Objective To explore the relation of the polymorphism of GSTT & GSTM1 genes with the susceptibility of breast cancer.Methods A hospital-based case-control study was conducted,and 105 normal women as a control group and 100 women cases with breast cancer were recruited.The polymorphism of GSTT1 and GSTM1 were assessed by polymerase chain reaction(PCR).Logistic regression was conducted to evaluate the odds ratio of breast cancer in relation to single,multiple gene and estrogen exposure factors.Results The results showed that significant difference was found in the distribution of GSTT1,GSTM1 between controls and cases.There was a negative correlation between CSTT1 & GSTM1 and the risk of breast cancer with OR of 2.133 and 2.458,respectively.Polygenic model analysis indicated that there was a statistically significant correlation of the vacancy of GSTT1 & GSTM1 with breast cancer.Furthermore,it was also revealed that individual in simultaneous lack of GSTT1 and GSTM1 would run 12 times as high risk as normal controls did(OR=12.338).Results from unconditional logistic regression analysis showed that GSTT1 and GSTM1 were significantly associated with the occurrence of breast cancer.Conclusion The study indicated that the polymorphisms of estrogen-metabolizing genes were related to the risk of breast cancer.

Objective To discuss the operative techniques of endoscopic endonasal transsphenoidal surgery for the resection of pituitary adenoma in elderly patients.Methods From June 2003 to June 2012,a retrospective analysis of 42 elderly patients with pituitary adenoma was conducted.Computed tomography (CT) scan,magnetic resonance imaging (MRI) scan,and endocrinological examinations were performed in all patients before operation.All patients underwent endoscopic endonasal transsphenoidal surgery for the resection of pituitary adenoma.Results The tumors were totally removed in 25 cases (59.5％),sub-totally removed in 8 cases (19.1％) and partly removed in 9 cases (21.4％).1 patient died after operaion.Patients were followed up for 6-36 months.The visual acuity and visual field were improved.Hormone replacement therapy were needed in 20 patients due to hypopituitarism.Tumor residuals were found in 12 patients,among whom 5 patients were treated by γ-knife radiosurgery.Conclusions The endoscopic endonasal transsphenoidal operation is minimally invasive and safe for the treatment of pituitary adenoma in elderly patients.The strengthening of perioperative management is the key to the successful operation.

Objective To systematically review the existing evidence about the effect of medial and lateral (crossed) entry pins versus only lateral entry pin fixation on the supracondylar fractures of the humerus in children.Methods Eligible studies were identified in Cochrane library,the Cochrane Bone,Joint and Muscle Trauma Group (till March 2011 ),Medline (from 1966 to March 2011 ),EMbase (from 1966 to 2011 ),CBM (from January 1979 to March 2011 ),PubMed,Wanfang Data (from 2000 to March 2011 ) and CNKI and the references of the included studies and several Chinese orthopedic journals were manually searched.Then,the randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) about two entries (crossed and only lateral pinning) for supracondylar fractures of humerus in children were collected.After evaluation of methodology with the enrolled studies,available data was extracted and systematic review was conducted via the method recommended by the Cochrane Collaboration.Results In total,five RCTs involving 311 patients were involved.Compared with the preoperative data,the meta-analysis results showed no significant difference in reduction stability in terms of change in Baumann angle and Carrying angle between the two groups.For the postoperative function outcome including complete reduction,Flynn grade and full return to function,no significant difference was found between the two groups.For the postoperative complications,there was no difference in the infection of pin tract,though lateral entry resulted in a significant lower incidence of the iatrogenic nerve injury compared with the medial and lateral entry.Conclusions With the Kirschner wire fixation for supracondylar fractures of humerus in children,current existing evidences indicate that the lateral entry of pinning has similar results in reduction stability,function outcome and incidence of pin tract infection compared with medial and lateral entry.Nevertheless,lateral entry,as a safe pinning technique,may effectively decrease the risk of iatrogenic nerve injury

