Objective:To evaluate the potential value of indocyanine green combined with methylene blue and methylene blue alone in the detection of sentinel lymph nodes (SLN) in breast cancer.Methods:The clinical data of 118 patients with early breast cancer from November 2016 to October 2018 in Dalian Central Hospital Affiliated to Dalian Medical University were retrospectively analyzed. Among them, 62 patients underwent SLN biopsy under methylene blue (methylene blue group, 160 SLN), and 56 patients underwent SLN biopsy under indocyanine green combined with methylene blue (combined group, 190 SLN). After SLN biopsy, patients underwent grade Ⅰ and Ⅱ axillary lymph node dissection.Results:There was no significant difference in the positive lymph node rate and accuracy rate between 2 groups ( P>0.05); the SLN dyeing rate and SLN biopsy positive rate in combined group were significantly higher than those in methylene blue group: 97.9% (186/190) vs. 93.1% (149/160) and 28.4% (54/190) vs. 18.1% (29/160), and there were statistical differences ( P<0.05); the false negative rate in combined group was lower than that in methylene blue group: 5.3% (3/57) vs. 14.7% (5/34), but there was no statistical difference ( P>0.05). Conclusions:In breast cancer patients, the dual -tracing method of indocyanine green combined with methylene blue is better than using methylene blue alone in identifying SLN and predicting the status of axillary lymph nodes, and it has a tendency to reduce the false negative rate.

ObjectiveTo evaluate the effectiveness of PBL teaching model for medical students in surgery bed side teaching.MethodsThe method of meta-analysis.ResultsFinally,twenty-six documents met the requirement.The resuhs of Meta-analysis showed that,in the aspect of theory improvement for medical students,WMD=6.46,95 ％ CI 为 2.56 ～ 10.36,P＜0.01 ; in the aspect of skill ability improvement,WMD=5.32,95 ％ CI 为 2.47 ～ 8.16,P ＜0.01.ConclusionThe model of PBL teaching could significantly improve the effectiveness in theoretical knowledge and skill ability.

This paper is to report our study in which the differences between prosthetic restoration and surgical reconstruction using traditional clasp retention technology were analyzed based on three-dimensional finite element methods in our laboratory. Firstly, the maxillary unilateral defect model was developed using medical image processing software MIMICS. Secondly, the prosthesis was generated by mirroring technology. The clasp was designed according to the methods raised by Aramany. Then, the stress distribution of maxilla was calculated by simulating occlusion. According to the results, after osseointegration of surgical reconstruction, stresses of unaffected abutments were reduced significantly, and less stress of junction occurred near zygoma of affected side, which were all less than stresses of prosthesis restoration. Thus, removing the clasp of surgical reconstruction increased the stresses of unaffected abutments. The stress trends of maxillary components were different between prosthetic restoration and surgical reconstruction. Surgical reconstruction is better than prosthesis restoration in protection of the abutments. Clasp can alleviate the occlusal burden of maxilla. Varieties of retentive technologies can be considered in prosthesis restoration. The surgical reconstruction is more conducive to rehabilitate unilateral maxilla biomechanically in clinic.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Image Processing, Computer-Assisted ; Mandibular Reconstruction ; methods ; Maxilla ; surgery ; Maxillofacial Prosthesis ; Osseointegration ; Zygoma

Objective To verify the performance of quantitative detection of interleukin-6 by using IMMUNITE1000 chemilumi-nescence analyzer.Methods According to the requirements of International Organization for Standardization(ISO)1 5 189,serum specimen were collected and levels of IL-6 were detected.The precision,accuracy,analytical measurement range,reportable range amd normal reference range of quantitative detection of interleukin-6 by using IMMUNITE1000 chemiluminescence analyzer were verified,and its performance was evaluated.Results The coefficient variation(CV)of between-day precision of high and low value was 6.42% and 1.97% respectively,and that of within-run precision was 3.40% and 3.82% respectively.Compared the test re-sults with the target values,the bias % was 0.91%.The regression equation:Y =0.986X - 7.1 (r 2 = 0.999,P < 0.05 ).With 27 times diluted,the recovery rate was from 97% to 100%,and the clinical reportable range was 2 to 27 000 pg/mL.The 95% refer-ence interval ranged from 0 to 5.3 pg/mL.Conclusion The performance of this system meets the manufacturer′s declaration,and could satisfy the quality requirements of clinical laboratory.

