OBJECTIVE: To observe the correlation between serum level of TXB2, 6-Keto-PGF1alpha and liver metastasis. METHODS: The metastatic model was made by injection of W256 carcinosarcoma. Rats were randomly divided into two groups: rats with blood stasis group and control group. Rats in control group were given normal saline via abdominal cavity once a day. Rats in blood stasis group were injected adrenalin in the fourteenth day. Tumor size and liver metastasis were observed. Serum TXB2 and 6-Keto-PGF1alpha were tested by radioimmunoassay. RESULTS: Tumor size in rats with blood stasis was significantly smaller than that of the control group (P<0.01). Occurrence of liver metastasis in rats with blood stasis was significantly lower than that of the control group (P<0.01). The values of 6-Keto-PGF1alpha, TXB2, and TXB2/6-Keto-PGF1alpha were higher in the group with blood stasis. CONCLUSION: In the status of blood stasis, W256 carcinosarcoma grows slowly, and liver metastasis increases insignificantly, with the elevations of 6-Keto-PGF1alpha, TXB2 and TXB2/6-Keto-PGF1alpha.

OBJECTIVES:To fathom situation and the cause about adverse drug reactions(ADR)from each drug manu?facturing enterprise and drug handling enterprise in our city.METHODS:501cases of ADR reports in our city collected by ADR monitoring center in2004were classified and analyzed statistically.RESULTS:Of the501ADR cases,226cases were resulted from antibiotic drugs which accounted for45.1%,80cases were resulted from by traditional Chinese drugs prepara?tions which accounted for16.0%;ADR most commonly manifested itself in the injury of skin and appendants,which accounted for48.9%(245cases),then the damage of digestive system and circulation system,there were21(4.2%)comparative serious ADR cases among which;most cases were resulted from iv which accounted for65.9%(330cases)of the total.CONCLU?SION:Cultivation of professional quality and service quality of the professional staff should be strengthened and the om?nibearing ADR monitoring work should be deployed so as to lessen and avoid the occurrence of ADR.

Objective To compare HER-2 state in breast cancer tissue deteced by fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) and analyze their correlation. Methods HER-2/neu protein expression and gene amplification were detected by FISH and IHC in 56 newly-diagnosed cases of female breast cancer from July 2008 to July 2009. Results Of the 56 patients, HER-2 protein expression (-), (+), (++), (+++) was 9 cases (16.1%), 29 cases (51.8%), 11 cases (19.6%) and 7cases (12.5%) respectively; 26 cases (46.4%) had HER-2 gene amplification while 30 cases (53.6%) didnt have. Type of HER-2 gene amplification was mainly HER-2(++) and HER-2(+++), and according gene amplification rate was 72 7% and 100%. HER-2 (+) gene amplification rate was 37.9 %(11cases) and no gene amplification was found in HER-2(-) tissue. The HER-2 positive rate using two methods had significant difference(χ2=19.778,P<0.01). HER-2(-) and HER-2(+++) had good consistency with the FISH results(Kappa=0.969),but HER-2(+) and HER-2(+ +) were poorly consistent with the FISH results(Kappa=0.271). Conclusions IHC is the preliminary screening method for detection of HER-2 expression. HER-2(-) and HER-2(+++) have good consistency with the gene amplification, and can guide clinical treatment. Some patients with HER-2(+) and HER-2(++) have HER-2 gene amplification. FISH is needed for targeted therapy.

Objective To determine the value of applying LIIR Automatic Analysis System of Infrared Spectroscopy in analyzing urinary stone composition. Methods 1450 samples of urinary stones were collected from 1032 male and 418 female patients. The age of patients ranged from 6 months to 88 years. The mean ages were 41.7±15.3 and 42.0±15.6 years for male and female patients, respectively. Of 1450 stones, 875 cases were located in kidney (60.34%), 504 cases in ureter (34.76%) and 71 cases in bladder (4.90%). All stones were analyzed by LIIR Automatic Analysis System of Infrared Spectroscopy (Tianjin). Analysis results were reevaluated by the artificial analysis of spectrogram, if necessary, with polarization microscope, chemical analysis, and X-ray diffraction.Results Calcium oxalate monohydrate stones were found in 714 cases (49. 24%), carbonate apatite stones in 444 cases (30.62%), anhydrous uric acid stones in 93 cases (6.41%), calcium oxalate dihydrate stones in 92 cases (6. 34 % ), ammonium magnesium phosphate hexahydrate stones in 28 cases (1.93%), cystine stones in 23 cases (1.59%), ammonium urate stones in 20 cases (1.38%), uric acid dihydrate stones in 16 cases (1.10%), brushite stones in 12 cases (0.83%), sodium urate monohydrate stones in 2 cases (0. 14%), calcium carbonate stones in 1 cases (0. 07%), and other stone types in 5 cases (0. 34%). Most urinary stones were composed of 2 or more compositions, and pure stones were only observed in 397 cases (27.38%). Most of the mixed stones contained calcium and non-calcium mixed stone was rarely observed. In addition, 15 stones were found in infants who had consumed melamine-contaminated milk powder. These stones were composed of uric acid dihydrate and ammonium urate. The results of reevaluation by artificial analysis showed the following: among pure and mixed stones, false detection occurred in 6 cases (0.41%), of which the composition was ammonium urate or carbonate apatite determined by automatic system but the true composition was anhydrous uric acid. False negative detection occurred in 9 cases (0.62%), of which the composition was ammonium magnesium phosphate hexahydrate or carbonate apatite in 7 cases, but in other 2 cases the composition could not be determined by artificial analysis. The false negative detection of components with relatively low content occurred in 6 cases and 10 cases in stones with 2 components and 3 components, respectively. The undetected composition in these cases was ammonium magnesium phosphate hexahydrate or carbonate apatite. Conclusion Automatic Analysis System of Infrared Spectroscopy has many advantages in accuracy, automation and is quick in analyzing the composition of urinary stones, and is worthy of promotion in clinical use.

