Objective To analyze the occurrence rate,positive rate,and other related factors influencing interpectoral lymph nodes in breast cancer patients,and to explore the significance and indications of the surgical dissection of interpectoral lympy nodes.Methods Clinical and pathological data from 148 breast cancer patients were retrospectively analyzed.All patients were subjected to modified radical mastectomy,and interpectoral lympy nodes were pathologically examined.The occurrence rate and metastasis of interpectoral lympy nodes were recorded,and the relationship between the interpectoral lympy nodes positive rate and tumor size,axillary nodes,clinical stages,neo-adjuvant chemotherapy,hormone receptors,human epidermal growth factor receptor-2 (Her-2) expression,and molecular subtypes of breast cancer were determined.Results The occurrence rate,overall metastasis rate,and the positive rate of interpectoral lympy nodes in patients with axillary lymph node metastasis were 13.5％(20/148),4.7％(7/148),and 10.9％ (7/64),respectively.I nterpectoral lympy nodes metastasis was significantly correlated with axillary node metastasis and clinical stages (P＜ 0.05).However,interpectoral lympy nodes metastasis was not significantly related with hormone receptor and Her-2 expressions(P ＞ 0.05).Interpectoral lympy nodes metastasis rate was not affected by neo-adjuvant chemotherapy.Patients with interpectoral lympy nodes metastasis were characterized by larger tumors,more positive axillary lymph nodes,and later chnical stages.Conclusions Interpectoral lympy nodes metastasis usually occurs in patients with larger tumors,more positive axillary lymph nodes,later clinical stages,as well as those with locally advanced cancer that meets the standard of neo-adjuvant chemotherapy.These indications suggest that the surgical dissection and pathological examination of interpectoral lymph nodes should be routinely performed.

Objective To explore the morphological changes of human mesenchymal stem cells(hMSCs) after exposure to extracorporeal shock wave(ESW).Methods An optimal experimental energy dose of ESW was applied to hMSCs of passage one.The morphological changes were examined by using inverted phase contrast microscope(IPCM),transmission electron microscope and cytochemical staining.Results ESW of 5kV and 100 times could raise the viability and proliferation of the cells.In the hMSCs of passage 3-5,the multiplicative division was speeded up,and the cells in the nuclear fission phase were increased.In the hMSCs of passage 7-9,the volume of the cells increased,and the endoplasmic reticulum was expanded.The Golgi's apparatus was developed and the matrix of the cells was bunchy.In the hMSCs of passage 11,the multiplicative division was also detected.Conclusion The proliferation and differentiation of the hMSCs can be improved by the treatment of ESW.

Objective To investigate the efficacy of anatomic plate internal fixation in treatment of complex proximal humeral fractures combined with humeral shaft fractures.Methods This retrospective case series study included 58 patients with complex proximal humeral fractures combined with humeral shaft fractures admitted from July 1998 to July 2015.There were 31 males and 27 females,with a mean age of 63 years (range,18-86 years).According to the Neer classification of proximal humeral fractures,three-part fractures were noted in 42 patients and four-part fractures in 16 patients.Four patients were combined with compressed or splitting fractures of the head of humerus and 38 patients with dislocation of the shoulder.According to the site classification of femoral shaft fractures,proximal 1/3 shaft fractures were noted in 36 patients,middle and distal 1/3 shaft fractures in 19,and multisegmental shaft fractures in three.All patients underwent anatomic reduction and anatomic plate internal fixation.Bone healing,Neer score of function outcome and complications were evaluated after operation.Results Mean duration of follow-up was 8.6 years (range,1-18 years).Bone union was observed in all patients after 10 to 24 weeks (mean,14.5 weeks).According to the Neer score,the outcomes were excellent in 23 patients,good in 25,fair in eight and poor in two,with the excellent rate of 83 ％.Complications such as infection,nerve injury and vascular injury were not observed after operation.Six patients suffered from limitations of shoulder anterior flexion and rise,one patient had humeral head necrosis and treated by shock wave treatment,and one patient had poor incision healing with hemorrhagic effusion and cured after dressing.Conclusion Anatomic plate internal fixation can contribute to fast functional recovery and few complications in treatment of complex proximal humeral fractures combined with humeral shaft fractures.

