Objective To explore clinical result of breast carcinoma by improvement radical correction in retention intercostobrachial nerves.Methods The clinical data of breast carcinoma in our hospital were analyzed,which were divided into detection group and control group.Results The operation time,hemorrhage of operation in detection group were lower than control group,the upper limb decreased,skin stabbing pain and relapse rate were higher than control group (P ＜ 0.05 ),the difference were statistically significant.Conclusion The clinical result is obvious,the prognosis is good.It's worthy of clinical application.

Objective To analyze the imaging performances and significance of Modic changes on X-ray,CT and MRI.Methods The imaging data (MR,CT and X-ray)of patients with low back pain were retrospectively analyzed.The selected patients’images were studied on the same work station by the two physician experts in muscle and bone imaging.A double-blind method was used. Firstly,MRI was used to sort the MC.Then,the alterations of the density in the lesions on X-ray plain film and CT image were measured.if the judgments of the two readers were inconsistent,another professor of radiology will join the discussion and consist-ent results will be got finally.The data were recorded using Excel 2010,and processed for statistical analysis using SPSS 1 6.0.Re-sults A total of 47 cases that met the requirements were collected which included 1 6 males and 31 females,aged from 32 to 76 years,with a median age of 56.0 years.A total of 93 on MRI endplate were changed.However,a part of lumbar endplates with MC on MRI images were displayed as higher density than normal vertebral body on the X-ray and CT reconstruction images (total of 36).The occurrence rates of Type Ⅰ,Type Ⅱ,Type Ⅰ/Ⅱ were 40.0%,14.8%,58.3%,respectively.But the occurrence rate of Type Ⅲ (100%)and hybrid Type which contained type Ⅲ were 100%.Conclusion Some Modic typeⅠ,Ⅱ,Ⅰ/Ⅱchanges in X-ray plain film, CT reconstruction images had a higher density,speculating that there is reactive new bone formation,which reflects the internal ver-tebral body bone mineralized rather than the change of the bone marrow.

Objective To understand the working pressure source of obstetric nurses in Kunming through a sample survey study, so as to provide a reference for obstetric nurses to adjust self-psychology and for clinical managers to relieve working pressure on obstetric nurses. Methods We gave a sampling survey on 249 obstetric nurses in provincial,municipal and private hospitals,and usedChinese nurse job stress scaleto collect the data for statistical analysis. Results Kunming obstetric nurses' working pressure mainly came from the workload and time allocation. The ten stressors with highest score of pressure were frequent highest score, too much work, low welfare benefits,too much useless paperwork, low social status,worry about mistakes at work, too high expectation of patients,too much non-nursing work, nursing work is not accepted by patients and their families, few nurses to work. Age,title and nature of the preparation had no effect on work stress. Public hospital nurses' working pressure was significantly greater than private hospitals. Conclusion Working pressure sources of obstetric nureses in Kuming are too much night shift,too much work,welfare berfits useless paperwork,social status,mistakes at work, patients expectation work is not accopted and staffing Hospital management and nuusing managers should doploy rationally human resoures on obstteic area,reasorabal scheduling.

Objective To evaluate the effect of ?-lipoic acid(ALA)as a antioxidant on the histomorphologic changes of the kidney in type 2 diabetic Goto Kakisaki rats.Methods Four healthy Wistar rats(normal control group)and 10 GK rats were divided randomly into two groups:diabetic control group and lipoic acid-treatment diabetic group(?-lipoic acid 35 mg/kg intraperitoneal injection qd alt),who were both fed for 12 weeks.Indexes of oxidative stress of kidney were measured.Sections of renal tissue were evaluated using both a light and electron microscope to assess histomorphologic changes.Paraffin sections of the left kidneys were prepared and stained with H&E,PAS and Masson stains to compare the histomorphologic changes.The image analysis software of Motic Image Advanced 3.1 was used to measure the area of glomerulus and mesangial region,and the thickness of the glomerular basement membrane(GBM).Results Compared with normal control group,there were significant decreases in GSH,SOD,VitC and VitE levels in diabetic control group.The kidneys of the normal control group exhibited normal cortical morphology as determined by light microscope.Mild glomerulosclerosis,characterized by widening of the mesangial region,mesangial expansion and intercapillary cells proliferation,and GBM thickening under electron microscope were observed in the diabetic control group.In the ALA-treatment group,all the above pathological changes were alleviated.Conclusion In the kidney of type 2 diabetic rat,there exists oxidative stress which is associated with diabetic nephropathy.?-Lipoic acid can alleviate the abnormal histomorphologic changes of the kidney via antioxidative effects.

