Objective To observe the expression and correlation of Twist,p53 and E-cadherin mRNA in breast cancer.Methods Thirty breast cancer tissue and adjacent noncancerous tissue in patients underwent modified radical surgery,and the normal breast tissue in 10 patients with benign breast lesions,respectively,were detected the expression of Twist,p53 and E-cadherin mRNA by RT-PCR and the relationship with clinicl pathological factors and their interrelationships.Results There was significant correlation between the expression of Twist mRNA and the degree of differentiation[high and middle differentiation 93.33％(14/15),1ow differentiation 53.33％(8/15)],lymphatic invasion[yes 93.75％(15/16),no 50.00％(7/14)]and TNM staging[Ⅰ-Ⅱ?stage 46.15％(6/13),III-Ⅳ?stage 94.12％(16/17)]in breast cancer tissue(P＜0.05),while there was no obvious correlation between the expression of Twist mRNA and the age,tumor diameter,adventitial infiltration,estrogen receptor,progesterone receptor(P＞0.05).The expression of Twist and p53 mRNA in breast cancer tissue were significantly higher than those in adjacent noncancerous tissue and normal breast tissue[(112.36±12.53)％ vs.(101.37±9.12)％ and(98.03±9.04)％,(101.73±13.32)％ vs.(91.43±7.43)％ and(90.83±6.58)％,P＜0.01],while the expression of E-cadherin mRNA in breast cancer tissue was significantly lower than that in adjacent noncancerous tissue and normal breast tissue[(55.43±12.49)％ vs.(69.39±5.63)％ and(72.73±7.93)％,P＜0.01],there was no significant difference between adjacent noncancerous tissue and normal breast tissue(P＞0.05).The expression of Twist mRNA in breast cancer tissue was positively correlated to the expression of p53 mRNA(r=0.526,P=0.004),and negatively correlated to the expression of E-cadherin mRNA(r=-0.500,P=0.000).Conclusions Twist and p53 in breast cancer tissue show higher expression,while E-cadherin shows lower expression.Twist can promote invasion,metastasis of breast cancer by up expression of p53 and down expression of E-cadherin,and it plays an important role.

Immunotherapy has become an important therapy for solid tumors,which is in addition to surgery,radiotherapy,chemotherapy and targeted therapy.However immune treatment mechanism is different from those previous treatment.The effect of immunotherapies is on the immune system and not directly on the tumor.The kinetics of immunotherapy is characterized by a cellular immune response followed by potential changes in tumor burden and survival period.They are not captured by the traditional World Health Organiza-tion (WHO)or the Response Evaluation Criteria in Solid Tumors (RECIST).New immune-related response criteria are defined which more comprehensively capture all response patters and gradually applied in clinical practice.

OBJECTIVE:To investigate the effects of Dexmedetomidine hydrochloride injection on elderly patients underwent thoracic surgery during anesthesia recovery period. METHODS:Totally 60 elderly patients underwent thoracic surgery in our hospi-tal during Jun. 2014-Feb. 2016 were selected as research objects and then divided into control group and observation group ac-cording to even and odd-numbered admission order,with 30 cases in each group. Control group was given Propofol injection 0.5-1 mg/kg intravenously 5 min after mask oxygen inhalation. Observation group was given Dexmedetomidine hydrochloride injec-tion 0.5-1.0 μg/kg intravenously. Both group were successively given Etomidate emulsion injection 0.1-0.2 mg/kg,Sufentanil citrate injection 0.3 μg/kg and Cisatracurium besilate for injection 0.2 mg/kg intravenously for anesthesia induction;tracheal intubation was performed and ventilator was used to assist ventilation after anesthesia induction. And then control group was given continuous intravenous dripping of propofol 3-6 mg/kg·h;observation group was given continuous intravenous dripping of Dexmedetomidine hydrochloride injection 0.2-0.5 μg/(kg·h). At the same time,both group were given continuous intravenous dripping of sufentanil 0.1-0.2 μg/(kg·min)and cis-atracurium 1.5-2 μg/(kg·min),and continuously inhaled 1%-2% sevoflurane for anesthesia mainte-nance. Hemodynamic index(HR,MAP,SpO2),postoperative recovery,the occurrence of delirium,restlessness,cough and involun-tary movement were observed in 2 groups before surgery (T0),after anesthesia induction (T1),at the moment of sputum suction and extubation(T2),5 min after extubation(T3),30 min after extubation(T4). RESULTS:At T2 and T3,HR and MAP of control group were increased significantly compared to at T0,T1,and higher than those of observation group,with statistical significance (P<0.05). At T0,T1,T4,there was no statistical significance in HR and MAP between 2 groups (P>0.05). At T0,T1,T2,T3, T4,there was no statistical significance in SpO2 level between 2 groups(P>0.05). The breathing recovery time,eye openning time and extubation time of observation group were significantly shorter than those of control group,with statistical significance (P<0.05). The incidence of postoperative restlessness,delirium,cough and involuntary movement in observation group were signifi-cantly lower than control group,with statistical significance (P<0.05). CONCLUSIONS:Dexmedetomidine hydrochloride injec-tion can keep hemodynamics stable in elderly patients underwent thoracic surgery during anesthesia recovery period.,shorten recov-ery time and reduce the occurrence of stress response as postoperative delirium,restlessness,cough,involuntary movement.

