0.05). But there were statistic difference in the those indexes and pathological changes of bile duct and liver between A and ligation groups on the 30th and 90th day after operation (P

Ojective To study the diagnosis and treatment of upper extremity edema after radical mastectomy. Methods Diagnosis depended on B type ultrasoundgraphy, CT, lymphography, venography, biopsy and axilla exploration. Lymphaticovenous anastomosis (LVA) with microsurgery technology was used for the treatment of simple lymphoedema. Results In 40 cases of lymphoedma after radical mastectomy, 7 patients were diagnosed as metastasis of cancer. 3 patients were diagnosed obstrcution of lymphatic and vein. 30 patients with simple lymphedema were treated with LVA. Short term efficacy was observed in all patients.The efficacy at 3～12 years was 83.3%. Conclusion The diagnosis of upper limb edema after radical mastectomy is essential. Metastasis and obstruction of vein are the causes. Biopsy conducted under high frequency B type ultrasoundgraphy may be a good method for the diagnsosis of matastasis, but a few patients were diagnosed only by axilla exploration. LVA may be given first priority to the theraphy of lymphedema after radical mastectomy.

Objective To investigate the changes of the serum high sensitive C-reactive protein (hs-CRP)level in patients with acute cerebral infarction (ACI) and study the relationship between hs-CRP level and ischemic stroke subtypes according to the trail of org10172 in acute stroke treatment (TOAST) criteria.Methods The serum hs-CRP was measured in 152 ACI patients by immunonephelometrical method. All ACI patients were classified into 5 major ischemic stroke subtypes based on TOAST criteria. And then the relationship between hs-CRP level and their TOAST subtypes were analysed.Results The percentage of each ischemic stroke TOAST subtypes of 152 patients was as following: stroke of undetermined etiology 41.45%, small-vessel occlusion 34.87%, cardioembolism 5.26%, large-artery atherosclerosis 15.79%, and stroke of other determined etiology 2.6%. Among 5 ischemic stroke subtypes, cardioembolism patients were related to the highest positive rate of hs-CRP(87.50%) and the highest hs-CRP level [(11.60?7.85)mg/L]. The hs-CRP level in large-artery atherosclerosis or stroke of other determined etiology were (10.77?4.27) mg/L or (6.45?3.25) mg/L respectively, Stroke of undetermined etiology and small-vessel occlusion subtypes were associated with the lowest positive rate of hs-CRP(38.10%, 37.74%) and the lowest hs-CRP level [(4.09?5.65)mg/L,(3.99?0.56)mg/L]. Apparently, other factors, such as age, systolic blood pressure, cholesterol, triglyeride, fasting blood sugar and fibrinogen, could also affect the hs-CRP level in serum(r=0.1640、0.2489、0.2066、0.1866、0.3029、0.2224,all P

OBJECTIVE To study the Pseudomonas aeruginosas drug resistance in intensive care unit and its fluoroquinolone-resistant molecular mechanism,and provide scientific basis for rational employment of antibiotics in clinic. METHODS E test was used to determine the minimal inhibitory concentrations(MIC) of 13 antibiotics against 83 P. aeruginosa strains. Twenty-eight fluoroquinolone-resistant strains were selected with standard sensitive strain-ATCC27853 as control. The quinolone resistance-determining region(QRDR)of the gyrA and parC genes was amplified by PCR and sequenced. RESULTS The positive rate of P. aeruginosa in sputum specimen was the highest from 83 strains (71.08%). gyrA Genes of all resistant strains had an ACC to ATC mutation in codon 83,leading to the amino acid substitution of threonine for a an isoleucine and 11 high level resistant strains also showed a GAC to GGC mutation in codon 87,leading to the substitution of an aspartic acid a glycine for. In addition,14 resistant strains also had an TCG to TTG mutation in codon 87 of parC gene,leading to the amino acid substitution of a serine for a leucine. We didn't find parC gene mutation existing independent in fluoroquinolone-resistant P. aeruginosa. CONCLUSIONS Meropenem remains highly active against P. aeruginosa. But the abuse of imipenem and other fluoroquinolones leads to rise in their drug-resistance rate. Fluoroquinolone-resistance has increased rapidly,the mechanism of resistance is gene mutant. It displayed that gyrA and parC gene mutation is associated with fluoroquinolone resistance.

Objective To investigate the pattern of fluctuations and clinical significance of fasting serum insulin(FINS) and C-peptide(CP) levels in patients with different subtypes of acute cerebral infarct(ACI) and its relationship with serum lipid. Methods FINS and CP were measured in 152 ACI patients by chemiluminescent immunoassay. All ACI patients were classified into 5 major ischemic stroke subtypes according to the trial of org10172 in acute stroke treatment(TOAST) criteria. And then the relationship between FINS and CP level and serum lipid in different TOAST subtypes were analysed. Results The percentage of each ischemic stroke TOAST subtype was as follow: stroke of undetermined etiology 40.13%, small-vessel occlusion 34.21%, cardioembolism 5.26%, large-artery atherosclerosis 15.79%, and stroke of other determined etiology 4.61%. Among 5 major stroke subtypes, large-artery atherosclerosis patients had the highest levels of FINS and CP. The levels of FINS and CP in small-vessel occlusion were (8.237?5.144) ?U/ml and (1.761?0.975)ng/ml,respectively. Stroke of other determined etiology subtypes were associated with the lowest levels of FINS and CP. Apparently, other factors, such as TC, TG, LDL, SBP, DBP, age and HDL, could also affect the levels of FINS and CP in serum. Conlusions Levels of FINS and CP varied in different subtypes of ACI. There was a significant correlation among insulin resistance, hyperinsulinemia(HIS) and lipid metabolic abnormality in ACI.

