Recurrence and metastasis is the main cause of death in breast cancer patients. Early detection and treatment of malignant breast cancer cells and metastasis are the hotspots of current resear-ches. The discovery of circulating tumor cells(CTC)may provide new ideas for the diagnosis and treatment of breast cancer. Detection of CTC will help the early detection of micrometastasis,the guidance of individ-ual treatment,and the evaluation of therapeutic effect and prognosis. Domestic and foreign research pro-gress of CTC was reviewed in this paper.

Objective To study the Application of X-linked differentially methylated polymorphism site in forensic medicine.Methods X-STR HUMARA was chosen as a model locus.PCR procedures were performed after digestion using methylation-sensitive restriction endonucleases.STR polymorphism of HUMARA was analyzed and compared in samples collected from male and female individuals.Result After digestion with methylation-sensitive restriction enzyme HpaⅡ,no PCR products were obtained from male samples,whereas PCR products from the female samples were normally typed.In monoclonal tumor cell samples from females,only one allele was detected.Conclusion The differentially methylated X-STR HUMARA locus is a novel marker for mixture analysis of mixed stains,sex determination and discrimination of tumor tissues.

Drowning represents one of the leading causes of unnatural death. The plankton test is still considered as one of the useful methods for medico-legal investigation of death by drowning although controversies concerning the reliability of the test exist. The methods commonly used for detection of planktons generally include microscopic examination after tissue samples are destructed with or without strong acid, and detection of the planktons by molecular biological techniques. The evaluation of the positive results by the former methods are limited by the physical-chemical characters of the planktons. Detection of DNA genetic markers by molecular biological techniques, which can provide abundant information and is applicable to studying various planktons, is a novel method helpful for investigation of drowning. In the present paper, several techniques for detection of planktons were reviewed as references for medico-legal practitioners in investigation of suspected cases of drowning.

Objective To explore the expression changes of HSP90αin cardiac muscles and survival rates in rats by using the different fluids to resuscitate the severs hemorrhagic shocked rats ,and provide reference for the clinical treatment of hemorrhagic shock with different resuscitation fluids .Methods Uncontrolled hemorrhagic shock rats model was established ,using lactic acid salinger liquid ,poly peptide injection gelatin ,hypertonic sodium chloride dextran for fluid resuscitation respectively ,and then checked the HSP90αexpression changes and survival rates in rats .Results the expressions of HSP90αin myocardial tissue and the mortality in rats were different after using different resuscitation fluids in severe hemorrhagic shock rats ,difference was statistically significant(P<0 .05) .Conclusion the expression of HSP90α in cardiac muscles of rats could be induced by severe hemorrhagic shock ,the HSP90αexpressed differently and regularly after using different resuscitating fluids ,it implied that the HSP90α played an important role in the hemorrhagic rats cardiac as a regulating fator .

Objective To study the association of serum L-kynurenine changes with nutritional status and vascular stiffness in maintenance hemodialysis (MHD) patients. Methods Twenty gender- and age-matched healthy volunteers (healthy group) and 40 MHD patients,including 20 cases with α-keto aicd(α-keto acid group)and 20 cases without α-keto aicd(non-α-keto acid group)were enrolled in the study.Serum L-kynurenine was measured by high performance liquid chromatography.C-reactive protein (CRP)and interleukin 6 (IL-6)were detected.Subjective global assessment(SGA)and malnutrition inflammation score(MIS)were applied to evaluate the nutritional status.Pulse wave velocity(PWV)was used to evaluate arterial stiffness for both groups of MHD patients. Results Serum L-kynurenine was significantly higher in MHD patients than that in healthy subjects[(3.20±1.12)μmol/L vs (1.74±0.27)μmol/L,P<0.01],while such difference was not found between α-keto aicd group and non-α-keto-aicd group [(3.20±0.88)μmol/L vs (3.29±1.34)μmol/L,P>0.05].IL-6 was significantly higher in MHD patients as compared to healthy subjects[(6.45±3.78)ng/L vs(1.38±1.59)ng/L,P<0.01],while such difference was found between α-keto aicd group and non-α-keto aicd group[(3.37±0.82)ng/L vs (9.62±2.48)ng/L,P<0.051.There was no difference of CRP concentration between two MHD groups.As compared to non-α-keto acid group,higher SGA score(26.00±1.75 vs 22.67±2.61,P=0.001),lower MIS score(5.82±2.27 vs 10.00±2.62,P=0.002),lower left side PWV[(21.11±8.21)m/s vs(24.57±5.45)m/s,P=0.244]and lower right side PWV[(19.27±3.22)m/s vs (24.19±5.41)m/s,P=0.015]were observed in α-keto aicd group.Pearson analysis showed positive correlation between serum L-kynurenine and IL-6(r=0.352,P=0.011)and negative correlation between L-kynurenine and pre-dialysis Scr(r=-0.412,P=0.019). Conclusions Inflammation is common in MHD patients.Tryptophan degeneration product L-kynurenine may indicate inflammation status.α-keto acid improves nutritional status,anemia and arterial stiffness maybe through the alleviation of inflammation in MHD patients.

