Objective To review the status and controversy on skin-sparing mastectomy (SSM) for breast cancer. Methods The pertinent literatures about SSM published recently to comprehend its relevant techniques and improvements in comparison with non-skin-sparing mastectomy (NSSM) were analyzed and also the safety of SSM by analyzing the relationships between SSM and ductal carcinoma in situ, restrict nipple-areola complex reservation, and postmastectomy radiotherapy were discussed. Results Skin-sparing mastectomy combined with immediate breast reconstruction is a safe operative modality for T1/T2 tumor without skin adhesion, multicentric tumors, and ductal carcinoma in situ. What is more, it does not defer adjuvant therapy. However, it may be prudent to reserve the nipple-areola complex only for peripherally located T1/T2 tumors and some other less serious invasion degree. Since the effect of SSM and immediate breast reconstruction on postmastectomy radiotherapy is confusing, there are still controversies on whether the patients who have already been operated should take radiotherapy. Conclusion SSM is a safe operative modality for selected patients with breast cancer, and delayed reconstruction may be a good choice for patients who would take postmastectomy radiotherapy.

Magnesium deficiency is common in patients with type 2 diabetes mellitus(T2DM);meanwhile,it may in crease the risk of the occurrence and development of T2DM.Adequate supplementation of magnesium may be helpful for the prevention and treatment of T2DM.

The prevalence of the metabolic syndrome (MS) in children has increased over the last decade.Research shows that the microelements including zinc,copper,iron,chromium,and selenium are relevant with the development of childhood MS.This article summarizes the recent advances in the relationship between microele-ments and MS.

BACKGROUND:The kidney tissues easily affected exercise ischemia reperfusion, increased free radicals and inflammation, resulted in abnormal renal function after acute exercise. OBJECTIVE:To observe the influence of Blackcurrant Extract on the structure of kidney and expression of tumor necrosis factor-α and nuclear factor-κB at 24 hours after exhaustiveexercise. METHODS:A total of 30 male Wistar rats were randomly divided into three groups (n=10). Rats in the Blackcurrant Extract group were intragastricaly administered 0.44 g/kg Blackcurrant Extract. Rats in the quietness control group and 24-hour exhaustive exercise group were intragastricaly given an equal volume of distiled water for 6 consecutive weeks. Rats in the 24-hour exhaustive exercise group and Blackcurrant Extract group received no swimming motion until exhaustion fatigue after final intragastric administration. Twenty-four hours later, samples were obtained. Kidney tissue morphology and ultrastructure were observed by electron microscopy and light microscopy. Protein expression of tumor necrosis factor-α and nuclear factor-κB was detected using immunohistochemistry. Tumor necrosis factor-αmRNA and nuclear factor-κB mRNA expression was detected using RT-PCR. RESULTS AND CONCLUSION:Compared with the quietness control group, tumor necrosis factor-α protein and nuclear factor-κB protein expression in the kidney was higher in the 24-hour exhaustive exercise group, and tumor necrosis factor-α mRNA and nuclear factor-κB mRNA expression was significantly increased (P < 0.01). Compared with the 24-hour exhaustive exercise group, tumor necrosis factor-α protein and nuclear factor-κB protein expression was lower in the Blackcurrant Extract group, and nuclear factor-κB mRNA expression was significantly decreased (P < 0.05); tumor necrosis factor-α mRNA expression was significantly reduced (P < 0.01). Kidney in the 24-hour exhaustive exercise group showed obvious morphological changes and ultrastructural damage. The structure of the kidney in the Blackcurrant Extract group tended to be normal. Results suggested that Blackcurrant Extract can repair the kidney tissue injury, reduce the expression of inflammatory factors, and prevent inflammatory damage in the kidney at 24 hours after exhaustive exercise.

