Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

Objective To investigate the relationship of programmed cell death 4(PDCD4) with the invasion of astrocytic glio-mas .Methods Using the immunohistochemical method to detect the expression of PDCD4 in astrocytic gliomas in different grades . Measuring the peritumoral low-density area on MRI scan ,then compared with the results of immunohistochemical expression .Re-sults The downregulation of PDCD4 was with the increasing of the malignant grade of astrocytic gliomas .The tumor grade malig-nancy was positively correlated with the grade of the peritumoral low-density area on MRI scan(P<0 .05) ,while the expression of PDCD4 was negatively correlated with the grade of astrocytic gliomas (P<0 .01) .Conclusion PDCD4 might serve as one of the in-dicators of invasion and malignant phenotype for astrocytic gliomas .

Objective To investigate the effect of bone marrow stem cells (BMSCs) transplantation combined with body weight supported treadmill training on neural functional recovery of rats with spinal cord injury.Methods T11 complete spinal cord injury (SCI) was introduced into 40 Sprague-Dawley male rats using an improved simple device,imitating the Allen method.The rats were randomly divided into a stem cell transplantation group,a body weight support treadmill training group,a combined treatment group and a control group,each of 10 assigned according to a random number table.One week after the SCI operation,stem cell transplantation was performed on the rats in the stem cell transplantation group and the combined treatment group.One day before their transplantation,the third passage BMSCs were labeled with 5-ethynyl-2'-deoxyuridine (Edu).The rats in body weight support treadmill training group and combined treatment group were received body weight support treadmill training,while the other two groups were not given any training.At the 1 st,2nd,3rd,4th and 5th week after SCI modeling,Basso-Beattie-Bresnahan (BBB) movement function score was used to evaluate the motor function recovery of all rats.At the 5 th week after SCI,immunohistochemical staining and immunofluorescence staining was applied to detect neural specific markers including the neuron specific enolase (NSE),microtubule associated protein (MAP-1 β) and vimentin (VIM).The survival and differentiation of the transplanted cells,as well as the nerve fiber recovery in the lesion were also observed.Results The average BBB score of the combined treatment group was (6.60 ± 0.97) at the 2nd week after SCI operation,significantly higher than the other 3 groups,while that of the stem cell transplantation group and the body weight support treadmill training group was (5.00 ± 0.67) and (4.80 ± 0.63) respectively,both higher than that of the control group but without significant differences (P ＞ 0.05).In the third week after modeling,however,the value of the stem cell transplantation group rose to (8.00 ± 0.67),significantly higher than that of the body weight support treadmill training group (6.80 ± 0.79).The immuohistochemical staining showed that a variable degree of neural specific markers (NSE,MAP-1 β,VIM) positive cells were observed in the SCI tissues of all groups,with those in the combined treatment group significantly higher than the other 3 groups.The immunofluorescence also found significantly higher fluorescence expression of neural specific protein markers including NSE,MAP-1 βand VIM in the combined treatment group than the rest group,with obvious proliferation and differentiation of nerve fibers.Conclusions Stem cell transplantation combined with partial body weight supported treadmill training can effectively promote the recovery of neural function of rats with spinal cord injury,and the effect is better than solely stem cell transplantation or the weight loss training.

OBJECTIVETo investigate the proinflammatory cytocine factors in patients with coronary artery disease by different treatments during perioperation.

METHODSTNF-alpha, IL-6, c-reactive protein (CRP) were measured in 37 patients with coronary artery disease (CAD) and 10 patients with mitral valve replacement (MVR, control group) before operation and aortic clamping or before coronary artery bypass grafting (CABG) in the patients with cardiopulmonary bypass, or before transmyocardial laser reperfusion (TMLR), when aortic declamping and 3, 6, 24 hours after operation.

RESULTSThe level of proinflammatory factors increased more significantly after operation than before operation. TNF-alpha increased more significantly in the patients with CPB than in those without CPB after operation [(4.10 +/- 0.71) pg/ml vs. (1.34 +/- 0.29) pg/ml, P < 0.05)]. IL-6 was not the different among all groups after operation. CRP was higher in the CAD patients with CPB than in the control group after operation [(12.89 +/- 0.29) pg/ml vs. (12.00 +/- 0.31) pg/ml, P < 0.05].

CONCLUSIONInflammatory response can be seen after operation in all CAD patients. In patients undergoing CABG without CPB or undergoing TMLR, the changes in flammatory response are milder than those in patients with CPB. Thus patients should undergo CABG without CPB if they are indicated.

