Objective To investigate the application effects of ultrasonic scalpel combined with bipolar coag-ulation tweezers on open thyroid surgery.Methods 80 cases of thyroidectomy patients were randomly selected.These patients were divided into two groups by random cluster sampling method,whch were the study group (n =40)and control group (n =40).The control group of patients were given ultracision ligature methods combined with traditional therapy,while the study group of patients were given ultrasonic scalpel combined with bipolar coagulation tweezers treatment.And then the surgical related indicators and complications of the two groups of patients were statistically an-alyzed.Results Compared with the control group of (90.5 ±3.6)min,(6.5 ±0.6)d,(40.5 ±2.0)mL,(50.3 ± 1.4)mL and (6.6 ±0.5)cm,the operative time and length of stay of the study group of patients[(58.5 ±5.4)min and (3.4 ±0.2)d]were significantly shorter (t =6.965,3.143,all P <0.05);the blood loss and postoperative drainage of (5.0 ±1.4)mL and (1.0 ±0.6)mL were significantly less (t =4.541,3.747,all P <0.05);the cut diameter of (3.8 ±0.3)cm was significantly shorter (t =3.365,P <0.05);the complication rate of 2.5% (1 /40) was significantly lower than the control group 10.0%(4 /40)(χ2 =9.35,P <0.05).Conclusion The application effects of ultrasonic scalpel combined with bipolar coagulation tweezers on open thyroid surgery are obvious.

Objective To investigate the effects of ultrasound irradiating hydroxycamptothecin (HCPT)-loaded microbubbles on apoptosis in human hepatoma SMMC-7721 cells, and to clarify its probable mechanism. Methods The SMMC-7721 cells were randomly divided into six groups as follows: control group, blank liposome microbubbles plus ultrasound, HCPT-loaded microbubbles, HCPT, HCPT plus ultrasound,and HCPT-loaded microbubbles plus ultrasound. Apoptosis was ascertained by Annexin V-Fire/ PI and TUNEL methods. The expression of Bcl-2 and Bax protein was detected by immunocytochemistry staining technique. Results In the group of HCPT-loaded microbubbles plus ultrasound,the apoptosis rate at early term was found to reach (12.18 ± 1.38)% by Annexin V-Fitc/PI assay, brown-colored positive apoptotic cells were observed and the apoptosis rate at advanced term was found to reach (34.25 ± 1.83)% with TUNEL method. The expression of Bcl-2 was found to decrease,the expression of Bax increase,and the ratio of Bcl-2/bax significantly decrease by immunocytochemistry staining technique in the same group. Differences with other groups were significant. Conclusions The method of ultrasound irradiating HCPT-loaded microbubbles can notability induce human hepatoma SMMC-7721 cells apoptosis. The decrease in the ratio of Bcl-2 to Bax might be responsible for cells apoptosis.

Objective To assess the impact of radiation on superior epigastric vessel pedicled transverse rectus abdominal myocutaneous (TRAM) for breast reconstruction.Methods Female breast cancer patients were divided into 4 groups:group A (immediate breast reconstruction + radiation therapy,123 cases),group B (immediate breast reconstruction,262 cases),group C (radiation therapy + delayed breast reconstruction,34 cases),group D (delayed breast reconstruction,53 cases) from June 2009 to June 2012 at Department of Breast Oncology,Tianjin Medical University.Patient demographics,operative details,radiation therapy details,postoperative complications,patient-centered evaluation of aesthetic and psychological outcomes were assessed.Results The average follow-up duration was 24.98 ± 6.99 months.2.5％ patients developed delayed wound healing postoperatively.Fat necrosis and flap contracture were seen in 7.0％ and 3.6％ of all patients,respectively.Irradiated patients had a significant statistical difference in cancer staging,involved lymph nodes,tissue invasion and neoadjuvant chemotherapy (P ＜ 0.05).No significant statistical differences were observed in post-operative early complications,but in advanced stage complications.There was no significantly statistical difference in breast aesthetic outcome before and after radiation therapy within four groups.Conclusions For breast reconstruction patients,those without postoperative radiotherapy were suggested immediate breast reconstruction,and those with postoperative radiotherapy were proposed to accomplish breast reconstruction after postoperative radiotherapy.

