Breast cancer survivors often suffer from a variety of complications post operation, such as upper limb dysfunction, limb lymphedema, brachial plexus nerve injury, and so on. This article reviewed the pathogenesis and rehabilitation of these complications.

With the change of medical mode and deepening of the medical education reforms,such educational idea as giving prominence to practice is widely used to improve students' comprehensive quality and innovative ability and practice ability. The medical shool of Tibet university has established long-term apprentice mechanism during the before class and playtimes and found four county hospitals, five health clinics in towns and townships and gradually improved the construction of mutual win-win 9clinical teaching bases. In this way it has been cultivating many advanced medical personnels, who are reliable, available, able to stay, and highly praised by the employers.

OBJECTIVE:To study the anti-tussive and anti-inflammatory effects of aqueous extract of Pegaeophyti Radix Et Rhizoma(P. Radix Et Rhizoma). METHODS:In the experiment,there were a model group,a positive control group [30 mg/kg co-deine for mice,18.38 mg/kg codeine for guinea pigs,20 mg/kg indometacin for mice and 15 mg/kg indometacin for rats] and P. Ra-dix Et Rhizoma low-dose,medium-dose and high-dose groups [2.0,4.0 and 8.0 g(medicinal materials)/kg for mice;1.2,2.4 and 4.8 g (medicinal materials)/kg for guinea pigs;1.4,2.8 and 5.6 g (medicinal materials)/kg for rats],with 10 animals in each group. The above-mentioned animals were given corresponding drug ig for 4 consecutive days,and then strong ammonia spraying method and sulfur dioxide stimulation method were employed to induce cough in mice and citric acid spraying method to induce cough in guinea pigs to observe the incubation period and times of cough,auricular swelling method to observe xylene-induced au-ricular swelling in mice and pedal swelling method to observe carrageenin-induced pedal swelling in rats. RESULTS:Compared to the model group,Aqueous extract of P. Radix Et Rhizoma could prolong the incubation period and reduce times of cough induced by strong ammonia spraying and sulfur dioxide stimulation in mice of positive control group and P. Radix Et Rhizoma medium-dose and high-dose groups;it could prolong the incubation period of and reduce times of cough induced by citric acid spraying in guinea pigs of positive control group and P. Radix Et Rhizoma medium-dose and high-dose groups;it could alleviate xylene-induced auricu-lar swelling in mice of positive control group and P. Radix Et Rhizoma medium-dose and high-dose groups;it could alleviate carra-geenin-induced pedal swelling in rats of positive control group and P. Radix Et Rhizoma medium-dose and high-dose groups. There were statistically significances (P<0.01 or P<0.05). CONCLUSIONS:Aqueous extract of P. Radix Et Rhizoma has anti-tussive and anti-inflammatory effects on the experimental animals.

Objective To investigate the effect of transcranial direct current stimulation (tDCS) on aphasia recovery after stroke. Meth-ods From April, 2012 to January, 2013, 20 aphasic patients after stroke were enrolled in an A-B experiment design. During phase A, ten times of sham tDCS and language training (five days a week) were implemented, then ten times language training combined with tDCS (five days a week) were implemented in phase B. The treatment lasted for four weeks. Picture naming was measured for all patients before and af-ter treatment both in phase A and phase B. Results The D-value scores of picture naming before and after treatment were significantly more in phase B than in phase A in both treatment items and non-treatment items (t>3.030, P<0.05). Conclusion tDCS could raise the accuracy of picture naming in patients with aphasia after stroke.

Objective To analyze the genotypes of clinical varicella-zoster virus(VZV) isolates in Tibet.Methods The samples of vesicular fluid from patients with chickenpox or zoster were collected to isolate VZV in human embryonic fibroblast cells.Furtherly,the isolated VZV were identified by indirect immunofluorescence assay and the positive ones were continuely cultured in vitro to get their genome DNAs.Then,PCR and nucleotide sequencing were performed on the part of open reading frames 1,21,50,54.To confirm the genotypes of isolated virus strains,the gene sequences obtained from PCR products were compared with that in GenBank of VZV Dumas strains,and their restriction enzyme sites were analyzed via Primer 5.0.Results Ten clinical isolates of VZV were obtained from sixteen specimens,the positive isolation rate was 62.5％.Gene analysis showed that among all the ten clinical isolates of VZV in Tibet,three strains are genotype A1,four are genotype A2 and the other three are genotype J1.Conclusion The VZV genotype distribution in Tibet was tightly related to their special geographic locations.

