[Objective]To investigate the cause precautionary measures and treatment countermeasure of impingement syndrome of the anterior ankle.[Method]From june 2000 to December 2004,18 cases of acute raumatic extravasated blood of the ankle without fracture and disbocating,20 cases of pain in front side and front inboard and front outside with dorsiflexion ache and dysfunction,all the cases were examined and treated under the arthroscope.The effect was analyzed.[Result]Follow-up lasted 6~52 months(mean 28 months).In all the 38 cases there were"excellent"outcomes in 17 cases"good"in 19 cases,"fair" in 0 case,and"poor" in 0 case in the acute traumatic extravasated blood of the ankle group.Impringement syndrome of the anterior ankle group:"excellent" in 15 cases"good" in 3 cases"fair"in 2 cases"poor"in 0 case.[Conclusion]Arthrotrauma and degranding are two reasons of the impingement syndrome of the anterior ankle,the initial stage arthroscope examination and treatment of the acute traumatic extravasated blood of the ankle without fracture and disbocating is the best active method to prevent the impingement syndrome of the anterior anlke,the clearing operation under the arthroscope is the best mininmally invasive treatment countermeasure for the impingement syndrome of the anterior ankle.

Objective To investigate the expression of breast cancer specific gene 1( BCSG1) in breast cancer tissues and its clinical significance.Methods The expression of BCSG1in 51cases of breast cancer tissues and 35 cases of adjacent tissues was determined by fluorescence quantitative polymerase chain reaction (FQ-PCR) and immunohistochenistry.Results FQ-PCR showed the expression level of BCSG1mRNA in breast cancer and adjacent tissues was 1.072 ± 0.178 and 0.324± 0.135 respectively.Immunohistochemistry showed the expression rate of BCSG1protein in breast cancer and adjacent tissues was 74.5％ (38/51) and 14.3％ (5/35).The expression of BCSG1mRNA and protein was dramatically increased in breast cancer tissues compared with that in normal background breast tissues (P ＜ 0.05).BCSG1mRNA and protein expression was significantly different in patients with lymph node metastasis and higher Nottingham prognostic index (P ＜ 0.05 ),and there was no significant difference with the pathological type of breast cancer,or status of ER,PR,and c-erbB2 ( P ＞ 0.05 ).Conclusions BCSG1is highly expressed in breast cancer tissues,which is closely related to the development and clinical prognosis of breast cancer.BCSG1is very likely to play an important role in the pathogenesis of breast cancer.

Objective To investigate the mRNA expression of β‐catenin and PTEN in hepatocellular carcinoma exposed to hepa‐titis B virus(HBV) and aflatoxin B1(AFB1) .Methods 108 HCCs came from different districts of Guangxi province were labeled as four categories based on their biomarkers of HBV and AFB1 exposure .Group A :HBV(+ )/AFB1(+ ) ,48 cases ,group B :HBV (+ )/AFB1(-) ,27 cases ,group C :HBV(-)/AFB1(+ ) ,19 cases ,group D :HBV(-)/AFB1(-) ,14 cases .And normal hepatic tissue from 20 cases of hepatic hemangioma ,liver resection and liver transplant donor were chosen as normal control group .And the mRNA expression of β‐catenin and PTEN were detected by RT‐PCR .Results The mean expression level of β‐catenin gene mRNA in group A ,B ,C ,D and control group were(1 .13 ± 0 .14) ,(1 .06 ± 0 .12) ,(1 .16 ± 0 .18) ,(1 .01 ± 0 .13) and(0 .085 ± 0 .13) respec‐tively .There were significant differences between group A and C ,A and D .And there were significant differences between these four groups and control group(all P<0 .05) .The mean expression level of PTEN gene mRNA in four subgroup A ,B ,C ,D and con‐trol group were(0 .54 ± 0 .13) ,(0 .59 ± 0 .16) ,(0 .97 ± 0 .16) ,(0 .92 ± 0 .13) and(1 .10 ± 0 .16) respectively .There were significant differences between group A and D ,C and D .And there were significant differences between group A and C (P=0 .002) ,A and D(P=0 .032) ,B and C(P<0 .001) and B and D(P=0 .011) .And there were significant differences between subgroup A ,B and D and control group(all P<0 .05) .Conclusion The over expression β‐catenin of HCC cases may be associated with the exposure to AFB1 while the loss of gene PTEN may relate to the exposure to HBV .