Objective To analyse the relationship between lymphatic vessels invasion and clinical pathological features of papillary thyroid carcinoma ( PTC ) .Methods The expressions of D2-40 and CK19 were examined in the 104 specimens of PTC using immunohistochemical staining with combined monoclonal antibodies and cocktail double enzyme labeled antibody( D2-40/CK19) stainings.The two methods were compared in the diagnosis of PTC metastasis, and the factors affecting lymphatic vessels formation were analyzed.Results The positive rate of lymphatic vessels invasion was 37.5%(39/104) by using immunohistochemical staining with combined monoclonal antibodies and 53.8%( 56/104 ) by cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining ( P<0.05).The lymph node metastasis rate was 83.9%(47/56) in the group with lymphatic vessels invasion, significantly higher than that without invasion 22.9%(11/48, P<0.01).The age of patients, diameter of primary tumor were the influence factors of lymphatic vessels invasion in PTC patients(P<0.05 and P=0.063).Conclusion Cocktail double enzyme labeled antibody ( D2-40/CK19 ) staining is a better method to detect lymphatic vessels invasion in PTC than immunohistochemical staining with combined monoclonal antibodies.

Objective To discuss how to use the core elements of international classification of functioning,disability and health(ICF) as a guide in stroke operation treatment to develop targeted,effective therapy plan and rehabilitation goals,establish individualized treatment of rehabilitation,and to observe the effect of limb movement function in stroke patients. Methods Sixty cases patients with stroke and aged from 40 to 65 years old were selected. The body function and structure of all stroke patients were marked by comprehensive evaluation scores of The National Institutes of Health Stroke Scale ( NIHSS ) and Fugl?Meyer assessment. And then they were randomly divided into two groups,30 cases in each group. The observation group used the Chinese version of brief ICF Core Sets for evaluation, and set individualized treatment according to the results of the assessment;The control group, according to the conventional rehabilitation process, involved in training routine physical therapy. Again 8 weeks after treatment for patients with evaluation,the assessment results was compared with the results of the first assessment. Results Before treatment, the NIHSS, Fugl?Meyer assessment and Chinese version of brief ICF core elements scale scores for the observation group were 7. 95±2. 37,34. 5±4. 0 and 82. 15±17. 96,for the control group were 7. 58±2. 25,34. 8±4. 0 and 81. 55±18. 78. After treatment,the above three rating scale scores, for the observation group were improved to 4. 78 ± 1. 63, 56. 3 ± 4. 2, 60. 45 ±11. 04,for the control group were improved to 5. 13±1. 75,48. 1±3. 8,73. 56±16. 89. The two groups were significantly improved ( observation group:t=4. 94, 15. 51, 18. 59, P<0. 05;control group:t=3. 17, 14. 66, 12. 33,P<0. 05). After treatment,compared with the control group of three rating scale scores(5. 13±1. 75,48. 1
±3. 8 and 73. 56±16. 89),the observation group(4. 78±1. 63,56. 3±4. 2 and 60. 45±11. 04) improved more apparently(t=3. 15,14. 54,15. 45,P<0. 05) . Conclusion Guided by the idea of ICF and scale,with the demand of the patients as the center,to develop personalized physical therapy,can achieve more productive and more targeted rehabilitation goals.

OBJECTIVE To analyze the correlation between number of tissue eosinophils(Eos) and blood Eos levels in patients with chronic rhinosinusitis with nasal polyps(CRSwNP), and to investigate if tissue and blood eosinophilia predicts disease severity and prognosis in CRSwNP. METHODS A retrospective analysis of 102 patients, who diagnosed with CRSwNP was carried out in this study. Surgical specimens were evaluated for degree of tissue Eos, which was compared with blood Eos. Patients were divided into two groups according to the results of endoscopy one year after surgery: recurrent and non-recurrent group. Statistical analysis was performed to compare tissue and blood Eos and CT Lund-Mackay scores. RESULTS Blood and tissue Eos in recurrent group was significantly higher than that in non-recurrent group(P=0.032, 0.033, 0.017). There was not a statistical difference of CT scores between two groups(P =0.089). There was a significant correlation between tissue Eos and absolute number of blood Eos(r=0.637, P=0.000) as well as between tissue Eos and percentage of blood Eos(r=0.542, P=0.000). However Eos and CT scores were not correlated statistically(P>0.05). CONCLUSION Blood Eos levels can predict the degree of Eos infiltration in nasal polyps. Blood and tissue Eos correlate with prognosis.