Objectives To assess the relationship between amniotic fluid erythropoietin(EPO)and neona-tal adverse outcome in fetal growth restriction(FGR)pregnancy labored during 28-36 gestational weeks.To explore the clinical application in timing of delivery. Methods The retrospective research had recruited 87 patients with single pregnancy complicated FGR,of which the gestational weeks range from 28 weeks to 36 weeks. All subjects were collected from amniotic fluid at cesarean section or within a week of cesarean section. Amniotic fluid EPO were detected according to the classical definition. We categorized EPO < 27 IU/L as an normal state,whereasE-PO≥27 IU/L as an abnormal state.The relationship between amniotic fluid EPO with biophysical profile,the flow velocity waveform/blood gas parameters of the umbilical artery,and the neonatal adverse outcome were observed. Results For FGR pregnant women who chose 28-36 weeks for delivery,the incidence of neonatal adverse out-comes was significantly higher in the amniotic fluid EPO increased group than that in normal concentration group (χ2= 9.49,P = 0.002). Pearson analysis showed that amniotic fluid EPO concentration was negatively correlated with umbilical artery pH(P<0.001,r=-0.908)and base excess(P<0.001,r=-0.624).However,it was pos-itively correlated with PCO2(P<0.001,r=0.631),whereas there was no significant correlation between amniotic fluid EPO concentration and PO2(P=0.068,r=-0.197).In addition,neither biophysical profile nor flow velocity waveform has difference in amniotic fluid EPO concentration. Conclusions The abnormal increased amniotic fluid EPO in FGR pregnant women who delivered before 36 gestational weeks were closely related to the adverse out-come of the newborn.The amniotic fluid EPO is expected to be an additional indicator of fetal hypoxia,which can help determine the time of birth.

OBJECTIVETo provide genetic analysis for a family affected with Duchenne muscular dystrophy (DMD) with a recurrent de novo mutation.

METHODSMultiplex ligation dependent probe amplification (MLPA) was used to detect potential deletion and duplication of the DMD gene, and the DNA products were sequenced on a Genetic Analyzer 3130 sequencer. Haplotype analysis was performed using four short tandem repeat polymorphism loci (44C/A, 45C/A, 49C/A and 63C/A) of the DMD gene for the family.

RESULTSA same deletional mutation (Del 48-50) of the DMD gene was detected in the proband and fetus, but not in their mother. The proband and fetus have inherited the same haplotype of the DMD gene from their mother. The fetus was predicted to be affected by the disease.

CONCLUSIONAbove findings suggested that the mother was very likely to have a germline mosaicism for the DMD gene mutation. For the de novo DMD mutation, although genetic analysis of peripheral blood DNA has indicated that the proband's mother was not a carrier, germline mosaicism could still not be ruled out, and prenatal gene diagnosis should be provided for subsequent pregnancies.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; China ; Dystrophin ; genetics ; Female ; Fetal Diseases ; diagnosis ; genetics ; Humans ; Infant ; Male ; Molecular Sequence Data ; Mosaicism ; Muscular Dystrophy, Duchenne ; embryology ; genetics ; Pedigree ; Pregnancy ; Prenatal Diagnosis ; Sequence Deletion

Objective Mitochondrial DNA depletion syndrome is a rare autosomal recessive disorder characterized by complex genetic and clinical manifestations.This study aimed to investigate the clinical and laboratory features of a boy with mitochondrial encephalomyopathy caused by SUCLG1 mutation.Methods The clinical data and genetic test of a patient with mitochondrial DNA depletion syndrome were retrospectively analyzed.Result The proband presented with limb weakness at the 4th month after birth,and presented dystrophic appearance,muscular hypotonia,psychomotor retardation,failure to thrive,hearing impairment,scoliosis,thoracocyllosis and facial features at 9 months old.Laboratory tests showed blood lactic acid and pymvate increased,liver damage and abnormal myocardial enzymes.Plasma camitine ester profiling showed that amino acids decreased and C4-dicarboxylic-carnitine increased.Urinary organic acid analysis showed increased concentration of methylmalonic acid and its metabolites indicating methyl malonic aciduria.MRI showed bilateral T2 hyperintensities in bilateral caudate nuelei and lenticular and brain atrophy-like changes.Brainstem auditory evoked potential showed severe hearing loss.His development quotient was 35.Genetic sequencing of MUT,,MMAA,MMAB and other classic mitochondrial disease related genes of the proband revealed no mutation.Two heterozygous mutations,c.961C＞G and c.713T＞C,inherited from the phenotype of normal parents were detected in his SUCLG1 gene.The copy number of mitochondrial DNA was 244/cell in peripheral blood leukocytes,equivalent to 68.4％ of that in normal control.Conclusion In this study,an infant with muscular hypotonia,psychomotor retardation,deafness and slightly increased urine methyl malonic acid was diagnosed by genetic test.For patients with unexplained hypotonia,mental retardation,abnormal movements,hearing disorder together with increased blood pyruvic acid and lactic acid,mild methylmalonic acidemia and abnormal acylcarnitine,mitochondrial DNA depletion syndrome should be considered.Gene analysis is important for diagnosis and prenatal diagnosis of the next pregnancy.

