Breast cancer-related lymphedema (BCRL) is one of the common complications after surgery.The pathogenesis of BCRL is unclear,and there is no definitely effective treatment for it.In this article we review the pathogenesis,risk factors and treatment of BCRL,propose the comprehensive strategies for prevention and treatment of BCRL.

Epithelial-mesenchymal transition( EMT ) and mesenchymal-epithelial transition are involved in the process of development of tissues and organs in embryonic stage. Currently studies are focused on the relationship between EMT and tumor invasion and metastasis. This article reviewed the role of EMT in the occurrence and development of gastric cancer by analyzing the relationship between EMT and gastritis,gastric mucosal barrier,initiation of gastric carcinogenesis, metastasis and invasion,drug resistance and immune escape which may provide insights to the pathologic mechanism and approaches to prevent and treat gastric cancer.

Objective To investigate the clinical effects of Shugan Jieyu Capsule combined with sertraline in the treatment of postpartum depression (PPD), to improve the postpartum depression and quality of life.Methods 72 cases of postpartum depression treated in our hospital were retrospectively chosen.They were randomly divided into two groups, each group was of 36 patients, and they were taken with different drug regimen.The control group was treated with conventional treatment drug sertraline, and the study group was taken with Shugan Jieyu capsule on the basis of the control group.six weeks of treatment were as the observation period, and the differences of scores of HAMD, TESS and Quality of Life Index for the two groups on admission, four and six weeks after treatment were compared.Results After treatment, the scores of HAMD, TESS and QL-Index of the study group were (0.92 ±0.58), (1.36 ±0.46), (7.83 ±1.68), significantly better than the control group of (1.67 ±0.43), (2.48 ±0.72), (6.79 ±1.24), ( P <0.05 ) .Conclusion The combination of Shugan Jieyu Capsule and sertraline can improve the patients'quality of life after the treatment of postpartum depression, the depression is improved, and with few adverse reactions.It has a positive effect in improving the quality of life of patients.

Objective To build a Monte Carlo dose verification tool for IMRT Plan by implanting an irradiation source model into DPM code and to extend the ability of DPM to calculate any incident angles and irregular-inhomogeneous fields.Methods The virtual source and the energy spectrum unfolded from the accelerator measurement data were used,in combination with optimized intensity maps,to calculate the dose distribution of the irradiation irregular-inhomogeneous field.The irradiation source model of accelerator was substituted by a grid-based surface source.The contour and the intensity distribution of the surface source were optimized by IMRT.The dose calculation was realized by combining the position of the emitter with the fluence map from the IMRT plan.The weight of the emitter was decided by the grid intensity.The direction of the emitter was decided by the combination of the virtual source and the emitting position.The weighted fraction of the emitter was also combined with the flux grid intensity based on the particle transport model of DPM code.Results The accuracy of calculation was verified by comparing with the measured data.It was illustrated that the differences were acceptable (＜ 2％ inside the field,2-3 mm in the penumbra).The dose calculation of irregular field by DPM simulation was also compared with that of FSPB (Finite Size Pencil Beam).The passing rate of gamma analysis was 95.1％ for peripheral lung cancer.The regular field and the irregular rotational field were all within permissible range of error.The calculation time of regular fields were less than 2 h,and that of the test of peripheral lung cancer was 160 min.Conclusions The adapted DPM code with its simple irradiation source model is faster than that with classical Monte Carlo procedure.Its computational accuracy and speed satisfy the clinical requiremcnt,and it can be useful as a Monte Carlo dose verification tool for IMRT Plan.

