There are two main lymphatic drainage routes of the breast: a superficial system and a deep system, and only the deep one can drain into the internal mammary lymph node (IMLN) which receive about 25%of the lymph of the breast. As one of the important nodal sites of lymphatic spread of breast, IMLN is important for neoplasm staging and it will guide adjuvant radiotherapy. However, there still lack an effective and feasible minimally invasive diagnosis technology of IMLN, leading to inaccurate staging and over/under-treatment. The“modified injection technique” broke through the bottle-neck of the low internal mammary visualization rate with traditional injection technique, and made the internal mammary sentinel lymph node biopsy possible to be a min-imally invasive assessment for IMLN status, and further guided internal mammary radiotherapy (IM-RT). Patients with IMLN positive should accept IM-RT, with IMLN negative can avoid IM-RT. With the unceasing progress in studies on internal mammary lymph drainage area, patients may obtain the individualized diagnosis and treat-ment. The review summarizes current knowledge on the anatomy and physiology of the lymphatic system of the breast to translate this into implications for clinical practice of IM-SLNB.

AIM: To evaluate the effects of different doses of valsartan alone or with concomitant benazepril on blood pressure, left ventricular hypertrophy, RAAS function and endoxin level in spontaneously hypertensive rats (SHR). METHODS: Thirty SHR (fourteen-week-old, male) were divided into five groups (six rats in each group ): SHR control group: fed with normal saline; benazepril group: fed with 1 mg?kg -1 ?d -1 benazepril); low dose valsartan group: fed with 8 mg?kg -1 ?d -1 valsartan ; high dose valsartan group: fed with 24 mg?kg -1 ?d -1 valsartan ; combination drug therapy group: fed with valsartan (8 mg?kg -1 ?d -1 ) and benazepril (1 mg?kg -1 ?d -1 ), all for 8 weeks. WKY control group (n=6):fed with normal saline for 8 weeks.RESULTS: SBP, LVM/BW,TDM of SHR were remarkably lower than those of control after drug intervene, and effect on SBP was most remarkable in high dose valsartan group and in the combination drug therapy group; effect on LVM/BW,TDM were most remarkable in combination drug therapy group. Renin activities in plasma and myocardium were remarkably increased in drug intervene groups. The levels of Ang Ⅱ in plasma and myocardium were remarkably increased in two different dose of valsartan treating group, and the larger dose of valsartan were, the higher levels of Ang Ⅱ in plasma and myocardium were; decreased in benazepril treating group and combination drug therapy group. Na +-K +-ATPase activities in myocardium were remarkably increased and the level of endoxin in myocardium were remarkably decreased as SBP decreased after drug intervene. CONCLUSION: Different dose of valsartan alone or combined with benazepril can decrease SBP of SHR, have the effect of inhibiting progression of ventricular hypertrophy. The effect of combination drug therapy group was most remarkable among five groups and can avoid the side effect of high AngⅡ in plasma and myocardium during long-term use of valsartan alone.

Background Based on prior research in the field, a preliminary questionnaire was created to compare the coping strategies of schizophrenic patients to those of non-ill community residents. Results of the comparison were subsequently used to develop a questionnaire suitable for use in schizophrenic patients.Methods Ninety-one of the 92 items in the preliminary questionnaire were identified from previous questionnaires, and one additional item was created based on information provided in individual interviews with schizophrenic patients. This questionnaire was administered to 315 community controls and 208 schizophrenic inpatients. Exploratory Factor Analyses to identify the factor structure of coping strategies were independently conducted for controls and patients. Based on these results, a revised 65-item instrument was developed and administered to a new group of 287 controls and 219 schizophrenic inpatients. Confirmatory Factor Analyses (CFA) using Linear Structural Relations (LISREL) were independently conducted for the two groups to confirm their respective factor structures.Results Six coping categories identified in normal controls were problem solving, avoidance, cognitive adjustment, emotional adjustment, seeking special support, and denial. Among schizophrenic patients, however,coping strategies of "seeking special support" and "denial" were not independent of the other four coping categories. Their items were distributed among the others. Results of CFA confirmed this four-category model of coping strategies for schizophrenic patients.Conclusions Coping categories employed by schizophrenic patients were different from those employed by normal community controls. Schizophrenic patients lacked the necessary flexibility of selecting appropriate coping strategies.

