Objective To investigate the diagnosis and treatment of the accessory breast cancer with breast cancer.Methods Five patients with accessory breast cancer were admitted,among of them,1 case with breast cancer,and their documents were retrospectively analyzed.Results Of the 5 cases,1 case underwent modified radical mastectomy,the other 4 cases underwent accessory breast enlarged resection and axillary lymph node dissection.They all received chemotherapy and radiotherapy and 1 case received tamoxifen therapy.Four cases were followed up for 2 years,there was no recurrence and metastasis,1 case was received CAP sequenced chemotherapy.Conclusions Accessory breast cancer is rare but aggressive.The diagnosis is mainly depended on imaging results and postoperative pathology.Combined therapy principle dominated by surgery should be followed.The operation of accessory breast enlarged resection and axillary lymph node dissection should be indicated.

Objective To discuss the activation and biological effects of STAT3 signaling pathway and its negative regulator PIAS3 in glioma cells. Methods Immunohistochemistry(IHC)was used to test the expression of p?STAT3 and PIAS3 in gliomas. AG490(60μmol/L),the in?hibitor of STAT3 signaling pathway,was used to treat U118 and U87 cells for 24/48 h,and the method of MTT assay was taken to evaluate the pro?liferation after AG490 treatment. The expression of p?STAT3 and PIAS3 was also examined by immunofluorescence(IF). Results There was no obvious significance between p?STAT3 and PIAS3 in nuclei or cytoplasm at different grades of gliomas. Whereas,p?STAT3 and PIAS3 were nega?tively correlated in the nuclei of vary grades malignancy gliomas. After AG490 treatment,U118 cells showed no obvious quantitative changes. How?ever,U87 cells showed obvious growth inhibition. IF results showed that there was no significant change at the levels of p?STAT3 and PIAS3 after AG490 treatment in U118 cells. However,the expression of p?STAT3 in the nuclei was down?regulated,and PIAS3 showed obvious nuclear translo?cation in U87 cells. Conclusion Nuclear translocation of PIAS3 plays the key role in modulating JAK/STAT signaling activation and inhibiting glioma cells proliferation.

Objective:To investigate the expression of GDNF mRNA on proximal end of sciatic nerve and T 12 L 1 spinal cord after sciatic nerve was cut in rats. Methods:The sciatic nerve of proximal end and spinal cord paralleling T 12 L 1 nerve root was taken respectively before and after sciatic nerve were severed. The level of GDNF mRNA on proximal end of sciatic nerve and spinal cord was observed and compared before and after sciatic nerve cut. Semi quantitative RT PCR method with ? actin as an inner consult was used to detect the expression of GDNF mRNA. Results:GDNF mRNA expression decreased by 10% 24 h after sciatic nerve was cut, 38% 7 d later, 45% 14 d and 52% 28 d in proximal end, while it decreased by 20%, 68%,80% and 85% on 1, 7, 14 and 28 d respectively in the spinal cord. Conclusion:The reduction of GDNF mRNA level on proximal end and homologous segmental spinal cord may be caused by losing the support of GDNF mRNA from the target tissue after sciatic nerve cut. This study provides a foundation for foreign GDNF to be used in treating SCI.

Objective:To evaluate the safety and efficacy of endoscopic cryoablation (ECA) in patients with upper tract urothelial carcinoma (UTUC).Methods:The clinical data of 9 patients with UTUC treated with ECA from April 2018 to September 2019 were retrospectively analyzed. Patients consisted of 3 males and 6 females, with median age of 76 years old (ranging from 50 to 88 years old). Among the patients, 6 cases had tumors of ureter, 1 case had tumor of renal pelvis and 2 cases had tumors of renal pelvis combined with ureter. Of the 9 patients, two had bilateral UTUC, six were presented with single lesion, three were presented with multiple lesion. The size of tumors were (1.53±0.91)cm. The tumors of all cases were localized (≤stage T 2), and there was no carcinoma or suspicious lymph node/distant metastasis. All patients enrolled in this study had strong will to choose kidney-sparing therapy. Biopsy, resection of intraluminal lesion with laser and cryoablation under ureteroscopy or percutaneous nephroscopy was performed under general aneasthesia.Ureteroscopy was performed 3 months after cryoablation. Perioperative complications and follow-up results were recorded and assessed. Results:Cryoablation was successfully performed in patients under ureteroscopy (n=8) or nephroscopy (n=1). The median cryoablation time was 6 (ranging from 4-16) minutes. The median follow-up was 16 months (ranging from 4-24 months). No tumor recurrence was observed at primary sites during follow-up. Two patients with multiple lesions were observed denovo ureteral neoplasms outside the primary sites 3 months and 6 months after cryoablation and treated with second cryoablation. One case died due to cardiovascular events 4 months after surgery. One patient underwent ureteral stricture during follow-up and received ureteroscopic balloon dilatation. No recurrent stricture was found in this case during the subsequent follow-up of 16 months. The other 5 cases showed no recurrence or complications like stricture during follow-up.Conclusions:ECA could probably be a promising treatment for localized UTUC. No recurrence in primary site and low incidence of ureteral stricture was observed during follow-up. The efficacy and safety of ECA need to be verified with large sample study.