ObjectiveTo evaluate nipple-areola complex sparing modified radical mastectomy for breast cancer.MethodsClinical data of 159 breast cancer cases undergoing NAC sparing modified radical mastectomy from Jan 1998 to Dec 2009 were retrospectively analyzed.ResultsNAC sparing modified radical mastectomy was successfully carried out in 141 out of the 159 cases ( 88.68％ ).In 14 cases (8. 81％ ) the original operative protocol was changed to modified radical mastectomy or radical mastectomy during the operations because NAC ischemia in 4 (2. 52％ )cases, NAC occult involvement or dysplasia in 5 cases (3. 14％ ), Ⅲ level lymph node metastasis was found in 3 cases (1.89％). Postoperative complete nipple necrosis occurred in 4 (2. 52％ ) cases. Other significant postoperative complications included nipple necrosis in 20 cases ( 12. 58％ ), skin flap necrosis and infection in 11 cases ( 6.92％ ), subcutaneous hydrops in 10 cases (6. 29％ ). All patients got follow-up ranging from 15 to 96 months,median follow-up was 51 months. Local region recurrences were observed in 5 cases (3. 14％ ), distant metastasis in 2 cases ( 1.26％ ). There was no recurrence in the region of NAC.ConclusionsNipple-areola complex sparing modified radical mastectomy is oncologically safe by strict preoperative selection criteria and strict operative procedure.

ObjectiveTo investigate the clinicopathological characteristics of nipple-areolar complex (NAC) involvement in patients with operable breast carcinoma and to determine the indications and risk factors of NAC-sparing modified radical mastectomy. Methods407 female patients with primary breast cancer were included in the study.Data like tumor position, tumor size, the distance from the tumor to the margin of areolar (D) were recorded.NAC sample in vitro was collected and routine pathological examination was performed.Statistical methods were employed to analyze the relation between the clinicopathological factors and NAC involvement.ResultsThe rate of NAC involvement was 13.27％ (54/407).NAC involvement had no statistically significant correlation with age or histological type, but had statistical correlation with tumor position, D value, tumor size, TNM stage, clinical manifestation of NAC, and status of axillary lymph nodes(P ＜ 0.05).ConclusionsTumor position, D value, tumor size, TNM stage, clinical manifestation of NAC and status of axillary lymph nodes are the major influential factors for NAC involvement.The indications of NAC-sparing modified mastectomy:1.in Ⅰ or Ⅱa TNM stage; 2.patients have strong will to preserve NAC or breast appearance; 3.noncentric tumor (D≥2 cm) ; 4.the maximum diameter of tumor should be less than 3 cm; 5.no abnormal manifestation like nipple discharge, eczematoid change or nipple inversion happened.6.no occult involvement in subareolar tissues was found by frozen pathology.

Objective To investigate the relationships between the level of heat shock protein (HSPs) 70 and severity of sepsis in order to find its effects on the status of sepsis and the prognosis of the patients. Methods In total, 120 patients diagnosed to be suffering from sepsis from the emergency department were selected as studying subjects. According to SAPS Ⅱ score, all of these patients were divided into mild, moderate and severe groups (n =40 in each group) , and at the same time, 40 healthy volunteers were studied as controls. The levels of intracellular HSPs70 in peripheral blood neutrophil cells in the mild, moderate and severe groups were determined by using flow cytometry, while serum levels of procalcitonin (PCT) and C-reactive protein ( CRP) were measured as well. Results ① The levels of heat shock proteins HSPs70 in neutrophil cells and PCT in patients with sepsis escalated gradually with the increase in SAPS Ⅱ score, and there were significant different among the mild, moderate, and severe sepsis groups(P<0.05). ② In all septic patients, the death happened only in the severe group. Compared other markers in the survivals , the level of heat shock protein HSPs70 was significantly higher in fatal patients. ③ In curve plot analysis in the patients with sepsis done by the curve of receiver operating characteristic (ROC) , the area of HSPs70 in neutrophil cells under the curve was significantly larger as compared with that of PCT and CRP. Conclusions Heat shock protein HSPs70 has a certain clinical value in determining the severity of disease and prognosis of patients suffering from sepsis.

ObjectiveTo summarizeand the law of lymph node metastases from adenocareinoma of esophagogastric junction ( AEG),analyses the extent of lymphadenectomy for AEG.Methods198 cases of AEG had been retrospectively analyzed from 2006.6.6 to 2010.12.31,and kept detailed record of the operation type、Siewert's type、TNM stage and group of metastatic lymph nodes.ResultsThe thoraco-abdominal two field lymph node dissection had been performed for 198 AEG,the total number of lymph nodes had been dissected was 3069,the average number was 15.50,the number of metastases lymph nodes was 859.In the 198 AEG,132 cases with lymph node positive,The metastatic rate and incidence was 66.67％ and 27.99％,respectively.The manner of the metastasis about 130 cases was station by station and 2 cases was skipping over station,accout for 98.48％ and 1.52％ of all nodes-positive cases,1 case skiped to left gastric and celiac axis and another case skiped to tracheal bifurcation.The location of positive lymph nodes about Siewert Ⅰ and Ⅱ were recorded:tracheal bifurcation(6.25％,3.33％ ) 、lower posterior mediastinum and paraoesophageai(25.00％,14.67％ ),right paracardiac (47.92％,52.00％ ),left paracardiac (31.25％,36.67％ ) 、lesser curvatura(43.75％,43.33％ ),greater curvatura( 27.08％,22.00％ ) 、left gastric and celiac axis( 27.08％,30.00％ ).The lymph nodes metastastic rate of stage T1 + T2 and T3 + T4 were 40.43％,74.83％,respectively,the difference were significantly.The lymph nodes metastastic rate of different tumor length were analyzed,≤ 3cm group were 40.74％,3 ～5cm group were 70.71％ and ≥5cm group were 88.89％,the difference were significantly;but there were no significant difference related to different differentiation grades and different Siewert types.The mediastinal lymph node metastase rates between Siewert Ⅰ (27.08％) and Siewert Ⅱ (14.67％) were significant difference,but the difference were not found in pericardiac lymph nodes.ConclusionSiewert Ⅰ 、Ⅱ AEG trend to metastasized to middle and low mediastinal and pericardiac,the modified left thansthoracic route and two field lymph node dissection maybe suitable to the lymphadenectomy for AEG.