objective To explore the mechanism of Naotaitong granule on ischemic apoplexy by observing the effect of Naotaitong granule on ischemic apoplexy model. Methods128 rats were randomly divided into sham operation group, console group, experimental group and control group. Ischemic apoplexy model were established in all the animals. Different disposal was given to different group. In the 7 d、 10 d、 14 d、21 d and 28 d after drug administration, immunohistochemistry were used to evaluate the expression of Slit2 and VEGF. In addition, behavior alteration and HE staining were applied to evaluate the variation of brain tissue neuron. ResultsAll the animals revealed hemiplegia and cerebral tissue softened after successfully establishing apoplexy model. The morphology of experimental group and control group was improved after drug administration with softened focus obviously reduced. Longa grade of console group in the 7 d、 10 d、 14 d、 21 d and 28 d was (2.92±0.20)、 (2.58±0.20)、 (2.25±0.27)、 (1.83±0.26) and (1.42±0.20) respectively. Longa grade of Naotaitong group in the 7 d、 10 d、 14 d、 21 d and 28 d was (1.92±0.20)、 (1.50±0.32)、 (1.25±0.27)、(0.83 ±0.26) and (0.50±0.00) respectively. Longa grade of control group in the 7 d、 10 d、 14 d、 21 d and 28 d was (2.33±0.41)、 (2.00±0.45)、 (1.75±0.27)、 (1.33±0.41) and (0.92±0.38) respectively. Longa grade of both control and Naotaitong group had statistics significance compared with the console group (P＜0.01) .Conclusion Naotaitong granule may improve anoxemia in rats brain and protect brain tissue.

Objective To explore the effects of Jiedu Quyu Ziyin Recipe (JQZR) on the apoptosis and expressions of bcl-2 and bax mRNA of peripheral-blood lymphocyte in MRL/lpr mice. Methods 80 MRL/lpr mice were randomly divided into model group,TCM group, Western medicine group and TCM and Western medicine group,20 mice in each group, meanwhile,20 Kunming mice were selected as normal group, then intragastrically administered normal sodium, JQZR apozem, prednisone suspension and JQZR apozem and prednisone suspension, 0. 5ml every time,once daily for 12 weeks respectively. At the end of the 12th week, peripheral-blood lymphocytes of every mice purified by gradient centrifugation were cultivated for 48 hours ,then the apoptosis was detected by flow cytometry. Furthermore,the expressions of bcl-2 and bax mRNA of peripheral-blood lymphocyte were detected by RT-PCR. Results At Oh or 48h,the apoptosis ratios of PBLC in normal group, TCM group,Western medicine group and TCM and Western medicine group are higher than model group and the differences are significant(P <0. 05 ,P <0. 01 ) ,while,at Oh,which are not significant within Western medicine group, normal group and TCM and Western medicine group ( P > 0. 05) ,even if which are significant between TCM group and TCM and Western medicine group or between model group and TCM and Western medicine group( P < 0. 05 ). At 48h, the differences of apoptosis ratios of PBLC are significant between Western medicine group and TCM and Western medicine group( P < 0. 05 ), and between TCM group and TCM and Western medicine group or between model group and TCM and Western medicine group which are significant, too( P < 0. 01 ). The ratios of bcl-2/bax mRNA of normal group,TCM group and TCM and Western medicine group are significantly lower than which of model group or Western medicine group ( P < 0. 05, P < 0. 05, P <0. 01 ,respectively) ,but there is no significant difference between which of model group and Western medicine group.Conclusion JQZR has adjustable effects on the apoptosis and expressions of bcl-2 and bax mRNA of peripheralblood lymphocyte in MRL/lpr Mice.

