Objective To evaluate the effect of different skin flap management methods on post operative (subcutaneous) fluid collection and skin flap necrosis after modified radical mastectomy for breast cancer. (Methods) A retrospectively analysis of clinical data of 119 cases of breast cancer operated by modified (radical) mastectomy in our hospital in recent four years. Statistically analyse the relationship between 4 different skin flap management methods to postoperative subcutaneous fluid collection and skin flap necrosis. Results 43 out of 119 cases developed postoperative subcutaneous fluid collection and/or skin flap necrosis. There were 13 cases with complication of subcutaneous fluid collection, 3 cases with skin flap necrosis among 79 (cases) treated by transverse incision;20cases with complication of subcutaneous fluid collection, and 7 cases of skin flap necrosis among 40 cases treated by longitudinal incision; 23cases with complication of subcutaneous fluid collection, and 8 cases of skin flap necrosis among 60 cases treated by "skin flap management type one"; 23cases with complication of subcutaneous fluid collection, and 2 cases of skin flap necrosis among 59 cases treated by "skin flap management type two". Conclusions A transverse incision after subcutaneous (injection) of 1∶400 adrenaline saline solution, plus the use of scalpel dissection and the technique of skin flap fixation by the "rivet" method can effectively decrease postoperative development of subcutaneous fluid (collection) and necrosis of incisional skin margins.

Objective To explore the value of MRI dynamic contrast-enhanced in differentiating adrenal adenomas from nonadenomas with washout rate of enhancement and the increased SI ratio. Methods Thirty-six patients with 41 adrenal masses enrolled into this study. All these masses underwent conventional T 1WI and T 2WI sequence first, and then FMPSPGR sequence through the center of each mass. Precontrast and dynamic contrast-enhanced FMPSPGR scans were preformed after administration of contrast material of Gd-DTPA intravenously. The signal intensity(SI) of masses was measured on the screen by electronic cursor. The washout rate of enhancement and increased SI ratio were compared between adenomas and nonadenomas. The differentiating adrenal adenomas from nonadenomas were carried out based on combination of the washout rate and the increased SI ratio, meanwhile, the sensitivity and specificity of the diagnosis of adenomas were evaluated well.Results The sensitivity and specificity of the diagnosis of adenomas were 74% and 73%,and accuracy was 73% when the washout ratio was used as a indicator at 5 min. The sensitivity and specificity of the diagnosis of adenomas would be improved markedly when the combination of the washout ratio and the increased SI ratio was used as a indicator.The sensitivity and specificity of the diagnosis of adenomas were 95%, 91% respectively,and accuracy was 93%. Conclusion Using MRI dynamic contrast-enhanced based on combination of washout rate of enhancement and the increased SI ratio,the diagnosis and differentiating diagnosis of adrenal adenoma and nonadenoma can be improved.

Objective To discuss perioperative nursing of pediatric patients with tethered spinal cord syndrome (TCS). Methods 35 pediatric patients with TCS underwent surgical treatment. Pre-operative nursing included psychological care for the parents to eliminate their fear and worries, prona-tion position practice and clean of skin for the children patients, post- operative care included monitor-ing of vital signs, maintaining of proper positions,close observation of the wound, skin care and rehabili-tation training. Results After intensive care, all cases went through the perioperstive period without bed sores. During follow- up disappearance of clinical symptoms occurred in 24 cases, 3 cases got allevia-tion,7 cases with no improvement, and 1 case with deteriorated clinical symptom. Conclusions Preopera-tive care for patients with tethered cord syndrome can provide doctors with the diagnosis and treatment reference, and it plays an important role in treatment and rehabilitation of children patients.

Objective To discuss the differences between hemiarthroplaty and dynamic hip screws (DHS) by comparing their effect in treatment of osteoporotic femoral intertrochanteric fractures. Methods A retrospective study was done on 86 patients with femoral intertrochanteric fractures treated by hemiarthroplasty and dynamic hip screws respectively. After a follow-up for six months, the operation duration time, loss of ambulatory grades and prosthesis loosing were compared between two groups. Re-suits Operation was lasted for hmgcr time in DHS group, with significant difference between two groups. Loosening rate varied with different degree of osteoporosis in high-, moderate- and low-risk groups but not in hemiarthroplaty group. Internal fixators penetrating cortical bone occurred in DHS group, with inci-dence rate of 51.2%. On the contrary, no evidence proved loosening of prosthesis in hemiarthroplaty group. Conclusion For osteoporosis patients with intertrochanteric fracture, the hemiarthroplaty is a reasonable alternative to DHS device, for it can help obtain earlier and better functional recovery and less postoperative complication.

