As an important surgical approach,breast cancer conservation therapy is still controversial in breast cancer patients with BRCA1/2 mutations.Since the risk of unilateral multiple and contralateral incidences is high in the familial breast cancer patients with BRCA1/2 mutations,breast cancer conservation therapy is not recommended but mastectomy and/or immediate mamoplasty.However,if carriers have a strong desire of breast cancer conservation therapy,it is feasible if they are fully informed the risks that may exist.At that time,we should need bilateral oophorectomy,tamoxifen therapy,and more interventions for the prevention of contralateral breast incidences.

Objective To study any change in the expression of γ-glutamylcysteine synthetase (γ-GCS) in the skeletal muscles of mice with emphysema.MethodsTwenty Kunming male mice were divided into a normal control group and an emphysema group (n =10 in each ).An emphysema model was established by passive cigarette smoking in 8 of the emphysema group mice.TUNEL staining was used to detect apoptotic skeletal muscle cells.Im munohistochemical assays were used to determine the protein level of γ-GCS synthetase.ResultsThe average optical density of apoptotic cells was significantly higher in the skeletal muscles of the mice with emphysema compared with the normal controls,and their average γ-GCS synthetase levels were also significantly higher.Conclusions Apoptotic cells increase in skeletal muscle during emphysema,which may be caused by an oxidation/antioxidant imbalance mediated by γ-GCS synthetase.

Objective To establish an acoustic perceptual method analyzing the compensatory articulation errors in children with operated cleft palate via the formants of Chinese pure vowels. Methods The first three formants which represent vocal transmission character in Chinese pure vowels of 84 subjects with operated cleft palate, were measured by Computerized Speech Signal Processing System (CSSPS). The Chinese vowel graph of postoperative patients with cleft palate was stated by the first formant frequencies (F1) and the second formant frequencies (F2) of the Chinese pure vowels between the two groups. Results Values of F1 and F2 of vowels except [a] in the poor articulation group (Group A) were significantly different from those in the good articulation group (Group B) (P<0.05 or P<0.01). As compared with that in Group B, the vowel graph demonstrated the decreased perceptual distances in Group A. These findings indicated that there might still be the backward movements of tongue, perverted mandibular movements and disharmonious lip movements in addition to the velopharyngeal insufficiency (VPI) in Group A. Conclusion The speech articulation of children with repaired cleft palate should be gained by correcting the aberrant compensatory articulation errors in the condition of velopharyngeal competence. Computerized Speech Signal Processing System (CSSPS), which is regarded as the content of objective quantitative measurement, is a precise, simple, reliable and atroumatic technique for children with cleft palate to analyze pathological compensatory articulation errors.

Objective To evaluate the risk factors,manifestation and utrasonography examination in the diagnosis of placental abruption.Methods The clinical data of 48 patients with placental abruptiontreated in our hospital from Jan. 1999 to Oct. 2006 were analyzed retrospectively. Results Premature delivery rate was 31.25%,the perinatal death rate was 10.42%,choke of neonaty rate was 16.3%,postpartum haemorrhage rate was 14.6%,uterine upoplexy rate was 4.17%,cesarean section rate was 52.1%,ultrasonography diagnosis rate was 28.6%.Conclusions The earlier diagnosis of placental abruption depends on comprehensive analysis risk factors,clinical symptoms and accessory examination such as ultrasonography.

Objective To study the relativity of pregnancy and idiopathic thrombocytopenic purpura(ITP).Method Thirty two pregnancies with ITP from 2000 to 2005 in our hospital were analyzed retrospectively(A group).Eighty feminine inpatients were selected at random and were compared(to include)forty nomal pregnancy delivery(B group)and forty ITP(C group).Results Compared with B group,the ratio of cesarean section,the occurrence of postpartum hemorrhage and time of hospitalization after postpartum of A group was higher.But the mortality of mother and baby and the ratio of choke of neonaty was not sigrificantly different.compared with C group,the number and width of platelet,functing of cruor,and the occurrence of hemorrhage was clearly differentce.Conclusion We think that ITP could effect the functon of cruor of pregnancy,and aggravate the occurrence of hemorrhage of pregnancy. pregnancy didn't affect the course of ITP.

Aim To evaluate the antitumor activity of ruthenium polypyridyl complexes and the underlying mechanism. Methods The right complexes 2b were filtered with highest activity and lowest toxicity by MTT assay. The change of cell cycle was detected by flow cytometry . The expression of p53 and p21 was detected by Western blot. The in vivo antitumor activity of 2b was evaluated by the assay of tumor bearing nude mice. Results 2b potentially inhibited proliferation of a variety of hepatoma cell lines, among which Hep 3B cell was the most significant ( IC50 was 12. 1 μmol · L-1 ) . The apoptosis of Hep 3 B cell was induced by 2b, as evidenced by DNA fragmentation, chromatin condensation and appearance of subG1 peak. The ac-tivities of caspase-9 and caspase-3 were activated by 2b. The phosphorylation of p53 was induced by 2b. The expression of p53 and p21 was also up-regulated by 2b. The growth of tumor of nude mice was signifi-cantly inhibited by 2b in vivo experiment. Conclusion 2b has good in vitro and vivo antitumor activities, and it can inhibite growth of Hep 3 B cells by inducing apoptosis.