Objective The study of capsaicin (CAP) on the effect and mechanism of indomethacin induced acute gastric mucosal injury in different period.Methods 80 SD rats were randomly divided into 8 groups with 10 rats in each group.The experiment was completed in two phases,and the Ⅰ period was 2 weeks,the Ⅱ period was 4 weeks.The Ⅰ period including group A1 (control group),group B1 (model group),group C1 (CAP group),group D1 (CAP + indomethacin group).The grouping method of the two periods were the same.The rats' gastric mucosa were damaged by indomethacin,and then killed the rats 4 hours later.Last,astric juice was collected to determine the total acidity of gastric acid,counted thegastric mucosal injury index,observed the gastric mucosa pathological injury,detected the expression of TRPV 1、CGRP、MDA、SOD and PGI2.Results The Ⅰ period:the gastric mucosa of group A1 and C1 had no damage.Group D1 compared with group B1,there was no significant difference in gastric mucosa injury (P ＞ 0.05),total acidity decreased significantly (P ＜ 0.05),MDA was no significant difference (P ＞ 0.05),SOD、PGI2 increased significantly (P ＜ 0.05),the expression of TRPV1、CGRP increased significantly (P ＜ 0.05).The Ⅱperiod:the gastric mucosa of group A2 and C2 had no damage.Group D2 compared with group B2,the gastric mucosa injury were significantly reduced (P ＜ 0.05),total acidity decreased significantly (P ＜ 0.05),MDA decreased significantly (P ＜ 0.05),SOD、PGI2 increased significantly (P ＜ 0.05),the expression of TRPV1、CGRP increased significantly (P ＜ 0.05).Conclusion There was no damage to the general morphology and histology of gastricmucosa in rats by intragastric CAP 1 mg/(kg· d) for 2 weeks and 4 weeks.2.It could prevent that indomethacininduced acute gastric mucosal injury in rats by pretreated with CAP 1 mg(kg· d) for 4weeks.

BACKGROUND:Transforming growth factor β1 (TGF-β1) and interleukin 1β (IL-1β) have been reported to play an important role in the occurrence and development of primary osteoarthritis. OBJECTIVE:To investigate the association between gene polymorphisms of TGF-β1 and IL-1β and primary knee osteoarthritis. METHODS: Han and Uyghur elderly populations in Xinjiang Uygur Autonomous Region, China were surveyed on the prevalence of osteoarthritis, followed by allotted to osteoarthritis and health groups according the symptoms and radiography. Genotyping TGF-β1-509C/T and -1348C/T and IL-1β-511C/T was performed to analyze the relationship between the gene polymorphisms of TGF-β1 and IL-1β and osteoarthritis. RESULTS AND CONCLUSION:Alleles T and C with genotypes CC, CT and TT were detected in both two groups. In the Uygur population, the genotype frequency of TGF-β1-509C/T and IL-1β-511C/T showed significant difference between osteoarthritis and health groups (P < 0.05). In the Han population, the genotype frequency of TGF-β1-1348C/T showed significant difference between two groups (P < 0.05). These results suggest that the Uygur individuals carrying TT genotype of TGF-β1-509C/T and IL-1β-511C/T, and Han people carrying the TT genotype of TGF-β -1348T are more susceptible to osteoarthritis.

Objective To explore the rule of central region lymph nodes metastasis in differentiated thyroid carcinoma (DTC) and the significance of central region lymph nodes neck dissection in surgical operation for DTC.Methods The clinical and pathological data of 122 lymph nodes in 109 patients (31 female and 78 male) with DTC undergoing neck lymph nodes ( central region lymph nodes included) dissection from Jan.2003 to Jun.2007 in our hospital were analyzed retrospectively.According to preoperative physical examination and imaging analysis,patients were divided into clinical cervical lymph nodes metastasis ( cN + ) group and clinical no cervical lymph nodes metastasis (cNO) group and compared respectively with their pathological data after surgery.Resuits Of the 122 lymph nodes,lymph node metastasis rate was significantly higher in region Ⅵ than in region Ⅱ,Ⅲ and Ⅳ.The difference had statistical significance (P ＜0.01 ).65.6％ (80/122) metastasis was in the central region.81.2％ (56/69) patients in cN + group and 45.3％ (24/53) patients in cN0 group had central region lymph nodes metastasis.Conclusions Central region lymph nodes metastasis is common for patients with DTC.Routine neck dissection in central region should be done in DTC operation.