Objective To perform the sentinel lymph node biopsy (SLNB) in the patients with early breast cancer by the strict screening conditions and to analyze the accuracy of the sentinel lymph node for predicting the axillary lymph node status .Methods SLNB combined with methylene blue dye and isotope was performed in 266 cases of early breast cancer treated in this department with full treatment courses .Then the axillary lymph node dissection(ALND) was routinely conducted .With the pathological ex-amination as the standard ,the related factors affecting SLNB were analyzed .Results The detection rate of SLN ,accuracy rate ,sen-sitivity and the false negative rate were 100% ,98 .5% ,95 .56% and 4 .44% respectively ;the accuracy of SLN was significantly cor-related with the tumor size ,pathological type and axillary lymph node status(P<0 .01);the false negative rate of SLN was related with the tumor location(P<0 .05) .Conclusion The combination of methylene blue dye and isotope used in SLNB is feasible in the patients with early breast cancer ,SLN could accurately predict the axillary lymph node metastasis status .

The nervous system and the immune system maintain homeostasis mainly through the hypothalamo-pituitary-adrenal(HPA)axis,the sympathetic nervous system and the parasympathetic nervous system(vagal cholinergic pahway).The homeostasis is broken after stroke,and results in peripheral immunosuppression,which is called stroke-induced immunodepression syndrome.Its mechanism is still under investigation.The article reviews the mechanism and clinical significance of stroke-induced peripheral immunodepression through the above three mentioned pathways.

Objective To confirm the transmission of Toxoplasma gondii by semen and to investigate the impact of vaginal status on the transmission of T. gondii in female rabbits. Methods Sixteen male rabbits were infected with T. gondii by intraperitoneal injection each with 1 ×105 RH tachyzoites. Eight rabbits died in 8-14 d after infection.Artificial vagina was used to collect semen from male rabbits weekly before and after infection for 8 weeks. If more than 2 portions of semen from 8 survived male rabbits were collected after infection, the collected semen was mixed weekly for later use. Twenty-seven female rabbits were divided into 4 groups: group 1 with normal vagina (7 rabbits), group 2with wounded vagina (7), group 3 with trichomonas vaginitis (7) and group 4 with colpomycosis infection (6). Tachyzoites were found in mixed semen digested by trypsinase, and were used for endovaginal artificial insemination to female rabbits by uterine cavity tube once a week for 8 consecutive weeks. 2-3 d after every insemination, 2 ml blood was collected from helix vein of each rabbit, and stored at -40 ℃ for use. Anti-T. gondii antibody was examined by ELISA and the B1 gene of T. gondii was detected by PCR. Results Anti-T. gondii antibody was detected in some rabbits (2, 3, 1, and 1 rabbits from each of the groups respectively) on the 16th day after the first insemination. The positive rate of ELISA was 25.9%. The amplification of B1 gene (200 bp) by PCR appeared positive from the blood samples on the 3rd day after the first insemination and the last positive one was proved on the 51th day after the first insemination.Number of positive samples was 2, 1, 3 and 1 in the 4 groups respectively, with an overall PCR positive rate of 18.5%.Only 3 of the 27 rabbits were positive by both ELISA and PCR. Conclusions T. gondii can be transmitted by semen and the health status of vagina shows no impact on it.

Objective To compare the influence of whole sevoflurane inhaling and target-controlled infusion of propofol for the myocardial protective effect on patients with heart valve replacement surgery. Methods 30 adult patients who went through heart valve replacement surgery with cardiopulmonary by pass were selected, including ASA staging II-III and cardiac function classification (NYHA) II-III. All patients were randomly divided equally into sevoflurane group (Group S) and propofol group (Group P) . Patients were monitored before anesthetic induction. Group S got 1%sevoflurane (fresh gas flow 6 L/min) with concentration of the vaporizer increased from 1%to 3%with 1 minute interval during anesthetic induction. Group P got target-controlled infusion of propofol during anesthetic induction,the initial target plasma concentration was set at 0.8μg/mL,and the concentration increased 0.5 μg/mL every minute until intubation. All the patients got fentanyl 5 μg/kg and rocuronium 0.6 mg/kg, and intubation was conducted when BIS decreased lower than 60 and mean arterial pressure (MAP) <20%basic MAP. During anesthesia maintaince,patients got 0.5-2 MAC sevoflurane inhaling or target-controlled infusion of propofol 2-4μg/mL with discontinuous intravenous fentanyl and rocuronium, and maintained BIS 40-60, MAP<±20%basic MAP, central venous pressure 5-15 cm H2O. Outcome variables included demographic characteristics of patients. The following parameters were also recorded, including cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and lactate (LAC) in before anesthetic induction (T0), aortic inbation (T1),30 minutes after aorta opening (T2), 6 hours after aorta opening (T3) and 24 hours after aorta opening (T4) . Results There was no statistical significance in demographic characteristics during peri-operation between the two groups ( > 0.05) . The pre-opertaive cTnI, CK, CK-MB and LAC were within the normal range, but increased siginicantly on T2, T3 and T4, and was more significant on T3 ( < 0.01) between two groups, and the intra-group comparison showed no difference on other time points. Conclusion When myocardial injury markers used as myocardial protection outcome variables, whole sevoflurane inhaling could not reduce the release of cTnI compared to propofol TIVA in heart valve replacement surgery.