Objective To investigate the effect of atorvastatin on endothelial diastolic function in patients with coronary artery disease.Methods he selected in January 2014 to December 2016 in our hospital make a diagnosis and give treatment of 80 patients with coronary heart disease(CHD)as the research object, the patients with its treatment is divided into two groups(control group and observation group)experiment, for the control group, 40 patients were treated with trimetazidine for observation group 40 cases of patients with trimetazidine+atorvastatin treatment;Compare the data of the two groups of patients.Results Observation group after treatment in patients with endothelial diastolic function level change is better than that of control group, the observation group vascular endothelin-1(60.48±12.72), nitric oxide(391.45±68.52), peripheral blood circulating endothelial microparticles(849.13±115.49), and other indicators are superior to control group vascular endothelin-1(70.47±15.52), nitric oxide(328.15±56.74), peripheral blood circulating endothelial microparticles(1019.67±127.52), compare the difference between groups was statistically significant(P< 0.05);The clinical therapeutic effect(95.0%)was superior to the control group(77.5%), and the difference in the group was statistically significant(P< 0.05).The incidence of adverse reactions(5.0%)was lower in the observed group(5.0%)than the control group(20.0%), and the difference in the group was statistically significant(P< 0.05).Conclusion Trimetazidine+atorvastatin therapy in patients with coronary heart disease in clinical effect is remarkable, can improve the endothelial diastolic function in patients with fully, is widely used in clinical treatment of coronary heart disease(CHD).

BACKGROUND:Bladder acellular matrix graft (BAMG) is frequently used for domains of tissue engineering scaffold due to its great biocompatibility and cell adhesion. OBJECTIVE:To verify the biological characteristics of BAMG after frozen and lyophilized processing. DESIGN,TIME AND SETTING:A biocompatibility experiment was performed at Shanghai Tissue Engineering Research and Development Center and Experimental Animal Department of the Sixth People's Hospital of Shanghai between May and November 2008. MATERIALS:Two New Zealand rabbits were used in this study for BAMG preparation. METHODS:After midsection of rabbit bladder,mucous membrane of urinary bladder was isolated and dipped in three-distilled water for 24 hours. Thereafter,the samples were incubated with acellular solution containing 0.1% Triton X-100 and 0.15% aqueous ammonia for 14 days. The culture medium was changed regularly. The samples in the control group were stored in 75% ethanol,while samples in the experimental group were frozen for 24 hours at -80 ℃,vacuum-dried for 24 hours,and stored in 75% ethanol. MAIN OUTCOME MEASURES:Biological characteristics of BAMG were detected using hematoxylin and eosin staining,Masson staining,and scanning electron microscopy; biological characteristics were compared between the two groups using cell adhesion test,MTT assay,and subcutaneously embedding test. RESULTS:Hematoxylin and eosin staining and Masson staining revealed that no residual cells were detected in the BAMG,and collagen was intact. Scanning electron microscopy demonstrated that cells exhibited a slit-shaped structure mainly containing collagen which was beneficial for cell adhesion. Mechanical test revealed that the BAMG after frozen and lyophilized processing not only reserved the mechanical properties of the raw BAMG,but also had a great elongation. MTT assay confirmed that cytotoxicity was grade 0,and BAMG had a good compatibility to smooth muscle cells. After subcutaneously embedding for one month,BAMGs had good adhesions to subcutaneous tissues,and muscular adhesion and vascular proliferation were observed. CONCLUSION:BAMG after frozen and lyophilized processing reserves original biocompatibility and has great elongation; therefore,it will become a useful and ideal biomaterial for tissue engineering scaffold.

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

Purpose To establish rabbit VX2 tumor model and to explore the relation between perfusion parameters and the expression of the VEGF in the portal vein VX2 implanting tumor emboli. Materials and Methods VX2 tumor was implanted in the portal vein of eight experimental rabbits. Multi-slice CT (MSCT) perfusion scan was performed after tumor formation to measure and compare portal vein tumor thrombus, hepatic blood lfow (HBF) near tumor foci and far away from tumor foci, hepatic blood volume (HBV), probability of surface area product (PS) and mean transit time (MTT). The VX2 tumor emboli were then resected to analyze the relationship between the liver perfusion parameters and VEGF expression using immunohistochemical method. Results MSCT liver perfusion parameters were not statistically signiifcant between foci close to or far away from the tumor (P>0.05). The HBF, HBV and PS within the tumor emboli were higher than that in hepatic parenchyma (P<0.05) and the MTT was higher (P<0.05). There was positive correlation (r=0.711, 0.646 and 0.626, P<0.05) between the HBF, HBV and PS of portal vein VX2 tumor emboli and VEGF expression, and there was negative correlation between MTT and VEGF expression (r=-0.565, P<0.05). Conclusion MSCT perfusion parameters in the portal vein VX2 implanting tumor emboli and the expression of VEGF are positively related. MSCT can evaluate the angiogenesis of portal vein VX2 implanting tumor emboli.