Objective To investigate the correlation between reproductive hormone concentration and the amplitude and latency of speech-evoked auditory brainstem response (speech-ABR) in young adults, and to explore the effects of reproductive hormone on the speech processing ability of young people.Methods Speech-ABR of thirty five normal hearing young adults, including seventeen females (27.29±1.83 years old) and eighteen males (28.17±2.50 years old) were recorded.The speech syllable /da/ was transmitted as a stimulus sound to the right ears through insert earphones in speech-ABR test.All participants had air conduction hearing thresholds of 20 dB HL or better across the standard audiometric frequencies (250~8 000 Hz) in both ears, and click-ABRs were also within normal limits.At the same time, the concentrations of estradiol and testosterone in the serum were examined.Results ① Females had a shorter latency than males in transient responses (waves V, A and O) and sustained responses (waves D, E and F) of speech-ABR (P<0.05, respectively).The amplitude of transient response (waves V and A) and sustained response (waves D, E and F) in females was also significantly larger than that in males (P<0.05, respectively), except for amplitude of peak O (P>0.05).The V/A slope in females was significantly steeper than that in males (P<0.05).② Estradiol levels in females (118.77±102.66 pg/ml) were significantly higher than that in males (52.91±14.77 pg/ml) (P<0.05), and the total testosterone concentration in females (457.65±140.82 pg/ml) was significantly lower than that in males (3 677.37±1 155.80 pg/ml) (P<0.05).③ A correlation analysis between speech-ABR and estradiol or total testosterone showed that all peak latencies of speech-ABR in transient responses (waves V, A and O) and sustained responses (waves D, E and F) were negatively correlated with the estradiol concentration (P<0.05 respectively), in which the correlation coefficient was between 0.2~0.4.All peak latencies of speech-ABR were positively correlated with the total testosterone concentration (P<0.05 respectively), in which the correlation coefficient was between 0.4~0.7.④ The amplitudes of speech-ABR increased with estradiol concentration growing, the wave V and estradiol concentrations were positively correlated (P<0.05).The estradiol concentrations showed a significant negative correlation with wave A, D, E, F and O wave (P<0.05 respectively), with a correlation coefficient between 0.2~0.7.On the contrary, the amplitudes of speech-ABR decreased with the increasing of total testosterone concentration, and the wave V, wave A, V/A slope and total testosterone concentration were moderately correlated (P<0.05),with a correlation coefficient between 0.4-0.6.The correlation between the amplitudes of D wave and total testosterone concentration was not statistically significant (P>0.05), and the correlation between wave E and wave F and total testosterone concentration was weakly correlated (P<0.05).In addition, the amplitudes of the wave O were also independent with testosterone levels (r=0.133, P>0.05).Conclusion There are correlations between the level of reproductive hormone and the amplitude and latency of speech-ABR.It is one of the reasons for the gender difference in the brainstem speech coding ability of normal young adult.

Objective To study the relationship between the cognitive function and speech recognition ability in young patients with OSAHS.Methods We selected 60 young male patients,according to the apnea-hypopnea index(AHI)and the severity of hypoxemia.They were divided into three subgroups on the basis of their syndrome severities:mild group (n= 19;AHI 5~15/h,85%≤minimum SaO2≤90%),moderate group (n= 20;AHI>15~30/h,80%≤minimum SaO2<85%),and severe group (n= 21;AHI>30/h,minimum SaO2<80%).First,we used the MoCA scale for cognitive function tests and recorded the scores.Then 15 lists of sentence Mandarin Speech Test Materials(MSTMs)were utilized to test each group.A data analysis was performed using SPSS 17.0 software. Results The total MoCA scores(mild group:27.32±1.16;moderate group:25.85±1.23;severe group:24.52± 1.69;control group:28.52 ±1.16)decreased progressively as the disease severity increased,showing significant differences between the control group and the mild,moderate and severe groups of OSAHS patients (allP<0.05). When sound stimuli were presented at 22,24,and 26 dB SPL,the speech recognition rates in the patients with se-vere(35.4±22.6,56.3±23.9,75.2±16.5)lower than the other groups (mild group:38.4±23.5,58.3±25.5,79.2 ±18.5;moderate group:38.8±21.6,58.7±22.7,78.5±16.7;control group:39.4±23.5,60.3±24.3,80.2±16.4, respectively,allP<0.05).The differences in intensity of 50% recognition rate between the severe group(4.15± 0.80)and the control(3.62±0.41),mild (3.66±0.50)and moderate groups(3.72±0.55)of OSAHS patients were statistically significant(allP<0.05).Conclusion With hypoxia and disease severity increased,speech recogni-tion abilities in OSAHS patients decreased.This may be an important factor associated with cognitive assessment scale score.

Objective To investigate expressions of surface maturation markers, secreting cytokines and the stimulat?ing effect on T lymphocytes in the dendritic cells (DC) from peripheral blood of tuberculosis (TB) patients after loading dose treatment. Methods TB patients who received initial treatment (n=68) were collected at the fifth hospital of Shijiazhuang from 2013 June to 2014 January. Base on clinical diagnosis and treatment guidelines of tuberculosis, they were divided into sputum smear-negative group (35 cases) and sputum smear-positive group(33 cases). Forty cases of healthy adult were se?lected as control group. Mononuclear cells were isolated from peripheral blood and were cultured in medium to differentiate into DCs. Expression levels of CD83 and CD86 on DCs were examined by flow cytometry. The proliferation of allogeneic mixed lymphocyte stimulated by DCs was dectected using MTT assay. Contents of IL-12, IL-10 and INF-γin the cultural supernatant of DCs and blood serum from TB patients were detected by ELISA. Results Compared with controls ,the ex?pressions of CD83 and CD86 on DCs in TB patients after loading dose treatment decreased obviously(P<0.05), and the ability to stimulate the proliferation of lymphocytes reduced evidently(P<0.05). What’s more, IL-12 level increased mark?edly(P<0.05)while IL-10 and INF-γlevels presented no significant difference among the three groups (P>0.05). Conclu?sion The expressions of maturation markers of DC cells of the peripheral blood in TB patients after initial treatment de?creased. The ability of stimulating mixed lymphocyte proliferation is also significantly reduced while secretion of IL-12 was enhanced.