Objective To determine the clinical implications of internal mammary node biopsy for neoplasm stage,treatment,and prognosis in patients with breast cancer.Methods Internal mammary node biopsy via intercostal space was performed in 229 cases of breast cancer.Anatomical location of internal mammary nodes was recorded.Results Internal mammary node biopsy was successfully finished in 220 patients.There were 56 cases (24.45％ ) with internal mammary nodes metastasis,126 cases (55.02％ ) with axillary nodes metastasis,43 cases (34.13％ ) with regional metastases in both the axillary and internal mammary lymph nodes and 13 cases ( 12.62％ ) with internal mammary node metastasis only.Internal mammary node metastasis rate in patients with the number of positive axillary nodes ≥4 was 49.32％ (36/73).pN stage migration was seen in 56 patients with positive internal mammary nodes.There was no statistic relation between internal mammary nodes metastases and tumor location ( x2 =0.661,P =0.719).70.7％ patients with medial/central tumors and 50.7％ patients with the number of positive axillary nodes ≥4 were free from internal mammary node radiotherapy on account of internal mammary node biopsy.There was no complication such as pneumothorax or haemorrhagia.Conclusions Internal mammary node biopsy from intercostal space is a reliable surgical technique and can improve pN stage in some breast cancer patients.With internal mammary node biopsy,patients with a negative internal mammary node can be prevented from radiation to internal mammary nodal areas.

Objective To explore the best operation method in the patients with papillary thyroid microcarcinoma.Methods A total of 139 patients with papillary thjroid microcarcinoma were treated at our institute between Jan.2000 and Jan.2010.The data on the clinicopathological characteristics of patients and treatment were collected.Results The mean tumor size was (0.45 ± 0.24) cm.Of the 139 patients,30.2％ had multifocal tumors,19.4％ had bilateral tumors,42.4％ neck lymph node metastases.The number of eases of lymph node metastasis in level Ⅵ,Ⅱa,Ⅲ and Ⅳ was 58(41.7％),3(2.2％),10(7.9％),5(3.6％),respectively.Only one had lymph node metastasis in Level Ⅲ Microscopic extrathyroid extension was associated with neck lymph node metastases in papillary thyroid microcareinoma patients (x2 =38.39,P ＜0.001).No one developed permanent hypoparathyroidism.The median follow-up time was 103 (range,30-154) months,and local recurrence in the thyoid was diagnosed in 2 patients who underwent hemi-or subtotal thyroidectomy.Follow-up of 10 years was done in 16 cases,and the survival rate of 139 patients for 10-year was 100％.Conclusions It suggested that patients with papillary thyroid microcarcinoma has uniform clinicopathologic characteristics and the pattern of lymph node metastasis from those with papillary thyroid carcinoma.Total thyroidectomy plus level Ⅵ dissection is the optimal surgical treatment of papillary thyroid microcarcinoma.

