Objective To investigate the clinical values of extracapsular invasion at sentinel lymph nodes in patients with breast cancer.Methods From Jan,2010 to Jan,2013,80 patients underwent axillary lymph node dissection due to sentinel lymph nodes invasion were enrolled in this prospective study.Patients were signed to extracapsular at sentinel lymph nodes positive group (n =45)and control group (n =35)according to the intra -operative pathology.The primary outcome was rate of positive non -sentinel lymph nodes and the second outcomes were 3 -year recurrence -free survival,mortality and health -related quality of life.Results Compared with the control group,the patients in extracapsular at sentinel lymph nodes positive group got a significantly higher rate of positive non -sentinel lymph nodes (91.11% vs.28.57%,χ2 =33.321,P <0.001 );a significantly lower rate of 3 -year recurrence -free survival(57.78% vs.88.57%,χ2 =9.114,P =0.003);a significantly higher rate of mortality (17.78% vs.2.86%,χ2 =4.390,P =0.036);and a significantly lower level of health -related quality of life[(78.43 ±12.43)vs.(87.54 ±11.89),t =11.324,P =0.000].Conclusion Extracapsular invasion at sentinel lymph nodes was a reliable predictor for non -sentinel lymph nodes invasion and long -term clinical outcomes.

Objective To study the effect application,method,time, and indwelling double J internal tube in the operation of upper urinary tract.Methods The double J of tubes were used as internal drainage and internal stent for 1～2 months in the operation of upper urinary tract in 104 patients with nephrolithiasis, ureteral calculi,PUJ obstruction,megaloureter syndrome and bladder tumor.Result No complications such as wound infection,leakage of urine occurrence after operation.Conclusions The double J tubes had the dual functions of internal sent and internal drainage. The double J tubes can be indwelled easily and safely.

Objective To establish the quality standard of charred Radix et Rhizoma Rhei. Methods Kromasil-C18 column (4.6 mm?150 mm, 5 ?m) was used with mobile phase of methanol-0.1% phosphate acid (85∶15), 1.0 mL/min, and detection at 254 nm. Result Average recoveries of charred Radix et Rhizoma Rhei: Emodin was 98.43% and Chrysophanol was 98.32%, RSD was 1.17% and 1.02% respectively. Conclusion This method is simple. The result is accurate and reproducible. It can be used in the study of the processing technics of Radix et Rhizoma Rhei and the quality control of charred Radix et Rhizoma Rhei.

ObjectiveTo quantitatively characterize the inter-fractional anatomy variations and advantages of dosimetry for the adaptive radiotherapy in pancreatic cancer.MethodsA total of 226 daily CT images acquired from 10 patients with pancreatic cancer treated with image-guided radiotherapy were analyzed retrospectively.Targets and organs at risk (OARs) were delineated by the atlas-based automatic segmentation and modified by the skilled physician.Various parameters,including the center of mass (COM) distance,the maximal overlap ratio (MOR) and the Dice coefficient (DC),were used to quantify the inter-fractional organ displacement and deformation.The adaptive radiation therapy (ART) was applied to handle the daily GT images.The dose distributions parameters from the ART plan were compared with those from the repositioning plan.ResultsThe inter-fractional anatomy variations of pancreas head were obvious in the pancreatic cancer irradiation.The mean COM distance,MOR and DC of pancreas head after the bony or soft tissue alignment and registration was ( 7.8 ± 1.3 ) mm,( 87.2 ± 8.4 )％ and ( 77.2 ±7.9)％ respectively.Compared with the repositioning plan,the ART plan had better target coverage and OARs sparing.For example,the mean V100 of PTV was improved from (93.32 ± 2.89) ％ for repositioning plan to ( 96.03 ± 1.42) ％ for ART plan with t =2.79,P =0.008 and the mean V50.4 for duodenum was reduced from (43.4 ± 12.71 )％ for the repositioning plan to (15.6 ± 6.25)％ for the ART plan with t =3.52,P=0.000.ConclusionsThe ART can effectively account for the obvious inter-fractional anatomy variations in pancreatic cancer irradiation and be used to escalate the radiotherapy dose for the pancreatic cancer,which will lead to a promising higher local control rate.

Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty (TKA) of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group ( 112.67°) was higher than that of the control group ( 106.98° ), while the preoperative active range of the knee joint of the navigation group [(70.87 ± 10.87)°] was significantly lower than that of the control group [( 105.08 ± 30.67)°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.

