Operation is one of the important ways in breast cancer treatment.With the deep basic medical research,new theory,new concept and new technology improve the operation therapy in breast cancer in more scientific and rational way Breast-conserving therapy and sentinel lymph node bipsy (SLNB) are applied,and the neoadjuvant chemotherapy make breast-conserving therapy more feasible.The progress of operation therapy in breast cancer make it critical to emphasize the individualized treatment in breast cancer.

Objective To investigate the olanzapine and quetiapine quetiapine in the treatment of Alzheimer's disease patients of different clinical effects and influence on the swallowing function of patient.Methods According to the order of visits to the author departments were 73 cases of Alzheimer's patients were divided into group A(37 cases) and group B(36 cases).Patients in group A were treated with olanzapine in the treatment of, and group B with quetiapine in the treatment, the time of the two groups of patients are 12 weeks, to observe the differences of the two groups during the treatment of swallowing function indexes and clinical efficacy.Results After treatment, the MMSE scores of two groups of patients compared with pre-treatment, there was no statistical significance and BEHAVE-AD score before treatment significantly decreased ( P <0.05 ).Post-treatment, the patients in two groups of MMSE, BEHAVE-AD score difference does not have statistical significance.The difference of clinical efficacy between two groups post-treatment was not statistically significant.Watian drinking water test score of two groups Post-treatment, SaO2 decreased value compared with those pre-treatment significantly increased (P<0.05).After treatment of two groups of patients Watian drinking water test score difference does not have statistical significance, and post-treatment, patients in group B of SaO2 decreased value lower than that in group A ( P <0.05 ).Mild dysphagia, two cases of moderate swallowing dysfunction occurred in twenty-six patients in group A, group B with mild swallowing dysfunction occurred in twenty-one patients, A group of swallowing dysfunction more serious than group B serious ( P <0.05 ) .Conclusion Olanzapine and quetiapine quetiapine in the treatment of patients with Alzheimer's disease clinical effect quite, patient's swallowing function cause some adverse effects, effects of olanzapine is more serious.

Objective To explore the value and criteria for primary tumor resection in patients with stage Ⅳ rectal cancer. Methods The clinical data were retrospectively analyzed for 53 patients with stage Ⅳ rectal cancer undergoing primary tumor resection. Results All patients were graded according to Eastern Cooperative Oncology Group (ECOG) performance as status 1. Seventeen of 53 patients (32%) received palliative resection. Thirty-six patients received adjuvant radiotherapy and/or chemotherapy. The median follow-up was 14 months. Forty-seven patients had complete resolution of their symptoms related to the primary rectal cancer for a year. The median survival was 16 months and 2-year overall survival of 24.5%. On multivariate analysis, chemotherapy was a determinant of prolonged survival (P=0.046). Conclusions Resection of primary tumor in patients with stage Ⅳ rectal cancer can improve the quality of life. Patients who have a good performance status, minimal metastatic disease and normal preoperative liver function tests should undergo resective surgery and aggresive systemic chemotherapy.

ObjectiveTo analyze the clinicopathologic characteristics and survival of ethnic minority female patients with triple negative breast cancer (TNBC) from Xinjiang Uygur Autonomous Region.Methods The clinicopathological characteristics,including age at diagnosis,size of tumor mass,lymphnode involvement,adjuvant therapy,recurrence of disease and survival of patient,of 48 ethnic minority patient cases with TNBC negative for estrogen receptor (ER),progesterone receptor (PR) and human epidermal growth factor receptor-2 (Her-2) were analyzed,whom were treated in our hospital from January 2001 to December 2005,including age at diagnosis,size of tumor mass,lymph node involvement,adjuvant therapy,recurrence of disease and survival of patients.ResultsOf the 48 patients,median age was 47 years,and 83.3 ％ (39 cases) of patients had stage Ⅱ or Ⅲ disease.The majority(85.4 ％,41 cases)of pathological types were grade Ⅱ or Ⅲ invasive ductal carcinomas,and lymph node involvement was detected in 56.2 ％ (27 cases) of these patients at initial diagnosis.46 patients were followed and had adjuvant therapy.Tumor-free survival and overall survival at 5 years were 43.5 ％ (20/46) and 52.2 ％ (24/46),respectively.Patients with lymph node involved had only 38.5 ％ (10/46) of overall survival at 5 years.ConclusionThe incidence of triple negative breast cancer of female patients in Xinjiang multiple minority groups is similar to domestic study,and the rates of over all survival is lower than that in Han Chinese patients. The female patients with TNBC in Xinjiang Uygur Autonomous Region multiple minority groups showed higher lymph node involvement at initial diagnosis and more distal metastasis.Patients with lymph node involved had poor survival.