Aged ; C-Reactive Protein ; analysis ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Disease ; immunology ; surgery ; Female ; Humans ; Interleukin-6 ; blood ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; analysis

Objective To investigate the strategies of reducing the incidence of missed diagnosis of severe traumatic brain injuries combined with multiple trauma. Methods Data of 432 patients with severe traumatic brain injuries and multiple trauma (ISS≥20) from January 2000 to August 2007 were analyzed retrospectively. All patients were divided into missed diagnosis group (MD group, n =54) and non-missed diagnosis group (NMD group, n =378) for correlation analysis on ISS, GCS, anatomical locations of the missed diagnosis, the time of delayed diagnosis and the prognosis. Results ISS was (42.97±10.94) points in MD group, with statistical difference compared with NMD group (P < 0.05). The patients with GCS≤8 in MD group was more than those in NMD group (P < 0.05). Conclusions It is effective to prevent missed diagnosis and improve the survival of patients with severe traumatic brain injuries combined with multiple trauma by judging injury severity quickly and precisely based on the principle of "life first" and repeated and systemic physical examination.

PURPOSETo investigate the changes of cerebral hemodynamics pre- and post-ventricular drainage in patients with posttraumatic acute diffuse brain swelling.

METHODSTwenty-four cases of traumatic diffuse brain swelling were analyzed retrospectively. Patients in nonsurgical group were treated by medicine therapy. Patients in surgical group were treated by external ventricular drainage plus medicine therapy. The first CT perfusion scan was completed within 4-5 h after trauma and scanned again after 7 days. The changes of perfusion parameters in area-of-interest in two groups were analyzed and compared before and after treatment.

RESULTSCompared with the nonsurgical group, the value of cerebral blood volume, cerebral blood flow and mean transit time in bilateral frontal temporoparietal grey matter, basal ganglia, cerebellum, and brain stem at pre- and post-therapy were increased significantly (p < 0.05) in surgical group, and consequently the prognosis of patients undergoing surgery was also better than that of nonsurgical group.

CONCLUSIONExternal ventricular drainage can improve cerebral perfusion and increase survival quality for the patients with posttraumatic acute diffuse brain swelling.

Adult ; Aged ; Brain ; physiopathology ; Brain Edema ; physiopathology ; therapy ; Brain Injuries ; complications ; Cerebrovascular Circulation ; Drainage ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVE: To explore the pathogenesis and genetic characteristics of a fetus with a der(X)t(X;Y)(p22.3;q11.2) karyotype. METHODS: G-banding karyotyping analysis, BoBs (BACs-on-Beads) assay, and single nucleotide polymorphism array (SNP-array) were used to delineate the structural chromosomal aberration of the fetus. The parents of the fetus were also subjected to karyotyping analysis. RESULTS: The fetus and its mother were both found to have a karyotype of 46,X,add(X)(p22), while the father was normal. BoBs assay indicated that there was a lack of Xp22 but a gain of Yq11 signal. SNP-array confirmed that the fetus and its mother both had a 7.13 Mb deletion at Xp22.33p22.31 (608 021-7 736 547) and gain of a 12.52 Mb fragment at Yq11.221q11.23 (16 271 151-28 788 643). CONCLUSION The fetus was determined to have a karyotype of 46,X,der(X)t(X;Y)(p22.3;q11.2)mat. The combined use of various methods has facilitated delineation of the fetal chromosomal aberration and prediction of the risk prediction for subsequent pregnancy.
Chromosome Banding ; Chromosome Deletion ; Chromosomes, Human, X/genetics* ; Chromosomes, Human, Y/genetics* ; Female ; Fetus ; Humans ; Karyotyping ; Male ; Pregnancy ; Prenatal Diagnosis ; Translocation, Genetic

BACKGROUNDDendritic cell (DC)-based immunotherapy is a new approach and effective for some malignant tumors. The aim of this study is to observe the efficacy and toxicity of immunotherapy with carcinoembryonic antigen (CEA) peptide-pulsed DCs in patients with refractory advanced lung cancer.

METHODSLung cancer patients with high CEA expression were enrolled into this project. Autologous DCs were generated from patients' plastic-adherent peripheral blood mononuclear cells and loaded with CEA 5 days later. Cytokine-induced killer cells (CIK) were cultured from non-adherent peripheral blood mononuclear cells. DCs and CIK were transfused to patients. Responses and toxicities were observed.

RESULTSA total of 22 patients with lung cancer received DCs immunotherapy. DCs doses were 2.5×10⁶-9.6×10⁷ (5.03×10⁶). CIK doses were 3.4×10⁸-46×10⁸. CD3, CD8, NK and IFN-γ levels obviously increased after treatment (P < 0.05). The 1-year survival rate was 68.2% (15/22). Main toxicities were fever and rash.

CONCLUSIONSDCs-based immunotherapy is feasible and safe to patients with lung cancer.