Objective：To study anatomic basis of ligaments factors in carpal radial instability. Methods:The length, width, thickness and maximum length of radial scaphoid capitate ligament(RSCL) , radial lunate ligament(RLL) , radial scaphoid lunate ligament(RSLL),radial scaphoid ligament(RSL), scaphoid trapezium ligament(STmL), scaphoid lunate interosseous ligament(SLIL), scaphoid triangular ligament(STgL) and radial ulnar triangular ligament(RUTgL)were measured in the neutral position. The length of RSCL, RLL, RSLL, RSL and RUTgL in the maximum position of radial deviation, ulnardeviation, palmarflexes and dorsiflexes were also measured. The normal and maximal distance of scaphoid lunate gap(SLG) , scaphoid trapezium gap(STmG), radial scaphoid gap(RSG) and capitate lunate gap(CLG) were measured,especially for variation of SLG in the condition of different ligament lesions. Results:Volar carpal radial ligaments were thicker than dorsal ones. The injuries of SLIL, STmL, RSL and CLL were considered generally when SLG>4.78±0.54mm, STmG>3.71±0.32mm, RSG>5.77±0.79mm, CLG>4.62±79mm; when SLIL was incised completely, SLG>5mm. Keeping anatomic structure of SLIL and incising other ligaments, there existed no obvious variation in SLG. Keeping dorsal part and incising proximal and palmar ones, no obvious variation of SLG can be observed. Conclusions: There were no effects on SLG when carpal radial ligaments (except dorsal part of SLIL) were injuried .Dorsal part of SLIL played a very important role in keeping SLG normal.

Objective To observe the changes of urinary microalbumin(UMA),and explore the relation between early impairment of renal function and level of UMA in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods OSAHS patients(n=67)and healthy control subjects(n=82).Then body parameter,serum creatinine(SCr),blood urea nitrogen(BUN),glomerular filtration rate(GFR)and UMA were determined in both groups.Furthermore,linear correlation was performed between UMA and body parameter,SCr,BUN,GFR and sleep-breathing parameters of patients with OSAHS,respectively.Results UMA level was higher in OSAHS patients than that in control subjects(P＜0.01).UMA level in OSAHS patients was correlated positively with body mass index(BMI),apnea hypopnea index(AHI),percentage of sleep time below 90% oxygen saturation (SaO2＜90%)and percentage of sleep time the total duration of apnea/hypopnea,respectively,and those were correlated negatively with the lowest SaO2 and the average lowest SaO2 respectively,but those had no correlativity with age,stature,waistline,neckline,SCr,BUN and GFR(P＞0.05).Conclusions UMA level increases in patients with OSAHS.The detection of microalbumin in urine is helpful in early diagnosis in OSAHS renal damage patients.

Objective:To investigate whether the risk of intravesical recurrence increases in patients with upper urinary tract urothelial carcinoma (UUT-UC) and diabetes mellitus (DM) after radical nephroureterectomy (RNU) with bladder cuff excision. Methods:We ret-rospectively analyzed the clinicopathological data of 282 UUT-UC patients with no history of bladder neoplasm and who underwent RNU with bladder cuff excision in the Second Hospital of Tianjin Medical University from January 2005 to December 2013. The recurrence-free survival (RFS) and cancer-specific survival (CSS) were compared between the non-diabetic (233 patients) and diabetic (49 patients) patients. The factors influencing intravesical recurrence in patients with UUT-UC after RNU were analyzed. These factors included age, DM, pathologic grade, and stage. Results:Among the 282 patients included in the study, 80 (28.4%) patients developed intravesical recurrence during the median fol ow up of 41 months, and the median time to recurrence was 11 months. Non-diabetic patients had a significantly longer duration of bladder neoplasm RFS than diabetic patients (P=0.013). Multivariate analysis using Cox's regression model indicated that DM (P=0.014), renal pelvis and ureter tumor (P=0.001), and postoperative chemotherapy (P=0.024) were independent influential factors for intravesical recurrence in patients with UUT-UC after RNU with bladder cuff excision. Conclusion:DM posed an increased risk for intravesical recurrence after RNU with bladder cuff excision in patients with UUT-UC. Therefore, these patients need to be closely monitored, and their blood glucose must be controlled.

Objective To investigate the effect of rapid repeated cold air inhalation stimulation on cold-sensitive chan-nel transient receptor potential ankyrin 1(TRPA1) associated inflammatory cytokines in living lungs .Methods A total of 20 male Wistar rats were randomly and evenly divided into 4 groups:cold air inhalation group , warm air inhalation group , TRPA1 channel agonist inhalation group and normal group , respectively . Tracheal intubation was carried out after anesthesia in rats of cold air inhalation group , and the tubes were linked to the air temperature controlled device with the temperature controlled at ( 2 ±1 )℃.The rats of warm air inhalation group were treated in the same way as cold air inhalation group except for the temperature at (36 ±1)℃.The rats of both groups were treated for 3 times, 1 hour each time.There were 12 hour intervals between treatments .The rats of TRPA1 channel agonist inhalation group were treated with atomizing inhalation of 60 mmol/L acrolein at room temperature (24 ±2)℃for 3 times, 1 hour each time.There were 12 hour intervals between two treatments .The rats were sacrificed after the last treatment .The tracheas and left lung tissues of all rats were taken and total RNA was extracted .The mRNA expressions of TRPA1, interleukin 1 beta ( IL-1β), interleukin 5(IL-5),and neutrophil chemoattractant chemokine (CXCL-1/KC)in the rat lungs were detected by real-time quantitative PCR .Results TRPA1 was expressed in rat lung tissues .In the short term cold air inhalation group , the expressions of IL-1β,IL-5 and CXCL-1/KC mRNA in the rat lungs were higher than those of the warm air inhalation or the normal groups .Similar results were also found in the specific TRPA 1 channel positive agonist ( acrolein ) inhalation group . Conclusion In living animals, the TRPA1 channels of the lungs can be activated by short-term cold air(<17℃),which results in the increasing expression of some inflammatory cytokines in lungs .

