Objective To explore the diagnostic value and security of percutaneous puncture biopsy on pancreas mass under CT guidance.Methods Seventeen patients who were found pancreas mass by imaging tests were treated with percutaneous puncture biopsy under CT guidance.And then pathological examinations of the tissue were carried out.Some patients were punctured more than one time.Results Among the total 17 patients,14 patients achieved positive pathological results (positive rate 82.35％).Results diagnosed 8 cases of pancreatic cancers,3 cases of lymphoma,2 cases of chronic pancreatitis and one case of malignant stroma tumor.Conclusion It's an important and minimal invasive technique of percutaneous puncture biopsy on pancreas mass under CT guidance.And it should be promoted in clinic because of its good security,however,adequate preoperative evaluation and preparation is necessary.

BACKGROUND:Whether there are breast cancer stem cel microspheres in the breast cancer tissues and whether these microspheres have an impact on isolation and culture of breast cancer stem cel s after different cycles of neoadjuvant chemotherapy are stil unclear. OBJECTIVE:To explore the proliferation and differentiation of breast cancer stem cel s in breast cancer tissues after different cycles of neoadjuvant chemotherapy. METHODS:Breast cancer stem cel microspheres were isolated from the breast cancer tissues after different cycles of neoadjuvant chemotherapy to drawn a cel growth curve. Immunocytochemical method was used to detect ALDH1 expression. RESULTS AND CONCLUSION:Microspheres could be obtained from the specimens of neoadjuvant chemotherapy for two, three and four cycles rather than one cycle. At 3 days prior to culture, there was no difference in the number of cel s isolated after two-and three-cycle neoadjuvant chemotherapy;but after 3 days, the cel s from the three-cycle neoadjuvant chemotherapy proliferated faster than those from the two-cycle neoadjuvant chemotherapy;after 6 days, the cel growth curve of two-cycle neoadjuvant chemotherapy was in the plateau stage, and the proliferation of cel s from the three-cycle neoadjuvant chemotherapy showed a rapid increase trend. The positive expression of ALDH1 in the microspheres from the three-cycle neoadjuvant chemotherapy was higher than that from the two-cycle neoadjuvant chemotherapy. These findings indicate that breast cancer stem cel s from the specimens of two-and three-cycle neoadjuvant chemotherapy both have proliferation and differentiation potentials, and the specimens of three-cycle neoadjuvant chemotherapy or above are preferred.

Objective:To explore the effect of continuous obstetric-pediatric cooperative nursing on anxiety, depression and the parenting sense of competence in NICU premature mothers.Methods:Totally 140 mothers of NICU preterm infants in hospital from January 2018 to December 2018 were selected and randomly divided into the control group and intervention group according to the method of random number table, and each group 70 cases. The control group received the routine nursing mode in obstetrics and paediatrics and the intervention group received the continuous obstetric-pediatric cooperative nursing based on routine nursing. To compare the anxiety level, depression level, the score of parenting sense of competence, hospitalization days of preterm infants, the outpatient rate and the readmission rate of preterm infants within 1 months of discharge between two groups.Results:The levels of anxiety and depression of the mothers of premature infants in the intervention group during hospitalization ,1 week after discharge and 1 month after discharge were (43.17±6.89), (8.96±2.67), (34.65±6.87), (7.65±1.92), (34.97±6.06), (6.29±1.54) points, lower than control group (47.03±8.06), (10.97±3.34), (45.44±7.72), (9.43±2.61), (41.46±7.26), (8.28±2.23) points, the differences between the two groups showed statistical significance ( t value was 2.331-6.097, P<0.05). The two dimensions of parenting efficacy and parenting satisfaction were (31.47±4.97), (43.38±4.21) points, which were higher than (25.91±5.42), (39.43±5.91) points of the control group, there were significant statistical differences among the two groups ( t value was -6.314 and -4.528, P<0.01). The hospitalization days of premature infants, outpatient and readmission rate within 1 month of discharge were (13.25±3.27) days, 8.57% (6/70), 2.86% (2/70), which were shorter or lower than (15.59±2.79) days, 24.29% (17/70), 12.86% (9/70) in the control group, the differences were statistically significant ( t value was 2.909, χ2 values were 6.295, 4.834, P<0.05). There were significant statistical differences among interaction effect, time effect and intergroup effect ( F values were 4.921-99.310, P<0.05). Conclusion:Obstetrical-pediatric cooperative nursing can effectively to lower the anxiety and depression level of preterm mothers, improve the parental competence, promote the mental health of preterm mothers, and ultimately shorten hospital days and decrease the rate of outpatient and readmission of premature infants, which is conducive to preterm infants′ rehabilitation.

