Objective:This study aims to analyze the occurrence rate, positive rate, and other related factors influencing interpec-toral lymph nodes (IPNs) in breast cancer patients. This work further aims to explore the significance and indications of the surgical dis-section of IPNs. Methods:Clinical and pathological data from 1673 breast cancer patients were retrospectively analyzed. All patients were subjected to modified radical mastectomy, and IPNs were pathologically examined. The occurrence rate and metastasis of IPNs were recorded, and the relationship between the IPN positive rate and tumor size, axillary nodes, clinical stages, neo-adjuvant chemo-therapy, hormone receptors, Her-2 expression, and molecular subtypes of breast carcinoma was determined. Results:The occurrence rate, overall metastasis rate, and the positive rate of IPNs in patients with axillary lymph node metastasis were 13.39%, 4.30%, and 10.01%, respectively. IPN metastasis was significantly correlated with axillary node metastasis and the tumor, node and metastasis (TNM) stage of tumors (P<0.05). However, IPN metastasis was not significantly related with hormone receptor and Her-2 expressions. IPN metastasis rate may be unaffected by neo-adjuvant chemotherapy. Patients with IPNs metastasis were characterized by larger tu-mors, more positive axillary lymph nodes, and later TNM stages. Conclusion:IPN metastasis usually occurs in patients with larger tu-mors, more positive axillary lymph nodes, later TNM stages, as well as those with locally advanced cancer that meet the standard of neo-adjuvant chemotherapy. These indications suggest that the surgical dissection and pathological examination of IPNs should be rou-tinely performed.

Objective To analyze and compare the independent and combined diagnostic values of high frequency ultrasonography (HFU) and molybdenum target imaging (MTI) for early breast tumor in a prospective study.Methods 258 patients with breast mass which were suspected as breast tumors by physical examination received HFU,MTI,their combined applications and operative treatments.Comparative studies were made between the surgical pathology and imaging evaluations.Results Totally 258 cases were enrolled in this study.Surgical pathology confirmed 135 cases of early breast cancer and 123 cases of benign breast tumor.For the diagnosis of early breast cancer,combined application was more effective than HFU or MTI alone in sensitivity (P<0.05),and more superior than MTI alone in accuracy.While the specificity,positive predictive value,negative predictive value, false positive rate, false negative rate had no difference among HFU, MTI and combined applications (P>0.05).In the patients of early breast cancer, compared with HFU,MTI found less nodules of calcification(18.3% vs 36.5%,P<0.01),but revealed more axillary lymph metastasis (69.0% vs 33.3%,P<0.01).Conclusion HFU and MTI alone or their combined application are reliable imaging methods for the diagnosis of early breast cancer.For the sensitivity and accuracy of diagnosis, combined applications has more superior advantages.

Objective To investigate the current status about the application of alteplase (rt-PA) for intravenous thrombolysis in acute ischemic stroke patients,and clarify the relevant factors affecting patients'compliance of intravenous thrombolysis.Methods The acute ischemic stroke patients admitted in Department of Emergency,from January 2014 to December 2015 were recruited for study prospectively.After the patients with contraindications of thrombolysis were excluded,the eligible patients were divided into two groups,intravenous thrombolysis group (ITG) and non-intravenous thrombolysis group (NTG).Receiver operating characteristic curve (ROC) was used to determine the optimal cutoff point and the crucial NIHSS score of patients for decision on thrombolysis therapy.Results There were 230 patients with acute ischemic stroke occurred in the period of two years.Of 189 eligible patients,33 refused the intravenous thrombolysis treatment (NTG) whereas 156 willing to take the intravenous thrombolysis treatment (ITG).The intravenous thrombolysis rate of eligible ischemic stroke patients reached to Henan Provincial People's Hospital within the time window (4.5 hours) was 67.8％ without contraindications.The results of the single-factor analysis for the patients of the two groups displayed that the differences in factors including age,baseline NIHSS score,limb weakness,hemiplegic paralysis,dysphasia,as well as dizziness were significant between two groups (t =2.578,P =0.047;U =157.221,P =0.000;x2 =26.702,P =0.000;x2=9.069,P =0.003;x2 =7.381,P =0.007;x2 =28.636,P =0.000).The ROC analysis demonstrated the relationship between the baseline NIHSS score and the patients receiving intravenous thrombolysis.When NIHSS score ＜ 7,patients tended to refuse the treatment with intravenous thrombolysis (sensitivity 0.87,specificity 0.82).Among the patients receiving intravenous thrombolysis,the significant differences in intracranial hemorrhage rate,hospitalization mortality rate and 3-month mortality rate were not found between the patients with baseline NIHSS score≥7 and score ＜7 (1.9％ vs.3.9％,P =0.662;1.9％ vs.7.8％,P =0.168 and 3.8％ vs.11.7％,P =0.142,respectively).However a higher rate of favorable prognosis (3-month modified Rankin Scale score ≤ 1) was observed in thrombolysis patients (75.5％ vs.41.7％,P =0.000).Conclusions Factors such as age,baseline NIHSS score,limb weakness,hemiplegic paralysis,dysphasia,as well as dizziness are supposed to be associated with patients' compliance of intravenous thrombolysis.

