Objective To summarize the experience in nursing the patients undergoing soft tissue defect repair using expanded flap after surgery of locally advanced breast cancer (LABC). Methods Thirteen LABC patients received neoadjuvant chemotherapy. Water balloon dilator was used to expand flap before the chemotherapy and expanded flap was used to repair the soft tissue defect after modified radical mastectomy . Skin preparation and psychological counseling were well prepared before operation . During therapy , more attention was paid to injection pot , abdominal wall flap and water injection and the nursing of the expanded flaps after repair . Results The water balloon dilator implantation for all patients was successful and soft tissues of chest wall defect were completely repaired . There wasn't flap necrosis or implantation metastasis in 0 . 5 to 2 years follow-up . Conclusion Expand flap can repair defect of chest wall after modified radical mastectomy . The nursing measures of perioperative nursing including implantation of expander , observation of the expanded flap variations during expanding of water sac and nursing of expanded flaps are important for the success of repair .

Objective To investigate the clinical efficacy and prognosis of transcatheter arterial chemoembo-lization(TACE)combined with radiofrequency ablation(RFA)in treatment of liver cancer.Methods 64 patients of liver cancer were selected as the research subjects,and they were divided into two groups by randomized single blind method.32 cases in the control group adopted the TACE treatment,while 32 cases in the observation group were given TACE combined with RFA.The tumor shrinkage,complete necrosis rate,local recurrence rate,AFP levels and adverse reactions of the two groups were compared.The patients were followed up for 3 years to record survival.Results After treatment,the tumor shrinkage rate and complete necrosis rate of the observation group were 90.63% and 75.00%, which were significantly higher than 68.75% and 50.00% of the control group,the differences were statistically significant (χ2 =8.453,8.203,all P <0.05).The local recurrence rate of the observation group was 21.88%,which was significantly lower than 43.75% of the control group,the difference was statistically significant(χ2 =7.887,P <0.05).After treatment,the AFP level of the observation group was (70.11 ±6.45 )ng/L,which was significantly lower than (157.76 ±10.42)ng/L in the control group,the difference was statistically significant (t =7.433,P <0.05).The survival rates of 1 year,2 years and 3 years in the observation group were 84.38%,71.88%,56.25%, which were significantly higher than 65.63%,53.13%,31.25% in the control group (χ2 =8.677,8.203,8.985,all P <0.05).The incidence rate of postoperative adverse reaction had no significant difference between the two groups (χ2 =1.337,P >0.05 ).Conclusion TACE combined with RFA in treatment of liver cancer can significantly improve the effect of tumor necrosis rate,reduce the local recurrence rate and prolong the survival time of the patients, and it had less adverse reaction,higher safety,and which should be applied in clinical.

Objective To investigate the nursing methods of transferring peduncle island skin flap in foot. Methods Nursing about 19 patients who have undergone the transferring of peduncle island skin flaps because of soft tissue injury in foot. The preoperative nursing included skin nursing, individual psycho-behavior guidance, room allocation. Postoperative nursing included placement of limbs correctly, nursing about the transferring district flaps, observation and nursing the vescular crisis, correct using anticoagulant and functional exercises of ankle-joint. Results There were 18 flaps survived completely, 1 flaps in distal end had partly necrosis, but flap had recovered well afterⅡ-period skin grafting. Conclusion Overall elaborate clinical nursing can guarantee the survival of the graft peduncle island skin flaps in foot.

BACKGROUND:Poly(D,L-lactide-co-glycolide)(PLGA)may produce lactic acid and glycolic acid when PLGA degrades,thus leading to the acid accumulation and inducing the inflammatory reaction locally.OBJECTIVE:To investigate the effect of lysine,histidine and arginine on regulating the acid accumulation of PLGA copolymer during the degradation.DESIGN:Repeated measurement and experiment.TIME AND SETTING:The experiments were performed in the College of Bioengineering.Chongqing University from July 2006 to August 2007.MATERIALS:PILGA(80:20)was produced by Sigma(USA);Lysine,histidine and arginine(purlty>99%)were purchased from Sigma(USA);Chitosan(deacetylation degree:85%)was purchased from Chengdu Kelong Chemical Reagent Factory;Algin(viscosity:1.05-1.15)was purchased from Tianiin Damao Chemical Reagent Factory.METHODS:Lysine,histidine and arginine were added into PLGA with the proportion of 5%(w/v)and 10%(w/v)respectively.The resultant film sample was put into a bottle with tri-distilled-water for 2-month degradation at 37℃.The pH value of degradation solution was detected by pH meter;Each film sample was taken out and lyophilized 12 hours to get its dry weight and calculate mass loss ratio.Each variety of the solution was sampled three specimens,the average pH value,average initial weight and average finial weight of these three specimens were taken as the indices at each sampling time point,respectively.Accordingly,the regulation effect of basic amino acid was comparexl with that of algin,chitosan and NaHCO3.MAIN OUTCOME MEASURES:The changes of pH value of degradation solution;the mass loss ratio of the composite.RESULTS:Each basic additive could relieve the acid accumulation,among them,NaHCO3 was the strongest,while algin and chitosan showed a lowest capacity,basic amino acid was moderate;The suitable regulation effect could be achieved at a level of 5%lysine.CONCLUSION:Basic amino acid can effectively regulate the acid accumulation after PLGA degrades,and the optimal concentration of lysine is 5%.