Hepatic sclerosing hemangioma (HSH) is a rare benign tumor that is considered fibrosis and hyaline change caused by degenerative changes of cavernous angioma, and changes in pathological features cause the changes in imaging features, making this atypical hemangioma easily misdiagnosed as primary or metastatic malignant tumor. Although there are many studies on the imaging findings of this disease, it is still difficult to diagnose and most patients underwent resection since it is misdiagnosed as malignant tumor. There is still a low rate of confirmed diagnosis before surgery. This article elaborates on the etiology, clinical manifestations and pathological features, imaging findings, diagnosis, and treatment of HSH, in order to provide a reference for the diagnosis and treatment of this disease.

Objective To construct a comprehensive evaluation model of long-term care for the elderly based on the situation of our country,which is suitable for the family,community and the pension service organization. Methods The model index item pool (7 one class indexes and 133 two class indexes) formed by literature research, theoretical extraction and qualitative interview were taken as the research object.To screen the model parameters by using the Delphi method,then formed a index system of hierarchical comprehensive evaluation model of long term care for the elderly. Results 25 experts were from 10 provinces of a total of 23 Medical Colleges and affiliated hospital,positive coefficients for the first round of 83.33% and the second round of 100.00%,the average value of the two authority coefficients were both >0.90, the coordination coefficient of the evaluation index for the first round of 0.221 and the second round of 0.266(both P<0.05).The primary model index system consists of 7 first level indicators,a total of 13 secondary indicators.Among them,the"daily life ability","cognitive ability","falling risk"and"pressure sore risk" evaluation were using very mature scales, the "medical care project", "abnormal performance/symptom" and "self care knowledge needs" evaluation were independently established in this study. Conclusions Preliminary construction process of the index system for the comprehensive evaluation model of long term care for the elderly was rigorous and had better theoretical support,and the Delphi method experts had higher degree of attention and participate in the research content, experts had good representativeness,can effectively guarantee the reliability of the selected items.

Chronic obstructive pulmonary disease （COPD） is one of the most common chronic diseases of the respiratory system in the clinic. The disease has a long course and is difficult to cure， which seriously threatens human health. Airway mucus hypersecretion （AMH） is an independent risk factor for COPD and has a significant impact on the development and prognosis of the disease. The review finds that the abnormal proliferation of goblet cells and the excessive secretion of mucin are the direct causes of AMH. The pathogenesis of AMH may be closely related to the inhalation of heterogeneous particles， airway inflammation， the imbalance of mucin/water salt ratio， and the regulation of related signaling pathways. Traditional Chinese medicine （TCM） believes that AMH of COPD belongs to the category of lung distension with phlegm-fluid retention syndrome， and the disease is mainly treated from phlegm on the basis of lung distension. This article summarizes the relevant research in the field of TCM in recent years and finds that the single TCM that effectively intervened AMH of COPD is mainly phlegm-resolving TCM， and the main active ingredients of TCM are flavonoids， terpenoids， phenols， and alkaloids. The main TCM compounds are mainly designed to remove heat-phlegm， warmly resolve cold-phlegm， dry dampness to eliminate phlegm， invigorate Qi， promote blood circulation and dispel phlegm， and invigorate lung， spleen， and kidney. Its mechanism of action may be direct inhibition or indirect inhibition of airway epithelial goblet cell metaplasia and mucin expression by inhibiting airway inflammation， regulating aquaporins to correct the imbalance of mucin/water salt ratio， and regulating signaling pathways， so as to reduce mucus oversecretion in COPD. However， there are still some problems. For example， the research mainly focuses on TCM compounds instead of the single TCM or its effective components. The research on the mechanism of action is not thorough enough， and the research results are not interoperable. The clinical transformation rate of basic research is insufficient. This article systematically reviews the research status of AMH in the treatment of COPD with TCM and puts forward some thoughts on the existing problems， so as to provide a reference for clinical rational medication and in-depth research.

OBJECTIVE It's known that post-retrieval extinction but not extinction alone could erase fear memory.However,whether the coding pattern of original fear engrams is remod-eled or inhibited remains largely unclear.Here we try to investigate whether the coding pattern of memory engrams is altered during post-retrieval extinction induced memory updating.METHODS To answer the question,by using activity-depen-dent neuronal-tagging technology,neuronal trac-ing technique combined with optogenetic manipu-lation and in vivo calcium imaging,we identified the fear and extinction cells in PrL and BLA and investigated the dynamic encoding of memory engram ensembles in the PrL and BLA during CS versus US initiated memory updating.RESULTS We found increased reactivation of engram cells in the prelimbic cortex and basolat-eral amygdala during memory updating.More-over,conditioned stimulus and unconditioned stimulu sinitiated memory updating depend on the engram cells reactivation in the prelimbic cor-tex or basolateral amygdala respectively.Finally,we found memory updating causes increased overlapping between fear and extinction cells and the original fear engrams encoding was altered during memory updating.CONCLUSION Our data provide the first evidence to show the overlapping ensembles between fear and extinc-tion cells and functional reorganization of original engrams underlying conditioned stimulus and unconditioned stimulus initiated memory updating.