Objective To evaluate the degree of hypothermia cerebral resuscitation patients by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and judge the prognosis,so as to prove the effectiveness of its application.Methods Data of 34 cases of patients with mild hypothermia cerebral resuscitation in ECIU or ICU were continuously observed,calculated the scores of APACHE Ⅱ and verify for establishing the regression model.Results The APACHE Ⅱ score was 20-47 (33.86 ± 5.12) scores.The APACHE Ⅱ score in 9 patients who were survived within 72 h was (27.83 ± 4.89) scores,and in 25 patients who were dead within 72 h was (35.56 ± 7.12) scores,there was significant difference (P ＜ 0.01).Logistic regression analysis showed that APACHE Ⅱ score was the risk factor (P ＜ 0.01).Conclusion APACHE Ⅱ score can be applied to evaluate the degree of mild hypothermia cerebral resuscitation and prognosis,it can guide the clinical decision making.

Objective To observe the expression of indoleamine 2,3-dioxy-genase(IDO) in hippocampus of rats with posttraumatic stress disorder (PTSD) and the protective effect of IDO inhibitor on neurons,and to explore the role of IDO in the pathogenesis of PTSD.Methods Adult male Wistar rats were randomly divided into the normal control group,PTSD model group and IDO inhibitor treatment group.The expression of IDO was detected by immunohistochemistry,RT-PCR and Western-blot.The apoptosis of rat hippocampal neurons was assayed by Tunel staining.Tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected by ELISA.Moreover behavioral evaluation was performed,including central residence time,percentage of open arm residence time and stage latency.Results Comparing with the control group,PTSD rats showed decreased central residence time ((22.65± 1.54)s),decreased percentage of open arm residence time((10.55± 1.96) ％),prolonged stage latency ((56.38±4.21) s) (P＜0.05),increased TNF-α ((8.58±0.6) pg/ml),IL-6 ((15.72±1.42) pg/ml) and IDO mRNA (0.8278±0.0796),increased IDO protein (1.2329±0.1148) expression and apoptosis rate ((81.47± 6.86) ％) in hippocampus (P＜ 0.05) (P＜ 0.05).However,rats treated with IDO inhibitor showed increased central residence time((30.78±3.20) s),increased percentage of open arm residence time ((10.55± 1.96)％),shortened stage latency ((56.38 4.21) s),meanwhile reduced expression of TNF-α((3.69±0.41) pg/ml),IL-6((7.45±0.58) pg/ml),IDO mRNA(0.2236 ±0.0387) and IDO protein(0.4235±0.0411) was detected in hippocampus(P＜0.05).Apoptosis rate ((42.54± 3.98)％) was also decreased in hippocampus(P＜0.05).Conclusion The content of TNF-α,IL-6 and IDO are increased significantly in the hippocampus of PTSD rats.IDO may participate in the pathogenesis of PTSD,and the IDO inhibitor may play a neuroprotective role in hippocampus of PTSD.