Objective:To explore the effectiveness of medial malleolus screw epiphyseodesis for pediatric ankle valgus correction and calculate the correction rate, and analyse the influence factors on deformity correction and the risk factors of deformity recurrence after screw removal.Methods:Medical records and radiographs of patients undergoing screw hemiepiphyseodesis of the medial physis of the distal tibia for ankle valgus between Jan 2011 and Dec 2020, at a single pediatric orthopedic department were retrospectively analyzed. A total of 41 patients (49 ankles) were included in following study, including 28 male patients and 13 female patients; with 24 left sides and 25 right sides. Median age at surgery was 10.75 (4.5, 13.9) years, and median follow-up time was 27 (12, 64) months. According to the clinical diagnosis: hereditary multiple exostoses were 23 ankles, fibula hemimelia were 5 ankles, tibia hemimelia were 2 ankles, endochondromatosis were 5 ankles, neurofibromatosis were 5 ankles, traumatic fracture were 6 ankles, and fibrous dysplasia were 3 ankles. The lateral distal tibial angle (LDTA) was measured on ankle weight-bearing X-ray to evaluate the deformity correction. Malhotra classification was used to describe shortening of the fibula at the ankle.Results:Eventually effective correction were obtained in 36 ankles, with an overall effective rate of 73.5%. Screw type (partial-thread or full-thread), screw length (whether to the contralateral cortex), washer used, clinical diagnosis, and age are not independent risk factors for effective correction. Multiple linear regression analysis ( R 2=0.67) was applied for postoperative correction amplitude in effective correction cases, and the length of correction time ( P<0.001), clinical diagnosis ( P=0.013) and preoperative LDTA ( P=0.002) were significant predictive factors after adjusting for age differences. One-way ANOVA were used to compare data between different clinical diagnosis, showed a significant difference in the mean postoperative correction rate ( F=5.05, P=0.003). Conclusion:Medial malleolus screw epiphyseodesis is an effective and reliable method for the treatment of ankle valgus deformity in children; different clinical diagnosis can produce significant differences in the correction rate of ankle valgus deformity.

Objective To observe the role of community popular opinion leader (POL) intervention on ocular epidemic study. Methods During the process of epidemiological survey of eye disease in Shenyang City,the community POL was interviewed to observe the change of the follow-up population from 2015 to 2016 and the effects of the POL intervention were analyzed. Results The study population follow-up rate was significantly improved after POL intervention (χ2 = 85.42,P < 0.01),the male-to-female ratio was balanced (χ2 = 6.51, P = 0.01),and more participants were willing and hoped to participate in the epidemic study for a long time. Conclusion Community POLs can improve the follow-up rate of epidemiological surveys and mobilize the enthusiasm of the population to participate in epidemiological investigations.

ObjectiveTo explore the therapeutic effect and mechanism of Yiqi Huoxue Tongbian prescription on slow transit constipation （STC） in rats. MethodThe rat model of STC was established by gavage of loperamide hydrochloride. Rats were assigned into control， model， mosapride， low-， medium-， and high-dose （3.51， 7.02， and 14.04 g·kg^-1， respectively） Yiqi Huoxue Tongbian prescription groups. The changes of general signs， fecal moisture content， and intestinal propulsion rate were measured after model establishment and drug administration. The colonic mucosal changes were observed by hematoxylin eosin staining. Enzyme-linked immunosorbent assay was employed to determine the content of substance P （SP） and vasoactive intestinal peptide （VIP） in the colon of rats in each group. The gray values of aquaporin （AQP） 3， AQP4， AQP8， and c-Kit in rat colon tissue were measured by immunohistochemistry and Western blot， and the changes of intestinal flora were detected by 16S rRNA high-throughput sequencing. ResultCompared with the model group， 10 days of treatment with Yiqi Huoxue Tongbian prescription increased the fecal moisture content and intestinal propulsion rate （P<0.01）. The medium- and high-dose Yiqi Huoxue Tongbian prescription groups and the mosapride group showed no obvious mucosal inflammation and neat arrangement of goblet cells with a large number in the colon tissue. Moreover， the three groups showed increased SP content （P<0.01） and decreased VIP content （P<0.01） in the serum. The medium- and high-dose Yiqi Huoxue Tongbian prescription groups showed down-regulated protein levels of AQP3， AQP4， and AQP8 （P<0.01） and up-regulated protein level of c-Kit （P<0.01）. The drug administration groups presented slightly increased observed species， Chao1， ACE， and Shannon， Simpson， and PD whole tree. The principal component analysis showed that the control group had a short distance with the high- and medium-dose Yiqi Huoxue Tongbian prescription groups， indicating that high- and medium-dose Yiqi Huoxue Tongbian prescription can recover the intestinal flora to that in the control group. ConclusionYiqi Huoxue Tongbian prescription can alleviate the defecation status of rats with slow transit constipation by down-regulating the expression of AQP3， AQP4， and AQP8 to reduce the absorption of water in the intestine， up-regulating the expression of c-Kit to increase the number and distribution of Cajal interstitial cells， and regulating the balance of flora in the colon tissue.