Objective To investigate the nutrition statuses of thiamine and riboflavin and their relationship with the antioxidant capacity and blood glucose and lipids levels in the middle-aged and elderly. Methods Totally 314 subjects aged above 40 years old from communities in Shanghai were enrolled. The 3-day survey of 24-hour's diet recall was made to evaluate the daily nutrient intakes using a nutrition assessment software provided by CDC China. Thiamine and riboflavin levels were detected by urine load test. Fasting blood glucose ( FBG), total choles-terol (TC), triglyceride (TG), superoxide dismutase (SOD) activity and malondialdehyde (MDA) were deter-mined by commercial kits. Results The average daily intakes of thiamine and riboflavin were (0. 82 + 0. 36) and (0. 91 +0.48) rag, respectively. The middle-aged and elderly whose intakes of thiamine and riboflavin reached recommended nutrient intake (RNI) level accounted for 11.8% and 17.2%, while those lower than 60% RNI ac-counted for 51.3% and 49. 4%, respectively. Urine load test showed the deficiency rates of thiamine and ribofla-vin were 65.0% and 58.6%, respectively. Compared with the normal group, plasma MDA, FBG, TC, and TG levels progressively increased and SOD activity decreased in insufficient and deficient groups; the plasma MDA, FBG, and TC levels were significantly different between normal group and thiamine deficient group ( P < 0. 05 ).The FBG and TC levels were negatively correlated with the status of thiamine ( r = - 0. 246, r = - 0. 154, P <0. 05). The MDA and TG levels were negatively correlated with the status of riboflavin ( r = - 0. 136, r =-0. 297, P <0. 05). Conclusions The nutrition statuses of thiamine and riboflavin are poor in the middle-aged and elderly in Shanghai. The nutritional statuses of thiamine and riboflavin are positively correlated with the antioxi- dant capacities and are negatively correlated with the level of FBG, TC, and TG.

Objective To study the relationship between trace elements and blood lipids and glucose in Shanghai adults. Methods Totally 245 subjects aged above 18 years from two communities in Shanghai were en-rolled into this study. Blood trace elements (Fe, Zn, Cu, Mg, Pb, Mn, and Cd) were examined with atom ab-serption spectrophotometry. Body mass index (BMI), waist hip rate (WHR), and blood pressure (SBP, DBP)were also determined. Results Compared with the normal control group, plasma Fe and Mn levels were signifi-cantly lower while Zn and Zn/Cu levels were significantly higher in hyperlipemia group (P <0.05 or P <0. 01 ) ;plasma Zn, Zn/Cu, and Mn levels were significantly lower while Cu and Pb levels were significantly higher in dia- betes mellitus group (P <0. 05 or P <0. 01 ) . A tendency of lower Mg and higher Cd levels were also found in both disease groups, but there were no statistical significance ( P >0. 05 ). Conclusions The metabolism of trace elements is abnormal in patients with hyperlipemia and diabetes mellitus. Intervention of these trace elements disor-der may be valuable in the prevention and treatment of these diseases.

Objective To realize the automatic delivery of the data in the laboratory and the synchronous transmission of the information on patient,diagnosis and laboratory.Method The system was designed and developed under the Client/server structure,with the application of MSSQLSERVER2000 database management and PowerBuilder8.0 language program.It has many functions,such as data transmission,quality control,comprehensive inquiry and data security management.Result The seamless connection between pre bar code hospital-laboratory information system and HIS makes the work efficiency and work quality enhanced,and makes the information shared and transmitted synchronously.The formal lab requisition results in scientific,normalized and standardized management.

Objective To explore surgical approach for internal mammary node biopsy in patients with breast cancer. Methods Modified radical mastectomy and incised intercostal muscles for internal mammary node biopsy was performed on 113 patients. The distance from the internal mammary artery to the lateral sternal border, and the intercostal distance between the two costal cartilage were measured. Anatomical location and maximal diameter of the excised nodes were recorded. Results The internal mammary artery runs through intercostal space along the lateral sternal border. The distance from the internal mammary artery to the lateral sternal border was (10. 9?4. 5) mm, (11.6?2.9) mm, (9.6?3.6) mm and (4.5?3.5) mm in the first, second, third and fourth intercostal space, respectively. The distance between the two costal cartilage was (14. 2?4. 1) mm, (16. 2?4. 2) mm, (13. 9?4. 3) mm and (9.9?3. 6) mm in the first,second, third and fourth intercostal space, respectively. Two hundred and seventy-nine internal mammary nodes were excised from 113 patients. The anatomical location of the internal mammary nodes which embedded in the fatty tissue surrounding internal mammary artery were 41. 2% at the medial side, 51. 6% at the lateral side and 7. 2% in an anterior plane to the internal mammary artery. Metastases in the internal mammary node were detected in 26 patients. The lymph nodes metastasis were detected only in the internal mammary nodes in 5 cases. Conclusion Internal mammary node biopsy via intercostal space is a feasible, minimally traumatic, low-risk procedure.

