Objectiv To investigate the expression and clinical significance of CA125 and CA15-3 in human breast cancer. Methods Radioimmunoassay method was used to determine the serum levels of CA125 and CA15-3 in 80 patients with breast carcinoma, 60 patients with benign breast diseases and 80 normal adults. Results The levels of serum CA125 and CA15-3 in patients with stage Ⅲ-Ⅳ breast carcinomas were significantly higher than those in patients with benign breast diseases,normal adults and stage Ⅰ～Ⅱ breast cancer patients (P0.05). Conclusion CA125 and CA15-3 are helpful to diagnose breast cancer, and can serve as a biological marker for monitoring tumor progression and evaluating prognosis in breast cancer.

Objective To observe the clinical curative effect of transcatheter arterial chemoembolization (TACE) in combination with 30% percutaneous acetic acid injection (PAI) under B-ultrasonic guidance to cure primary massive hepatocellular carcinoma. Methods Twinty three patients with intermediate or advanced stage of massive hepatocellular carcinomas were undergone transcatheter arterial chemoembolization. After 15-20 days, 30% percutaneous acetic injection was done for 2-3 times under B-ultrasonic guidance. Results After 2-3 periods of treatment, a significant difference (P

OBJECTIVE:To introduce the operation instructions and routine maintenance method of horizontal laminar flow cabinet(HLFC) in PIVAS to provide reference for standardized operation of HLFC.METHODS:The standardized utilization and maintenance of HLFC in respects of compositions,operation principle,operation instructions,etc.RESULTS & CONCLUSIONS:The standardized operation and correct maintenance can ensure the dispensation quality of intravenous drugs and extend service life of HLFC.

Purpose To investigate the feasibility of 30 ml low-dose contrast medium in reducing the accumulation of contrast medium in venous system while maintaining enough artery enhancement in 256-slice CT angiography (CTA) of intracranial and cervical arteries.Materials and Methods Sixty patients with head and neck CTA were recruited prospectively,and they were randomly divided into group A and group B.The scan parameters of the two groups were identical,but the protocol of contrast medium injection was different.Group A was injected 60 ml contrast medium and 30 ml saline successively with the rate of 4.0 ml/s.Group B was injected 30 ml contrast medium and 50 ml saline successively with the rate of 5.0 ml/s.CT attenuation values of aortic arch,common carotid artery,subclavian artery,cerebral middle artery,superior vena cava,innominate vein,subclavian vein,internal jugular vein were measured,and the image quality was evaluated.Results The average CT values of superior vena cava,right innominate vein,right subclavian vein in two groups had significant differences (P＜0.05).The average CT values of left brachial vein,left subclavian vein,left and right internal jugular vein in two groups had no significant differences (P＞0.05).The average CT values of aortic arch,left and right common carotid artery,left and right subclavian artery,left and right cerebral middle artery in two groups had significant differences (P＜0.05).The scores of image quality in two groups also had significant difference (P＜0.05).Conclusion Head-and-neck CTA with 30 ml low-dose contrast medium is feasible and the images are satisfactory for diagnosis,which can reduce the dose of contrast medium and accumulation of contrast medium in venous system,while maintaining enough artery enhancement.

Objective To explore the feasibility and value of laparoscopic-assisted surgery(LAS) for colorectal cancer.Methods The clinical data of 51 cases of LAS for colorectal cancer were reviewed retrospectively.Of them,3 cases were converted to open operation,and in 48 cases LAS for colorectal cancer was completed.Among them,9 cases underwent right hemicolectomy,8 cases left hemicolectomy,14 cases sigmoid resection,9 cases rectal anterior resection,and 6 cases Miles operation.Results No intra-operative deaths occurred. The average operation time was 195(150-320)min with 120(40-300)mL average blood loss.The average number of lymph nodes excised was 8(2-26).The time of bowel function recovery was 20-72h after operation.The average hospital stay after operation was 8(7-10)d.No major intra-operative blood loss nor postoperative complications were observed.The follow-up time was from 3-54months for 45(88.2%) patients.Two cases with Ducke′s C rectal cancer died,one died of liver metastasis 17 months after operation,and the another died of diffuse peritoneal metastasis 19 months after operation.There was no trocar port tumor metastasis and no local tumor recurrence at the small abdominal incision.Conclusions LAS of colorectal cancer is technically feasible and has advantages such as less surgical trauma,less bleeding and quick recovery.It is a mini-invasive,safe and efficient treatment for colorectal cancer.