AIM:To study the changes of ?-adrenoceptors in peripheral lymphocytes at different stages of asthma. METHODS:?-adrenoceptors in peripheral lymphocytes, cAMP and cGMP levels in blood plasma were measured by radioligand binding assay and radioimmunoassay.RESULTS:Bmax and Kd of ?-adrenoceptors in asthma at remission stage were markedly higher than that in normal subjects, while cAMP levels in blood plasma were not different between them. Bmax of ?-adrenoceptors and cAMP levels in blood plasma in asthma at acute exacerbation stage were significantly lower than that in normal subjects, Kds between these two groups were not much different. There was no correlation between ?-adrenoceptors, cAMP and cGMP levels in blood plasma and ventilatory functions.CONCLUSIONS:Changes of ?-adrenoceptors in asthma rather be a pathological change accompanied by the course of the disease than a primary defect.

Objective To investigate the G protein-coupled receptor kinase 2 (GRK 2) level in peripheral blood lymphocytes with cardiac func-tion in elderly patients with acute myocardial infarction. Methods This study enrolled 40 patients with acute ST-segment elevation myo-cardial infarction (STEMI) and 40 patients with unstable angina. All patients were 65 years or older. Cardiac function was evaluated by echocardiography, and the GRK 2 level in peripheral blood lymphocytes was measured. Patients with STEMI were followed up for 2 years. Results The GRK 2 level in peripheral blood lymphocytes was significantly higher in patients with STEMI than in patients with unstable angina, and was negatively correlated with left ventricular ejection fraction, cardiac output, stroke volume, and left ventricular fractional shortening. The GRK 2 level was significantly elevated in some patients with acute STEMI and poor cardiac function. Conclusions In-creased GRK 2 level in patients with acute STEMI may contribute to poor myocardial systolic function and myocardial remodeling. Meas-urement of the GRK 2 level in peripheral blood lymphocytes may assist in the evaluation of cardiac function and myocardial remodeling in elderly patients with acute STEMI.

Objective:To explore the effect of early mother to child separation on neonatal nervous system and its related mechanism.Methods:Randomly selected during January 2015 to September 2015,was born in 120 cases of newborn mice as the research object,the newborn mice was born after the implemented of mother-to-child separation as observation group (60),not the implemented of separation of mother and baby after birth as the control group (60),in view of the two groups of newborn mice of the nervous system,the change of the nerve cells were compared and researched.Results:The apoptotic rate of neurons in the neonatal mice was significantly higher than that in the control group (P ＜0.05).The neurons of caspase-3 protein expression was significantly higher than the control group (P ＜0.05).The expression of Caveo-1 protein in the glial cells of 14 days and 21 days was observed in the neonatal mice.The expression of Caveo-1 protein in the glial cells of the control group For comparison,(P ＜0.05),which were statistically significant.Conclusion:The early implementation of matemal and infant birth separation of neonatal nervous system will produce great influence,and influence the expression of the nervous system in the development of newborn,which affect the behavior of the neonatal adult dysplasia.

