Objective To investigate the methods and clinical significances of preserving the pectoral nerve(PN) and intercosto-brachial nerve(IBN) in modified radical mastectomy. Methods Eighty-seven patients suffering from breast cancer in stage Ⅰ and Ⅱ were randomly divided into 2 groups. Transpectoral anterior approach was used on patients in group A(n=52),with axillary lymph node dissection, preservation of the pectoralis minor muscles, PNS and IBNS. Patients in group B(n=35) were operated on through transpectoral posterior approach, with dissection of pectoralis minor muscles, sections of PNS and IBNS. Results No case in group A and 28 cases(80%) in group B suffered from postoperative atrophy of pectoralis major muscles(P

Polysaccharides extracted from radix of Chinese DC and dried Polyporus umbellate (pers) as well as a well known mitogen,phytohemagglutinin(PHA),were studied.It has been revealed that both the poly-saccharides as well as PHA stimulate the rate of DNA synthesis characterized by their increasing the incorporation of 3H-TdR and accelerating the release of thymus cells. These effects disappeared after adrenalectomy.Corticosterone concentration was found to be increased in the plasma after the administration of the polysaccharides These phenomena suggested that the adrenal cortex was the mediator of their actions. When they were administered to animals before an irradiation of 800 rad, the survival rate was increased by 30-70% over that of the controls. The mechanism of the effects was discussed.

Objective: To investigate and analyze the clinical data of tetramine poisoning in a family and prevent similar incidents from happening again. Methods: The study was conducted in July 2016 in a fami-ly with thiamine poisoning in shandong province, and the clinical data were analyzed. Results: In this case, there are six cases of poisoning caused by the tetramine poisoning, and the convulsions are the main clinical manifestations, and the blood perfusion can have a good effect on the severe patients. After positive treatment, all 6 patients were cured. Conclusions The tetramine poisoning can cause severe convulsion, although the country has banned the production and use of it, the tetramine poisoning case still exist and cannot be ignored.

OBJECTIVETo investigate the effect of neutrophil gelatinase-associated lipocalin (NGAL) on prognosis of patients with type 2 hepatorenal syndrome (HRS).

METHODSA total of 54 patients with type 2 HRS were included in the study, and stratified for analysis according to survival status at 6-month followup:survival group, n=25; death group, n=29. Single factor analysis was used to compare the betweengroup differences for levels of plasma NGAL, urine NGAL, renin, aldosterone, and blood biochemical indicators. The Cox proportional hazard regression model was used to assess the prognosis of patients with type 2 HRS. The F-test, t-test, chi-square test, Pearson's correlation analysis, and Cox regression model were used for the statistical analyses.

RESULTSThe HRS patients with liver cirrhosis showed significantly lower levels of hemoglobin, platelets and albumin (all P < 0.05), but significantly higher international normalized ratio and levels of aspartate aminotransferase, alanine arninotransferase, total bilirubin, direct bilirubin, serum creatinine, plasma NGAL, urine NGAL, renin and aldosterone (all P < 0.05). Plasma NGAL and urine NGAL were positively correlated with renin, aldosterone, blood creatinine, MELD score, Child-Pugh score and ascites (P < 0.05). The patients in the 6-month survival group showed significantly lower levels of albumin, serum sodium, serum creatinine, plasma NGAL, urine NGAL, renin, and aldosterone than those in the death group (P < 0.05), but significantly higher glomerular filtration rate (vs. death group, P < 0.05). The Cox proportional hazard regression model showed that MELD, plasma NGAL, total bilirubin and creatinine were influencing factors of 6-month prognosis for patients with type 2 HRS (relative risk: 1.214, 1.157, 1.098 and 1.016 respectively).

CONCLUSIONPlasma NGAL is high in patients with type 2 FHRS, and is associated with risk of death.

Acute-Phase Proteins ; Bilirubin ; Biomarkers ; Creatinine ; Gelatinases ; Glomerular Filtration Rate ; Hepatorenal Syndrome ; Humans ; Kidney Function Tests ; Lipocalin-2 ; Lipocalins ; Liver Cirrhosis ; Neutrophils ; Prognosis ; Proportional Hazards Models ; Proto-Oncogene Proteins