Objective To evaluate the effects of modified early goal directed therapy (EGDT )on the prognosis of patients with septic shock .Methods Clinical data of 116 patients with septic shock admitted to ICU during January 2011 to March 2013 were retrospectively analyzed .Patients were divided into modified early goal‐directed therapy group (n=57) and traditional early goal‐di‐rected therapy group (n=59) according to different methods of treatment ,the patients′28‐day survival rates of these 2 groups were compared .Modified early goal‐directed therapy are divided into survival group (n=46) and non‐survival group (n=11) according to 28‐day prognosis .Acute physiology and chronic health evaluation Ⅱ (APACHEⅡ ) score ,sequential organ failure assessment (SOFA) ,multiple organ dysfunction syndrome (MODS) score and other relevant indicators of survival group and non‐survival group were compared .Results The 28‐day survival rate in modified early goal‐directed therapy group had increased approximately 18 .9% higher than that of the traditional early goal‐directed therapy group(P< 0 .05) .The APACH Ⅱ score ,SOFA score and MODS score in non‐survivors were significantly higher than those of survivors in modified EGDT group ,which were[(29 .36 ± 1 .57)d vs .(24 .30 ± 3 .27)d] ,[(13 .45 ± 0 .52)d vs .(12 .78 ± 1 .33)d] ,[(9 .00 ± 0 .00)d vs .(4 .04 ± 1 .94)d]separately .And vaso‐pressors time and mechanical ventilation time was significantly longer in non‐survivors than survivors(P<0 .05) .Conclusion Mod‐ified early goal directed therapy could improve 28‐day survival rate ,and it show s beneficial effects on outcome of critical patients w ith septic shock .

Objective To evaluate the advantage of video-assisted mini thoracotomy for patients with esophageal cancer compared with routine open thomcotomy.Methods Perioperative clinical results were compared between 24 csses received VAMT(test group)and 26 cases underwent routine open thoracotomy(control group)during the same period.All the cancer stages were T2-3N0-1M0.Results This study showed that VAMT Was a minimally invasive swgew with shorter operation time(40.0±3.3)min vs.(70.3±3.2)min,P＜0.05)and had less bleeding volume both during and after operation compared to the control group(108.1±15.2)ml V8.(200.1±11.3)ml,(380.8±45.4)ml vs.(780.1±52.2)ml,P＜0.05).No significant differences were observed in the two groups with respect to complication occurrence rate(4.2%vs.19.2%,P＞0.05).Conclusion It is suggested that VAMT is safe,reliable and less invasive in the treatmem of esophagus carcinoma.

Objective To evaluate efficacy and safety of glucocorticoids for community-acquired pneumonia (CAP).Methods We searched relevant randomized controlled trials (RCT) from Pubmed,EMBASE,Cochrane Library,Chinese Journal Full-text Database,Chinese Biomedical Literature Database and traced the related reference to obtain the information that had not been found by using key words of steroids,glucocorticoids,cortisol,corticosteroids,community acquired pneumonia and CAP.The quality of RCT included was evaluated.Meta-analysis was performed with RevMan 5.0 provided by the Cochrance Collaboration.Results Seven RCTs involving 944 patients were included in the meta-analysis.Mean length of hospital stay in glucocorticoids treatment group was significant shorter than that in conventional treatment group (WMD =-1.70,95％ CI:-2.01-1.39,Z =10.81,P ＜0.01).No significant differences were found regarding mortality (RR =0.77,95％ CI 0.46-1.27,Z =1.03,P =0.30),mean length of ICU stay (WMD =1.17,95％ CI:-1.68-4.02,Z =0.81,P =0.42),the risk of double infection (RR =1.32,95％ CI 0.66-2.63,Z=0.79,P=0.43),the incidence of hyperglycemia (RR=1.84,95％ CI0.76-4.41,,Z=1.36,P=0.17),the incidence of upper gastrointestinal bleeding (RR =1.98,95％ CI O.37-10.59,Z =0.80,P =0.42) between conventional treatment group and glucocorticoids treatment group.Conclusions Glucocorticoids treatment used in patients with community-acquired pneumonia may shorten the course of illness and possess better safety,but could not reduce the mortality.