OBJECTIVE: To objectively evaluate the voice rehabilitation status in different period after treatment of Tis--T1 glottic carcinoma by CO2 laser with voice parameters. METHOD: A retrospective review of 41 cases with Tis--T1 glottic carcinoma treated by CO2 laser was performed, 23 cases were stage Tis (Tis group) and 18 cases with stage T1N0M0 (T1 group). The range of excision of the lesion by CO2 laser was according to the different stages of the tumor, and ensured theoperation negative margin was by intraoperative frozen pathological examination. We tested and compared the actual voice (coritaine F0, Jitter, Shimmer, NNE and MPT) of 30 cases of healthy middle-aged and old male(normal group) and all the patients at one day prior to operation, three months, six months and one year after operation respectively, which was to evaluate the voice rehabilitation status in different period after operation objectively. RESULT: Postoperative pathological examination revealed, 23 cases were squamous epithelium severe atypical hyperplasia, 16 cases were well differentiated squamous cell carcinoma, and 2 cases were moderately differentiated squamous cell carcinoma. Palatoglossal arch mucosal tear occurred in 3 patients. Respiratory difficulties were not seen in all cases, and normal oral feeding was obtained in all cases in postoperative three days. All patients were followed up for one year. There was statistical significance in F0, Jitter, Shimmer of both Tis group and T1 group after operation in different periods(P<0.05). But there was no statistical significance in NNE and MPT between six months and one years after operation in the two groups(P>0.05). CONCLUSION CO2 laser surgery is an effective treatment for early glottic carcinoma. Postoperative vocal function was improved in varying degrees, and voice quality gradually improved with the rehabilitation time. Partly objective parameters reflecting the vocal function gradually stabilized after half a year after operation.
Carcinoma, Squamous Cell ; complications ; therapy ; Glottis ; Humans ; Laryngeal Neoplasms ; complications ; therapy ; Laser Therapy ; Lasers, Gas ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Voice Quality

Though achieved great success as the only curative treatment for end-stage liver diseases, liver transplantation has been severely restricted by the shortage of donors. The adoption of extended criteria donor (ECD) tackles the donor shortage problem to some extent, thus became an issue we must face in China at present stage. As the transplantation effect and recipient safety is largely decided by the quality of liver graft, ECD graft should be cautiously selected and adopted because of its inherent defects. This relies on individualized decisions made for recipients by transplant surgeons who have a good understanding of the risk factors and evaluation criteria of ECD. In this article, we investigate the risk factors, evaluation criteriaand allocation of ECD liver grafts as well as the application of mechanic perfusion, and we discuss the fundamental issues and prospects of ECD study.

Objective To investigate the risk factors of femoral head necrosis after internal fixation of fem-oral neck fracture,and to clarify the predictive role of serological index plasminogen activator inhibitors-1(PAI-1)on femoral head necrosis.Methods A total of 95 patients undergoing internal fixation for femoral neck fracture were included in the study.Relevant clinical information of patients was obtained and the serum PAI-1 levels of the patients before surgery,1,2,and 3 days after surgery were detected.After 1-year follow-up,patients were divided into necrosis group and non-necrosis group according to the occurrence of femoral head necrosis.Visual Analog Scale(VAS),Western Ontario McMaster University Osteoarthritis Index(WOMAC),and Harris Hip Score(HHS)were conducted in all patients one year after the surgery.The differences of basic clinical information and serum PAI-1 levels before and after the surgery between necrosis group and non-necrosis group were compared,and Logistic regression analysis was performed to identify the relevant risk factors for femoral head necrosis.The relationships between the PAI-1 level after operation and the VAS,WOMAC,and HHS scores of patients were figured out.The receiver operating characteristic(ROC)curve of serum PAI-1 as a predictive indicator for femoral head necrosis was drawn to clarify its predictive val-ue.Results Garden classification and reduction quality between the necrosis group and the non-necrosis group were risk factors for femoral head necrosis(P＜0.05).The serum PAI-1 at 1 day and 2 days after surgery in the necrosis group were significantly higher than that in the non-necrosis group(P＜0.05).The level of PAI-1 at 1 day and 2 days after surgery was positively correlated with VAS and WOMAC(P＜0.05),and negative-ly correlated with HHS(P＜0.05).Logistic regression analysis showed that the increase of serum PAI-1 level at 1 day and 2 days after surgery were risk factors for femoral head necrosis(P＜0.05).The ROC curve showed that serum PAI-1 level at 2 days after surgery had higher predictive value than that at 1 day after sur-gery,and the cut-off value was 44.8 ng/L,the sensitivity was 68.49％,the specificity was 86.36％,and the ar-ea under the curve(AUC)was 0.807.Conclusion The serum PAI-1 level at 1 day and 2 days after internal fixation of femoral neck fracture could be used to predict the occurrence of femoral head necrosis,especially the serum PAI-1 levels at 2 days after surgery.