There are a lot of feasibility studies, using sentinel lymph node biopsy SLNB instead of Alex lymph node dissection (ALND), having got a conseusus that SLNB is a safe and useful method in the treatment of breast cancer. But in clinical practice, there are much false negative rate (FNR) which need to be carefully dealt with for SLNB. In order to diminish the FNR, how many nodes should be the perfect number to lower the FNR? If positive detection was found in the SLN, should ALND always be needed? And when micro metastasis was found in the post operation HE staining? Does it need further treatment? We make a review to discuss those matters.

BACKGROUND: Breast cancer is the most common type of cancer in females. Aberrant expression of microRNA-21 (miR-21) has previously been reported in breast cancer tissue. The aim of this study was to investigate expression levels of serum miR-21 in breast cancer patients and evaluate its prognostic value in Chinese females. METHODS: Real-time quantitative (RQ)-PCR was used to analyze miR-21 expression in archived serum, tumor tissue, and adjacent normal tissue from 549 participants (326 with breast cancer, 223 without breast cancer). We also analyzed associations between serum miR-21 expression and breast cancer subtypes and patient prognosis. Recurrence and survival were analyzed by using the multivariate Cox proportional hazards model. RESULTS: Expression of miR-21 was significantly higher in breast cancer tissues compared with normal adjacent breast tissues (P<0.001). The 2(-DeltaDeltaCt) values for serum miR-21 in breast cancer patients versus healthy controls were 9.12+/-3.43 and 2.96+/-0.73, respectively. Multivariate Cox proportional hazards model suggested that serum miR-21 expression was an independent poor prognostic factor for both recurrence (hazard ratio [HR]= 2.942; 95% confidence interval [CI]=1.420-8.325; P=0.008) and disease-free survival (HR=2.732; 95% CI=1.038-7.273, P=0.003) in breast cancer. CONCLUSIONS: Increased serum miR-21 expression level was correlated with poor prognosis of breast cancer patients, indicating that serum miR-21 may be a novel prognostic marker for recurrence and survival of breast cancer patients before resection.
Biomarkers, Tumor/genetics ; Breast/metabolism ; Breast Neoplasms/metabolism/mortality/*pathology ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; MicroRNAs/*blood ; Neoplasm Recurrence, Local ; Prognosis ; Proportional Hazards Models ; Real-Time Polymerase Chain Reaction

Objective:The aim of the current study is to understand the sleep disorders in children with autism and related factors.Methods:A case-control study method was conducted in this study which included 198 children autism who met the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ) and 233 cases of gender-and age-matched normal children.Their general demographic and sleep data were collected and the children with autism were assessed with Autism Behavior Checklist,Child Behavior Checklist and Autism Spectrum Screening Questionnaire.Correlation analysis and regression analysis were performed to compare sleep quality,sleep problems and the related factors of the two groups.Results:The scores of difficulty falling asleep,sleep restlessness,taking hold or shaking,restless sleep,interrupted sleep,nightmares,sleepwalking,night terrors,sleep snoring,nocturnal enuresis,sleep apnea,mouth breathing,sweating and sleep scores were higher in the autism group compared to the normal control group before falling asleep (P ＜ 0.05),while the proportion of daytime sleep time in the autism group was lower than the normal control group (P ＜0.05).With sleep status as dependent variable,linear regression analysis was conducted with children's birth weight,walking month age,speaking month age,father age,and autism spectrum as independent variables.The multiple linear regression analysis showed the scores of,sensory behaviors,body and object use behaviors,and self-help behaviors in Autism Behavior Checklist for autistic children were positively associated with their sleep (β =0.21,0.21,0.29,P ＜ 0.05).However,paternal age at birth in the autism group had negative associatin with the sleep of autistic children (β =-0.16,P ＜0.05).In the autism group,their total scores of Autism Behavior Checklist and the scores of language and social behavior in Autism Behavior Checklist were not associated with their sleep status score (P ＞ 0.05).Conclusion:It suggests that children with autism may have more sleep problems,and their sleep problems are related to autism symptoms including the scores of,sensory behaviors,body and object use behaviors,and self-help behaviors in Autism Behavior Checklist for autistic and their paternal age at birth.

