Objective To establish an animal model by placing one end of PICC in the hepatic portal vein of a beagle dog and leaving the other end out of its body.Methods Six Beagle dogs were given respiration anesthesia through orotracheal intubation.An incision was made through the right rectus abdominalis to locate the superior mesenteric vein (SMA) and the main hepatic portal vein.The left branch of SMA was separated and cut to put PICC into the main hepatic portal vein before being ligated and fixed.The other end of PICC was elicited through the right abdominal wall and passed beneath the skin to the back neck and fastened in case of movement.Results The anesthetic effect was good and all the operations were successful.The mean operation time was about an hour and the mean blood loss was about 15 ml.The incision healed 5-7 d after operation.Conclusion The establishment of the model can improve the effects of liver-targeting drugs,which can cut down the dosage,lower the cost of treatment and experiment and reduce the adverse effect of medicines.Through PICC,we can directly draw blood from the hepatic portal vein to measure the blood concentration before the first pass elimination.Then according to the concentration,we can calculate the absorption rate in the gastrointestinal tract,which can facilitate related experimental studies.

Objective:To explore concordance between preoperative core needle biopsy(CNB)and resection specimen(RS)in evaluat-ing biomarkers and molecular subtypes with immunohistochemical method.Methods:A retrospective study was performed on 324 breast cancer patients who underwent modified radical mastectomy at the Tianjin Medical University Cancer Institute and Hospital be-tween August 2015 and November 2016.All patients who had received neoadjuvant systemic therapy were excluded.The aim of this analysis was to report concordance between CNB and surgical specimens in evaluating biomarkers,such as ER,PR HER-2,Ki-67,and molecular subtypes.Results:There was concordance between estrogen receptor(ER)assessment on CNB and RS in 94.1%(305/324) of the patients(κ=0.84).Concordance of the progesterone receptor(PR)and the human epidermal growth factor receptor 2(HER-2) assessments were observed in 90.7%(294/324,κ=0.76)and 61.1%(198/324,κ=0.38)patients,respectively.Evaluation of Ki-67 re-vealed an accordance rate of 86.7%(281/324,κ=0.34),and the concordance for immunohistochemistry detection for assessing breast cancer(BC)molecular subtypes was 73.4%(91/124,κ=0.64).Conclusions:Although CNB showed good accuracy for evaluating hormon-al receptor status and BC molecular subtypes,its evaluation of HER-2 and Ki-67 statuses was less accurate than other biomarkers. Therefore,we should combine immunohistochemical results with both CNB and RS samples in order to improve accuracy when diag-nosing molecular subtypes.Moreover,improved diagnoses can provide the basis for more effective systemic therapies.

Objective To explore the application value of external fixator in obsolete hip dislocation.Methods Retrospective analysis of 9 cases of obsolete hip dislocation treated with external fixator from January 2010 to January 2017.There were 6 males and 3 females,with an average of 32.0±8.3 years old (range 19-47).The time from injury to operation was 3-9 months,with an average of 6.2± 1.9 months.The patient's limb shortening length,traction time,traction length,operation time,surgical bleeding volume,preoperative and last follow-up VAS score,Epstein score,D'Aubigne functional score were recorded.Results The length of the limb shortened 5-11cm,with an average of 6.7±2.0 cm.The preoperative traction time ranged 20-45 d,with an average of 26.9±8.2 d.The length of traction ranged 5-12 cm,with an average of 7.1±2.2 cm.The second reconstruction operation time was 2.0-4.0 hours,with an average of 2.8±0.7 h.The bleeding volume was 800-2 000ml,with an average of 1 216.7±422.8 ml.The Epstein score at the last follow-up was excellent in 4 cases,good in 4 cases and improved in 1 case.The preoperative VAS score and the final follow-up VAS score were 0.9±0.8 points and 4.6±0.9 points respectively.There was a significant difference between preoperative and postoperative VAS scores (t=8.981,P=0.000).The D'Aubigne functional scores of preoperative and final follow-up were 5.2±1.0 points and 13.1±2.0 points respectively and the difference was statistically significant (t=-12.044,P=0.000).Conclusion The external fixation in the treatment of obsolete dislocation of the hip is helpful and accepted in patients with femoral head dislocation.It is easy to carry and tract for patients and convenient for functional exercise.The external fixation makes operation simple and flexible;the traction force is strong and the effect of the femoral head reduction is obvious,the operation method is simplified and the quality of the reduction is improved.

