Research on the relationship between obesity and breast cancer has been deepened in recent years.Obese breast cancer patients have poorer prognosis than normal-weight patients.Weight variation is correlated with relapse in breast cancer survivors.The role of adipokines in this process can not be ignored.The correlations between adipokines,estrogen,cell proliferation,angiogenesis and breast cancer prognosis are reviewed in this article.

Objective To investigate the risks and anesthetic management of scar uterus undergoing cesarean section.MethodsOne hundred pregnant women(aged 24-43 years old)with scar uterus underwent cesarean section.Epidural anesthesia was used in 90 cases(group A)and general anesthesia in 10 cases(group B).The monitorings included ECG,BP,HR and SpO_2.CVP was measured in the high risk cases.The time from skin incision tO neonatal delivery(I-D).the time from uterine incision to delivery(U-D),and Apgar scores of neonates were recorded.Results Incomplete blockade was seen in 20 cases(22％).The I-D time was shorter in group B than that in group A[(7.5±2.0)min vs.(12.3±2.6)min](P<0.01).Intraoperative hypotension occurred in 32 cases (32％).Neonatal asphyxia happened in 21 cases(21%).Apgar scores of 11 neonatals werc less than 3,of whom 5 neonates died.Apgar scores were 4 to 7 in 10 cases,8 to 10 in 79 cases.Subtotal uterectomy was performed in 2 cases.Repair of injuried bladder had to be done in one case.Intraoperative huge bleeding took place in 15 cases.Conclusion The scar uterus undergoing cesarean section has a high risk for mothers and neonates.The incidence of incomplete epidural blockade is higher.Effectively preventing and managing the risk factors are the keys for reducing maternal and neonatal complications and mortality.

Objective To study the clinical effect of escitalopram oxalate in treating patients with depression accompanied with anxiety disorder.Methods Sixty-four patients with depression accompanied with anxiety disorder (met DSM-IV diagnostic criteria)were randomly divided into study group (n =32)who were treated with escitalo-pram oxalate 5-20mg/d and control group (n =32)with mirtazapine 15-45 for eight weeks.Clinical effect was evalua-ted with the Hamilton Depression Scale (HAMD)and the Hamilton Anxiety Scale (HAMA)as well as the adverse reactions with the Treatment Emergent Symptom Scale (TESS).Results There were no statistically significant differ-ences (P >0.05)in HAMD and HAMA scores between the study group and control group before treatment,but after treatment for 8 weeks,HAMD score showed statistically significant difference (P =0.000)and the difference of HAMA score was statistically significant (P =0.010).The total effective rate of the study group was 93.8%,which of the control group was 87.5%,the clinical effect had no statistically significant difference (P =0.391 ).The study group and the control group had equal effect,and there were no serious adverse reactions.Conclusion Escitalopram oxalate has high anti-depressant and anxiolytic effect,fewer adverse reactions,good tolerability and compliance,there-fore,escitalopram oxalate can be popularized in treating patients with depression accompanied with anxiety disorder.

The process of late lung development is disturbed in bronchopulmonary dysplasia (BPD).One of the keys in late lung development is secondary septation, in which secondary septa arise from primary septa, producing plenty of small alveoli, which significantly increase the surface area of gas exchange.Secondary septation,together with architectural changes to the vascular structure of the lung which minimize the distance between the blood and the inspired air, are the targets of late lung development.BPD is a disease of premature infants in which development of the alveoli is stunted caused by many factors including volutrauma,inflammation,and oxygen toxicity.Compared with early lung development, the later development of the immature lung remains unclear.This paper is to emphasize remarkable latest research of arrested late lung development and BPD.

AIM: To study the effectiveness of urapidil and nitroglycerine on controlling the cardiovascular responses to tracheal intubation/extubation in patients with essential hypertension. METHODS: 45 patients with essential hypertension undergoing general anesthesia were divided randomly into control (C, without depressor, n=15), urapidil (U, 0.5 mg?kg -1 , n=15), and nitroglycerine (N, 1 ?g?kg -1 , n=15) groups. The SBP, DBP, MAP, HR and RPP were measured during intubation and extubation and at the induction of anesthesia and the end of operation respectively. RESULTS: The SBP, DBP, MAP, HR and RPP increased markedly (P

0.05).SF-36 data revealed significant postoperative improvement(P0.05).Main complications included deep infection in one case,deterioration of spondylolisthesis in two cases,conjunctional stenosis in one case,and broken pedicle screws in two cases.Six patients received revision surgery.[Conclusion]Surgical treatment of DLSS may result in satisfactory outcome.Transpedicular screw fixation may not improve the clinical outcomes and posterior instrumentation should be adopted cautiously and properly.

