Purpose:To investigate the prognostic factors f or local-regional control and survival in patients with regional lymph nodes re currence following mastectomy. Methods:Seventy-seven patients with their first recurrences in the regional lymph nodes treated during 1994-2003 were retrospectively analyze d. The recurrence were confined to supraclavicular region in 45 patients, in axi llary nodes in 16 patients, in internal mammary nodes in 6 patients, and with mo re than one lymph node region involved in 10 patients. The median follow-up was 34.4months. All patients were treated with radiotherapy to a total dose ranged from 50-74 Gy with a median dose of 60 Gy. Results:The median survival time was 4.67 years with 2-,5-an d 8- year survival rate of 77.8%,47.4% and 31.5% respectively. Disease-free i nterval, hormonal-receptor status were independent prognostic factors for survi val. Thirty patients had a second recurrence either in the original recurrent si te (4 patients) or in the other local-regional sites (26 patients). Chest-wall was the most frequently involved site for second recurrence, with 18 patients h ad a second recurrence including chest-wall, representing 23% of the whole coho rt. The axillary lymph nodes metastatic status of primary surgery was the only i ndependent prognostic factor for local control. Conclusions:Radiotherapy provides an efficient treatment for re gional lymph nodes recurrence following mastectomy. Twenty-three percent of pat ients present a second recurrence involving chest-wall, which suggests the sign ificance of an elective radiation to the chest-wall, especially in patients wit h 4 or more lymph nodes involved in primary surgery. Sub-group with a disease- free interval of more than 2 years, receptor positive has a better survival. The role of systemic treatment in the regional lymph nodes recurrent patients has n ot been established.

Objective To compare real-time fluorescence quantitative PCR with general PCR in detecting bovine and porcine derived materials in hydrolysate samples.Methods DNA were extracted from hydrolysate samples which prepared by different steps by real-time fluorescence quantitative PCR and general PCR.Results DNA of bovine and porcine could be detected by real-time fluorescence quantitative PCR and general PCR in samples prepared in the processes before enzymolysis solution, but not detected in samples from supermatant to the fourth ultrafiltrate.Conclusion Both real-time fluorescence quantitative PCR and general PCR can be applied to detect the fragments in hydrolysate samples.And real-time fluorescence quantitative PCR has the advantage such as rapid,convenient, non-environment-polluted, good repeatability, which improves the quality and efficiency.

Objective To investigate the clinical treatment of severe hypertensive intracerebral hemorrhage in basal ganglia and broken into ventricles .Methods 16 patients with severe hypertensive intracerebral hemorrhage in basal ganglia and broken into ventricles received microsurgical treatment using posterior central gyrus posterior -lateral fissure upper approach .The hematoma cavity and ventricle were opened ,and brain surgical department drainage was placed in the hematoma cavity in the operation .The curative effect was analyzed retrospectively 6 months after operation.Results According to Glasgow Outcome Scale ( GOS):6 cases had good recovery;4 cases had moderate disability;2 cases had severe disability;1 case was in persistent vegetative state and 3 cases were dead .Conclusion Craniotomy microsurgical operation using posterior central gyrus posterior -lateral fissure upper approach is an effec-tive treatment of severe hypertensive intracerebral hemorrhage in basal ganglia and broken into ventricles .The fatality rate was reduced .

Objective To compare the knee of patient controlled subcutaneous injection of morphine analge-sia after hip joint replacement ( PCSA ) and intravenous morphine patient-controlled analgesia ( PCIA ) effect and safety of postoperative analgesia.Methods 60 patients undergoing artificial total knee arthroplasty patients were selected and randomly divided into PCIA group of 30 cases,30 cases in group PCSA, two patients were completed under epidural anesthesia in the operation.Group PCIA and group PCSA single dose divided into 1mg/and 2.5mg/, lock time divided into 5min,20min,in the postoperative pain perception,from the patient's own pain medication.After 4h,8h,12h,24h record patient morphine dosage,frequency,pain score (VAPS),mean arterial blood pressure and re-spiratory rate,compose degree,analgesic effects were compared between the two groups.Results In group PCSA after 24h treatment for the total dose was (30.41 ±10.00) mg,significantly higher than that of group PCIA (18.03 ± 6.04)mg,there was significant difference between the two groups (t=3.98,P<0.05);but after each time point of the two groups of patients the average dosage had no statistically significant difference (P>0.05).PCIA group after 0-4h and >4-8h analgesia and sedation were better than those in PCSA group (t=3.4,3.2,3.5,3.7,all P<0.05), PCIA group,the incidence rate of nausea and vomiting was 30%,higher than 12%in the PCSA group,there was sig-nificant difference between the two groups (χ2 =5.76,P<0.05).Conclusion The two kinds of methods of analge-sia has a good analgesic effect,but PCSA analgesia is slower,less adverse reactions,should be given a loading dose at the beginning before PCSA,in order to improve the early analgesia effect.