Objective:To compare the reliability and validity of the Standard Swallowing Function Assessment Scale (SSA) with those of the GUSS Swallowing Function Assessment Screen (GUSS) in screening for and evaluating dysphagia among stroke survivors.Methods:Forty-seven stroke survivors had their swallowing function evaluated using the GUSS scale and the SSA scale. The results were compared with those of endoscopic swallowing function examinations.Results:Both scales delivered good reliability and validity. The SSA scale′s test-retest reliability had an ICC value=0.828 and an inter-evaluator reliability with an ICC value=0.909. Those were better than the GUSS scale′s values, but the latter had better intrinsic reliability (Cronbach′s α=0.939). Both scales showed good structural and calibration validity, with the sensitivity of the GUSS scale (72.73%) superior to that of the SSA scale, but the GUSS scales′ specificity, Jordan index and area under the operating characteristics curve were inferior to the SSA scale′s values. Combining the two scales in dysphagia screening could produce an area under the curve of 0.77.Conclusion:Both the SSA and GUSS scales have good reliability and validity in screening for swallowing disorders after a stroke. In clinical practice, the SSA alone or the two in series can improve diagnoses so as to prevent aspiration after a stroke.

Objective:To analyze the surgical methods of operable breast cancer and analyze the follow-up results.Methods:A retrospective analysis of the clinical and pathological data of 636 operable breast cancer patients admitted to Zibo First Hospital from July 2008 to April 2018, including the clinical stage, pathological staging. Analyze of the proportion of four surgical methods, and through follow-up, analyze the treatment effect of different surgical methods.Results:All patients are female, aged 26-80 years, the clinical stage of 636 patients: Tis 18 cases, stage Ⅰ 143 cases, stage Ⅱ 354 cases, stage Ⅲ 114 cases, stage Ⅳ 7 cases. There are four types of surgery: ① breast conserving surgery + sentinel lymph node biopsy in 124 cases (19.50%); ② breast conserving surgery + axillary lymph node dissection in 39 cases (6.13%); ③ mastectomy + sentinel lymph node biopsy in 163 cases (25.63%); ④ modified radical surgery in 310 cases (48.74%). Sentinel lymph node biopsy in 427 cases (67.14%), success in 404 patients (94.61%); all patients with lymph node negative 384 cases (60.38%). Follow-up for 1 to 9 years, 11 cases of local recurrence after breast-conserving surgery, It accounted for 6.75% of breast-conserving surgery; 43 cases of local recurrence of chest wall after mastectomy, accounting for mastectomy 9.09%; 33 cases of recurrence and metastasis of axillary lymph nodes and supraclavicular lymph nodes, 4 cases of axillary recurrence after sentinel lymph node biopsy.Conclusions:The proportion of breast-conserving surgery in this group of patients was high and the local recurrence rate of breast-conserving surgery was less than that of mastectomy group; the proportion of simple modified radical surgery declined further; patients with axillary lymph node metastasis were less in the whole group. The choice of reasonable operation method is an important factor to improve the prognosis of breast cancer.

Objective To investigate the pharmacological components of "Szechwan Chinaberry Fruit-Rhizoma Corydalis" drug combination and its potential molecular mechanism in the treatment of liver cancer based on network pharmacology. Methods Related databases, such as TCMSP, Uniprot, and GeneCard, were used to obtain the effective components of Szechwan Chinaberry Fruit and Rhizoma Corydalis, their corresponding action targets, and the disease targets of liver cancer, and the intersecting targets of drugs and diseases were selected. In addition, STRING and Metascape databases were used to screen out the core targets of drug action and perform GO function and KEGG pathway enrichment analyses. Results There were 9 active components in Szechwan Chinaberry Fruit and 49 active components in Rhizoma Corydalis, with 1 common component between the two drugs; there were 181 action targets of Szechwan Chinaberry Fruit and 1097 action targets of Rhizoma Corydalis, with 143 common targets between the two drugs. There were 162 intersecting targets between the drug combination and liver cancer, and the main genes involved were IL6, TP53, VEGFA, TNF, and CASP3. KEGG analysis showed that the main pathways involved included cancer pathway, AGE-RAGE signaling pathway of diabetes complications, TNF signaling pathway, NF-κB signaling pathway, and thyroid hormone signaling pathway. Conclusion There are many different components in the drug combination of "Szechwan Chinaberry Fruit-Rhizoma Corydalis", which can exert a therapeutic effect on liver cancer by acting on related genes and signaling pathways.