanding of SSFC and did not take double contrast radiology of colon. By way of cololysis of splenic flexure, redundant colon resection and managment other companying abdominal diseases, most patients with SSFC may expect satisfactory treatment effects.