Objective To explore the feasibility of Ilizarov technique in managing large tibia defects combined with soft tissue defects.Methods A total of 24 patients with large tibial defects combined with soft tissue defects caused by compound open tibial fractures were fixed with Ilizarov technique from September 2003 to September 2010.All patients belonged to open tibial fractures,including 20 patients with Gustilo type Ⅲ B and four with Gustilo type Ⅲ C.After debridement,the soft tissue defect areas was 10 cm ×6 cm and the bone defect was(8 ±4)cm.Fifteen patients with tibial defects ＜5 cm were treated with one stage debridement,fibula resection and tibial defect end compression.The other nine patients with tibial defect ＞ 5 cm were managed by one stage debridement,bone transport and bone lengthening.Then,15 patients were treated with one stage debridement,wound closure or wound reduction,bone grafting treatment and second stage cleansing of the incarcerated skin and fracture end.Results All patients were followed up for average 14 months(10-24 months),which showed reconstruction of the bone defects,restoration of the limb length,fracture healing and less than 2 cm difference between health limb and contralateral limb.One patient experienced common peroneal nerve palsy after operation,but recovered three months later.Of all,19 patients recovered without extra surgery,three restored with skin graft and two received skin flap.Conclusion Ilizarov technique is an effective option for treating the tibial defects combined with soft tissue defects at one stage.

Objective To compare the differences in responsive ability and oxidative stress damage between type 2 diabetic rats and normal rats under acute sepsis associated with stress hyperglycemia.Methods GK rats with type 2 diabetes and Wistar rats were established critical ill models of sepsis by intraperitoneal injection of 5 mg/kg lipopolysaccharide(LPS).Before and after LPS injection,serum levels of proinflammatory cytokines tumor necrosis factor α (TNF-α),interleukin (IL)-1β3,and IL-6,and anti-inflammatory cytokine IL-10 were determined.Malondialdehyde (MDA) and total antioxidative capacity (T-AOC) levels in serum and tissues (lung,liver,kidney,heart) were measured by colorimetric determination.Results Before LPS injection,serum levels of TNF-α,IL-6,and IL-10 in GK rats were higher than those of Wistar rats.The serum levels of TNF-α,IL-6,and IL-10 after LPS injection were raised in both GK rats and Wistar rats (all P＜0.05).At baseline,serum MDA level of GK rats was higher than that of Wistar group [(25.76 vs 12.71) μmol/L,P＜0.05],while T-AOC level were lower [(0.60 vs 2.8) U/ml,P＜0.05].One hour after LPS injection,the serum MDA level in two kinds of rats significantly increased compared with those of their baseline levels [(32.30 and 20.19) μmol/L,both P＜0.05],while their serum T-AOC level decreased [(0.20 and 2.08) U/ml,P＜0.05]).There were no signigicant differences in the change trend of serum MDA and T-AOC between the two kinds of rats.MDA and T-AOC levels in tissues had no significant difference before and after LPS injection in GK and Wistar rats (P＞0.05).Conclusions The rats with type 2 diabetes had lowered level of proinflammatory factors and raised level of anti-inflammatory factors under acute sepsis,presenting better tolerance and lowered probability of inflammatory diffusion compared with normal rats.

Acute rejection is one of the serious early postoperative complications after liver transplantation.Many studies have shown that acute rejection was mainly mediated by T cells,while humoral factors were responsible for chronic rejection.However,accumulating evidences have demonstrated that humoral immune factors also played an important role in early acute rejection and usually resulted in severe adverse events.Here we clarify the role of humoral immunity in liver transplant rejection,which may help guide the clinical management of such patients with humoral rejection after liver transplantation.