Objective To explore the diagnosis and treatment of closed abdominal injuries in infants.Methods A retrospectively analysis of the clinical data of 84 infants with closed abdominal injury was made.Results Among the 84 cases, 60 cases had closed parenchymal visceral injury (32 cases of liver and 28 cases of spleen), 10 cases had small intestine perforation, and 14 cases had soft tissue contusion of abdominal wall. Non-operative treatment was used in 27 cases of liver injury and 22 cases of splenic injury, operative treatment in 5 cases of liver injury and 6 cases of splenic injury, and operative treatment for the 10 cases of other types of injury. All the 84 infant patients were cured.Conclusions In diagnosis and treatment of closed abdominal injuries in infants, abdominal centesis, type-B ultrasound and CT should be rationally chosen and applied in order to quickly determine location and extent of visceral injury; indications for operation should be under strict control. Non-operative treatment of parenchymal visceral injury of infants is proved to be safe and with a high cure rate.

Objective To study the results of diagnosis and treatment of duodenal papilla carcinoma. Methods The clinical data of 48 cases of duodenal papilla carcinoma admitted and treated in our hospital during a 7-year period were analyzed retrospectively. The main clinical symptoms included jaundice(43 cases), upper abdominal pain(23 cases), pruritus of skin(12 cases) and other symploms (7cases). The diagnosis accuracy rate of B ultrasound, CT, and ERCP examination were 39.6%, 50.0% and 93.3% respectively. Pancreaticoduodenectomy was performed in 39 cases. (of these, 1 case underwent pylorus-preserving procedure), 5 cases underwent cholecystojejunostomy and/or gastroenterostomy, and 3 were willfully discharged after diagnosis.Results Thirty-six patients were followed up.Survival beyond 1 year and beyond 2 years afer pancreaticoduodeneoctomy were 66.7% and 30.6% (respectively), and 2 cases among 8 cases of 7-year survivors are alive now. But the 3 discharged patients who refused operations lived less than 1 year; and only 1 patient among those who underwent cholecystojejunostomy and/or (gastroenterostomy) lived more than 1 year. Conclusions ERCP plus biopsy are the primary means of diagnosis, and radical resection is the main treatment modality for duodenal papilla carcinoma.

Objective To investigate the diagnostic points of multiple sclerosis and multiple metastatic encephaloma.Methods Choose a case of multiple sclerosis,which had been misdiagnosed as multiple metastatic encephaloma and operated on,to analyse its reasons of misdiagnosis.Results Reasons for the misdiagnosis:The neglect of the importance of the disease history.The scant knowledge of the early represen- tations of the atypical MS(demyelinating pseudotumor).The lack of the knowledge of the non-demyelinating lesions of the MS.The lack of attention to the different representations of the MRI scan between the acute MS and the multiple metastatic encephaloma.The excessive importance is attached to the imageological report. The neglect of the routine examination of cerebrospinal fluid.Conclusion When multiple metastatic en- cephaloma develops,the differential diagnosis of MS should be made.The further examinations should be done to those cases which are hard to tell the difference with metastatic encephaloma by clinical and imageo- logical representations.Try to avoid undergoing surgery or radiotherapy hastily.

Guidelines as Topic ; Head and Neck Neoplasms ; Humans

Objective To study the level changes and correlation of homocysteine (Hcy) ,high-sensitivity C-reactive protein(hs-CRP) ,cystatin C(Cys-C) and plasma fibrinogen(Fib) in the patients with acute cerebral infarction (ACI) .Methods The fasting blood samples were collected from 178 cases of ACI(ACI group) and 93 healthy individuals blood samples (control group) .The lev-els of serum Hcy ,hs-CRP and Cys-C were detected by the BECKMAN AU-680 fully automatic biochemical analyzer and plasma Fib was determined by the RAC-100 fully automatic coagulometer .Results The levels of serum Hcy ,hs-CRP ,Cys-C and plasma Fib in the ACI group were significantly increased compared with the control group (P<0 .05) .There was significantly positive correlation between Hcy with hs-CRP and Cys-C in the ACI group(r=0 .326 ,0 .361 ,P<0 .05) ,but there was no significant correlation be-tween Hcy and Fib ;there was significantly positive correlation between hs-CRP with Cys-C and Fib(r=0 .365 ,0 .421 ,P<0 .05);the same significant positive correlation also existed between Cys-C and Fib (r=0 .447 ,P<0 .05) .The positive rate of the joint de-tection of Hcy ,hs-CRP ,Cys-C and Fib was 93 .8 % ,which was obviously higher than that of the single indicator detection (P<0 .05) .Conclusion Cys-C ,hs-CRP ,Fib and Hcy participate in the occurrence and development process of ACI ,their joint detection has the important clinical significance for the prevention ,early diagnosis and treatment of ACI .

Objective To study the nerve protective mechanism of puerarin on ischemic brain injured and observe the expression change of TNF-α cytokines in ischemic brain area. Methods 90 healthy male SD(Spraque-Dawley)rats were used to built the animal model of brain medium sized artery focal cerebral ischemia reperfusion with the patching methods, and the rats were randomly divided into three groups: Sham operation group(n=30),operation group(n=30),operation with puerarin interfered group(n=30).There were five different observing time in every group(6h,12h,24h,48h,72h after operation).The operation with puerarin group rats were treated with puerarin solution, the sham operation and operation group rats were injected the same volume Sodium Chloride. To observe the expression of TNF-α cytokines in different time, immunohistochemistry staining in ischemic region was used. Results Compared with the sham operation group. the expression of TNF-α cytokine in cerebral isehemic reperfusion brain tissue in the operation and the operation with puerarin interfered groups was higher(P＜0.01).Compared with the operation group, the expression of TNF-αcytokine was significantly decreased in different time after cerebral ischemic-reperfusion in the operation with puerarin interfered group(P＜0.01 or P＜0.05).Conclusions The puerarin can restrain the expression of the TNF-α cytokine.

Action Potentials ; drug effects ; Animals ; Estradiol ; pharmacology ; Female ; Guinea Pigs ; Heart Ventricles ; cytology ; Myocardial Contraction ; drug effects ; Papillary Muscles ; drug effects ; physiology ; Progesterone ; pharmacology