OBJECTIVE: To explore the changes of serum interleukin-6 (IL-6) level in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and OSAHS associated type 2 diabetes mellitus (T2DM) and their significance. METHOD: All observed subjects were divided into 3 groups: 20 cases of normal subjects, 35 cases of simple OSAHS patients, 48 cases of OSAHS associated T2DM patients, IL-6 concentrations of serum were measured by the enzyme-linked immunosorbent. RESULT: IL-6 level was higher in the group of OSAHS with T2DM than the group of OSAHS and the healthy control group (P < 0.05); IL-6 level was higher in the simple OSAHS group than the healthy controls. CONCLUSION IL-6 and other inflammatory factors may involved pathological physiological process in OSAHS patients sugar metabolic abnormalities; and is associated with the development of OSAHS associated with type 2 diabetes.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; complications ; Humans ; Interleukin-6 ; blood ; Sleep Apnea, Obstructive ; blood ; complications

OBJECTIVE: To investigate the significance of tumor necrosis factor-alpha (TNF-α) and plasma endothelium (ET) in pathophysiologic process of patients with obstructive sleep apnea hypopnea syndrome(OSAHS) with type 2 diabetes mellitus (T2DM). METHOD: All observed subjects were divided into 4 groups. A number of 80 patients with OSAHS, 65 cases of OSAHS with T2DM patients, 20 patients with T2DM, and 32 cases of healthy control group were observed in this study. The serum levels of TNF-α and ET were detected by double antibody sandwich ELISA, the content of TNF-α and ET were compared between OSAHS group and OSAHS + T2DM group. It were also compared before and after treatment of CPAP or surgery. RESULT: TNF-α level is higher in OSAHS+T2DM group than that in the OSAHS group, T2DM group and the control group (P < 0.05); TNF-α level in OSAHS group and the T2DM group are higher than that in the control group (P < 0.05), but there was no difference in TNF-α level between the OSAHS group and the T2DM group. There was also no difference in ET level of the four groups. There were significant differences of TNF-α before and after treatment of CPAP or surgery in OSAHS group and OSAHS+T2DM group (P < 0.05). But there was no significant differences of ET before and after treatment of CPAP or surgery in the OSAHS+T2DM group (P > 0.05). CONCLUSION TNF-α may be involved in the development of OSAHS and T2DM, while ET may have little effect on the occurrence and development of OSAHS and T2DM.
Antibodies ; Diabetes Mellitus, Type 2 ; blood ; complications ; Endothelins ; blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Sleep Apnea, Obstructive ; blood ; complications ; Tumor Necrosis Factor-alpha ; blood

Objective To observe the effects of different energy of extracorporeal shock waves (ECSWs) on diabetic neuralgia in rats.Methods Fifty clean-grade healthy male Sprague-Dawley rats of both sexes,aged 8 weeks,weighing 180-200 g,were divided into 5 groups (n=10 each) using a random number table method:control group (group C),diabetic neuralgia group (group DN),low-energy ECSW group (group L + DN),medium-energy ECSW group (group M + DN),and high-energy ECSW group (group H+DN).Diabetic neuralgia models were established by intraperitoneally injecting streptozotocin (60 mg/kg) in DN,L+DN,M+DN and H+DN groups.ECSWs at 1,2 and 3 bar were applied during 4 consecutive weeks after successful establishment of the model once a week (T1-T4) in L+DN,M+DN and H+ DN groups,respectively.The mechanical paw withdrawal threshold (MWT),thermal paw withdrawal latency (TWL) and motor nerve conduction velocity (MNCV) were measured at T1-T4.Animals were sacrificed after the last measurement,and the sciatic nerve samples were obtained for determination of the expression of tumor necrosis factor-alpha (TNF-α) and interluekin-6 (IL-6) (by Western blot) and expression of TNF-α and IL-6 mRNA (by real-time polymerase chain reaction).Results Compared with group C,MWT,TWL and MNCV were significantly decreased at T1-T4,and the expression of TNF-α and IL-6 protein and mRNA was up-regulated in the other groups (P＜0.05).Compared with group DN,MWT at T2-4 and TWL and MNCV at T3,4 were significantly increased,and the expression of TNF-α and IL-6 protein and mRNA was down-regulated in L+DN,M+DN and H+DN groups (P＜0.05).Compared with group H+ DN,MWT at T2-4 and TWL and MNCV at T3,4 were significantly increased,and the expression of TNF-α and IL-6 protein and mRNA was down-regulated in L+DN and M+DN groups,and the expression of IL-6 mRNA was significantly down-regulated in group L+DN (P＜0.05).Conclusion ECSWs can mitigate diabetic neuralgia in rats,and the low-and medium-energy ECSWs produce better efficacy,and the mechanism is related to inhibiting inflammatory responses.