ObjectiveTo evaluate whether oral administration of Chinese tradiational medicine,Qing-Xue granula,can prevent mouse lung injury caused by thoracic radiation.Methods128 BalB/C mice were divided into 4 groups:control (C) group; radiation (R) group; radiation plus high dose Qing-Xue granula (H) group and radiation plus median dose Qing-Xue granula ( M ) group.The H and M groups were fed 0.64 g and 0.32 g of Qing-Xue granula dissolved in 0.5 nl anline once daily for two months,which were 4 and 2 times of human dosage,respectively.Whole thorax radiation of 12 Gy was delivered with a single ventral-dorsal field with 6 MV X-ray.Group C and group R received 21 days of 0.5 ml saline feeding.Mice were sacrificed at 1,2,4 or 6 months after radiation. Macrophage cell count of lung lavage fluid and hydroxyproline content of left lung were assayed,and the lung fibrosis was scorred according to the Ashcroft's criteria.The plasma interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) concentration were assayed with ELISA method.The One-way ANOVA was used to test the significance of any differences between groups at each time point. Results The macrophage cell number of lung lavage fluid was significantly lower in the 1st month in group M than in group R (2∶4,q =3.92,P ＜ 0.05 ),but had no significant difference between group M and C ( 1 ∶ 4,q =2.13,P＞0.05 ).The hydroxyproline content of group H was significantly lower than group R in the 1st and 6th months (q =3.62,3.54,all P ＜ 0.05 ),but still higher than group C ( q =4.09,3.72,all P ＜ 0.05 ).The fibrosis score of group H was significantly lower than group R in the 2nd,4th and 6th months (q=3.38 -4.16,all P＜0.05).The IL-6 concentration of group H was significantly lower than group R in the 1st month ( q=3.53,P＜0.05 ),but not significantly higher than group C (q =1.41,P＞0.05).The VEGF concentration was significantly higher in group R than group C since the 2nd month ( q =3.12 - 3.78,P ＜ 0.05 ).The VEGF concentration was significantly higher in group H and M than group R in the 2nd and 6th months ( q =3.08 - 3.92,all P ＜ 0.0 5 ).Conclusions Oral Chinese traditional medicine,Qing-Xue granula,could prevent radiation induced lung fibrosis in mice,especially at high dosage.The degree of elevation of VEGF in plasma was not parallel with that of lung fibrosis.

ObjectiveTo evaluate the effect on lung injury of gefitinib or/and radiation.Methods Totally 160 mice were divided into five groups:control (C) ;gefitinib (G) ;radiation (R) ;gefitinib followed by irradiation ( G + R) ;and R + G.12 Gy irradiation was delivered.Geiitinib fed by 200 mg/kg once daily for 3 weeks.Mice were sacrificed on 1,2,4 or 6 months after radiation.Macrophage count of lung lavage fluid and hydroxyproline assessed,lung fibrosis scored.and plasma TGF-β1 concentration assayed.One-way ANOVA was used to test the significance. Results The lung lavage macrophage cell number were significantly higher in group R,R + G and G + R than group C ( q =2.95 - 8.61,all P ＜ 0.05 ) on 4 and 6months,yet no significant difference between the three groups ( q =0.37 -3.49,all P ＜ 0.05 ) ; The macrophage was significantly lower in month 1,4 and 6 in group G than R,R + G and G + R ( q =3.37- 6.25,all P ＜ 0.05 ).The hydroxyproline content and the fibrosis score of G,R,R + G and G + R were significantly higher than C ( q =3.14 - 4.76,all P ＜ 0.05 ),but no significant difference between the four groups ( q =0.70 - 4.19,all P ＞ 0.05 ).The TGF-β1 concentration of R,G + R,R + G at all time points and TGF-β1 concentration of G at 1 st and 2nd months were significantly higher than C ( q =3.76 -8.09,all P ＜ 0.05).ConclusionsGefitinib could cause lung fibrosis in vivo in BalB/C mouse.The combination of gefitinib and radiation did not significantly exacerbate lung injury caused byeither alone.The mechanism of lung fibrosis caused by gefitinib might be different from that by radiation which needs further research.