Objective To explore the feasibility of blood oxygen level-dependent (BOLD) MRI to detect the chronic hepatitis b-induced early kidney injury. Methods Seventeen clinically diagnosed chronic hepatitis b patients with early kidney injury and 10 healthy volunteers were enrolled in this preliminary study. The 17 patients underwent dynamic nuclear renography and then subdivided into stage 1 kidney injury group (n=7) and stage 2 kidney injury group (n=10). All of the enrolled subjects underwent BOLD examination and T2* relaxation rates (R2*) of renal cortex and medulla of split kidney, and the ratio between them (R2*med/cor) were measured separately. One-way analysis of variance (ANOVA) were performed on the control group and chronic hepatitis b patients group (kidney injury stage 1 and stage 2 group) to compare the difference of renal cortical and medullary R2*values and R2*med/cor ratio. ROC curves were used to evaluate the efficacy of renal cortical and medullary R2* values and R2*med/cor ratio to diagnose the chronic hepatitis b-induced kidney injury. Results The cortical R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were(16.87 ± 0.74)/s,(17.88 ± 0.73)/s,(20.29 ± 2.87)/s, respectively;the medullar R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were (28.07±1.03)/s,(31.14±2.49)/s,(32.81±3.28)/s, respectively;R2*med/cor of the of control group, stage 1 kidney injury group and stage 2 kidney injury group were 1.67 ± 0.09, 1.75 ± 0.16, 1.63 ± 0.13, respectively, and the differences among the three groups were statistically significant (F values were 17.779, 19.170 and 3.439 , all P<0.05). Furthermore, the renal cortical and medullary R2* values of chronic hepatitis b patients were significantly higher than the control group, and the the renal cortical R2* value of the patients in stage 2 kidney injury group was also higher than the stage 1 kidney injury group. The area under curve (AUC) of ROC of the renal cortical and medullary R2*values and R2*med/cor to diagnose chronic HBV hepatitis-induced early kidney injury were 0.903, 0.949 and 0.526, respectively. Conclusion It's feasible and has great value to use renal BOLD MRI for the diagnosis of chronic hepatitis b-induced early kidney injury, and the renal cortex is more sensitive than the medulla to the kidney injury.

Objective To analyze the MRI characteristics of vestibulocochlea neurovascular compression in patients with vestibular paroxysmia (VP) and to investigate the effect of the compression,its site and degree,on the occurrence of VP.Methods Twenty-eight cases of VP (VP group) and 28 cases of vertiginous patients other than VP (control group) were retrospectively reviewed.Three dimensional magnetic resonance angiography (3D-MRA) was performed and the data were used for neurovascular crosscompression (NVCC) analysis.The frequency and type of NVCC,the origin of the offending vessel and the distance between compression site and brainstem were compared between the two groups.Results The frequency of NVCC was 96.4％ (27/28) in VP group,with a significant difference compared with control group (13/28,46.4％ ;x2 =17.15,P ＜0.01).The most common NVCC type was vascular loop compression at vestibulocochlear nerve (15/35,42.9％).Anterior inferior cerebellar artery was the most common offending vessel (25/35,71.4％) in VP group.There were no significant differences between the two groups in the type of NVCC or the origin of the offending vessel.The frequency on the distortion and (or) displacement of vestibulocochlear nerve which was severely compressed by vessel in VP group (7/56,12.5％) was significantly higher than that in control group (0; P =0.013).The distance between compression site and brainstem was (8.57 ± 5.08) mm in VP group,and (8.93 ± 4.64) mm in control group,showing no significant difference.The ratio that the distance was less than 15 mm between compression site and brainstem in unilateral NVCC of VP group (100％) was significantly higher than unilateral NVCC of control group (7/10,P =0.033).Conclusions The VP patients have higher NVCC incidence and the most common NVCC type is vascular loop compression at vestibulocochlear nerve which is mainly caused by anterior inferior cerebellar artery.NVCC in VP patients mostly occurs in the central myelin portion of vestibulocochlear nerve.The site and degree of neurovascular compression may relate to the occurrence of VP.

Objective To evaluate the effects of TIMP-1 and Ang-1 gene-modified BMSCs transplantation on the left ventricular function of rats with myocardial infarction.Methods The rat BMSCs were.transfected with eukaryotic expression plasmid encoding TIMP-1 or/and Ang-1 gene by liposome.Acute myocardial infarction was made in male rats by ligation of the left anterior descending (LAD) coronary artery.BMSCs carrying TIMP-1 or/and Ang-1 gene were injected into the ischemic myocardium after LAD ligatior.Four weeks after the administration,cardiac function was assessed by echocardiography and the hearts were harvested and sectioned for immunohistochemistry to examine the apoptosis,the collagen content and angiogenesis density.Results TIMP-1 and Ang-1 genemodified BMSCs transplantation significantly improved the cardiac function,myocardial apoptosis was alleviated,collagen content decreased and the angiogenesis density in border-zone was increased significantly (P＜0.05).Conclusions The results suggest that the combination of TIMP-1 and Ang-1-gene modified BMSCs transplantation can improve the cardiac function of rats with myocardial infarction.The increase of the blood supply,the alleviation of myocardial apoptosis and ventricle remolding after myocardial infarction possibly play important roles in the mechanism.