Objective To evaluate the outcome , side effects and prognosis of prostate carcinoma treated with external radiotherapy. Methods From 1990 to 1999, a total of 45 prostate carcinoma patients were treated. Four cases were lost during follow up. Forty one patients underwent orchiectomy before radiation therapy , 29 received orchiectomy combined with hormone treatment. All patients received conventional radiation therapy with a median dose of 68.3 ?Gy (50.4 75.9?Gy), 1.8 2.0?Gy per fraction, five fractions weekly. Results The median follow up duration was 28 months (1 111 months). The overall 5 year survival was 76.4% and the 5 year disease specific survival was 76.5%. In terms of acute GI side effects, the frequencies of Grade Ⅰ, Ⅱ or Ⅲ reactions were 53.5%, 7.0% and 9.3% while Grade Ⅰ or Ⅱ , acute GU side effects were 41.9% and 4.7%, respectively. For the long term deleterious effects,Grade Ⅰ or Ⅱ in GI late complications were 16.7% and 7.1% and the GU late morbidities of Grade Ⅰ,Ⅱ or Ⅲ were 23.8%, 4.8% and 2.4%, respectively. Regional lymph node metastasis was closely correlated with both overall survival (P= 0.002 ) and disease specific survival (P= 0.002 ). Multivariate analysis revealed, only regional lymph node metastasis was of prognostic value to predict the overall survival and disease specific survival. Conclusion The outcome of radiation therapy for patients with T 2 T 4 prostate carcinoma is satisfactory with the side effects tolerable to most patients.

Objective On basis of physical dose optimization, LQ model was used to investigate the difference between the curves of biological effective dose and physical isodose. The influence of applying the biological dose concept on three dimensional conformal radiotherapy of prostate carcinoma was discussed. Methods Four treatment plannings were designed for physical dose optimization: three fields, four-box fields, five fields and six fields. Target dose uniformity and protection of the critical tissue -rectum were used as the principal standard for designing the treatment planning. Biological effective dose (BED) was calculated by LQ model. The difference between the BED curve drawn in the central layer and the physical isodose curve was studied. The difference between the adjusted physical dose (APD) and the physical dose was also studied. Results Five field planning was the best in target dose uniformity and protection of the critical tissue -rectum. The physical dose was uniform in the target, but the biological effective doses revealed great discrepancy in the biological model. Adjusted physical dose distribution also displayed larger discrepancy than the physical dose unadjusted. Conclusions Intensified Modulated Radiotherapy (IMRT) technique with inversion planning using biological dose concept may be much more advantageous to reach a high tumor control probability and low normal tissue complication probability.

Objective To explore the teaching effects of physiology lectures and students' attitude to lectures,their suggestions for contents,forms and other aspects of lectures.Methods Random sampling questionnaire survey was conducted among 500 students of 2008 grade and 2009 grade in Xiangya medical school of central south university.The percentage of the option in the questionnaire was calculated and the findings were directly described.Results All students thought that physiology lectures were necessary.Teachers should arrange lectures which students were interested in,pay attention to inspire thinking and enhance teacher-student interaction.67.6％ of students thought that the knowledge learned from lectures can be used in expanding scientific thinking.Conclusions The lectures are popular among most students,playing an important role in cultivating students' ability of strict scientific thinking.

To improve students' experimental research skills,innovative consciousness,promote the construction of functional experimental center,we established series of “comprehensive,contrivable,innovative” experiments in medical students.

Investigators selected students who had finished physiology course using the second edition of textbook for long-term medical program.A questionnaire about its content organizations as well as overall compiling condition was designed.Investigators collected the feedback information from the 94 available questionnaires.Meanwhile,some contributive suggestions were provided for the compiling of the whole series of long-term medical program textbooks.

Objective:To investigate the expression of human epidermal growth factor receptor 2 (HER2) in pancreatic ductal adenocarcinoma(PDAC) and its relationship with the prognosis of patients with PDAC.Methods:From January 2001 to December 2012, 109 paraffin embedded PDAC tissue samples and 27 normal pancreatic tissue samples were collected from the Department of Pathology, Huadong Hospital Affiliated to Fudan University. The expression of HER2 protein in pancreatic tissue was detected by immunohistochemical Envision two-step method. HER2 expression was evaluated according to Hercept test, and its relationship with clinicopathological features and survival time was analyzed.Results:The expression of HER2 protein was negative (-) in 29.4% of PDAC tissues, weakly positive (+ ) in 35.8%, positive (+ + ) in 25.7% and strongly positive (+ + + ) in 9.2%, respectively, and the overexpression rate (+ + , + + + ) was 34.9%; the negative (-) and weakly positive (+ ) expression of HER2 protein in normal pancreatic tissues accounted for 88.9% and 11.1% respectively. There was no expression with positive (+ + ) or strongly positive (+ + + ), therefore, the overexpression rate was 0. The overexpression rate of HER2 protein in PDAC and normal pancreatic tissues was significantly different ( P=0.000). The expression of HER2 protein was significantly correlated with age, and the expression of HER2 protein in patients with PDAC over 65 years old was significantly higher than that in patients with PDAC under 65 years old ( P=0.043), but not with gender, tumor location, tumor grade, T stage, N stage and nerve invasion (all P>0.05). Univariate Cox proportional hazards analysis showed that HER2 expression was associated with postoperative survival time of patients with PDAC ( P=0.032). Multivariate Cox proportional hazards analysis showed that HER2 expression was an independent prognostic factor for survival of patients with PDAC ( P=0.040). The median survival period of patients with HER2 expression + + + was significantly longer than that of patients with HER2 expression -~+ + (128.4 months vs 21.5 months), and the difference was statistically significant ( P=0.038). Conclusions:The overexpression of HER2 in PDAC tissue was related to the age of patients. The survival time of patients with HER2 strongly positive PDAC was significantly longer. HER2 can be considered as an index to evaluate the biological behavior and prognosis of PDAC.