Objective To investigate the risk factors of postoperative infection in patients with liver transplantation.Methods Clinical data and laboratory findings of 1 1 3 patients undergoing liver transplantation admitted in Beijing Chaoyang Hospital,Capital Medical University during January 201 1 and December 201 4 were retrospectively analyzed.Among 1 1 3 patients,postoperative infection occurred in 35 patients,multivariate Logistic regression analysis was performed to identify the risk factors of postoperative infection.Results Univariate analysis showed that length of hospital stay,model for end-stage liver disease (MELD)score,preoperative use of antibiotics,duration of postoperative respirator use,length of ICU stay, dosage of albumin,days of parenteral nutrition,intra-abdominal hemorrhage,fasting blood glucose,blood concentration of immunosuppressant (FK506 ),the duration of prophylactic use of antibiotics and pleural effusion were associated with postoperative infection (t =2.56,3.1 9,2.71 and 5.05;χ2 =3.87,5.75,4.66 and 5.46;Z =4.88,3.69,5.86 and 3.90;P <0.05 or <0.01 ).Multivariable logistic regression analysis showed that preoperative use of antibiotics (OR =35.03,95% CI:6.48 -94.64,P <0.01 ),duration of postoperative respirator use (OR =1 .02,95%CI:1 .01 -1 .04,P <0.01 ),days of parenteral nutrition (OR =1 .20,95%CI:1 .07 -1 .35,P <0.01 ),postoperative fasting plasma glucose(OR =1 .46,95%CI:1 .1 0 -2.1 6,P <0.05),the duration of prophylactic antibiotics use (OR =1 .1 0,95%CI:1 .33 -1 .86, P <0.05),and pleural effusion(OR =5.70,95%CI:1 .02 -31 .84,P <0.05 )were independent risk factors of postoperative infection.Conclusion Taken account of possible risk factors,effective prevention and control measures should be taken to prevent postoperative infection after liver transplantation.

Objective To prepare transferring and R8 co-modified liposome (TF/R8-LP)for forhepatoma targeting.Methods The co-modified liposome were prepared by film-ultrasonic method.The appearance,particle size,Zeta potential were evaluated.The cellular uptake by HepG2 cell in vitro was used to evaluate the targeting efficiency and in vivo imaging were used to evaluate the targeting efficiency. Results The particle diameter of the co-modified liposome was(108.5 ±12.6)nm and the Zeta potential was(24.15 ±4.78)mV.The liposome kept stable in 50% FBS at 24 h.The result demonstrated that the co-modified liposome uptaken by HepG2 were 2.4,2.6 times higher than that of R8-LP and TF-LP,respectively(P<0.05).The evaluation of tumor spheroid penetration and in vivo imaging results showed the co-modified liposome had the strongest fluorescence intensity. Conclusion The co-modified liposome might serve as a promising hepatoma delivery system of antitumor drugs.

Objective To evaluate the effect of neoadjuvant chemotherapy factor on neuromuscular block induced by cisatracurium in the patients undergoing radical gastrectomy.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 48-79 yr,with body mass index of 20-27 kg/m2,scheduled for elective laparoscopic radical gastrectomy,were divided into 2 groups (n =30each) according to whether the patient received neoadjuvant chemotherapy before operation or not:nonchemotherapy group (group A) and neoadjuvent chemotherapy group (group B).Anesthesia was induced with cisatracurium 0.15 mg/kg (3×ED95) injected intravenously.When T1 recovered to 10％ of control height,Ⅳ infusion of cisatracurium was started with an initial dose of 1.5 μg · kg-1 · min 1,and the infusion rate was adjusted with the amplitude of 0.2 μg · kg 1 · min-1 to maintain T1 at 5％-10％ of control height.The onset time,nonresponse time,time for T1 to recover to 10％,recovery index and time for train of four ratio to recover to 90％ were recorded.The consumption of cisatracurium was continuously recorded event 30 min starting from Ⅳ infusion of cisatracurium for 3 times,90 min in total.The mean infusion rate within 90 min was calculated.Results Compared with group A,the onset time,recovery index and time for train of four ratio to recover to 90％ were significantly prolonged,the nonresponse time and time for T1 to recover to 10％ were shortened,and the consumption of cisatracurium and mean infusion rate were increased in group B (P＜0.05).Conclusion Neoadjuvant chemotherapy factor can weaken neuromuscular block induced by cisatracurium in the patients undergoing radical gastrectomy.

Objectives To investigate the immune effect of hepatitis B vaccine under the influence of congenital human cytomegalovirus (HCMV) infection. Methods The newborn rat model of congenital HCMV infection was developed by intra-peritoneally inoculating pregnant rat with HCMV suspension,while the offsprings of healthy rats were used as the control group. Offspring rats in all groups were inoculated with hepatitis B vaccine in the postnatal 1st, 3rd and 5th week and were taken blood from hearts separately in 3rd, 5th, 7th and 11th week. Antibody to Hepatitis B surface antigen (HBsAb) titer in all groups was de-tected by ELISA method. Results The serum HBsAb titer in both groups all showed a trend of increasing gradually with added vaccinating times and decreased differently with time extending after completed vaccinations. Differences among changes of HBsAb titer along with prolonged time in each group were all statistically significant (P<0.001). At all time points (3rd, 5th, 7th, 11th week), the titer of serum HBsAb in congenital HCMV infection group was lower than that in the control group respectively, and there were statistically significant differences (P<0.01). Conclusions Congenital HCMV infection could weaken the im-mune effect of hepatitis B vaccine.