Objective To observe the efficacy and side effects of Jianpi Qutan Decoction combined with Quetiapine in the treatment negative symptoms of schizophrenia.Methods 60 inpatients with schizophrenia were randomly divided into two groups,with one group treated with Jianpi Qutan Decoction combined Quetiapine and the other group treated with Quetiapine.Effects and side effects were assessed with the Positive and Negative Syndrome Scale (PANSS) and Treatment Emergent Symptoms Scale (TESS) respectively 1,4 and 8 weeks before and after the treatment.Results There was no significant difference in the overall efficacy between the two groups,but the improvement of the negative symptoms and illness provocation was significantly better in the treatment group than that in the control group respectively (P＜0.05).Moreover,the adverse reaction was milder in the treatment group.Conclusion It is suggested Jianpi Qutan Decoction in combination with typical antipsychotics is effective and safe in treating negative symptoms in schizophrenia patients.

Objective To explore the clinical curative effect and safety of intra -abdominal beacizumab bead sheet resistance combined with hyperthermic intraperitoneal chemotherapy in treatment of ovarian cancer perito-neal effusion.Methods 60 patients with ovarian cancer peritoneal effusion in Binzhou Central Hospital from June 2012 to July 2015 were randomly divided into two groups.30 cases in the control group were treated with intraperito-neal hyperthermic perfusion chemotherapy, while 30 patients in the observation group were given intra-abdominal beacizumab bead sheet resistance combined with hyperthermic intraperitoneal chemotherapy.The short-term effica-cy,toxicity and quality of life were compared.Results The effective rate of the observation group was 73.33%, which was significantly higher than 53.33% in the control group,the difference was significant (χ2 =8.55,P<0.05).In the two groups, there were no significant differences on thrombocytopenia, reduced white blood cells and hemoglobin,nausea,vomiting and abdominal pain (χ2 =1.07,1.87,0.90,1.51,2.88 , all P >0 .0 5 ) .The improvement rate of life quality of the observation group was 76.67%,which was significantly higher than 50.00%of the control group,the difference was significant (χ2 =8.06,9.31,all P<0.05).Conclusion Intra-abdominal beacizumab bead sheet resistance combined with hyperthermic intraperitoneal chemotherapy has remarkable curative effect in treatment of ovarian cancer peritoneal effusion,with high safety,and can significantly improve the quality of life of patients,that is suitable for clinical application.

Objective To observe and explore the therapeutic effect of acupuncture combined rehabilitation training in treating with spasm cerebral palsy patients.Methods 128 spasm cerebral palsy patients in our hospital from February 2012 to May 2014 were selected and randomly divided into the observation group (68 cases) and the control group (60 cases).The patients of the control group were given massage,ganglioside intravenous treatment,the patients of the observation group were given acupuncture combined rehabilitation training on the basis of the control group.The total treatment was 3 months,after the treatment,the Ashworth score and the total effective effective rate of the two groups were compared.Results After treatment,the observation group of patients with Ashworth spasm rating scale significantly better than that of control group (P ＜ 0.05),the observation group of patients and the control group after treatment in patients with Ashworth spasm of rating scale were significantly better than that of before treatment (P ＜ 0.05),the treatment of patients with observation group total effective rate is significantly higher than control group (P＜ 0.05).Conclusions On the basis of the comprehensive treatment of acupuncture combined rehabilitation training therapy in patients with spastic type cerebral palsy treatment effect significantly,can significantly improve the patient' s level of limb muscle tension,worthy of clinical popularization and application.

Emphysematous pyelonephritis is a rare life-threatening condition caused by a severe acute necrotising infection of the renal parenchyma and its perinephric tissues, and it is commonly seen in diabetic patients. There is a rare association between emphysematous pyelonephritis and hepatic portal venous gas. Hepatic portal venous gas is an uncommon radiological finding, which implies a significant underlying abdominal disease. The management of emphysematous pyelonephritis has evolved from prompt nephrectomy to medical therapy. In the present report, we present a case of a diabetic woman diagnosed with bilateral emphysematous pyelonephritis with hepatic portal venous gas that was successfully managed medically despite the presence of poor prognostic factors, such as acute renal failure and thrombocytopenia.

Objective To investigate the effect of olfactory entheath cells (OECs) transplantation on neural function and synaptic density of rats with traumatic brain injuries (TBI) and the possible mechanism. Methods Rats were divided into sham operation group, TBI group and OECs engrafted group. The brains of the rats were injured by Feeney percussion device through free falling. After cultured and identified by using specific marker (known as P75), OECs were transplanted into the area around the injured brain. Cortical somatosensory evoked potential (CSEP) and motor evoked potential ( MEP) were evaluated at day 14 after cell transplantation to determine the neurophysiologic function following TBI. Moreover, the synaptic densities around the injured brain were determined by using immunohistochemical method. One-way ANOVA test was used for statistical analysis. Results The transplanted OECs could survive and migrate around the injury site in the host brain 14 days after OECs transplantation. In addition, rats subjected to OECs implantation showed a marked neurophysiologic improvement and a significant increase of synaptic densities compared with the control group. Conclusion OECs transplantation can improve the neurophysiologic function and increase the synaptic density, which provides experimental basis for treatment of TBI with OECs.