Objective To investigate the expressions of CD133 and CD44 and their prognostic significance in gastrointestinal stromal tumors (GIST).Methods Streptavidin perosidase (SP) method of immunohistochemistry was used to detect expressions of CD133 and CD44 proteins in 42 cases of GIST, and the relationship between their expressions and tumor size, mitotic count were analyzed by univariate and multivariate factor analyses.Results The expressions of CD133 and CD44 proteins in GIST were 21.4％ (9/42) and 78.6％ (33/42), respectively.The expressions of CD133 and CD44 proteins were significantly correlated with tumor size and mitotic count (P ＜ 0.05).Univariate factor analysis showed that the overall survival of GIST patients with positive CD133 protein (23.2 months) was shorter than that of patients with negative CD133 protein(63.1 months) (P ＜ 0.05).The overall survival of GIST patients with negative CD44 protein (23.2 months) was shorter than that of patients with positive CD44 protein (63.3 months) (P ＜ 0.05).Multivariate factor analysis showed that tumor size, mitotic count and CD44 protein were independent prognostic indicators for survival time after operation.Conclusions The positive expressions of CD133 and CD44 proteins might be the prognostic factors of GIST patients.

Objective To investigate the effects of shRNA targeting a disintegrin and metalloproteinases 17(ADAM17)on the proliferation of human breast cancer MCF-7 cells in hypoxia environment.Methods The four specific ADAM17-shRNA se-quences aiming at ADAM17 were designed,transfected into MCF-7 cells by electroporation,and cultured in hypoxia environment. The experiment was divided into the control group (blank phosphate buffer solution,PBS),nonsense sequence group (transfected with ADAM17-shNC)and shRNA transfection group (transfected with ADAM17-shRNA,the highest silencing efficiency of shR-NA was selected for following experiments).Real-time PCR was used to detect the expression of ADAM17 mRNA.The prolifera-tion ability and cell cycle change of MCF-7 cells were detected by iCELLigence and flow cytometry (FCM),respectively.Results Compared with control group and nonsense sequence group,the four ADAM17-shRNA transfection groups all had the silence effect on ADAM17 gene expression (P <0.05 ),the difference was statistically significant(P <0.05 ),particularly shRNA1219 had the highest inhibitory rate (F =5.11,P <0.01 ).The cellular proliferation ability and cell growth speed in the shRNA transfection group were significantly decreased compared with the control group and nonsense sequence group (P <0.05).Most cells of shRNA transfection group remained in the G0/G1 phase (73.35 ± 2.45 ),which in the control group and nonsense sequence group was (62.56±2.35)and (62.68 ±1.20)respectively,the difference was statistically significant(P <0.05).The cell cycle progression was significantly delayed.Conclusion ADAM17-shRNA inhibits the proliferation of MCF-7 cells under hypoxic environment.

Spinal cord injury is a kind of disease with high disability rate and poor prognosis. According to the degree of injury and damage plane, adopting appropriate rehabilitation measures can effectively enhance the patient's sensory and motor function, and ultimately improve the quality of life. This article briefly introduced the content of rehabilitation training corresponding with various periods, and summarized that relieving the secondary injury, improving the regenerative microenvironment, promoting proliferation and differentiation of endogenous neural stem cells differentiation and inducing plasticity were the biological mechanisms underlying the effect of rehabilitation training.

Blood glucose levels of 220 days were recorded in 85 type 2 diabetic patients for monitoring glycemia for 48-72 h each one by the continuous glucose monitoring system (CGMS). Frequencies of nocturnal hypoglycemia (blood glucose≤2. 8mmol/L) were estimated when bedtime blood glucose levels were≤4.4mmol/ L,≤5.0mmol/L,≤5. 6mmol/L,≤6.1mmol/L,≤6. 7mmol/L, or≤7. 2mmol/L respectively. Nocturnal hypoglycemia occurred in 39 nights of 220 days (17.7%) of 26 patients and their bedtime blood glucose level was (4.4?2.6)mmol/L with a range from 2. 2 to 12. 6 mmol/L. Using a cut-off of bedtime blood glucose at≤6. 7 mmol/L, area under the ROC curve was reached maximal value (0. 359?0. 046). The positive predictive value was 25% and the negative predictive value was 91. 7%. CCMS is a useful tool to detect unaware nocturnal hypoglycemia.

Objective To optimize the enamel electron paramagnetic resonance (EPR) spectral processing by using the EPR spectral simulation method to improve the accuracy of enamel EPR dosimetry and reduce artificial error.Methods The multi-component superimposed EPR powder spectral simulation software was developed to simulate EPR spectrum models of the background signal(BS) and the radiation- induced signal (RS) of irradiated enamel respectively.RS was extracted from the multi-component superimposed spectrum of irradiated enamel and its amplitude was calculated.The dose-response curve was then established for calculating the doses of a group of enamel samples.The result of estimated dose was compared with that calculated by traditional method.Results BS was simulated as a powder spectrum of gaussian line shape with the following spectrum parameters:g =2.00 35 and Hpp =0.65 - 1.1 mT,RS signal was also simulated as a powder spectrum but with axi-symmetric spectrum characteristics.The spectrum parameters of RS were:g(1) =2.0018,g (11) =1.996 5,Hpp =0.335 - 0.4 mT.The amplitude of RS had a linear response to radiation dose with the regression equation as y =240.74x + 76 724 ( R2 =0.9947 ).The expectation of relative error of dose estimation was 0.13.Conclusions EPR simulation method has improved somehow the accuracy and reliability of enamel EPR dose estimation.