Objective To review the status and controversy on skin-sparing mastectomy (SSM) for breast cancer. Methods The pertinent literatures about SSM published recently to comprehend its relevant techniques and improvements in comparison with non-skin-sparing mastectomy (NSSM) were analyzed and also the safety of SSM by analyzing the relationships between SSM and ductal carcinoma in situ, restrict nipple-areola complex reservation, and postmastectomy radiotherapy were discussed. Results Skin-sparing mastectomy combined with immediate breast reconstruction is a safe operative modality for T1/T2 tumor without skin adhesion, multicentric tumors, and ductal carcinoma in situ. What is more, it does not defer adjuvant therapy. However, it may be prudent to reserve the nipple-areola complex only for peripherally located T1/T2 tumors and some other less serious invasion degree. Since the effect of SSM and immediate breast reconstruction on postmastectomy radiotherapy is confusing, there are still controversies on whether the patients who have already been operated should take radiotherapy. Conclusion SSM is a safe operative modality for selected patients with breast cancer, and delayed reconstruction may be a good choice for patients who would take postmastectomy radiotherapy.

Objective To introduce the method of treating chronic mallet finger using Micro Arc bone Anchor, and investigate the feasibility of this method with the clinical effects.MethodFourteen chronic mallet fingers were treated with Micro Arc bone Anchors. During the operation, a "?" skin incision over the dorsum of the DIP joint was made to expose the extensor tendon and resect the scar tissue between the disrupted ends. Then the DIP joint was made at extending position was immobilized with a 1mm Kirschner wire and the ends of extensor tendon was sutured with horizontal mattress suture method. After that,the Micro Arc bone Anchor was sutured into the dorsal base of the distal phalanx,the suture thread attached the end of anchor was tied to the proximal end of the extensor tendon to reinforce the former suture. External fixation on the anterior face of forearm was applied to immobilize the wrist at 30?of extention and the metacarpophalangeal and interphalangeal joints and extending position for 3 w, and Kirschner wire fixation was taken out 6 w postoperatively. Functional exercises were performed after the Kirschner wires were removed.ResultAll the cases were followed up for 6 months to 1 year, and excellent results were obtained in 10 cases, good in 2, fair in 2 and poor in 1 according to Dargan's functional assessment system, with dysfunction of flexion in DIP joint in 1 case, and recurrence of abnormity in 1 case.The total rate of excellent and good results was 85.7%.ConclusionMicro Arc bone Anchor is a convenient and effective alternative for the treatment of chronic mallet finger deformity with many advantages such as the high suturing intensity,low recurrence rate of abnormity, convenient for operation and reliable effect.

Objective To evaluate the effects of different surgical treatments on polycystic hepatic disease and multiple simple hepatic cysts.Methods A total of 35 cases of polycystic hepatic disease and 54 cases of multiple simple hepatic cysts were surgically treated in our department from Jan.1998 to Jan.2006.Of the 35 cases of polycystic hepatic disease,12 were treated with the partial hepatic resection in combination with cyst fenestration,18 with laparotomic fenestration,5 with laparoscopic fenestration.Of the 54 cases of multiple simple hepatic cysts,6were treated with percutaneons aspiration and instillation of sclerosing agents (ethanol) under the guidance of ultrasonography B,36 with laparotomic fenestration,13 with laparoscopic fenestration.The surgical outcome and longterm follow-up outcome were retrospectively analyzed.Results After treatment,all polycystic hepatic disease patients experienced relief of symptoms when discharged.And the follow-up for an average of 3.0 years showed that 2 patients developed recurrence after the partial hepatic resection in combination with cyst fenestration,8 after the laparotomic fenestration,5 after the laparoscopic fenestration.The recurring rates were 16.7%,44.4% and 100.0% ,respectively.However,all patients of multiple simple liver cysts cured.Conclusions The approach of partial hepatic resection in combination with cyst fenestration is the most effective treatment for polycystic hepatic disease.Liver transplantation can cure polycystic hepatic disease,and is the only effective approach for severe cases.Percutaneous aspiration under the guidance of ultrasonography B is only effective for relief of symptoms before operation.Laparoscopic fenestration should be applied with caution.Laparoscopic fenestration is the first choice for multiple simple hepatic cysts with clinical symptoms.

Objective To explore the expression of drug transporter organic anion transporting polypeptide2(Oatp2) and P-glycoprotein(P-gp) in brains of chronic epileptic rats induced by lithium-pilocarpine.Methods Chronic epilepsy modles were elicited after status epilepticus(SE) induced by lithium-pilocarpine in adult Wistar rats.The expressions of Oatp2 and P-gp were detected by immuno-histochemistry(SABC) method.Results Positive expression of Oatp2 was predominantly in the plexus epithelial cells and(blood-brain) barrier endothelial cells.Weak staining for Oatp2 was also detected in the neurocyte.In contrast,apparent expression of(P-gp) was seen in brain capillary and neurocyte only.Compared with normal control rats,expression of Oatp2 on the plexus epithelial cells and brain capillary in chronic epileptic rats was significantly decreased(P

In recently years,the incidence rate of obesity - related glomerulopathy(ORG)is increasing. Adi-pose tissue as a new endocrine organ releases inflammatory factors which can lead to glomerular artery endothelial damage,mesangial expansion and extracellular matrix accumulation and podocyte lesion,etc. Studies have confirmed that the chronic inflammation may play a key role in the pathogenesis of ORG. Now,the molecular mechanisms of chro-nic inflammation and its effect in the development of ORG were summarized.