Abstract A novel luminol electrochemiluminescence strategy based on titanium dioxide/carbon nanotubes ( TiO2/CNTs) nanocomposites for detection of glucose was developed. First, the TiO2/CNTs nanocomposites were prepared by a sol-gel method and modified on the glassy carbon electrode. The electrochemiluminescence ( ECL) signal could be greatly enhanced when the electrode was established by the nanocomposites, which finally resulted in the increased sensitivity. Glucose oxidase calalyzed the oxidation of glucose to form H2 O2 , and the H2 O2 reacted with luminol to produce the ECL signal. Thus the above system was proved to be efficient for glucose detection. The modified electrode exhibited excellent ECL signals and a good linear range of 1. 0í10-7-5. 0í10-6 mol/L with a detection limit of 5. 2í10-8 mol/L towards glucose detection. This strategy was successfully demonstrated as a sensitive, rapid, simple and cost-effective method to detect glucose. Meanwhile, the TiO2/CNTs nanocomposites offered a novel material for the signal enhancement in electrochemiluminescence sensor.

Objective To explore the population reproductive regularity and reproductive performance of rhesus and cynomolgus monkeys in Kunming area, and to provide reference data for the construction of rhesus and cynomolgus monkey breeding base,reproductive biology research and biological resources protection.Methods The reproductive regularity and reproductive performance in a rhesus monkey population of 20 males and 130 females, and a cynomolgus monkey population of 120 males and 780 females in a large-scale experimental monkey breeding base in Kunming were observed for a whole year and statistically analyzed.Results There was a distinct seasonal variation in the reproduction of rhesus monkeys in Kunming area, while no obvious seasonal changes was observed in cynomolgus monkeys.The pregnancy rate, reproductive rate and neonatal survival rate of rhesus monkeys were 76.15%, 69.23% and 90.70%, respectively.The pregnancy rate, neonatal reproduction rate and survival rate of cynomolgus monkeys were 78.98%, 74.87% and 94.81%, respectively.The menstrual cycle and pregnancy period of rhesus monkeys were (28.80 ± 2.33) d and (165.87 ± 7.52) d, respectively.The menstrual cycle and pregnancy period of cynomolgus monkeys were (29.35 ± 3.05) d and (157.93 ± 5.42) d, respectively.The average birth weight and weaning weight of rhesus monkey pups were (425.00 ± 100.50) g and (1491.67 ± 172.35) g, and those of cynomolgus monkeys were (314.33 ± 61.18) g and (1013.50 ± 115.50) g, respectively.Conclusions The reproduction regularity of rhesus and cynomolgus monkeys in Kunming area are defined.The reproductive performance of rhesus and cynomolgus monkeys are reported in detail.It provides basic data for the breeding of rhesus and cynomolgus monkeys in Kunming area and the development of research of experimental monkey reproductive biology.

Objective:To explorethe the clinical manifestations, treatment and prognosis of anastomotic pseudoaneurysm after renal transplantation caused by infection.Methods:Clinical data of 1 recipient with pseudoaneurysm after renal transplantation due to Pseudomonas aeruginosa infection were retrospectively analysed and combined with a literature review. Results:At Month 2 post-transplantation, the recipient developed right lower abdominal pain, and contrast-enhanced ultrasound examination showed a pseudoaneurysm at the artery anastomosis. Anti-infection and anti-rejection therapy had no obvious effect, and therefore next surgical exploration was performed. A size4.0 cm×3.5cm pseudoaneurysm was found intraoperatively at the graft renal artery anastomosis.After graft was evaluated as having no preservation value, the transplanted kidney and pseudoaneurysm were resected. Bacterial culture indicated Pseudomonas aeruginosa infection.The recipient recovered well and waited for next transplantation. Conclusions:Pseudoaneurysm of transplanted kidney is a very rare complication after renal transplantation, and caused by infection of Pseudomonas aeruginosa is more rarer, It has not been reported in mainland China.This type of recipient has the characteristics of high graft inactivation rate and high mortality rate. Timely surgical resection can effectively prevent the deterioration of disease.