Objective To study the relationship between expression of matrix metalloproteinases-7 (MMP-7) and clinicopathological characteristics in patients with primary non-smaU cell lung cancer(NSCLC). Methods MMP-7 in 20 normal people and 60 advanced NSCLC patiens were detected with reverse-transcription-polymerase-chain-reaction. Gelatum image analysator analyzed the result. Results The amount of MMP-7 was less in normal people (30.000) than in NSCLC patients(41.231) significantly(P<0.05); the level of MMP-7 was no correlated with gender, age, pathology pattern, tumor size, was inverse correlation with differentiation, and was positive correlation with clinical stages(P <0.05). Conclusion The level of MMP-7 is closely correlated with tissue differentiation and clinical stages of NSCLC, which may serve as a parameter for determining tumor invasion and metastatic.

Objective To explore the effect of apolipoprotein E deficiency on astrocyte destruction in the ex vivo spinal cord slice model. Methods Vibratome-cut transverse spinal cord slices from C57BL/6 postnatal day 7 ApoE -/-mice and wild-type mice were cultured on transwell porous supports. After 7 days in the culture , spinal cord slices were exposed to LPS for 5 days. The expression of AQP4, GFAP and Iba1 was detected by immunofluorescence. The concentration of TNF-α and NO were detected by ELISA and method of nitrate reductase, respectively. Results Marked loss of AQP4 and GFAP staining were shown in LPS-affected groups, not in the control group, and the lesion score was higher in ApoE-/-group than WT-group (P<0.05). In addition, the expression of Iba1 and concentration of TNF-α, NO in the LPS-affected groups were more than that of the control group (P < 0.05), and they were higher in the ApoE-/-LPS group than the WT-LPS group (P < 0.05). Conclusions ApoE deficiency exacerbates astrocyte injury, likely through promoting the release of pro-inflammatory mediators from microglia.

Objective To develop a scoring system to determine peptic ulcer risks and to evaluate its screening efficiency.Methods A total of 862 people who underwent gastroscopy for the first time ranging from 18 to 45 years old were enrolled in this study.They were divided into two cohorts with the method of simple random sampling,514 in the original cohort and 348 in the validation cohort.Information such as demographic characteristics,dietary intake,lifestyle,symptoms relating to peptic ulcer was obtained.A multivariable logistic regression method was used to determine independent predictors of peptic ulcer.Based on the logistic regression model,a scoring system was developed with a regression coefficient-based scoring method.Then the scoring system was internally and externally validated.Each value of calibration,discrimination and accuracy were computed and then compared with those of original cohort to assess its screening efficiency.Results Three variables (gender,smoking and melena) composed the scoring system with scores ranging from 0 to 4 points.It had good calibration (P =0.956) and discrimination (area under the ROC =0.70,95％CI:0.65-0.76).With 2.5 points as the screening cutoff value,the sensitivity,specificity,accuracy rate,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 49.5％,82.2％,75.5％,41.6％,86.4％,2.78 and 0.61,respectively.In the validation cohort,the sensitivity,specificity,accuracy rate,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 27.2％,92.7％,71.3％,64.6％,72.3％,3.89 and 0.79.The results above indicated that the screening efficiency of the scoring system in the original cohort was similar to that in the validation cohort.Conclusion The scoring system to determine peptic ulcer risks,containing gender,smoking and melena,has good screening efficiency and can be applied to predict the risks of peptic ulcer.

Objective:To evaluate the effect of propofol on dopaminergic neurons of mice with Parkinson′s disease (PD).Methods:Forty-eight pathogen-free healthy male C57BL/6 mice, aged 8-12 weeks, weighing 22-32 g, were divided into 3 groups ( n=16 each) using a random number table method: control group (group C), group PD and propofol group (group Pro). The neurotoxin 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropypridine (MPTP) was intraperitoneally injected for 7 consecutive days in PD and Pro groups, while the equal volume of normal saline was given for 7 consecutive days in group C. At 30 min after intraperitoneal injection of MPTP, propofol 25 mg/kg was intraperitoneally injected in group Pro, while the equal volume of normal saline was given daily in group C and group PD.At day 8 after the end of establishment of the model, gait analysis system experiment and rotarod test were used to record the step distance and retention time.The animals were sacrificed after the behavioral tests, and the brain tissues were removed for the dopamine neuron count in substantia nigra (by immunohistochemistry) and for determination of the expression of alpha-Synuclein (α-Syn) and Tyrosine hydroxylase (TH) in the substantia nigra (by Western blot). Results:Compared with group C, the step distance was significantly decreased, retention time were shortened, the dopamine neuron count in substantia nigra was decreased, the expression of TH was down-regulated, and expression of α-Syn in substantia nigra was up-regulated in group PD ( P<0.05), and no significant change was found in the parameters mentioned above in group Pro ( P>0.05). Compared with group PD, the step distance was significantly increased, retention time were prolonged, the dopamine neuron count in substantia nigra was increased, the expression of TH was up-regulated, and expression of α-Syn in substantia nigra was down-regulated in group Pro ( P<0.05). Conclusion:Propofol has protective effect on dopaminergic neurons of PD mice, and the mechanism may be related to the down-regulation of α-Syn expression in substantia nigra.