Objective To explore the incidence and clinical significance of corona mortis vessels.Methods From December 2015 to December 2017,48 patients with pelvic acetabular fractures were treated with the Stoppa approach,including 36 males and 12 females,aged 30 to 67 years,with an average age of 47.2±8.2 years.There were 52 sides of hemipelvis in the all including 44 cases of unilateral pelvic acetabular fractures and 4 cases of bilateral pelvic acetabular fractures.In the 48 patients,there were 6 pelvic fractures,40 acetabular fractures and 2 pelvic combined with acetabular fractures.According to Judet-Letournel classification:there were 6 cases of anterior column fracture,4 cases of anterior column with anterior wall fracture,2 cases of anterior column with posterior transverse fracture,4 cases of transverse fracture,6 cases of "T" shape fracture and 20 cases of double column fracture.According to Tile classification,there were 2 cases of B1 type,2 cases of B3 type,2 cases of C1 type,and 2 cases of C2 type.The time from injury to surgery was 5 to 16 days,with an average of 8.3±2.8 days.All patients were treated with the Stoppa approach for reduction and fixation.The incidence,number and type of corona mortis vessels across the superior pubic branch,and the diameter and the distance between the vessels and the pubic symphysiswere detected and recorded.Results In the 52 hemi pelvis,there were 46 sides with an anastomotic blood vessel,and no anastomotic blood vessel was found in 6 sides,with the incidence of corona mortis vessels of 88.5％ (46/52).Among them,36 cases were venous type,with the incidence of 78.3％ (36/46);8 cases were arterial type,with the incidence of 17.4％ (8/46);2 cases were mixed type,with the incidence of 4.3％(2/46);corona mortis venous blood vessel diameter was 1.8-3.7 mm,with an average of 2.9±0.5 mm;arterial blood vessel diameter was 2.4-3.0 mm,with an average of 2.7±0.3 mm;the distance between the vessels and the pubic symphysis was 48-71 mm,with an average of 56.9±5.8 mm.Conclusion The corona mortis vessels are common,with the incidence through Stoppa approach about 88.5％.In the clinical treatment of pelvic acetabular fractures,we should pay attention to careful separation of pubic branches exposed by the Stoppa approach,especially when using ilioinguinal approach to avoid corona mortis vessels injury and haemorrhage.

Objective:To evaluate the staging and grading valut of Ki-67,TP53,Cyclin D1,HER-2 in non-muscle invasive bladder cancer (NMIBC).Methods:Retrospective analysis was performed on the clinicopathologic characteristics of 184 Ta,T1 stage NMIBC patients who underwent transurethral resection of the bladder(TURBT)at the Tianjin Medical University Cancer Institute and Hospital from January 2015 to December 2016.The expression of Ki-67,TP53,Cyclin D1 and HER-2 was evaluated by immunohistochemical assay.Then,the association between immunohistochemical indicators expression,staging and grading of NMIBC were assessed by univariate analysis.The independent factors of staging and grading in NMIBC were assessed by multivariate Logistic analysis,and their sensitivity and specificity were compared. Results:Univariate analysis showed a positively correlation between tumor size and T1 and G3 of NMIBC(P<0.05).The high expression of Ki-67 and HER-2 was positively correlated with tumor staging and grading(P<0.05)in T1,G3 NMIBC tissues.The high expression of CyclinD1 was negatively correlated with tumor staging and grading(P<0.05)in Ta stage tissues.Logistic multivariate analysis showed that high expression of Ki-67 and low expression of Cyclin D1 were independent predictors of T1 in NMIBC.High expression of Ki-67,high expression of HER-2 and low expression of Cyclin D1 were independent predictors of G3 in NMIBC.The Ki-67 expression had high sensitivity and specificity for predicting tumor staging and grading in NMIBC.The sensitivity were 81.40%(48/59)and 76.80%(96/125),and the specificity were 76.83%(63/82)and 86.30%(88/102),respectively.Conclusions:Detection of Ki-67 expression could predict staging and grading in NMIBC,and provide the basis for appropriate treatment.

Objective To investigate the etiological characteristics of food poisoning isolates of Vibrio parahaemolyticus (VP) from 2019 to 2021 in Zhongshan City. Methods A total of 37 strains of Vibrio parahaemolyticus isolated from 8 food poisoning incidents in Zhongshan City from 2019 to 2021 were collected, including 1 residual food isolate and 36 human isolates. The genetic correlation of Vibrio parahaemolyticus food poisoning isolates in this region was analyzed by serological typing, virulence gene detection (TLH, TDH, and TRH), drug sensitivity test, pulsed field gel electrophoresis (PFGE) and multipoint sequence typing (MLST). Results The 37 strains of Vibrio parahaemolyticus were divided into 4 serotypes: O3:K6, O10:K4, O4:K8, and O4:KUT. The tdh+ and trh- were the main virulence genotypes, accounting for 97.30% (36/37). The drug resistance rate of cefazolin was 40.54% (15 strains R, 22 strains I), and no multidrug-resistant strains were found. The 37 VP strains were divided into 23 PFGE types and 6 cluster groups, with correlation coefficients ranging from 60.4%-100%. The multipoint sequencing typing showed that the 37 VP strains were divided into 9 ST types and 3 complex groups, of which ST3 type was the main type (23 strains, 62.1%). Conclusion This study has found that the dominant virulence types of Vibrio parahaemolyticus food poisoning isolates in Zhongshan City from 2019 to 2021 are tdh⁺ and trh^-, and 37 representative strains can be divided into 6 PFGE clusters and 9 ST types with MLST type being mainly ST3. This study has identified the rare serotype O10:K4 which has caused an increase in the proportion of food poisoning events, suggesting that we should strengthen detection and be alert to the risk of continued local epidemics of new rare serotype strains.