Objective To evaluate the value of extended latissimus dorsi flap (ELDF) in immediate breast reconstruction in patients with breast cancer after modified radical mastectomy.Methods Thirty-six patients with breast cancer who accepted modified radical mastectomy and 12 patients with breast cancer who accepted immediate breast reconstruction after modified radical mastectomy from January 2008 to June 2009 were included.The complications,cosmetical results and quality of life of these patients were compared.The shape of breast reconstruction was also evaluated.Results All of 12 patients succeeded in proceeding immediate breast reconstruction with ELDF.The evaluation of shape of breast reconstruction was good in 6 cases,secondary in 4 cases,and bad in 2 cases,which was beyond that in patients of radical operation group (P0.05).The patients in breast reconstruction group had a better quality of life compared with the patients in radical operation group (P

Objective To evaluate and compare the diagnostic value of digital mammography-guided biopsy with mammography for early-stage breast cancer. Methods 68 of 156 foci(from 148 cases) with diameter≤2.0 cm from 2850 mammographic cases during Nov.2001 and Sep.2002,were urdestaken mammography-guided biopsy and then compared the coherence of the biopsy and mammographic results with the pathology. Results The obviously accuracy of mammography-guided biopsy is obviously superior to the mammography(P

Objective To detect ret mutations in two Chinese families with multiple endocrine neoplasia type 2A(MEN2A).Methods In our study,9 members from these two families including 3 patients were recruited.Polymerase chain reaction(PCR)and direct gene sequencing of PCR products by an automated DNA sequencer were applied to scan the entire 21 exons of ret proto-oncogene in the leukocyte DNA of the subjects.Results Two missense mutations were detected in exon11 of the ret proto-oncogene.One was C634R in the 2 patients from a family and the other was C634Y in 2 subjects from another family(one was the patient).Two heterozygous variants(A45A and L769L)in these 4 subjects were revealed.Conclusion Two mutations(C634R and C634Y)are detected in two families with MEN2A.Direct DNA sequencing analysis can diagnose MEN2A at gene level,which is helpful in making clinical management of the disease and in diagnosing earlier in their offspring.

Objective To investigate the effects of specific immunotheraphy(SIT) using allergens for children atopic dermatitis(AD) to find an efficacious method to treat AD. Methods 148 children with AD were divided into SIT group and control group. All patients were given allergen intradermal tests. The patients in SIT group received SIT using positive aero-allergens for 8 to 18 months. The patients in control group received the treatment of antihistamine drugs and drugs for external use. Results Total effective rate and curative rate of SIT group were 93.2% and 68.9% respectively, and those of control group were 68.9% and 17.6% respectively, which had a significant difference between the two groups(P

Objective To investigate the contents of cAMP and cGMP in the central nervous system in morphine dependent and withdrawal rats.Methods A physical morphine dependent model in rats was established by subcutaneous injection of morphine in gradually increasing doses.The cAMP and cGMP contents in the brain regions were determined by radioimmunoassay.Results Compared with control group,morphine dependence could significantly decrease the cGMP content or profoundly increase the cAMP content and the cAMP/cGMP ratio in rat striatum,diencephalons,midbrain,pons and hippocampus,but these changes described above were not detected in cerebellum.Compared with morphine dependent group,naloxone induced withdrawal could significantly decrease the cGMP contents or increase the cAMP contents and the cAMP/cGMP ratio in striatum and hippocampus,but these changes described above were not observed in the other regions.Conclusion The changes of the cAMP and cGMP contents may be one of the important molecular mechanisms leading to morphine dependence and abstinence.

Objective To compare the efficacy of mechanical ventilation (MV) with low tidal volume (LTV) plus positive expiratory end pressure (PEEP) and conventioal MV in the treatment of traumatic acute respiratory distress syndrome(ARDS). Methods From Oct 1997 to Oct 2003, 26 cases of traumatic ARDS patients were treated by conventioal MV(group A, n=11) or MV with LTV plus PEEP(group B,n=15), and clinical data of the patients were recorded and compared. Results There were no statistical difference in the PaO 2 of blood gas analysis and hemodynamic indices between the two groups, while the PaCO 2 was higher in group B than that in group A(P

ObjectiveTo explore the practicability of combined surgical treatment for the patients with Hepatocellular Carcinoma(HCC) complicated with Portal Hypertension(PH).MethodsThe clinical data of 43 patients withHCCcomplicatedwithsignificantesophagealvaricesandhyperspleniawereanalyzed retrospectively.All patients were diagnosed with esophageal varices and hypersplenia of different degrees, 14 of them had severe esophageal varices, the other 29 patients had moderate esophageal varices.Firstly all patients underwent splenectomy, 18 of them had selective portoazygous devascularization in addition.After that the patients received hepatectomys ,with local excision or segmentectomy as the major operation methods.Results All patients received hepatectomy combined with splenectomy treatment.There was no perioperative mortality, but 12 patients had complications after the surgery.Over seventy percents patients(33/43)accepted regular followup.Among these 33 patients,the 1-year and 3-year survival rates were 90.9％ (30/33) and 63.6％ (21/33)respectively.Eleven patients died of tumor recurrence.Four patients had upper postoperatively gastrointestinal hemorrhage.ConclusionHepatectomy combined with splenectomy didn't increase the mortality in the patients with HCC complicated with PH.The combined surgery might reduce the incidence of severe complications, such as postoperative bleeding.We believe the combined surgical treatment is feasible for this group of the patients.

