Sentinel lymph node biopsy has been an important part of breast cancer surgery,which includes reactive dye method,radionuclide method and the combination of both. However,the radionucli-ded tracer is not approved domestically,which limits its clinical application. Near-infrared fluorescent method depends on near-infrared light. It activates indocyanine green to produce fluorescence and then flu-orescent image device can be used to observe the lymphatic system,which is a real time and dynamic de-tection for lymphangion and lymph node. Furthermore,the definite incision site can be located,which less-ens the damage of tissues. The fluorescent method can avoid some disadvantages of the above methods. However,the shadowless lamp should be turned off during the operation,which prolongs the operation time. Due to the quenching effect,the brightness of fluorescence will attenuate and the detected depth will be limited. Combination of near-infrared fluorescence method and reactive dye method may improve the detection,but further large-scale clinical trials are required for confirmation.

The MLN64 gene,which is localized in q12-q21 of the human chromosome 17,encodes a novel transmembrane protein containing 445 amino acids .The C-terminus of MLN64 shares significant homology with the steroidogenic acute regulatory (StAR)protein,while its N-terminal domain exhibits a function of targe-ting the protein to late endosomes .MLN64 is likely to be involved in cholesterol transport and synthesis of steroid hormones.MLN64 gene,coamplified with C -erbB-2,is overexpressed in certain breast carcinomas and exerts an influence on biological characteristics of breast cancer cells .The high levels of MLN 64 observed in some breast carcinomas could contribute to the growth and progression of these tumors through increased intratumoral steroido -genesis,and is considered as a predictive factor of breast cancer prognosis .

Breast cancer is a kind of hormone-dependent tumor,the high level of estrogens is an impor-tant risk factor of breast cancer.There is evidence that estrogens through estrogen receptor (ER) signaling pathways and estrogen metabolic products participate in the development and progression of breast cancer.Recentally,studies demonstrated that SDF-1 and its receptor CXCR4 are involved in breast cancer.Estro-gens play an important role in the growth,proliferation and metastasis of breast eaneers through SDF-1/CX-CR4 signaling pathways.These findings may'provide a novel therapeutic target for breast cancer.

Physical activity is closely related to the quality of life of postoperative patients with breast cancer, which is expressed in fre-quency, duration, intensity, and others factors. There is no uniform measurement of physical activity, the common measurements may be classified as subjective and objective, such as exercise log, physical activity questionnaire and self-reported physical activities of the former;doubly labeled water, indirect calorimetry, motion sensors and heart rate monitors of the latter. The age, educational level, social and eco-nomic status, and body mass index are related to the level of physical activity in patients post operation for breast cancer, while illness and treatment, psychological and social support, and health-related quality of life also affect the level of physical activity, which suggest that such patients need to improve their physical activity before operation.

Recently many studies have focused on the roles that tumor microenvironment plays in the occurrence and development of tumors,and the therapeutic effects of adjuvant chemotherapy and neoadjuvant chemotherapy.Recent researches show that tumor microenvironment has an obvious impact on the therapeutic effects of neoadjuvant chemotherapy,which mainly includes cancer-associated fibroblasts (CAF),stromal cell derived factor-1 (SDF-1) and collagens.

Objective To explore the clinical effect of local prophylactic application of methotrexate(MTX) in laparoscopic linear salpingostomy. Methods The data of 102 women with confirmed unruptured tubal pregnancy and desire to conceive were collected.They were divided into two groups: the study group(local application of MTX in the operation,n=51) and the control group(without application of MTX,n=51).The demographic data,the incidence of persistent ectopic pregnancy(PEP)postoperation,and the hysterosalpingography(HSG) 3 months(postoperation) were analysed,and the side effects of the study group were observed. Results There was 1 case of PEP in the study group and 9 cases in the control group(2.0% vs 17.6%,P0.05).There were no obvious side effects such as nausea,vomit and dental ulcer in the study group. Conclusion Patients who were treated with local MTX injection during the laparoscopic linear salpingostomy present less incidence of PEP with no obvious side effects.

Objectives: This prospective,randomized and controlled clinical trial was designed to investigate the effect of short course intensive insulin therapy(SCIIT) on stress-induced hyperglycemia and outcomes in critically ill patient. Methods:The diabetes or other illness which directly influenced blood glucose were excluded and the critically ill patients was maintained with normoglycemia((4.4-6.1) mmol/L) in the first seven days by intensive insulin therapy.After the first seven days,these patients was treated like conventional insulin treatment group.Conventional insulin treatment group was maintained with blood glucose at a level between 3.9-10 mmol/L.Results: Of 41 patients enrolled in the study,30 patients were eligible for analysis.After intervention stopped,blood glucose level in intensive insulin treatment group(5.92?1.24 mmol/L) was lower than in conventional insulin treatment group((9.22?)2.51 mmol/L).And in the same time,insulin consumptions in SCIIT group was lower than in conventional insulin treatment group.There was no significant difference in ICU mortality between two groups,although decreasing trend favored to treatment group. Conclusion: In critical ill patient,(SCIIT) can achieve similar blood glucose range when compared with the plan of IIT.The benefit of improving morbidity and mortality could be expected in large sample RCTs.

Objective To investigate the role of resting pulm on ary function (FEV 1,FVC,VC) and diffusing capacity (D LCO) on exercise limitation in patients with chronic obstructive pulmonary disease (COPD).Methods During the period of 2002-04~12 the results of resting pulmonary function test which were and diffusing capacity test performed on 26 subjects with stable COPD were reviewed.The symptom-limited maximum exercise (S LME) were performed.Dyspnea index (DI) and oxygen consumption (V? O 2/kg) were determined with a metabolic cart during exercise.Borg Scale s (BS) was used for counting degree of exertional dyspnea which appeared during exercise.At the end of SLME,arterial blood gas analysis was performed to determi ne PaO 2max,PaCO 2max and Phmax at that time.Results In stepwise multiple regression analysis,the variables significantly contributing to V?O 2max/kg were D LCO % and FEV 1/VC.Conclusion Lung function and diffusing capacity can be importan t determinants of exercise capacity in COPD.

Cerebral arteriovenous malformation is a common cerebrovascular disease.Its exact pathogenesis remains unclear.At present,it is thought that this disease is caused by kinds of factors,including congenital and acquired factors.