Immune checkpoint is one of the most effective research targets for tumor immunotherapy. Immune checkpoint inhibitors, mainly programmed death receptor 1 and its ligand 1, have achieved good response rates in various tumor treatments, but some tumors still have low response rates. In recent years, bispecific antibodies have developed rapidly in the field of tumor research, because they can target multiple targets and play a combined role in tumor therapy, and can effectively inhibit tumor immune escape. This article reviews the research progress and clinical status of bispecific antibodies targeting immune checkpoints.

Objective To evaluate the function of the domestic sickbeds set up by our hospital in the prevention and cure of non infectious chronic diseases. Methods A perspective study was made through offering health education, guidance and home treatment to 116 cases using domestic sickbeds and employing the method of self management. In addition, the clinical treatment results of the patients and the rate of their satisfaction towards domestic sickbeds were surveyed, analyzed and assessed. Results Through long term follow up visits, it was found that compared with the intermittently standardized group and the completely non standardized group, the control rate of chronic diseases in the standardized group with systematic management and treatment was significantly higher while the rates of complications and mortality were much lower (P

Objective To investigate the feasibility and the short-term efficacy of laparoscopic surgery for the treatment of uterine malignant tumors. Methods Laparoscopic radical hysterectomy and pelvic lymphadenectomy was performed in 25 cases of cervical cancer and 24 cases of endometrial cancer from February 2003 to March 2005 in this hospital.Of the 49 cases,a selective paraaortic lymphadenectomy was carried out in 5 cases. Results All the operations were successfully performed under laparoscope except for 1 case of conversion to open surgery.The operating time was 190?45 min,the blood loss during operation was 172?99 ml,and the number of excised lymph nodes was 17?6.Surgical complications occurred in 8 cases(8/49,16%),including 1 case of bladder injury,1 case of internal iliac vein injury,3 cases of urinary retention,1 case of vesicovaginal fistula(VVF) at the 6 postoperative month,and 2 cases of lymphatic cyst.Follow-up observations were carried out for 1~12 months in 21 cases,12~24 months in 17 cases,and 24~27 months in 4 cases.No recurrence was seen.Conclusions Laparoscopic surgery for the treatment of uterine malignant tumors is safe and feasible and offers significant short-term effects.

Objective To explore clinical indications and curative effects of microwave coagulation combined with submucous 5-fluorouracil (5-FU) injection in the management of early-stage lower rectal cancer. Methods Nine patients with early-stage lower rectal cancer underwent microwave coagulation with submucous 5-FU injection from January 1996 to December 2002. After the microwave treatment, a retention enteroclysis with 100~200 ml normal saline containing 1.0 g 5-FU was performed once daily for 3 days. Results In 3 patients, levels of carcinoembryonic antigen (CEA), which were preoperatively increased, were reduced below normal limits after microwave treatment. No hemorrhage or other intra- or post-operative complications was observed. Follow-up observations to January 2006 showed that all the 9 patients survived. One patient survived for 3 years and 5 months, 1 patient survived for 3 years and 8 months, and 1 patient experienced a tumor relapse at 1 year and 4 months and survived for 2 years and 9 months after a Miles procedure. Among 6 patients who survived longer than 5 years, 1 survived for 5 years and 1 month, 1 for 6 years and 3 months, 1 for 6 years and 8 months, 1 for 7 years and 6 months, and 2 for 9 years. Conclusions Surgical indications for microwave coagulation combined with submucous 5-FU injection for rectal cancer included early-stage cancer, lesions located within 7 cm away from the anus, the mass type cancer, tumor diameter at 0.5~3.0 cm or less than one third of the rectum’s circumference, well differentiated tumor, and patient’s strong anus-sparing demand. This method is minimally invasive, safe, reliable, and cost-effective.