Objective To study the changes of Na+K+-ATPase,Ca2+Mg2+-ATPase activities in erythrocyte membrane and blood viscosity in children with essential hypertension.Methods The activities of Na+K+-ATPase,Ca2+Mg2+-ATPase in erythrocyte membrane were determined by a colorimetric method.Blood viscosity was measured and analyzed with the statistic analysis SPSS 12.0 software in 50 children from Nov.2004 to Dec.2004 in the people's hospital of guizhou province and adolescents with essential hypertension.Thirty healthy children were collected as control group.Results The activities of Na+ K+-ATPase[(6.12?1.30)?molpi/(gHb?h)and(4.59?1.40)?molpi/(gHb?h)],Ca2+Mg2+-ATPase[(7.46?1.30)?molpi/(gHb?h)and(5.81?1.20)?molpi/(gHb?h)] were lower significantly in hypertension group than those in control group(Pa

Adolescent ; Adult ; Child ; Child, Preschool ; Electrocoagulation ; methods ; Female ; Humans ; Hypothermia, Induced ; Male ; Middle Aged ; Prospective Studies ; Tonsillectomy ; methods ; Young Adult

?AlM: To observe the expression of Acin1 ( apoptotic chromatin condensation inducer 1 ) in congenital cataract mouse retina during development and investigate the differences of retinal apoptosis and the connection of lens and retina development between congenital cataract mouse and normal mouse.
?METHODS: There were congenital cataract mice ( 10 female and 5 male) and normal C57BL/6 mice (10 female and 5 male) . One male and two female mice were fed in the same cage randomly. The young mice were divided into two groups: congenital cataract group and normal control group. Five young mice were treated each group on 1, 5, 9, 14, 17, 21, 26, 60d. The left eyes were fixed with 4% neutral formalin to detect AClN1 protein by immunohistochemistry and retinas from right eyes were used to detect the mRNA expression of Acin1.
?RESULTS: Acin1 had sustained expression in each group. AClN1 protein gradually expressed from the ganglion cell layer, inner nuclear layer to the outer nuclear layer following retinal development. lt mainly expressed on ganglion cell layer and inner nuclear layer, but not neuroblastoma layer. AClN1 protein positive cells on P1 ~ P14d increased in normal control group, P17d reduced, after P21d positive cells of each layers decreased. The overall trend was similar in congenital cataract group with normal control group, P1 ~ P14d positive cells count was lower than normal control group, P17-P21d positive cells were flat and higher than the normal control group. Compared with the same day of the two groups, the differences except for P17, P26, P60d were significant (P<0. 05). The overall difference was statistically significant in congenital cataract group ( Fcataract=295. 07, P<0. 01);in addition to P1 and P5, P17 and P21, the differences were statistically significant ( P< 0. 05 ) compared with each other in congenital cataract group. The overall difference was statistically significant in control group (Fnormal=214. 21, P<0. 01); in addition to P1 and P5d, the difference was statistically significant ( P<0. 05) compared with each other in control group. The expression of P17d in congenital cataract group was lower compared with that of P14d in control group, the difference was statistically significant (P<0. 05). Acin1 mRNA trends of two groups were similar with AClN1 protein. Compared with the same day of the two groups, the difference was significant except for P17, P21, P60d (P<0. 05 ) . The overall difference was statistically significant in each other of the two groups ( Fcataract=522. 29, P<0. 01;Fnormal=472. 05, P<0. 01). The difference was statistically significant compared with each day in control group ( P<0. 05). Compared with all the rest of days except for P21 and P26d, the difference was statistically significant in congenital cataract group (P<0. 05).
?CONCLUSlON: Acin1 exist differential expression of time and space in mouse retina during development, congenital cataract crystal developmental disorder may affect the expression of Acin1 and retinal cell apoptosis and development.

Objective:To investigate the therapeutic effect of carbon dioxide laser tonsillectomy.Method:In this prospective,randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectom,and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar.Result:Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2±2.1)ml, while control group have hemorrhage in operation (92.0±35.0)ml. Laser group have pseudomembrane early but desquamate late.Conclusion:Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time ,it's an safe , efficient and mini-trauma operation.