Objective: To determine possible relations between early adiposity rebound and adolescent development. Methods: Prospective children cohort from 2 kindergartens selected through clustering convenience sampling method in Anhui Province was established since Sep. 2010. Participants were classified as Cohort 1 (2010), Cohort 2 (2011) and Cohort 3 (2012) according to the recruiting year. Till Sep. 2015, a toal of 802 girls were included in this study, and received follow-up till primary school. During kindergarten period, physical examination was carried out every 3 months, 8 times in total. In primary school, physical examination was carried out annually; till Sep.2015, the cohort 1, 2, 3 took physical examination for 12, 11, 10 times, respectively. Information on household economic status and child physical activity was acquired through parents questionnaire survey, and breast development were assessed through visual inspection and palpation. Adiposity rebound was determined according to Rolland-Cachera's method for each girl. Differences between early adiposity rebound and normal adiposity rebound groups were compared by using t test and χ² test. Multivariate regression analysis was applied to explore the association between early adiposity rebound and breast development. Results: The average age of participants was (8.90±0.87) years old and the BMI was (17.48±2.70) kg/m². The average age at adiposity rebound was (6.16±0.90) years old and the BMI was (15.33±1.82) kg/m². Premature breast development was found significantly higher in girls in early adiposity rebound group (27.8%, 54/802) than it in normal adiposity rebound group (13.7%) (P<0.001). After current adiposity, age, household economic status, childhood physical activity adjusted, the OR of premature beast development in early adiposity rebound group was 2.41(95%CI: 1.41-4.12). Conclusion Early adiposity rebound increases the risk of premature puberty in girls.

Objective:To investigate the influencing factors of surgical site infection (SSI) after abdominal surgery.Methods:The retrospective cross-sectional study was conducted. The clinical data of 567 patients undergoing abdominal surgery in 6 medical centers, including 445 cases in the Zhengzhou Central Hospital Affiliated to Zhengzhou University, 54 cases in the the First Affiliated Hospital of Zhengzhou University, 49 cases in the Shangqiu First People's Hospital, 10 cases in the Luoyang Central Hospital, 5 cases in the First Affiliated Hospital of Henan University of Science and Technology and 4 cases in the Henan Provincial People's Hospital, from June 1 to June 30, 2020 were collected. There were 284 males and 283 females, aged (51±18)years. Observation indicators: (1) incidence of SSI after surgery; (2) influencing factors of SSI. Follow-up was conducted using outpatient examination and telephone interview to detect the incidence of SSI. Patients without implant were followed up within postoperative 30 days, and patients with implant were followed up within postoperative 1 year. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measure-ment data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was performed using the chi-square test or Fisher exact probability. Univariate analysis was performed using the corresponding statistical methods. Multivariate analysis was performed using the Logistic stepwise regression model advance method. Results:(1) Incidence of SSI after surgery. All the 567 patients were followed up after surgery as planned. There were 27 cases with SSI after surgery including 9 cases with superficial incision infection, 9 cases with deep incision infection, 9 cases with organ/gap infection. Of the 27 cases with SSI after surgery, 18 cases with positive results of incisional microbial culture including 8 cases with positive results of Escherichia coli, 6 cases with positive results of Klebsiella pneumonia, 3 cases with positive results of Enterococcus faecium and 1 case with positive result of Pseudomonas aeruginosa. (2) Influencing factors of SSI. Results of univariate analysis showed that age, preoperative hemoglo-bin, preoperative albumin, preoperative fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site, surgical incision type, duration of intensive cure unite, duration of post-operative hospital stay, duration of total hospital stay, operation time, hospital expense were related factors affecting the incidence of SSI of patients undergoing abdominal surgery ( χ2=40.12, Z=?4.22, ?2.21, ?4.75, χ2=7.07, 16.43, 38.06, 17.50, Z=?4.43, ?4.42, ?7.14, ?7.15, ?5.90, P<0.05) and the American Association of Anesthesiologists Classification, preoperative oral antibiotics, surgical methods and postoperative intensive care unit stay were related factors affecting the incidence of SSI of patients undergoing abdominal surgery ( P<0.05). Results of multivariate analysis showed that age, preopera-tive fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site as appendix and rectum, surgical methods, surgical incision type as infective incision and polluted incision, operation time were independent factors affecting the incidence of SSI of patients undergoing abdo-minal surgery ( odds ratio=7.69, 1.21, 0.27, 5.82, 5.19, 19.08, 0.23, 27.76, 4.97, 1.01, 95% confidence intervals as 2.04?28.95, 1.04?1.41, 0.08?0.94, 1.36?24.85, 1.10?24.43, 4.48?81.25, 0.06?0.87, 2.54?303.53, 1.12?22.14, 1.01?1.02, P<0.05). Conclusion:Age, preoperative fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site as appendix and rectum, surgical methods, surgical incision type as infective incision and polluted incision, operation time are independent factors affecting the incidence of SSI of patients undergoing abdominal surgery.