Objective:To evaluate the predictive value of the National Institutes of Health Stroke Scale(NIHSS)score and the Glasgow Coma Scale(GCS)score for bleeding in patients with acute cerebral infarction after thrombolytic therapy.Methods:A total of 281 patients with acute cerebral infarction were enrolled at Henan Provincial People's Hospital and were treated with urokinase or recombinant human tissue plasminogen activator(rt-PA)for thrombolysis.The patients were followed up for up to 1 month after thrombolysis.Data on age, sex, time to thrombolysis, smoking, systolic blood pressure, platelets, prothrombin time, international normalized ratio, and NIHSS and GCS scores were collected.Logistic regression analysis was used to identify related factors for bleeding after thrombolysis in acute cerebral infarction and the receiver-operating characteristic curve(ROC)was used to assess the predictive values of these factors through calculating the area under the curve(AUC).Results:Logistic regression analysis showed that time to thrombolysis, prothrombin time before thrombolysis, NIHSS score before thrombolysis, NIHSS score 24 h after thrombolysis, GCS score before thrombolysis, and GCS score 24 h after thrombolysis were independent factors for hemorrhage after thrombolytic therapy( OR=23.318, 0.238, 17.099, 4.561, 0.004, and 0.258, P=0.038, 0.021, 0.038, 0.027, 0.006, and 0.040, respectively).ROC curve analysis showed that NIHSS score before thrombolysis, NIHSS score 24 h after thrombolysis, and time to thrombolysis were important factors for predicting bleeding after thrombolysis(AUC=0.833, 0.795, and 0.714, respectively, all P=0.000). Conclusions:For patients with acute cerebral infarction, the risk of bleeding after thrombolysis is significantly increased if the NIHSS score is unfavorable before thrombolysis or 24 h after thrombolysis, or the duration of acute cerebral infarction is long.Attention to risk factors and early intervention are warranted.

[Objective] To observe the effects of autophagy induced by different doses of ultraviolet B (UVB) irradiation on the apeptosis in human skin fibroblasts.[Methods] Skin fibroblasts were isolated from the circumcision specimen of a 23-year-old healthy male,and subjected to a primary culture.After 3 to 10 passages,the cells were collected and applied in the following experiment.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation of some fibroblasts treated with different concentrations (0,0.5,2.0,5.0and 10.0 mmol/L) of 3-methyladenine (3-MA).To qualitatively and quantitatively detect the autophagy in fibroblasts treated with different concentrations of 3-MA and in fibroblasts treated with 3-MA of 0.5 mmol/Lfollowing UVB irradiation,monodansylcadaverine (MDC) staining was carried out,and immunofluorescence was used to detect the expression of microtubule-associated protein 1 light chain (LC3).Some fibroblasts were classified into 8 groups to remain untreated,be irradiated with UVB of 30,50 and 100 mJ/cm2 alone,treated with 3-MA of 0.5 mmol/L alone,or treated with 0.5 mmol/L 3-MA following irradiation with UVB of 30,50 and 100 mJ/cm2,respectively,then,cell apoptosis was qualitatively detected by Hoechst and propidium iodide (PI)staining,and quantitatively detected by flow cytometry with annexin V and PI.[Results] The percentage of autophagic cells was (63.037 ± 5.876) ％ in fibroblasts treated with starvation condition,significantly decreased to (34.425 ± 5.183) ％ in fibroblasts treated with 3-MA of 0.5 mmol/L.The expression of LC3 showed a gradually increasing trend from untreated fibroblasts,to fibroblasts irradiated with UVB of 30,50 and 100 mJ/cm2,while the increase was attenuated by the 4-hour treatment with 3-MA immediately after the irradiation.Compared with the other concentrations,the 3-MA of 0.5 mmol/L showed the least influence on the viability of fibroblasts.The addition of 3-MA of 0.5 mmol/L increased the percentage of cells both positive for Hoechst and PI staining in fibroblasts irradiated with UVB of 50 mJ/cm2,but decreased that in fibroblasts irradiated with UVB of 100 mJ/cm2.Similarly,the percentage of middle and late apoptotic cells was significantly higher in fibroblasts irradiated with UVB of 50 mJ/cm2 followed by treatment with 3-MA of 0.5 mmol/L than in those irradiated with UVB of 50 mJ/cm2alone ((10.933 ± 0.839) ％ vs.(7.267 ± 0.473) ％,t =5.20,P＜ 0.05),but lower in fibroblasts irradiated with UVB of 100 mJ/cm2 followed by treatment with 3-MA of 0.5 mmol/L than in those irradiated with UVB of 100 mJ/cm2alone ( (7.100 ± 0.781 ) ％ vs.( 1 0.133 ± 0.681 ) ％,t =6.29,P ＜ 0.05 ).[Conclusion]s The irradiation with UVB of 50 mJ/cm2 may protect fibroblasts by inducing autophagy and suppressing apoptosis,while the high level of autophagy induced by UVB of 100 mJ/cm2 may lead to autophagic cell death in fibroblasts.