Objective Toanalyzetheclinicalcharacteristicsandtreatmentoutcomesofspinalfilum terminalevascularmalformation.Methods Theclinicaldataof6patientswithfilumterminalevascular malformation diagnosed and treated from January 2008 to December. 2013 were analyzed retrospectively. The definition of filum terminale vascular malformation is anterior/posterior spinal artery feeding arteriovenous fistula or arteriovenous malformation and located below conus medullaris,and does not complicate with spinal vascular lesions in the other part. The Aminoff & Logue score and MRI of spinal cord function were performedatoneyearaftermicroneurosurgeryand/orendovascularembolization.Results Allpatients were males. Their clinical presentations were the weakness of both lower extremities and sphincter disturbance. The mean course of disease was 17. 1 ± 5. 2 months. The pathological type of the 6 patients were all arteriovenous fistulas. The feeding arteries included lumbar artery,internal iliac artery,and median sacral artery. Two of the 6 patients underwent Onyx glue embolization,3 were treated with microneurosurgery,and 1 was treated with embolization in combination with microneurosurgery. They were all achieved anatomic cure. The Aminoff & Logue scores were improved after 1 year (3. 8 ± 1. 9 scores before procedure,2. 8 ± 2. 0 scores after procedure),there was no significant difference (P >0. 05). The myodynamia scores were improved in 3 patients,2 did not change,1 got worse. The urinary and bowel functions were improved in 2 patients,and4didnotchange.Conclusion Filumterminalevascularmalformationisararevascular malformation of spinal cord. Both embolization and surgical treatment can achieve anatomic cure. Although the spinal cord function can be only partially restored,but continuous deterioration can be prevented.

Objective To investigate the feasibility of low dose dual phase contrast-enhanced chest CT with iterative mod el reconstruction (IMR) technique.Methods Totally 130 patients with suspected pulmonary occupying lesions underwent dual phase contrast-enhanced chest CT,who were randomly assigned into 2 groups (group A and group B,each n=65).Patients in group A were scanned with 100 kV,DoseRight technique with dose right index 10,and images were reconstructed with the hybrid iterative reconstruction (iDose4).While patients in group B were scanned with 80 kV,DoseRight technique with dose right index 8,and images were reconstructed with iterative model reconstruction (IMR).The objective image quality,subjective image scores and the excellence rate of vascular visualization were compared in both pulmonary artery (PA) and bronchial artery (BA) phases.The radiation dose was also calculated.Results The effective dose was (3.30 ±0.89)mSv in group A and (1.27 ±0.19)mSv in group B.Compared to group A,the effective dose reduced 61.52％ in group B (P＜0.001).Lower image noise and greater CNR were obtained in group B compared to group A in both PA and BA phases (all P＜0.001).No significant difference was found in subjective image scores of lung and mediastinal setting and the excellence rate of vascular visualization in both groups (all P＞0.05).Conclusion Using IMR,dual phase contrast-enhanced chest CT allows for a radiation dose reduction up to 61.52％,meanwhile,ensures the image quality and meets the diagnostic requirements.

ObjectiveThis study was to review our experience for the management of hepatocellular carcinoma(HCC) invading the inferior vena cava(IVC). Methods Eleven patients were operated on. Tumors were first resected under portal triad clamping(PTC) and then the tumor emboli in the IVC were removed either under hepatic vascular exclusion(HVE) or under side clamping of the IVC. Results Surgery was successful in all cases, without operative death and complication caused by the removals of tumor emboli from the IVC. The mean operative time was 179 min (range 120～255 min) and the mean intraoperative blood loss 1 482 ml(range 600～3 000 ml). The mean PTC and HVE times were 27 9 min(range 12～83 min) and 16 5 min(range 7～28 min), respectively. The postoperative complications included pleural effusion in one needing thorancentesis and bile leak in one. During the follow up, 3 patients died at 30, 10 and 14 months, respectively, and the remaining 8 patients were alive at the follow up of 1 to 14 months. ConclusionsHCC with tumor thrombus in the IVC is operable and the proper procedure is hepatectomy plus thrombectomy with a favourable postoperative prognosis.