Objective To analyze lesional and clinical characteristics of Langerhans cell histiocytosis in children.Methods A clinical retrospective study was performed on 126 patients with Langerhans cell histiocytosis collected from 2006 to 2011 at the Hunan Children's Hospital.Results Of the 126 patients,the youngest was 2months old,and the oldest was 9 years old.The ratio of male to female was 2.5 ∶ 1.Clinical manifestations included eczematid,seborrheic lesions,hemorrhagic maculopapules,yellow nodules and white macules.Of the three clinical phenotypes of Langerhans cell histiocytosis,Letter-Siwe disease was the most prevalent,and most cases of LetterSiwe disease were associated with hepatosplenomegaly,abnormal chest X-ray,impaired hematopoietic function and multifocal bone injuries.The clinical grade was mainly Ⅲ and Ⅳ in patients with Letter-Siwe disease,Ⅰ in patients with eosinophilic granuloma,and varied from Ⅰ to Ⅳ in patients with Hand-Schuller-Christian disease with Ⅱ as the most common.Of these patients,those with eosinophilic granuloma had the oldest average age with bone as the only affected organ,while those with Letter-Siwe disease had the youngest average age with the greatest number of affected organs.The treatment of Langerhans cell histiocytosis included surgical operation and combined chemotherapy.Conclusions Langerhans cell histiocytosis has characteristic skin lesions and diverse clinical manifestations.Pathology has diagnostic significance to Langerhans cell histiocytosis.Therapy strategies and curative effects are dependent on the severity of,and the organs affected by Langerhans cell histiocytosis.

Objective:To investigate the efficacy and safety of ticagrelor and clopidogrel in patients with coronary atherosclerotic heart disease (CHD) and hyperhomocysteinemia (Hhcy).Methods:A total of 101 patients with CHD complicated with HHcy who had successfully undergone percutaneous coronary intervention (PCI) were enrolled. They were divided into ticagrelor group ( n=49) and clopidogrel group ( n=52) according to the different antiplatelet drugs used. The clinical data of the two groups were collected, and the incidence of major cardiovascular and cerebrovascular adverse events (MACCE) and bleeding events in one year were compared between the two groups. Results:There was no statistical difference in baseline datas and PCI datas between the clopidogrel and ticagrelor groups ( P>0.05). Compared with clopidogrel group, ticagrelor can reduce the total MACCE (8.16% vs 32.69%, P<0.05) and the incidence of unstable angina pectoris events (0 vs 13.46%, P<0.05) in patients with hyperhomocysteinemia PCI 1 year after operation. The incidences of ischemic stroke, unstable angina pectoris, recurrent myocardial infarction, and cardiogenic death were compared separately between the two groups, and the difference was not statistically significant ( P>0.05). The incidence of major bleeding events, minor bleeding events, and minimal bleeding events were similar between the two groups, and the difference was not statistically significant (4.08% vs 0; 4.08% vs 1.92%; 20.41% vs 9.62%; P>0.05). Conclusions:In patients with CHD and Hhcy, ticagrelor can play a better antithrombotic effect, reduce the incidence of ischemic events, and has good security, which is more worthy of clinical recommendation.

Objective To study the therapeutic mechanism of Polygonum cuspidatum extract on the gouty arthritis induced by monosodium urate (MSU). Method Acute gouty arthritis rats model was induced by MSU. Twelve hours after modeling,the positive expression area and integral optical density of intercellular adhesion molecule-1 (ICAM-1) and nuclear factor-?B p65 protein (NF-?Bp65) in synovial membrane were observed by immunohistochemical assay. The effect of Polygonum cuspidatum extract on ICAM-1 and NF-?Bp65 was observed. Results There existed less expression of ICAM-1 and NF-?B p65 protein on synovial membrane in the normal group,and their expression was much increased in the model group. Polygonum cuspidatum extract in the dose of 360 mg/kg significantly reduced the positive expression area and integral optical density of ICAM-1 and NF-?Bp65 protein. Conclusion Polygonum cuspidatum extract can inhibit the abnormal expression and activation of ICAM-1 and NF-?Bp65 in synovial tissue,which may be an important therapeutic and preventive mechanism for gouty arthritis.