Aim To evaluate whether the combination of polypeptide AP25 and docetaxel is more efficient in treating experimental breast cancer,than either reagent used alone,and to offer suggestions for clinical use. Methods An experimental breast carcinoma model was set up to investigate the anti-tumor effects of AP25 and docetaxel combination.The Q value was caluculat-ed by Guinness rules and the anti-tumor effects of the combination of polypeptide AP25 and docetaxel were e-valuated.Results The treatment by the combination of polypeptide AP25 and docetaxel showed a better tumor inhibition rate.The combination of AP25 20 mg ·kg -1 and docetaxel 10 mg·kg -1 significantly inhibi-ted the tumor growth with 0.85 1.15,showing a synergistic effect.Conclusions The combination of AP25 and docetaxel can significantly in-hibit the tumor growth with a synergistic effect and de-crease the dose of chemotherapy.

Objective To assess the effect of two-dimensional speckle tracking imaging (STI) on prognosis of patients with acute infarcted myocardial(AMI).Methods Eighty patients with AMI and 30 healthy subjects were selected as our subjects.Among the AMI patients,there was 30 cases were emergency percutaneous coronary intervention (PCI),25 cases were selective PCI group and 25 cases with conservative.All were performed a 4-6 months following up after discharge from hospital.Left ventricular ejection fraction(LVEF) was measured by Simpson's.Rotation were measured in the left ventricular basal and apical short-axis views using STI.LV Peak twist (Ptw),apical Peak rotation (PAR),the basal Peak rotation (PBR),twist at aortic valve closure(AVC tw),twist at mitral valve opening(MVO tw),untwisting rate (Untw R),and half time of untwisting (HTU) were calculated.And the correlation between Ptw and LVEF was analyzed.Results Compared with the control group,the value of Ptw,PAR,AVC tw and MVO tw were significantly decreased in myocardial infarction group(F =22.481,12.899,18.923 ;P ＜ 0.05).Ptw,PAR in emergency PCI group at following up periods were (18.61 ± 8.08) ° and (12.16 ± 6.98) °,higher than that in hospital periods ((13.76 ± 6.31) °,(7.03 ±5.76)°).Ptw,PAR in selecting PCI group were (19.5 ±7.73)° and (13.4 ±7.02)°,higher than that in hospital periods((15.25 ± 6.83) °,(9.69 ±.6.72) ° ; t =-2.607,-3.104,-2.079,-1.955 ; P ＜ 0.05).Significant correlation was found between Ptw and LVEF (r =0.527,P ＜ 0.05).Conclusion Left ventricular twist can be measured using STI.LV rotation can be the quantitative index to evaluate the systolic function of LV.STI can be the new method to guide clinic diagnosis and therapy.

Objective:To investigate the expression of miR-203a in bladder cancer (BC) cell lines (RT-112, T24, 5637, UM-UC-3) and evaluate the effects on BC cell proliferation and radiosensitivity.Methods:Mir-203a mimics, mir-203a inhibitor, CDK6 siRNA, CDK6 expression plasmid and corresponding negative controls were transfected into BC cells. Quantitative real-time PCR was used to detect the expression of miR-203a in BC cell lines and human bladder epithelial immortalized cell line (SV-HUC-1). CCK8 assay was used to investigate the regulation of miR-203a and cyclin-dependent kinases 6(CDK6) on the proliferation of BC cells. Colony formation assay was performed to assess the effect of miR-203a and CDK6 on the radiosensitivity of BC cells. The target gene of miR-203a was confirmed by luciferase reporter assay. The effect of miR-203a on CDK6 protein expression was detected by Western blot. Multi-group comparison was performed by one-way ANOVA and two-group comparison was conducted by t-test. Results:Compared with the SV-HUC-1 cells, the expression levels of miR-203a in RT-112, T24, 5637 and UM-UC-3 cells were significantly down-regulated (all P<0.05). Compared with NC group, overexpression of miR-203a significantly inhibited the proliferation of BC cells, whereas knockdown of miR-203a significantly promoted the proliferation of BC cells (both P<0.05). Compared with NC group, overexpression of miR-203a significantly increased the sensitivity of BC cells to radiotherapy, whereas knockdown of miR-203a significantly weakened the sensitivity of BC cells to radiotherapy (both P<0.05). CDK6 was the target of miR-203a. Compared with NC group, overexpression of miR-203a significantly down-regulated the expression level of CDK6 protein, whereas knockdown of miR-203a significantly up-regulated the expression level of CDK6 protein (both P<0.05). After overexpression of CDK6 in T24 and UM-UC-3 cells transfected with miR-203a mimics, the cell proliferation ability was significantly increased, whereas the sensitivity to radiotherapy was significantly decreased compared with mir-203a mimics (both P<0.05). After CDK6 was silenced in RT-112 and 5637 cells transfected with miR-203a inhibitor, the proliferation ability of cells was significantly decreased, whereas the sensitivity to radiotherapy was remarkably increased compared with miR-203a inhibitor group (both P<0.05). Conclusion:miR-203a can serves as a tumor suppressor gene to inhibit the proliferation of BC cells and enhance the radiosensitivity of BC cells.