Objective To evaluate the value of fat-saturated three-dimensional fast imaging with steady state procession(FS-3D-FISP)sequence in detecting hyaline cartilage defects in osteoarthritis in rabbits.Methods Osteoarthritis was induced in eighteen male rabbits by injecting papain into the left knee joints.The same volume of sterile saline solution was injected into right knee joints as controls.MRI of knee joints was done at 1,2 and 4 weeks after injection using FS-3D-FISP sequence.The the rabbits were killed and pathohistological examinations of the femoral condylars and tibial plateaus were performed.The cartilage changes were observed by MR image according to the Outerbridge method and by pathology using Collins staging.Results There was closely correlation between MR imaging and pathology in grading of cartilage injury in grade I～II and grade III～IV(P＜0.001).Conclusion FS-3D-FISP can evaluate accurately the degree of articular injury.

Objective To study the construction of tissue engineering fat filler and the survival of fat particles.Methods Stromal vascular fraction (SVF) was derived from inguinal subcutaneous fat of rabbits,mixed with autologus mature fat particles and with or without neuropeptide Y to construct PLGA composite tissue.The complex was subcutaneously transplantef into back sites of the rabbits.Based on the different combination five groups were divided:Group A:PLGA + mature fat particles without NPY;Group B:PLGA + mature fat particles + NPY;Group C:PLGA + complex of SVF with mature fat particles without NPY;Group D:PLGA + complex of SVF with mature fat particles + NPY;Group E:Complex of SVF with mature fat particles + small ball with NPY.Diffenrence of virous constructive ways and fat particle survival was evaluated by general observation,histological staining,fluorescence tracing at two weeks,one month and three month after operation.Results Group D was superior to groups A,B,C and E in survival volume,graft texture and vascularization at one mouth and three mouths.The fat average srvival rate was 57.5±2.5％.Fat cell grew well,and precursor cells proliferated and differentiated actively.Conclusions High quality tissue engineering materials are successfully established with SVF-mature fat particle complex,PLGA and NPY,which could obviously improve fat particle transplantation.

Objective The effect of Asperosaponin Ⅵ(ASAⅥ)on adipocyte differentiation and the involvement of Wnt signal pathway was investigated. Methods The murine bone marrow stromal cell line ST-2 were divided into 6 groups:control group, adipocyte differentiation group, and 4 different doses of ASAⅥgroups. Control group was exposed to the vehicle, adipocyte differentiation group was exposed to adipogenic reagent, and those 4 ASAⅥgroups were treated with different concentration(10-7, 10-6, 10-5, 10-4 mol/L)of ASAⅥafter adipocyte differentiation induction. 5 days later, oil red O staining was performed to calculate adipocyte rate. Then mRNA transcription levels of PPARγ, FABP4 genes andβ-catenin that were Wnt/β-catenin signaling pathway proteins were examined by FQ-PCR. Then Wnt pathway inhibitor DKK1 was supplemented into ST-2 cells treated with 10-4 mol/L ASAⅥfor 5 days. After that FQ-PCR was used to detect whether tran?scription levels of PPARγ, FABP4 andβ-catenin in ST-2 cells were changed. Results Compared with adipocyte differenti?ation group 10-5 mol/L and 10-4 mol/L ASAⅥtreatments greatly down-regulated the number of lipid droplets and markedly inhibited transcription levels of adipocyte characterization transcription factors included PPARγ, FABP4 while up-regulat?ed transcription level ofβ-catenin in ST-2 cells. DKK1 can reverse the inhibitory effect of ASAⅥon adipocyte differentia?tion in ST-2 adipocyte. The transcription levels of PPARγand FABP4 were up-regulated significantly while transcription level ofβ-catenin was inhibited. Conclusion ASAⅥblocks adipocyte differentiation in ST-2 cells which might be medi?ated through activating Wnt/β-catenin signaling pathway.