Objective To investigate the relationship of serum uric acid level to the risk of coronary artery disease in young adults.Methods One hundred and fifty six young adults(≤45 years) hospitalized in Peking University First Hosipital during January 2005 to April 2008 were divided into coronary heart disease(CHD) group(96 cases) and control group(60 cases),according to coronary angiography.The CHD group was then sub-divided into 3 groups: single-vessel group(n=55),double-vessel group(n=21) and multi-vessel group(n=20).The relationship of serum uric acid level to the risk of CHD was analyzed.Results The serum uric acid level in CHD group was higher than that in control group(347.3?77.8 ?mol/L vs 306.1?76.6 ?mol/L,P

ObjectiveTo evaluate morphometric changes of brain in patients with alcohol addiction by voxel-based morphometry. MethodsFifteen patients with alcohol addiction and 15 health controls were recruited and underwent fluid attenuated inversion recovery (FLAIR) and 3D fast spoiled gradient echo (FSPGR) T1 -weighted sequences on a 3.0 T MRI system. 3D FSPGR T1 structure images were normalized,segmented and smoothed, and then underwent voxel-based morphometry. An ANCOVA was applied with age,body mass index ( BMI ), and education years as covariates because of exact sex match.A statistical threshold of P ＜ 0. 01 (uncorrected) and more than continuous 50 voxels were determined as significant.ResultsRegional results showed there was a significant reduction of gray matter volume in left middle frontal gyrus, superior frontal gyrus, precuneus, gyrus rectus, right medial superior frontal gyrus and orbital gyrus in patients with alcohol addiction compared with health controls, and the regional reduction of white matter volume in patients with alcohol addiction mainly located in the white matter of bilateral superior frontal gyrus. Global brain volume analysis showed there was a significant smaller volume in white matter [ (675. 14 ± 70. 62) ml]and brain parenchyma [ ( 1578. 81 ± 199. 05 ) ml]for patient group than that in white matter [ ( 841.33 :± 177. 35 ) ml]and brain parenchyma [ ( 1722. 13 ± 117.62) ml]for control group (t ＝ 11.37,5. 764, respectively, P ＜0. 05 ), but there was no difference in the gray matter volume between patient group [(903.67 ±1±9.87) ml]and control group [(880.79 ±1±7.10) ml](t ＝0.177, P＞0. 05 ). ConclusionsRegional gray and white matter atrophy can be the initial changes in patients with alcohol addiction and the frontal region is a relative specific damaged brain region.VBM has a potential value for the detection of subtle brain atrophy in patients with alcohol addiction.

Objective To investigate the effect of diabetes mellitus on neuromuscular blocking effect of cisatracurium in patients. Methods Forty ASA Ⅱ patients, aged 30-64 yr, weighing 44-90 kg, scheduled for neurosurgical operation under general anesthesia, were assigned into 2 groups (n = 20 each): type 2 diabetes mellitus group (group D) and non-diabetes mellitus group (group ND). General anesthesia was induced with midazolam,fentanyl and etomidate. Neuromuscular block was assessed with Epoch XP nerve electrophysiology monitor. A train-of-four stimulation of ulnar nerve was used. Cisatracurium 0.15 mg/kg was injected intravenously over 5 s after T1 was maintained at 100%. Tracheal intubation was performed after the onset of the muscle relaxant. Anesthesia was maintained with iv infusion of propofol 4-8 mg· kg - 1 · h - 1 and remifentanil 0.1-0.3μg· kg - 1 · min - 1. The effect of inmbation was evaluated and graded. The onset time, clinical duration, recovery time and recovery index were recorded. Results The onset time was significantly longer in group D than in group ND ( P ＜ 0.05). There was no significant difference in the clinical duration, recovery time and recovery index and intubation effect grade between the two groups ( P ＞ 0.05). Conclusion Diabetes can prolong the onset time of cisatracurium, but has no effect on the clinical duration and recovery time.

Objective To investigate the effects of two different resuscitation fluids of two different temperatures and two different target MAP on the outcome of hemorrhagic shock in rabbits. Methods Forty adult male rabbits weighing 2.3-3.2 kg were anesthetized with iv pentobarbital sodium 30-35 mg/kg and tracheostomized. Spontaneous breathing was maintained. Hemorrhagic shock was induced according to modified Wiggers method. used. The temperature of the fluids was 23 ℃ (B_1) and 45 ℃ (B_2) respectively. The target MAP was 60 mm Hg (C_1) and 80 mm Hg (C_2). Forty animals were randomly divided into 8 groups (n=5 each) : group A_1B_1C_1; group A_1B_1C_2; group A_1B_2C_1; group A_1B_2C_2; group A_2B_1C_1; group A_2B_1C_2 ; group A_2 B_2 C_1 and group A_2B_2C_2 .Arterial blood samples were obtained from femoral artery at 5 min before blood-withdrawal, immediately after shock was induced and at 1, 2, and 3 h of resuscitation for blood gas analysis and determination of blood lactate concentration and serum concentrations of TNF-α and IL-6. Hemodynamies and changes in mesenteric capillaries were continuously monitored. Results PaO_2 was significantly higher in animals resuscitated with HSD (A_2) than in animals resuscitated with HS (A_1). Blood lactate concentration was significantly higher in group A_1B_1 (HS-23℃) than in group A_2B_1 (HSD-23℃). There was no significant difference in blood lactate concentration between group A_1B_2 (HS-45℃) and group A_2B_2 (HSD-45℃). The 3 factors did not have different effects on mesenteric capillaries. The serum TNF-α and IL-6 concentrations were significantly higher in animals resuscitated with HS (A_1) than in animals resuscitated with HSD (A_2) .Conclusion The effect of resuscitation of hemorrhagic shock is better with HSD than with HS. The resuscitation fluid of 23 ℃ is superior to fluid of higher temperature. The target BP during resuscitation does not influence the outcome of resuscitation.