Objective The aim of this study was to investigate the effects of hesperidin ( HDN) on antioxidant ac-tivity in mice.Methods HDN scavenging free radicals was detected by spectrophotometry, inhibition of mitochondrial swelling was detected by pyrogallol autoxidation, and erythrocyte hemolysis was detected by Fe2+phenanthroline.The mice were fed with HDN at different concentrations (0, 80, 160, 320 mg/kg) by gastric gavage for 12 days.ELISA and spec-trophotometric methods were used to assay the amount of MDA in mouse liver and kidney tissues and the activity of antioxi-dant enzymes ( SOD, CAT, GSH-PX) , and the antioxidant enzyme gene mRNA expression was analyzed by RT-PCR.Re-sults Compared with the control group, the radical (· OH, O2 -· , DPPH· ) clearance rate was significantly increased in the HDN groups.There was a significant decrease of oxidative hemolysis of erythrocytes and mitochondrial swelling in vitro. MDA content in the mouse liver and kidney tissues and serum showed a decrease, and the activity of antioxidant enzymes ( SOD, CAT, GSH-PX) in the HDN group was significantly higher than that in the control group.There was an up-regula-tion of mRNA expression of antioxidant enzyme in mouse liver and kidney tissues.Conclusions The results showed that HDN can eliminate free radicals, reduce cell oxidative damage caused by free radicals, inhibit superoxide production, up-regulate antioxidant enzyme gene expression and enhance their enzyme activity, thus showing a good antioxidant effect.

Objective To explore the 15-years change in fasting TG level and the accumulative incidence of type 2 diabetes mellitus (T2DM) from 1992 to 2007,and to assess the association between the change in TG level and the accumulative onset risk of T2DM.Methods A total of 11 387 subjects aged 35-64 years were recruited from 6 provinces in China in the baseline survey in 1992,and were followed-up for cardiovascular disease till 2007.In 2007,9184 subjects were successfully followed-up and 5966 subjects entered into the second examination.Totally 5408 participants,who were free of diabetes at baseline and had complete information for both check ups,were included in this analysis.Fasting TG levels were categorized into three groups:＜ 1.70 mmol/L,1.70-2.25 mmol/L and ≥2.26 mmol/L.The association between 15-years change in TG level and the accumulative onset risk of T2DM was assessed by logistic regression analysis.Results In 1992,the mean level of TG was 1.49 mmol/L in male and 1.26 mmol/L in female.During the 15 years,TG levels increased by 0.25 mmol/L and 0.53 mmol/L in male and female,respectively.The prevalence of elevated TG ( ＜ 1.70 mmol/L) increased from 23.4％ in 1992 to 39.0％ in 2007.The 15-year accumulative incidence of diabetes was 13.9％ in male and 11.8％ in female.The incidence rates were 10.5％,16.2％ and 26.6％ for TG levels of ＜ 1.70 mmol/L,1.70-2.25 mmol/L and ≥2.26 mmol/L,respectively.Multivariate logistic regression analysis showed that the baseline TG level was significantly associated with the onset risk of diabetes after adjustment for other cardiovascular risk factors.At any given baseline TG level,the onset risk of diabetes increased with the TG levels in the second examination in 2007.After adjusting other risk factors,participants with the highest categories of both baseline and follow-up TG levels had 2.1 folds higher accumulative onset risk of diabetes ( RR =3.39,95％CI 2.49-4.61 ) than those with the lowest categories of both baseline and follow-up TG levels.Conclusion Baseline TG level is independently associated with diabetes onset risk,and the change of TG level in a 15-year interval predicts the onset risk of diabetes beyond the baseline TG level.

Objective To evaluate the association between serum HDL-C and the risk of cardiovascular diseases(CHD) in subjects aged 35-64 years. Methods A prospective study was carried out in 11 provinces from 1992 to 2002. The association of baseline HDL-C level and cardiovascular disease occurrence was analyzed in 30384 subjects aged 35-64 years using Cox multivariate proportional hazards regression. Results (1) Compared with the group of HDL-C≥1.56 mmol/L, multivariate-adjusted relative risk of ischemic cardiovascular disease(ICVD), including CHD and ischemic stroke increased continuously with decreased HDL-C level. (2)HDL-C level had different impact on different types of CVD.Positive association was observed between HDL-C level and the risk of ischemic stroke,but the relationship between HDL-C level and the risk of hemorrhagic stroke was indefinite. Compared with the group with HDL-C≥1.56 mmol/L,the risk of CHD of the group with HDL-C≤1.03 mmol/L increased by 45%(RR=1.45,P＜0.05)and that of ischemic stroke increased by 53%(RR=1.53,P＜0.01).(3)6.4% of ICVD,7.2% of the acute CHD and 7.3% of the acute stroke was attributable to low serum high density lipoprotein cholesterol. Conclusions Starting from HDL-C≥1.56 mmol/L, the risk of ICVD increasescontinuously with decreased HDL-C level. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce theoverall risk of CVD.