Objective:To investigate the prevalence of thyroid nodule in middle-aged and elderly people in Heilongjiang Province, and to analyze its epidemiological characteristics and influencing factors.Methods:From December 2017 to December 2018, middle-aged and elderly people aged 40-70 years old were recruited through probability proportional sampling (PPS) method for a cross-sectional survey. The respondents were stratified by age (40-49, 50-59, 60-70 years old), urine samples were collected at random once during the day, and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry (WS/T 107.1-2016). At the same time, questionnaire surveys and thyroid ultrasound examinations were conducted on the respondents. Logistic regression was used to analyze the relationship between the related investigation factors and the thyroid nodule.Results:A total of 2 771 middle-aged and elderly people were included, and their age was (54.32 ± 8.24) years old. The median of urinary iodine was 157.04 μg/L, which was an iodine appropriate level. The prevalence of thyroid nodule was 43.63% (1 209/2 771), and the prevalence increased with age(χ 2trend=49.400, P < 0.01). The prevalence of thyroid nodule in females [46.98% (917/1 952)] was significantly higher than that in males [35.65% (292/819), χ 2=30.082, P < 0.01]. In patients with thyroid nodule, small nodule accounted for 57.65% (697/1 209), large nodule accounted for 42.35% (512/1 209), and the proportion of large nodule increased with age (χ 2trend=18.751, P<0.01). Solitary nodule accounted for 42.76% (517/1 209), multiple nodule accounted for 57.24% (692/1 209), and the proportion of multiple nodule increased with age(χ 2trend=18.437, P<0.01). Cystic-solid nodule was the most common[47.97%(580/1 209)], followed by solid nodule [44.25% (535/1 209)], and cystic nodule was the least common [7.78% (94/1 209)]. Logistic regression analysis showed female [odds ratio ( OR)=1.868, 95% confidence interval ( CI): 1.538-2.269, P < 0.01], age (50-59 years old: OR=1.258, 95% CI: 1.020-1.550, P < 0.05; 60-70 years old: OR=1.762, 95% CI: 1.407-2.207, P < 0.01), overweight ( OR=1.303, 95% CI: 1.078-1.574, P < 0.01), hypertension ( OR=1.332, 95% CI: 1.037-1.712, P < 0.05), and diabetes ( OR=1.604, 95% CI: 1.077-2.387, P < 0.05) were independent risk factors affecting the occurrence of thyroid nodule in middle-aged and elderly people. Conclusions:The epidemiological characteristics of thyroid nodule in middle-aged and elderly people in Heilongjiang Province have obvious age trends and gender differences. The proportion of large nodule and multiple nodule increase with age. Early screening and attention to the prognosis of women, older, overweight, hypertension and diabetes people should be strengthened.

OBJECTIVE： To investigate the effects of chelidonine on proliferation， collagen synthesis and TGF-β1 receptor of activated hepatic stellate cells CFSC-8B. METHODS： CFSC-8B cells in logarithmic phase were collected and then divided into normal control group， model group， solvent group （ethanol）， positive control group （1 μg/mL colchicine ethanol solution）， chelidonine low， medium and high concentration groups （2.1， 4.2， 8.4 μg/mL chelidonine ethanol solution）. Except for normal control group， other groups were activated with 20 μg/L TGF-β1 for 24 h； the latter 5 groups were intervened with relevant medicine for 24 h. Cell proliferation of activated cells was assayed by CCK-8 assay. Hydroxyprolin （Hyp） content was assayed by enzyme digestion； the levels of typeⅠ collagen （Col-Ⅰ） and type Ⅲ collagen （Col-Ⅲ） were assayed by ELISA； the expressions of TβR-Ⅰ and TβR-Ⅱ protein were assessed by Western blot； mRNA expressions of α-SMA， TβR-Ⅰ and TβR-Ⅱ in hepatic stellate cells were assessed by RT-PCR. RESULTS： Compared with normal control group， cell proliferation rate， Hyp content， the levels of Col-Ⅰ and Col-Ⅲ， the protein expressions of TβR-Ⅰ and TβR-Ⅱ as well as mRNA expressions of α-SMA， TβR-Ⅰ and TβR-Ⅱ were increased significantly （P＜0.05）. Compared with model group， there were no significant difference in above indexes of hepatic stellate cells in solvent group （P＞0.05）； there were no significant difference in the proliferation rate of hepatic stellate cells in chelidonine low concentration group （P＞0.05）， above indexes of hepatic stellate cells were decreased significantly in positive control group and chelidonine high concentration group （P＜0.05）. The decrease of Hyp and Col-Ⅲ levels were not significant in chelidonine medium concentration， but other above indexes were decreased significantly （P＜0.05）. Compared with chelidonine medium concentration group， the rate of cell proliferation， Col-Ⅰ level， protein and mRNA expressions of TβR-Ⅰ and TβR-Ⅱ were decreased significantly in chelidonine high concentration group （P＜0.05）. CONCLUSIONS： Chelido- nine can inhibit the proliferation， collagen synthesis as well as the protein and mRNA expressions of TβR-Ⅰand TβR-Ⅱ in activated CFSC-8B cells.