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.

ObjectiveTo improve the compliance behavior of discharged patients with chronic obsturctive pulmonary disease(COPD)by health education of telephone visit.Methods240 COPD patients were divided randomly into the experimental group and the control group with 120 cases in each group.The experimental group accepted telephone visit regularly for six months after 1 week since discharged from hospital and the control group did not receive any intervention.Six months later,the compliance behavior and the readmission of two groups were compared.ResultsThe results indicated that the compliance behavior of the experimental group was significantly better than that of the control group (P<0.01).ConclusionsConducting the health education of telephone visit can strengthen the patients' compliance behavior,postpone the process of disease,prevent complications,lighten economic burden and improve their life quality.

Objective To research the effect of octreotide on the lung injury of far place organ after ischemia-reperfusion in rabbit liver.Methods Prings maneuver rabbit hepatic ischemia-reperfusion models were established. 24 adult New Zealand rabbits were random divided into three groups: group Ⅰ (sham operative group) , group Ⅱ (ischemia-reperfusion by physiological saline group) and group Ⅲ (octreotide preconditioning group). To group Ⅲ, we injected octreotide of 20μg/kg to abdominal cavity and octreotide of 30(μg/kg to skin following, and octreotide was dissolved into 2ml with 0. 9% physiological saline. To group Ⅰ and Ⅱ, octreotide were replaced with the same amount of physiological saline. The changes of MAP, HR in every group were recorded at the time before ischemia (T1 ) , 30min (T2) after ischemia, 30min(T3) , 60min(T4) , 120min(T5) , 240min(T6) after reperfusion. The tumor necrosis factor-alpha (TNF-a) and interleukin-lbeta (IL-1β) in the plasma in every group at T1, T2, T3, T4 , T5, T6 were detected. These rabbits were killed 240 min after reperfusion, then the lung's hepatocellular ultrastructures of every group were observed under electromicroscope, and the apoptosis of lung was detected by TUNEL. Results The MAP, HR of group Ⅱ and group Ⅲ were lower than that of group Ⅰ at T2 to T4. Moreover, group Ⅱ were lower than that of group Ⅲ (P <0.05). The TNF-a, IL-1β of group Ⅱ (fromT2) and group Ⅲ ( from T3) were higher than that of group Ⅰ ( P < 0.05) , and group Ⅲ were lower than group Ⅱ after ischemia (P <0. 01). Through electromicroscope, we found that the injury of the lungs hepatocellular ultrastructure in group Ⅲ was slighter than that in group Ⅱ . We detected the apoptosis of the lung organizes by TUNEL under 5 fields of light microscopes, and found that the apoptosis counts of group Ⅱ (55. 82 ±4. 19) and group Ⅲ (32. 17 ±3. 10) were more than that of group Ⅰ (3. 96 ±0. 87), and group Ⅲ were less than thatof group Ⅱ (P < 0. 01). Conclusion Octreotide can protect the lung injury of far place organ after ische-mia-reperfusion in rabbit liver.

Objective To explore the influences on biological function induced by hyperthermia in human lung cancer cell line H1299, and to investigate the possible molecular mechanism. Methods H1299 cells were cultured in vitro and divided into 2 groups. The cells in culture flasks of hyperthermia group were immersed into a water bath at 43 ℃for 1 h, and the cells of control group were cultured at 37 ℃. The cell growth was detected by CCK8 assay, and the cell cycle and apoptosis rates were detected by flow cytometry [propidium iodide (PI) staining and PI/Annexin V staining]. The effects of hyperthermia on migration and invasion abilities of H1299 cells were determined by Transwell migration and invasion assays, respectively. The expression of LLGL1 was measured by Western blot. Results The cell cycle had no significant difference between the two groups, but the apoptosis rate was significantly higher in hyperthermia group [(24.81 ±2.80) %] than that in control group [(11.73 ±1.55) %] (t= 7.709, P= 0.0021). The migrating cell number was decreased in hyperthermia group (25.67±4.81) than that in control group (85.00±10.31) (t=5.182, P=0.0066). The invasive cell number was also decreased in hyperthermia group (22.00±2.08) than that in control group (108.3.0±10.14) (t=8.342, P=0.0011). The expression level of LLGL1 protein in hyperthermia group was 4.2 times that in control group(t=3.028, P=0.0389). Conclusion Hyperthermia induces the cell apoptosis and inhibits migration and invasion abilities of H1299 cells, which maybe associate with increasing LLG1 expression.