Objective: To explore the acute toxicity of Diquat in mice and to calculate the median lethal dose (LD₅₀) of Diquat to rats and observe the pathological changes of tissues and organs in rats with different concentrations of Diquat. Methods: Diquat solution of 50 mg/kg was prepared freshly with 1 000 mg of Diquat and dilute the solution with water to a total of 20 ml. A total of 99 healthy adult male Wistar rats were randomly divided into part one, part two and control groups. In the first part, 36 rats were randomly divided into 4 groups: 100 mg/kg group, 200 mg/kg group, 300 mg/kg group and 400 mg/kg group, which were treated with 100 mg/kg, 200 mg/kg, 300 mg/kg and 400 mg/kg of Diquat solution by gavage, respectively. The death and symptoms of poisoning after intragastric administration were recorded, and the maximum tolerated dose and absolute lethal dose were measured. In the second part, 54 rats were randomly divided into 6 groups: 200 mg/kg group, 220 mg/kg group, 240 mg/kg group, 260 mg/kg、280 mg/kg group and 300 mg/kg group, whichwere treated with 200 mg/kg, 220 mg/kg, 240 mg/kg, 260 mg/kg, 280 mg/kg and 300 mg/kg of Diquat solution by gavage, respectively. The survival of rats in different concentration of Diquat was observed and the LD₅₀ was calculated by Excel processing the formula of Koch's method. The control group were given equal volume water under the same experimental conditions. And moreover, the lungs, kidneys, hearts, livers, and brain tissues were collected and fixed by formaldehyde, embedded by paraffin, and sectioned for histopathological light microscopy. Results: The maximum tolerated dose was 240 mg/kg and the absolute lethal dose was 300 mg/kg. The LD₅₀ of Diquat for Rats was 280.58 mg/kg. The high-dose group had significantly more organ damage than the low-dose group after diquat poisoning. Conclusion The determination of the half-lethal dose of diquat, at the same time observed multiple organs damaged in rats after the diquat quickly poisoned. Kidneys, lungs and heart might be the main organ which was heavily damaged. With the extension of observation time, the organ damage of rats exposed to small doses gradually stabilized.

Objective: To investigate a mass of occupational acute methyl bromide poisoning incident and analyzed their clinical data. Methods: To investigate an incident a mass of occupational acute methyl bromide poisoning in occurred in Shandong province in November 2016, and the clinical datas of 3 cases of severe patients with methyl bromide poisoning were analysed. Results: This event was a sudden occupational poisoning incident. Lack of vocational training and irregularities is the main reason for the accident 3 patients with nervous system, respiratory system, circulatory system, urinary system damage is given priority to, after comprehensive rescue treatment, 2 cases died and 1 case survived. Conclusions Methyl bromide can cause severe poisoning, has high mortality in patients with acute severe poisoning.

Objective: To investigation to an accident of occupational trichloroethylene explosion and analyze the clinical datas. Methods: An investigation was carried out on the explosion of trichloroethylene in a place in shandong province in June 2016, and the clinical data of 4 patients with trichloroethylene poisoning were analyzed. Results: The incident is caused by irregularities in workers, 4 patients were characterized by different levels of the respiratory system, nervous system, liver, and skin lesions. Among them, respiratory system damage was more prominent, mainly manifested as chemical bronchitis and pneumonia, after positive rescue and treatment all recovered and discharged. Conclusions Trichloroethylene leak can cause severe ex-plosion accidents, can cause workers of the respiratory system, nervous system, liver and skin lesions, mainly glucocorticoids comprehensive therapy has good curative effect.

Objective: To investigate an incident of mushroom poisoning and related clinical data. Methods: A descriptive analysis was performed to investigate an incident of poisonous mushroom poisoning in Jinan, Shandong Province, China in July 2016. The clinical data of four patients were analyzed and summarized, and the causes of this incident and prevention and control measures were summarized. Results: This incident of acute poisonous mushroom poisoning was caused by Lepiota brunneoincarnata. The patients mainly had digestive system symptoms, including nausea, vomiting, and severe abdominal pain, and later developed liver damage. After comprehensive rescue treatment, one patient died and three survived. The main clinical manifestation of the patient who died was multiple organ failure, especially liver failure. Conclusion This incident of poisoning was caused by Lepiota brunneoincarnata the residents ate by mistake.

Objective:To evaluate the efficacy and safety of sodium hyaluronate gel in preventing adhesion after prophylactic enterostomy.Methods:One hundred and twenty four patients from 6 hospitals were enrolled in this prospective multi-center randomized controlled trial. Patients were randomized into the study group ( n=59) or the control group ( n=65).All patients underwent prophylactic enterostomy. Patients of study group received odium hyaluronate gel for adhesion-prevention,while those in control group did not receive any adhesion-prevention treatment. The incidence of moderate to severe adhesion around the incision in the stoma area were evalutated during stoma reduction surgery. Results:The incidence of moderate to severe adhesion around the incision in the stoma area was 6.3% in the study group, the difference was statistically significant ( P<0.05) compared to that of the control group (32.6%). Conclusion:Sodium hyaluronate gel can safely and effectively reduce the incidence of moderate and severe adhesions after abdominal surgery.