Objective To investigate the hemostatic effect and influence on coagulation function of hemecongulase during neurosurgical operation.Methods Sixty patients with neurosurgical trauma at American statistical association(ASA) Ⅰ-Ⅱ were randomly divided into hemocoagnlase treatment group (n =30) and control group(n =30).Both two group were injected Baquting 2U at the day before the operation,30 min before the operation,every two day after the operation and end up 3 d.Treatment group were pedormed with Baqyting 4 U + physiological saline 10 ml topical spraying.The intelligibility of operating region,the volume of intraoperative,the volume of bleeding during the operation,transfusion of blood,postoperative drainage,and drainage tube exelcymosis time were recorded in all the patients.Prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen level(FIB),fibrinogen degradation product(FDP) and the two D-dimer and platelet count(PLT) before and after the surgery were also determined.All the patients were postoperatively followed up.Results The intelligibility of operating region was 70.0％ (21/30) in the hemocoagnlase treatment group,higher than that in control group (0％,P ＜0.05).The volume of bleeding during the operation in the hemecoagulase treatment group was (680.00 ± 95.22) ml,significantly fewer than that in the control group((790.00 ±47.00) ml,P =0.034).PLT significantly decreased after the surgery in both of the groups compare to that in preoperation (P ＜ 0.05 or P ＜ 0.01) and no significant difference was seen between two groups (P ＞ 0.05).No severe adverse events were found in both groups.Conclusion Hemocoagulase treatment during the operation can improve the intelligibility of operating region,reduce the volume of bleeding and transfusion of blood,and do not affect the coagulation function in the patients.Therefore,hemocoagulase is a safe and effective hemostatic and through local application during the operation it can improve curative effect.

Objectives To assess the efficacy and safety of Xiaoyao Powder (Carefree Powder) in the treatment of depression using the method of systematic review of evidence-based medicine.Method Data published before December 2009 were searched from MEDLINE,Cochrane library,CNKI,VIP,CBM.We included randomize-controlled trials (RCT) testing Xiaoyao Powder against placebo or antidepressants,and Xiaoyao Powder combined with antidepressants against antidepressants alone.Two researchers collected data independently.The assessment of methodological quality was based on Cochrane handbook and the materials were analyzed with software RevMan 5.017.The outcome measure index was relative risk or difference of mean value (95% confidence interval).Results Thirty-two RCTs involving 2 253 patients were included.Involved trials published in Chinese were of low quality.In the trials of comparison between Xiaoyao Powder and placebo,only decrease of self-rating depression scale (SDS) score was not significantly different.For general clinical improvement and decrease of Hamilton rating scale for depression (HAMD) and SDS scores,Xiaoyao Powder combined with antidepressants was more effective than antidepressants alone,but the effect of Xiaoyao Powder was equal to antidepressants.No adverse effect was reported in the trials regarding Xiaoyao Powder.Conclusions Xiaoyao Powder appears to be effective for depression.However,the exact effect needs to be confirmed in well-designed large-sampled clinical trials.

Objective To analyse the clinico-pathologic characteristics,diagnosis,therapy and prognostic of small cell neuroendocrine carcinoma of the cervix(SCNCC).Methods The clinic-pathological features of 12 patients with SCNCC treated in Tumor Hospital of Guangxi Medical University,admitted during March 2006 to July 2010,were analyzed retrospectively.Results Of 12 patients,the mean age was 38.7 years(rang 28-57 years),6 had stages Ⅰ b1-Ⅱa,6 had stagesⅡb-Ⅳ.Among 8 patients(Ⅰ b1-Ⅲb)underwent surgery,4 of them received neoadjuvant chemotherapy,8 of them received adjuvant chemotherapy and(or)radiotherapy.All had greater than one-half stromal invasion,4 patients had positive pelvic lymph nodes metastases.The positive ratio of the chromogranin(CgA),synaptophysin,neuronspecific enolase(NSE),cytokeratins(CK),CD56 tested by immunohistochemical staining were 8/12,9/10,4/4,4/4,4/4,respectively.Median follow-up period was 3 months(1-22 months).Among 8 patients underwent surgery,2 patients developed lung metastases,1 patient developed liver and lung metastases,1 patient developed liver metastases concurrently with bone metastases,disease-free survival (DFS)were 3 months(Ⅰ b2 with positive lymph nodes),4.6 months(Ⅱ a),7 months(Ⅰ b1),17 months (Ⅰ b2);2 patient died(8.5 and 11.3 months,respectively)after surgery;4 patients are alive and show no evidence of disease.Among 4 patients untreated,1 patients received concurrent chemoradiation and are alive for 10.1 months.Two patient untreated(Ⅲb,Ⅳ)died after 0.6 and 1.3 months final diagnosis,respectively.One patient Was lost follow-up.Conclusions SCNCC is a highly malignant tumor with rare morbility,propensity for distant spread and dismal prognosis.Final diagnosis of SCNCC depends on pathomorphology and immunohistochemical analysis.Combined therapeutic modalities may in favor of survival in some patients.