Objective To explore the possible mechanism of over expression of P-glycoprotein(Pgp) in brain tissue and peripheral blood in refractory epileptic rats with amygdale kindled by electricity and kainic acid,and compare the expression tendency of Pgp in brain tissue and peripheral blood of the different ways to establish refractory epileptic rats models.Methods The models of refractory epileptic rats were made by electrical kindling and kainic kindling in amygdale.Group A was for amygdale-electrical-kindling rats(n=12),group B was for amygdale-kainic-kindling rats(n=12),group C was implanted electrode without kindling and Carbamazepine was given by gavage(n=8),group D was injected saline in amygdale and Carbamazepine was given by gavage(n=8),group E was implanted electrode without kindling and saline was given by gavage(n=8) and group F was injected saline in amygdale and saline was given by gavage(n=8).The expression of Pgp in brain tissue and peripheral blood was detected by immunohistochemistry in each group.Results The expression of Pgp in brain tissue and peripheral blood of rats in group A and B were both much higher than those in the other groups and there were statistical differences(all P

Objective To investigate the effects of intrathecal (IT) ketamine on the synapsis remodeling in the spinal dorsal horn during devolopment of morphine tolerance in a rat model of neuropathic pain (NP). Methods Male SD rats weighing 200-250 g were used in this study. IT catheter was placed in the subarachnoid space according to Yaksh. Forty-eight SD rats in which IT catheter was successfully placed were randomly divided into 6groups (n=8 each): group sham operation (group S); group NP; group normal saline 20 μl IT(group NS);group morphine 20 μg IT (group M); group ketamine 50 μg IT (group K) and group morphine 20 μ g + ketamine 50 μg IT (group MK). NP was induced by compression of right L4,5 dorsal root ganglions with steel wire inserted through L4,5 intervertebral foramen in NP,M,K and MK groups. Normal saline or morphine and/or ketamine were injected IT once a day for consecutive 14 days. Paw withdrawal threshold (PWT) to mechanical stimulation and paw withdrawal latency (PWL) to a thermal nociceptive stimulus were measured on 0, 1, 3, 5, 7, 9, 11, 14 days during the consecutive 14 days of administration. The animals were sacrificed after the final IT administration. The lumbar segment of the spinal cord was removed for determination of the number of synapsis in the spinal dorsal horn by immuno-histochemistry in 4 animals in each group and observation of synaptic structure remodeling using electron microscope in another 4 animals in each group. Results Compared with group S, PWT was significantly decreased and PWL was shortened in the other 5 groups, and the number of synapsis was significantly increased and the synaptic structure was thickened in NP, NS, M and K groups (P ＜ 0.05). Compared with group NP,PWT was significantly increased and PWL was prolonged in M, K and MK groups, and the number of synapsis was significantly decreased and the thickness of synaptic structure was significantly reduced in group MK ( P ＜ 0.05).Compared with group M, PWT was significantly increased, PWL was prolonged, the number of synapsis was significantly decreased and the thickness of synaptic structure was significantly reduced in group MK ( P ＜ 0.05). Conclusion IT ketamine can inhibit the synaptic remodeling in the spinal dorsal horn during development of morphine tolerance in a rat model of NP.

Objective To observe the effects of metformin on the serum levels of adiponectin,interleukin-18(IL-18) and C-reactive protein(C-RP) in overweight/obese type 2 diabetes. Methods The changes of serum levels of HOMA2-IR,adiponectin,IL-18,C-RP and lipid profiles were observed before and after the treatment of metformin. Results After the eight weeks of treatment,the levels of adiponectin and IL-18 were not significantly changed,while C-RP(0.49±0.23 vs 0.89±0.22ng/dl),total cholesterol(TC)(4.58±0.83 vs 6.15±2.23mmol/L),LDL-C(2.65±0.78 vs 3.66±0.84mmol/L) and HOMA2-IR(1.1±0.7 vs 2.3±1.7) were decreased (all P<0.05),HDL-C(1.23±0.30 vs 1.02±0.24mmol/L) was increased (P<0.05). Conclusions Metformin may reduce the serum C-RP level and modulate the disorder of blood lipids,but may have no effect on adiponectin and IL-18

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 observe the effect of octreotide acetate on plasma ETX and serum inflammatory cytokine of the rabbit with hepatic ischcmia reperfusion injury. Methods Pringle's maneuver rabbit hepatic ischemia-repeffusion models were established. 24 adult New Zealand rabbits were random divided into equal 3 groups: sham operative group(group A), iacbemia reperfusion group(group B)and octreotide acetate preconditioning group(group C). Endotoxin (ETX) in the plasma, tumor necrosis factor-alpha (TNF-α) and intcdeukin-1beta (IL-1β) were detected in every rabbit at the time before iachemia (T1), 30min after ischemia (T2), 30min (T3) and 120min (T4) after reperfusion. Results From T2 to T4, the ETX in group B and C were higher than that in group A (P < 0.05), the ETX of group C were lower than that in group B (P<0.05). From T2 to T4, the TNF-α of group B and C were higher than that of group A(P<0.05). From T3 to T4 the TNF-α of group C were higher than that of group A(P<0.05). From T2 to T4,the IL-1β of group B and group C were higher than that of group A(P<0.05), and the IL-1β of group C were lower than that of group B (P<0.05). Conclusion Octreotide acetate can decrease plasma ETX and down-regulate inflammation factors, such as TNFαand IL-1β, in serum of the rabbit with hepatic iacbe-mia-reperfusion injury, which may be the protective mechanism of oetreotide acetate on rabbit hepatic isehemia-reperfusiun injury.

Breast Neoplasms ; classification ; pathology ; Female ; Humans ; World Health Organization