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.

This article introduces the progress about study of lipid mdeiating action of chitosan. It was found that chitosan could mediate blood lipids and modification of chitosan could improve its lipid mediating activity in animal and human.

Objective To analyze the composition principles of Chinese patent drugs containing Rehmanniae Radix;To provide reference for clinical application and new drug research and development.Methods Based on the software Traditional Chinese Medicine Inheritance Support System (V2.0), the authors built prescription database containing Rehmanniae Radix in National Standard for Chinese Patent Drugs (NSCPD). Then the authors adopted the statistical module by using data mining methods such as association rules and improved mutual information method, with a purpose to analyze the attending disease, combination rules and the core groups in prescriptions containing Rehmanniae Radix.Results In 357 prescriptions containing Rehmanniae Radix, 17 most commonly used drug combinations were mined. Meanwhile, two diseases, namely, insomnia and vertigo were chosen from the 22 diseases that Rehmanniae Radix was most frequently used to make deeper analysis, showing that Rehmanniae Radix can achieve different therapeutic effects through different compatibility.Conclusion Prescriptions containing Rehmanniae Radixin NSCPD mainly concentrate on clear heat and cool blood, and nourish Yin. The composition principles obtained from the research that Rehmanniae Radix used when curing different diseases can fully play the efficacy of RehmanniaeRadix and provide evidence for clinical scientific formulae.

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.

Objective:To establish an optimum preparation process for Hongteng decoction hollow suppositories. Methods:An orthogonal design was performed to screen the proportion of drug and base(A),the temperature of mold filling with drug and base(B)and stripping time(C),and the appearance and melting time were used as the indices ,the best preparation technology of the hollow suppositories was optimized. Results:The optimum preparation technology of the hollow suppositories was as follows:the proportion of drug and base was 1 ∶2,the filling temperature was 40℃,and the stripping time was 30 min. Conclusion:The optimum preparation technology of Hongteng decoction hollow suppositories is simple and feasible.

Objective To understand the status of soil-transmitted nematode infections,as well as the awareness and healthy behavior on soil-transmitted nematodiasis in rural residents of Dezhou City. Methods Six villages were selected according to the stratified sampling method;the permanent resident population aged 3 years or above was determined as the investigation objects. The modified Kato-Katz technique was adopted to detect the eggs of Ascaris lumbricoides,hookworm and Trichuris trichiura in the feces of the residents,and the method of cellophane anal swab was used to detect the Enterobius vermicularis infection in children under 12 years old. More than 50 households in each investigated site were randomly selected to investigate the awareness status on nematodiasis prevention and treatment and the condition of healthy behavior formation. Results A total of 2 294 residents were detected by Kato-Katz methods,11 of them were positive,and the total infection rate of soil-transmitted nematodes was 0.48%. To-tally 260 children were detected and 40 were infected with E. vermicularis,and the infection rate was 15.38%. A total of 898 resi-dents were investigated in the household survey and the awareness rate of nematodiasis prevention and treatment was 44.99%,the proportion of residents with healthy behavior was above 70%. Conclusions The infection rate of soil-transmitted nematode is low in rural areas of Dezhou City,but the infection rate of E. vermicularis in children is higher. The condition of healthy behavior forma-tion is satisfying,but the awareness rate of nematodiasis prevention and treatment of the residents is low. Therefore,the control measures as well as healthy education still should be strengthened.

Aim To investigate the release feature of ginsenoside Rd solid lipid nanoparticles (Rd-SLN) in vitro,and to clarify the difference in absorption of Rd-SLN from varied rat intestinal segments and pharmacokinetic properties in vivo. Methods Dialysis method was used to determine ginsenoside Rd release rate from nanoparticles in vitro. Perfusion method was used to study the intestinal absorption of Rd-SLN in rat. HPLC assay was established to determine the concentration of ginsenoside Rd in plasma. After intragastric administration,the concentrations of drug in rat blood at different time points were recorded to investigate the absorption and pharmacokinetics of Rd-SLN. Results The release of ginsenoside Rd from Rd-SLN was slowed down and presented the property of sustained release. There was no significant difference between the absorption rate of Rd-SLN and control solution in duodenum and jejunum. However,it was obviously different in ileum and colon. Comparing with other intestinal segments,significantly higher percentage of Rd-SLN was absorbed in colon. In Rd-SLN group,the concentration of ginsenoside Rd in blood was maintained,and the Cmax,MRT,AUMC,and AUC were all increased. Conclusions Rd-SLN possesses sustained-release effect. The colon is the preferable absorption site for Rd-SLN in intestinal tract. Rd-SLN can enhance the oral bioavailability of ginsenoside Rd.

Objective To investigate the value of emergency transcatheter arterial embolization in the treat-ment of liver and spleen rupture,in order to provide the reference for clinical therapeutic strategies.Methods In our hospital,58 patients with liver and spleen rupture were selected.Operation time,catheter angiography,embolization of success rate,postoperative survival rates and the postoperative complications were recorded.Then follow-up,patients with sequela of occurrence was recorded.Results Embolizations of 55 cases were successful,3 cases accounted for 94.8%,2 were successful, no embolization failed, the success rate of catheter angiography in the diagnosis was 100.0%.31 cases of arterial embolization for splenic artery,10 cases of hepatic artery,8 cases of right hepatic artery, 2 cases of left hepatic artery.The average operation time was (57.8 ±15.6) min.All the patients were successfully hemostatic,postoperative survival rate was 100.0%for patients.2 cases of postoperative biliary leakage,1 cases with splenic abscess,the incidence of postoperative complications was 5.2%.Recovery of all patients was good,without the occurrence of sequelae.Conclusion Rupture has good clinical efficacy of emergency transcatheter arterial emboliza-tion in treatment of liver and spleen,liver,spleen can be retained in the circumstances,the effective control of hemor-rhage,improve the clinical success rate.

BACKGROUND:A large number of clinical trials have found that the number of bone marrow stem cels at the femoral neck and proximal femur in patients with osteonecrosis of the femoral head is significantly reduced, accompanied by decreased activity, which causes a significant decrease in osteogenic capacity that the necrotic bone cannot be effectively repaired after absorption, leading to the colapse of the femoral head. OBJECTIVE:To probe into the early clinical efficacy of autologous peripheral blood mononuclear cel transplantation with porous core decompression for treatment of avascular necrosis of the femoral head. METHODS:Forty-five patients with avascular necrosis of the femoral head (49 hips) were enroled in this study, and underwent autologous peripheral blood mononuclear cel transplantation with porous core decompression. After treatment, pain scores, Harris hip score, scores on the satisfaction of patients were evaluated, as wel as X-ray, CT and MRI examinations. RESULTS AND CONCLUSION:Al the patients received a folow-up visit of 11-14 months, averagely (12.5±0.6) months. During the folow-up, there were no complications and serious adverse reactions. Postoperative pain scores and Harris scores were both improved significantly compared with preoperative ones (P < 0.05). At 12 months after treatment, the excelent satisfaction rate was up to 92%. Patient’s MRI low signal region accounting for a percentage of the volume of the femoral head was decreased from (40.1±7.34)% preoperatively to (20.23±5.4)% at 6 months postoperatively, and there was a significant difference (P < 0.05). These findings indicate that autologous peripheral blood mononuclear cel transplantation with porous core decompression for treatment of avascular necrosis of the femoral head has significantly clinical effects at early stage, which can obviously reduce joint pain, improve and restore hip joint function, and delay progression of disease.

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.