Objective To investigate the potential effect of depression on overweight and obesity in Tangshan city .Methods A total of 2 180 subjects were enrolled into this cross‐sectional survey conducted in Kailuan community .Anthropometric measurement and structured questionnaire survey were administered to each subject .Status of depression was assessed by Patient Health Ques‐tionaire‐9(PHQ‐9) .The potential effect of depression on overweight and obesity was analyzed with Logistic regression .Results The average score of PHQ‐9 as well as the prevalence of moderate or major status of depression in people with overweight and obe‐sity was significantly higher than those with normal weight .The multivariate logistic regression showed that the score of PHQ‐9 was a risk factor for prevalence of overweight and obesity (OR=1 .43 ,95% CI:1 .05-1 .95 ,P<0 .05;OR=1 .07 ,95% CI:1 .04-1 .10 ,P<0 .05) .In comparison to the none/mild depression ,moderate and major depression could significantly increase the risk for overweight (OR=2 .28 ,95% CI:1 .49-3 .49 ,P<0 .05 ;OR=3 .47 ,95% CI:2 .06-5 .84 ,P<0 .05) and obesity (OR=1 .22 ,95%CI:1 .03-1 .45 ,P<0 .05 ;OR=1 .81 ,95% CI:1 .44-2 .29 ,P<0 .05) .Conclusion The depression status could contribute to the development of overweight and obesity and the role of psychological elements should be taken into consideration in overweight and obesity management .

BACKGROUND:With the medical development, prognostic outcomes of spinal cord injuries have not been improved significantly, and most patients also suffer from severe complications. Nowadays, lots of laboratories and clinical researches have suggested that celltherapy has a great potential, especial y the application of umbilical cord blood stem cells in nervous system diseases. OBJECTIVE:To explore the feasibility and clinical effect of umbilical cord blood neural stem cells transplantation for patients with obsolete spinal cord injury. METHODS:Umbilical cord blood was harvested from newborns under aseptic condition, and differentiated into neural stem cells in vitro that were prepared into cellsuspension at a concentration of 109/L. The cellsuspension (3 mL) was injected via the L 3-4 or L 4-5 into the subarachnoid space. American Spinal Injury Association (ASIA) scores and the residual urine were assessed before and 3 months after transplantation. RESULTS AND CONCLUSION:After transplantation, al the patients showed a stable life indication. Three months later, ASIA scores were increased and the residual urine decreased, which significantly differed from those before transplantation (P<0.05). These findings indicate that umbilical cord blood neural stem cells transplantation is a new treatment that can improve the limb function and life quality of patients with obsolete spinal cord injury.

Objective To study the difference in post-resuscitation lung injury between cardiac arrest induced by anoxia and ventricular fibrillation in porcine model.Methods WuZhiShan inbred miniature pigs were randomly (random number) divided into the asphyxia (AS,n =24) and ventricular fibrillation group (VF,n =24).Cardiac arrest (CA) was induced by endotracheal tube clamping or programmed electric stimulation.Cardiopulmonary resuscitation (CPR) or defibrillation was performed for returning of spontaneous circulation (ROSC).Pulmonary perfusion/ventilation measured with isotope scanand positron emission tomography-computed tomography (PET-CT) scanning were done before and 4hrs after ROSC.The oxygenation index (OI),respiratory index (RI),oxygen delivery (DO2),blood lactic acid,and dynamic pulmonary compliance (Cdyn),airway resistance (Raw),extra-vascular lung water index (EVLWI),pulmonary vascular permeability index (PVPI),were measured before cardiac arrest,ROSC 0 h,ROSC15 min,ROSC 30 min,ROSC 1 h,ROSC 2 h,ROSC 4 h and ROSC 6 h.All pigs were sacrificed with euthanasia at ROSC 6 h and the lungs were dissected for observing histopathological changes.The level of Na +-K +-ATPase,Ca2+-ATPase,superoxide dismutase (SOD),Methane Dicarboxylic Aldehyde (MDA),Bcl-2,Bax,Caspase3 and apoptosis index (AI％) in lung were measured.Results The ROSC rate and ROSC 6hrs survival rate of in AS group was lower (P ＜0.01) than those of the VF group.The damages of lung in AS group were more severe than that in VF group by the results of enzymology and protein detection (Na +-K +-ATPase,Ca2 +-ATPase,SOD,MDA,Bax,Bcl-2 and Caspase3).AI％ was higher in AS group (P＜0.01).The deterioration of the indexes (OI,RI,DO2,Lac,Cdyn,Raw,EVLWI,PVPI) at all time points were more severe in AS group than those in VF group.Obvious filling-defect was found by the PET-CT scan of both groups,but not revealed by the isotope scan.Conclusions The lung injury after CA was closely related to the cause of CA rather than the external chest compression.Asphyxia induced more serious lung injury than ventricular fibrillation.