OBJECTIVETo compare the clinical therapeutic effects on intractable facial paralysis among acupuncture, acupoint catgut embedding and PDS embedding.

METHODSTwo hundred and seventy-nine patients of intractable facial paralysis were randomized into an acupuncture group, a catgut embedding group and a PDS embedding group, 93 cases in each one. Cuanzhu (BL 2), Yuyao (EX-HN 4), Taiyang (EX-HN 5), Xuanlu (GB 5), Dicang (ST 4), Jiache (ST 6), Quanliao (SI 18), Qianzheng (Extra), Xiaguan (ST 7) and Fengchi (GB 20) on the affected side and bilateral Hegu (LI 4) and Zusanli (ST 36) were selected in the three groups. In the acupuncture group, acupuncture was applied to those acupoints, once every two days; 10 treatments made one session; the successive three sessions were required. In the catgut embedding group and the PDS embedding group, catgut and PDS were embedded separately, once every 10 days; 3 treatments made one session and the successive two sessions were required. The therapeutic cycle was 2 months in the three groups. The therapeutic results were analyzed statistically 2 months later. The scores of Sunnybrook facial nerve grading system and the facial nerve electroneurography (ENoG) were used for the efficacy assessment before and after treatment in the three groups.

RESULTSAfter treatment, the score of Sunnybrook facial nerve grading system was improved apparently after treatment as compared with that before treatment in any of the three groups (all P < 0.05). The score in either of the embedding groups was better than that in the acupuncture group (both P < 0.05). The difference was not significant between the catgut embedding group and the PDS embedding group (P > 0.05). After treatment, ENoG wave ampli tude values in the frontal muscle and orbicularisoris muscle on the affected side were improved as compared with those before treatment in the three groups (all P < 0.05). Those in the catgut embedding group and the PDS embedding group were better than those in the acupuncture group (all P < 0.05), and had no significant difference as compared with those on the healthy side (P > 0.05). In the acupuncture group, ENoG wave amplitudes on the affected side were lower than those on the healthy side (both P < 0.05).

CONCLUSIONAcupuncture, catgut embedding and PDS embedding at acupoints all achieve the therapeutic effects on intractable facial paralysis. However, the acupoint embedding therapy presents more advantages on the recovery of facial nerve function. The efficacy is similar between the catgut embedding and the PDS embedding.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Catgut ; utilization ; Facial Paralysis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To analyze the correlation of intervertebral disc degeneration with the blood perfusion of its adjacent border of vertebral body by dynamic contrast‐enhanced MRI (DCE‐MRI) .Methods 3 .0T DCE‐MRI examinations were performed in 15 patients (50 discs) .Intervertebral discs from L1 to L5 were classified to normal group(17 discs) and degeneration group(33 discs) based on the Pfirrmann grading system .The DCE‐MRI pharmaeokinetic parameters of the region of interest(ROI):volume transfer constant (Ktrans ) ,blood volume(BV) and blood flow (BF) were obtained .Independent sample t test was used to compare normal group and de‐generation group .Results In normal group (n=17) ,the mean Ktrans ,BV and BF were (0 .036 2 ± 0 .011 2)min-1 ,(4 .81 ± 1 .17) mL/100 mL ,(5 .68 ± 1 .55) mL · min-1 · 100 mL -1 for the superior border of vertebral body ,and (0 .042 ± 0 .012 9)min-1 ,(5 .03 ± 0 .797) mL/100 mL ,(6 .02 ± 1 .28) mL · min-1 · 100 mL -1 for the inferior border of vertebral body .In degeneration group (n=33) ,the mean Ktrans ,BVand BF were (0 .030 4 ± 0 .011 2)min-1 ,(4 .22 ± 1 .03) mL/100 mL ,(4 .73 ± 1 .38) mL · min-1 · 100 mL-1 for the superior border of vertebral body ,and (0 .033 8 ± 0 .012 5) min-1 ,(4 .07 ± 0 .940) mL/100 mL ,(4 .72 ± 1 .43) mL · min-1 · 100 mL -1 for the inferior border of vertebral body .By statistical analysis :(1)There were no significant differences between superior border and inferior border of vertebral body in Ktrans ,BV and BF in normal group(t= -0 .98 ,-0 .479 ,0 .533 respectively ,P>0 .05 ) .(2)There were no significant differences between superior border and inferior border of vertebral body in K trans ,BV and BF in degeneration group(t= -0 .906 ,0 .497 ,0 .013 respectively ,P>0 .05) .(3)There were significant differences between normal group and degeneration group in Ktrans ,BV and BF(t= -2 .26 ,-3 .01 ,-2 .99 respectively ,P<0 .05) .Conclusion The bone marrow per‐fusion in degeneration group is decreased when compared to normal group with dynamic contrast‐enhanced MRI .Intervertebral disc degeneration correlates with the loss of its blood supply .