Objective To investigate the effect of capsaicin on hepatic stellate cells (HSCs) and liver fibrogenesis.Methods HSCs were cultured.The reactive oxygen in HSCs under capsaicin at different concentrations was tested by DCFH-DA kit.The proliferation of HSCs was detected by CCK-8 test kit.Smoothmuscle α-actin (α-SMA) expression of HSCs was evaluated by Western blot.The fibrosisrelated genes were tested by RT-PCR.The apoptosis of HSCs was measured by flow cytometer.Bcl-2,bax and cyt-c was detected by Western blot.A murine model of liver fibrogenes was established.Capsaicin of different concentration was injected intraperitoneally.Liver pathology was observed using HE staining.Hydroxyproline content of liver and levels of collagen Ⅲ and hyaluronic acid in serum were tested.Results In dose dependent manner capsaicin inhibited the generation of the reactive oxygen species.Proliferation and activation of HSCs was inhibited by capsaicin (respectively F =13.267,57.392,all P ＜ 0.05) and the apoptosis of HSCs was promoted by capsaicin (F =235.571,P ＜ 0.05).Bax,cyt-c and caspase-3 was increased obviously (respectively F =29.334,38.274,138.329,all P ＜ 0.05).Capsaicin changed the expression of fibrosis-related genes (TGF-β1,TIMP-1) in HSCs (respectively F =376.534,253.751,all P ＜0.05).Capsaicin downregulated the level of hydroxyproline,collagen Ⅲ and hyaluronic acid in the rat model (respectively F =153.397,27.149,38.392,all P ＜ 0.05).Conclusions Capsaicin inhibits the proliferation and activation of hepatic stellate cells.Capsaicin promotes the apoptosis of hepatic stellate cells,and inhibits liver fibrogenesis.

Objective To investigate the curative effect of large dose ambroxol on ventilatorassociated pneumonia(VAP)in the elderly.Methods From January 2009 to January 2011,76patients with VAP treated by ambroxol were randomly divided into general dose group and large dose group(n =38 for each group).General dose group received 60 mg ambroxol in 250 ml normal saline,and large dose group received 500 mg ambroxol in 250 ml normal saline,intravenous drip,twice daily for 14 d.The other therapeutic measures in all patients were accorded to 2005 guidelines for the hospital-acquired pneumonia.Procalcitonin(PCT)and clinical pulmonary infection score(CPIS)were used to detect the degree of pulmonary infection.Treatment effects were described with duration of mechanical ventilation,rates of tracheotomy intubation and second endotracheal intubation.Results PCT concentrations and CPIS in large dose group during treatment of 5 d[(0.79±0.68)mg/L and (5.50±2.08)scores]and 14 d[(0.44 ± 0.36)mg/L and(5.42 ± 2.23)scores]were significantly lower than in general dose group at 5 d[(1.18±0.97)mg/L and(6.61±2.32)scores]and 14 d[(1.11±0.91)mg/L and(6.47±2.17)scores](t =2.065,2.189,4.220 and 2.090,P＜0.05),and the level of PCT in large dose group during treatment of 14 d was decreased as compared with 5 d(P＜0.05).The time of mechanical ventilation,rates of tracheotomy intubation and second endotracheal intubation in large dose group[(6.03± 1.87)d,7.9％ and 10.5％]were declined as compared with general dose group[(7.24±2.72)d,26.3％ and 31.6％](t=2.264,x2 =4.547,5.066,P＜0.05).Conclusions Ambroxol in large dose for the treatment of VAP have better clinical efficacy than in general dose.