Objective To explore the effect and safety of three-dimensional conformal radiotherapy (3D-CRT) m combination with nimotuzumab and chemotherapy in treatment patients with locoregionally advanced nasopharyngeal carcinoma.Methods 60 patients with stages Ⅲ-ⅣA nasopharyngeal carcinoma were enrolled.All patients were treated with 3D-CRT and concurrent and sequential chemotherapy by paclitaxel and eisplatin and given nimotuzumab 100mg i.v.weekly for 6 ～ 7 weeks before radiotherapy.Results After two months,the complete response rates(CR) of nasopharyngeal carcinoma and cervix lymph nodes were 98.3％,96.7％ respectively,l-year locoregional control and distant metastasis-free survival rates were 100％,96.7％ in 38 patients.2-year,3-year locoregional control and distant metastasis-free survival rates were 100％ in 16 patients and 8 patients.The major side effects included oral mucositis,actinodermatitis,neutropenia,nausea,vomiting,and fatigue.Grade 3 acute oral mucositis often occured.No skin rash or allergic toxicities appeared.All the effects were tolerable.Conclusion 3D-CRT combined with nimotuzumab and peclitaxel and cisplatin chemotherapy may improve the complete response rate and locoregional control and distant metastasis-free survival rate on locoregionally advanced nasopharyngeal carcinoma,with mild to moderate side effects.

BACKGROUND: The selective innervation of different sacral nerve roots on bladder in SD mice is still uncertain.OBJECTIVE: To study the selective innervation of sacral nerve roots to bladder in order to provide evidence for rebuilding bladder function after spinal cord injury and establishing experimental animal model of artificial bladder.DESIGN: Randomized and controlled study.SETTING: Department of orthopaedics in two universities and physiological department of a medical university.MATERIALS: The experiment was conducted in the Key Laboratory of Hand Function Reconstruction of Ministry of Public Health in Medical College of Fudan University from October 2000 to June 2002. Totally 10 male SD mice of clean class with body mass between 250 and 300 g were chosen.INTERVENTIONS: The mice were randomly divided into two groups of which one used left side as experimental side and the other used right side. Extradural electric stimulation was conducted to St -4 nerve roots of SD mice after spinal cord injury.MAIN OUTCOME MEASURES: To record the change of action potential of cystic nerve plexus and compound muscle action potential of bladder smooth muscle, and insert the pressure monitor into bladder to record internal pressure of bladder by pressure transducer.RESULTS: S1 -4 nerve all participate the innervation of bladder in SD mice,among them, the S2 nerve is the most important one, next with S1, S3 and S4is the minimum one.CONCLUSION: Different sacral nerve roots have different dominative effects to bladder smooth muscle. It is meaningful for patients of spinal cord injury to improve their urination function by performing artificially electric stimulation for emiction through the main nerve roots controlling of bladder or rebuilding artificial bladder reflex arc by neurorrhaphy

Objective To establish the examination criteria for the prosthodontic clinical practice using Delphi method,to improve the evaluation level of clinical practice of dental students.Method 15 clinical experts in the department of prosthodontics,Peking University School of Stomatology were selected in this study.The evaluation indicators system of prosthodontic clinical practice was established by two rounds of investigations by Delphi method.Initiative ratio and authority coefficient (Cr) of the experts were used to evaluate the reliability of the new examination criteria.Next,the eight-year program students in class of 2007 (38 students) and 2008 (34 students) were examined by old and new examination criteria respectively and the feedback of the students were collected by the method of questionnaire.SPSS 16.0 was used for data processing.Results In this study,the initiative and the authority of the experts was very high,and the initiative ratio and authority coefficient were 100％ and 0.860 respectively.A new examination criterion of prosthodontic clinical practice was established,including 3 first-level indicators,9 second-level indicators and 19 third-level indicators.Questionnaire analysis revealed that only 12％ (n=4) and 9％ (n=3)of the students in class of 2008 considered the new examination criteria was not comprehensive enough or objective enough,which was obviously less than the students in class of 2007 [45％ (n=17) and 36％ (n=14)].Conclusion A new examination criterion of prosthodontic clinical practice was successfully established by Delphi method.The new examination criterion is more comprehensive and objective than the old one and can promote the educational quality of clinical practice of dental students.The method of this study also provides reference for the educational reform of clinical practice in other fields.