Objectives To investigate the infection and colonization of Mycoplasma genitalium and Ureaplasma urealyticum in different male populations, to explore the association of M. genitalium and U. urealyticum with nongonococcal urethritis (NGU) respectively. Methods A case-controlled, cross sectional study of four different male populations was performed, namely: NGU patients (G1), non-NGU subjects attending STD clinic (G2), men who had sex with men participating in a health education program (G3), and healthy volunteers (G4). Nested PCR and culture were used to detect U. urealyticum. Nested PCR and PCR product sequencing were applied to detect M. genitalium. Results The prevalence rates of M. genitalium in the four study populations were 25.0%(25/100), 6.4%(6/94), 5.5%(6/110) and 0% respectively. Significant difference was found between each two groups except G2～G3 with a p value of 0.80. By multivariate regression analysis, controlling for the age of first sex, new sexual partners, urethritis and condom use in the previous 3 months, M. genitalium was only associated with urethritis (P= 0.004, OR = 6.754, 95% CI 1.833～24.893). The direct sequencing of PCR products showed gene mutations, in comparison with the reference sequence in GenBank, in 3 samples. The prevalence rates of U. urealyticum by PCR in 4 groups were 40.0%, 44.7%, 22.7% and 46.9% respectively, and there was no significant difference between G1～G2, G1～G4 or G2～G4 with a p value of 0.419, 0.325, 0.868 respectively, but the prevalence rate of U. urealyticum in G3 was significantly lower than that in other groups. Conclusions M. genitalium is strongly associated with NGU and the prevalence rate is significantly higher in groups with high risk sexual behaviors than that in general population. There is no association between the colonization of U. urealyticum and NGU.

Objective To estimate the prevalence of sexually transmitted diseases(STDs) among men who have sex with men (MSM) in some cities of Jiangsu province.Methods A cross-sectional questionnaire survey was carried out among MSM attending gay bars in some cities of Jiangsu province.Participants underwent screening for STDs in accordance with their personal wishes.Urethral swabs,first void urine and blood samples were collected at these survey sites and delivered to the STD research laboratory for testing.Univariate analysis and multivariate logistic regression analysis were performed to assess factors associated with STDs.Results A total of 388 subjects completed the questionnaire and underwent physical examination and STD screening.Of these subjects,45.6％ had only homosexual behavior.Examination of urine or urethral swab specimens showed that the prevalence rate was 1.3％ (5/388),9.4％ (36/385),17.2％ (66/384) and 28.1％ (109/388) for Neisseda gonorrhoeae,Chlamydia trachomatis,Mycoplasma genitalium and Ureaplasma urealyticum infection respectively.Serological tests revealed that the positivity rate was 1.0％ (4/388) for anti-human immunodeficiency virus (HIV)antibody,18.8％(73/388) for Treponema pallidum particle agglutination assay (TPPA),12.1％(47/388) for rapid plasma reagin (RPR) test,9.8％ (38/388) for human herpes simplex virus (HSV)-2-IgG,9.8％ (38/388) for hepatitis B surface antigen,1.0％ (4/388) for anti-hepatitis C virus antibody and 2.1％ (8/388) for anti-hepatitis E virus antibody.Multivariate analysis indicated that Chlamydia trachomatis infection was independently and significantly associated with polymorphonuclear leucocyte (PMNL) counts in urethral swab smears (adjusted odds ratio (AOR):5.30,95％ CI:2.04-13.77,P ＜ 0.01),Mycoplasma genitalium infection was significantly associated with age (AOR:2.84,95％ CI:1.17-6.87,P＜ 0.05),PMNL counts in urethral swab smears (AOR:2.37,95％ CI:1.01-557,P＜ 0.05) and urethral discomfort in the past three months (AOR:2.43,95％ CI.1.18-5.02,P＜ 0.05),and syphilis (defined as a positive TPPA and RPR test) was associated with age (AOR:2.46,95％ CI:1.05-5.75,P ＜ 0.05) and seropositivity for anti-HSV-2 antibodies (AOR:3.70,95％ CI:1.62-8.44,P ＜ 0.01).Conclusions There is a high prevalence of STDs among MSM attending gay bars in some cities of Jiangsu province,with Chlamydia trachomatis and Mycoplasma genitalium as the most common pathogens of urethritis.