Angina pectoris is an important event in coronary heart disease.Many researches are conducted on the risk factors and risk stratification of the problem,so as to classify the patients into different risk groups,properly predict their prognosis,take the most effective therapeutic measures and achieve the best results with the least risks and expenses.

It is limited for cartilage tissue to repair its injury. The biological substitution of articular cartilage, namely artificial cartilage, has a good prospect due to the tissue engineering. Biological scaffold material is an important part of tissue engineering cartilage, and therefore, it is significant to explore the progress in biological scaffold materials for the construction of articular cartilage. The main research tendency of recent biological scaffold materials for artificial cartilage is to develop composite, bionic and intelligent materials with good biocompatibility and mechanical functions, through integrated application of surface modification, new construction technology and respective advantages of natural and synthetic materials.

Objective To investigate the induction of specific anti-tumor immune response by transfected dendritic cells (DCs) with survivin mRNA of human pancreatic cancer, and to provide the experimental evidences for the treatment of human pancreatic cancer with DCs vaccine. Methods DCs were isolated and cultured from peripheral blood mononuclear cells (PBMCs). After being transcripted and amplified, survivin mRNA was transfected into DCs by electroporation. The expression of survivin in DCs at different time points was detected by quantitative real-time PCR. The survival rate of DCs before and after transfection was determined by MTT method. The induction of specific cytotoxic T lymphocyte (CTL) response by survivin mRNA transfected DCs was measured by 51Cr standard cytotoxicity test. The induction of specific CTL activation by survivin mRNA transfected DCs was evaluated through testing released IFN-γ by ELISA method. Results After survivin mRNA transfection for 48h, the expression of survivin mRNA in DCs reached the highest point (46.09±6.57). After transfection, the survival rate of DCs was stabilized around 80%. The DCs transfected with survivin mRNA could effectively induce HLA-A2+ / survivin+ specific CTL immune responses. Stimulated with pancreatic cancer cell line Capan-2 cells or SCL-1 cells as control group, the IFN-γ released in 24 hours by survivin specific CTL were (28.79±5.70) U/ml and (25.12±2.13) U/ml respectively, there was no significant difference (P=0.761). Conclusion The induction of CTLs by DCs transfected with human pancreatic cancer survivin mRNA could produce specific anti-tumor immunity.

BACKGROUND: A variety of cages for lumbar interbody fusion have been used, which have good mechanics and clinical effects. Conventional posterior fusion requires parallel implantation of two cages, but some researchers believe that single lumbar fusion cage in oblique way is also possible.OBJECTIVE: Through in vitro biomechanical tests, to find a method with favorable effect and little trauma by combination of percutaneous lateral oblique way into the single expansive lumbar fusion cage between the fixed-line operations.DESIGN, TIME AND SETTING: A randomized, controlled experiment was performed at the Shanghai Institute of Biomechanical Engineering between May 2005 and May 2008.MATERIALS: Expansile lumbar interbody fusion cage was simulated from B-Twin Cage (Disc-O-Tech, Israel). Fresh calf lumbar specimens were used.METHODS: Biomechanical tests were performed in 18 specimens of calf lumbar function spinal units (FSU), which were divided into 3 groups: 6 in control group, 6 in single cage groups and 6 in two-cage groups. The biomechanical tests of two experimental groups were performed following tests of intact specimens. Stiffness tests were conducted in the WE-10A MTS,including axial compression, flexion, extension, lateral bending, and torsion.MAIN OUTCOME MEASURES: Axial and torsion stiffness results of each group.RESULTS: The stiffness was greater in two-cage groups compared with single cage group in axial compression and extension, but significant differences were only found in axial compression and extension tests (P < 0.05). The torsion stiffness of single cage group was significantly greater than two-cage groups (P < 0.05).CONCLUSION: Percutanous lumbar interbody fusion by single expansile lumbar interbody fusion cage from lateral approach is feasible theoretically. Biomechanical properties of FSU with B-Twin cage are improved, which contributes a lot to lumbar stability. Compared with posterior approach of single cage, two-cage can provide better stiffness and stability but its torsion stability is lower.

Objective To investigate the best method of transfecting total RNA extracted from pancreatic cancer MiaPaCa-2 cells into dendrtic cells (DCs). Methods DCs were cultured from peripheral blood mononuclear cells induced by rhGM-CSF, rhIL-4 and TNF-α. Morphology of DCs was observed. Flow cytometry was used to detect the mature DCs specific surface markers:CD40, HLA-DR, CD83, CD86. Mixed lymphocyte (MLR) was used to determine the ability of DCs to stimulate allogeneic T cell proliferation.Liposomal transfection, electroporation method and passive transfection was used to transfect MiaPaCa-2 cell total RNA into DCs, Real time RT-PCR and MTT assay was used to determine the expression of MUC1 mRNA and the survival rate of the RNA transfected DCs. Results The cells acquired showed typical DCs morphology, the positive rate of CD40, HLA DR, CD83 and CD86 were 34.3% ,50.2% ,89.2% and 73.6%,and they showed a strong ability to stimulate allogeneic T cell proliferation. 48 h after transfection with MiaPaCa-2 cells total RNA by using electroporation, the MUC1 mRNA amount (45.39 ± 9.33) in DCs was higher than that of liposomes method (3 1. 68 ± 7.25) and passive transfection method (18.53 ± 3.26) . DCs survival rate was (80.36 ± 2.43)% by using electroporation, which was relatively lower than (91.48 ±5.42) % by using passive transfection method, but higher than (67.44 ± 2.51) % by using liposomes method,and it was stabilized around 80%. Conclusions Transfecting total RNA extracted from pancreatic cancer MiaPaCa-2 cells into DCs with electroporation is efficient and safe.