Objective To explore the pattern of cervical nodal metastasis and the clinical significance of total thyroidectomy plus functional neck lymphadenectomy in papillary thyroid carcinoma patients. Methods Clinical and pathological data of 172 patients with papillary thyroid cancer who underwent total thyroidectomy plus functional neck lymph node dissection at Jinan Military General Hospital were retrospectively reviewed, including patient demographics, extent of surgery, parathyroid hormone level,recurrence, tumor pathology, such as tumor size, multifocality, capsular invasion, vascular invasion,extrathyroidal extension, and lymph node status. Results Of the 172 functional neck dissection patients (47 ambilateral), the incidence of lymphonodus metastasis in regions Ⅵ, Ⅳ and Ⅲ was 96. 3% ,78. 5%and 62.1% respectively. Rate of nodal metastasis was higher in patients with extracapsular invasion than in patients with no invasion ( P ＜ 0. 05 ). Serum parathyroid hormone levels significantly decreased immediately postoperatively in total thyroidectomy plus functional neck dissection and remained low for several weeks thereafter ( P ＜ 0. 01 ). The 5-, 10- and 15-year survival rate was ( 98. 83 ± 0. 82) %, (98. 23 ± 1.02 ) % and (96. 42 ± 1.43 )%, respectively. Conclusions Therapeutic neck lymph node dissection for papillary thyroid cancer is recommended for cervical nodal metastasis patients. Total thyroidectomy plus functional neck dissection is important in the treatment of papillary thyroid cancer.

Objective To evaluate the safety and feasibility of INTRABEAM in breast conserving surgery for early stage breast cancer.Methods Clinical data of 43 cases of early breast cancer undergoing INTRA-BEAM intraopetative radiotherapy from Jan.2013 to Dec.2014 were retrospectively analyzed.All cases underwent breast conserving surgery combined with 20 Gy INTRABEAM intraoperative radiotherapy.The postoperative incision,incidence of local complications and acute radiation injury were recorded after surgery.Breast recovery,the cosmetic effects,early overall survival,recurrence-free survival,and non-metastatic survival were followed up.Results All cases were given breast conserving surgery associated with INTRABEAM intraoperative radiotherapy (20 Gy),with median radiotherapy time of 31 mins ranging from 25 to 39 mins.Five cases underwent postoperative whole breast irradiation.Major early complications included incision infection (1 case),postoperative effusion (5 cases),radiation area skin pain (4 cases).The short-term follow-up survey showed that the satisfaction rate was 93.0％.The overall survival rate,recurrence free survival rate and metastasis free survival rate was 100％ respec tively.Conclusion Breast conseving surgery combined with INTRABEAM intraoperative radiotherapy for early breast cancer patients is safe and feasible.

ObjectiveTo investigate the changes of serum concentration of parathyroid hormone (PTH) and calcium after thyroid surgery and compare the changes among different modes of operation. MethodsFrom Aug. 2006 to Dec. 2009, 470 patients accepted thyroid surgery. The serum concentration of PTH and calcium in different groups was measured and compared before and 1 day after surgery. According to the extent and similarity of the surgery, patients were classified into 7 groups and they were compared in terms of postoperative changes of PTH and serum calcium. Statistical analysis was performed. ResultsThe serum concentration of PTH and calciurn decreased significantly after surgery in all patients except for those receiving unilateral and bilateral partial thyroidectomy. Compared with unilateral lobectomy, surgeries such as bilateral subtotal thyroidectomy, unilateral thyroidectomy with contralateral subtotal thyroidectomy, bilateral near-total thyroidectomy and total thyroidectomy resulted in more dramatic decreases of serum concentration of PTH and calcium and higher incidence of hypocalcemia ( P ＜ 0.05 ). The comparison between patients receiving CLND or not had the same result. Conclusions Almost all kinds of thyroid surgery affect the parathyroid function. The wider the surgery, the higher the possibility of postoperative hypoparathyroidism. The indications and criteria of different types of thyroid surgery are essential for hypoparathyroidism prevention. In some cases, vitamin D and calcium are recommended for preventive purpose.

Objective To evaluate the clinical efficacy of the local drug resistance spectrum antibiotics and foreign guideline in the treatment of patients with community acquired pneumonia(CAP). Methods A prospective,randomized,single blind,and positive drug parallel controlled design was used in the treatment. CAP patients with no underlying disease outpatients and inpatients<48 hours were selected as the research object. The patients in the trial group were given sensitive local drug resistance spectrum antibiotics: moxifloxacin,400 mg and 1 times a day. The patients in the control group were given azithromycin tablets(each 500 mg,once daily) promulgated by the 2007 version of the IDSA / ATS adult CAP guideline. Results There were 106 cases of CAP patients,of which 77 cases completed treatment,including 39 cases in the experimental group and 38 cases in the control group. There were significant differences in the clinical efficacy and bacterial clearance rate between the two groups,with the clinical efficacy of 89.7% and 68.4%(P < 0.01),the bacterial clearance rate of 87.9% and 54.5%(P < 0.05),respectively. Conclusion The clinical efficacy of drug resistant spectrum sensitive antibiotics in the treatment of CAP in Kunming was better than that of IDSA/ATS. Clinicians should pay attention to the characteristics and composition of resistance of common pathogenic bacteria in our country during the study and reference from foreign guideline,and adjust the therapeutic regimen according to the changes of the local drug resistance monitoring data rather than copy the recommended treatment plan by foreign countries.