Breast conserving surgery has become the first choice for the treatment of early breast cancer.However,the safety margin is still one of the important issues for surgeons in the implementation of breast conserving surgery.Because variety of clinical factors have some effects on the safety margin,at present,no consensus on safe margin of breast conserving surgery is reached,and the controversy still goes on.

Background:Studies have shown that GEF-H1 can activate Rho protein, and is closely associated with tumorigenesis,tumor progression,infiltration,migration. Aims:To construct human pEGFP-GEF-H1 vector and stably transfect into colon cancer HCT116 cells,and determine the expression of GEF-H1. Methods:The gene sequence was designed according to the Online primers synthesis software for constructing recombinant plasmid pEGFP-GEF-H1. HCT116 cells were transfected with plasmid pEGFP-GEF-H1,empty plasmid,respectively,and HCT116 cells without transfection were served as blank control group. Expression of green fluorescence protein was observed under fluorescence microscope. mRNA and protein expressions of GEF-H1 were determined by RT-PCR and Western blotting,respectively. Results:Human pEGFP-GEF-H1 vector was successfully constructed and identified by sequence analysis. After transfection with pEGFP-GEF-H1,green fluorescence could be observed in HCT116 cells,and the mRNA and protein expressions of GEF-H1 were higher than those in empty plasmid group and blank control group. Conclusions:Recombinant plasmid pEGFP-GEF-H1 is successfully constructed in vitro,and transfection into HCT116 cells leads to high expression of GEF-H1, thereby can provide experimental materials needed for further study on correlation between colon cancer and GEF-H1.

Objective To study the relevance between blood loss, widespread brain contusion injury and consumptive coagulopathy. Methods One hundred and fifty-three cases with severe brain injury was studied about their coagulation data. Analyzed the relationship between blood loss group according to ≥3000 ml and ＜ 3000 ml and coagulation features, the relationship between widespread brain contusion injury and disorder of coagulation;according to whether with brain contusion injury,kinds of bloods transplant and prognosis were asseseed;according to whether with widespread brain contusion injury in ≥ 3000 ml blood loss group,kinds of bloods transplant and prognosis were assessed. Results Compared with ＜ 3000 ml blood loss patients, ≥ 3000 ml patients' blood coagulation changed obviously, with PT prolonging, Fbg and Plt decreasing, the differences were statistically significant (P ＜ 0.05). Compared with no extensive brain contusion injury patients, in extensive brain contusion injury patients, APTT, PT, TT prolonged, Fbg and Plt decreased,and the difference was statistically significant (P ＜0.05). Extensive brain contusion injury patients with blood loss compared with those without such loss, needed more blood transfusion volume,larger amount of input of fresh frozen plasma Plt volume,the former survival rate was lower [68.29%(28/41)vs. 96.43%(108/112)], the difference between them was statistically significant (P＜ 0.05 ). In 41 patients who had brain widespread contusion ,the cases with extensive blood loss ( ≥ 3000 ml) were compared with those ＜ 3000 ml, and the differences in blood transfusion treatment, fresh frozen plasma, Plt volume,survival rate were statistically significant (P ＜ 0.05). Conclusion When blood loss ≥ 3000 ml after trauma,patients show various degrees of coagulopathy,and when accompanied with extensive brain tissue injury,coagulation disorders are more obvious, and the prognosis is even worse.

A nuclear accident likely leads to the leakage of radiocesium to a large degree,which could poses threatens to the environment and human heahh.Hence,it is very important to remove radiocesium ion from the environment and human body in the aftermath of a nuclear accident.In this review,the new progress of radiocesium ion removal in a nuclear emergency is discussed.The main technique to reduce soil pollution is to remove and purify topsoil.The methods of purification include leaching method,electrokinetic process and soil immobilization.The technique to remove radiocesium from water is mainly via adsorption.Common adsorbents include crown ether,calix ether,ammonium molybdophosphate and Prussian blue.Radiocesium removal from human body is mainly via oral administration of Prussian blue at fractioned doses in a timely manner but spents a relatively long response time,possibly accompanied with some severe side effects,like hypopotassemia and physical damage of digestive tract.Therefore,new techniques are still in need of development to remove radiocesium ion from human body more effectively.

Objective To study the clinical features,diagnosis and treatment of polycystic liver disease (PLD)complicated with portal hypertension (PHT).Methods The clinical data of one patient with PLD and PHT was retrospectively analyzed,and relevant literature was reviewed.Results The patient presented fatigue,dyspepsia, abdominal distension and lower limb edema.Laboratory examination showed mild liver dysfunction(Alkaline phospha-tase 291.2U/L,gamma glutamyl transpeptidase 168.1U/L,59.9g/L,total protein,albumin 32.2g/L,21.0μmol /L, total bilirubin,direct bilirubin 11.5μmol /L).Abdominal ultrasound (US)and computerized tomography (CT) showed multiple noncommunicating cysts of varying size in both liver and kidney.Antioxidant supplements and diuretic were introduced,and the therapy was approved to be effective.Conclusion The case in this report illustrates that PLD could occasionally present with PHT.Physician should be alert to prevent misdiagnosis.

OBJECTIVEThis study aims to construct a long-term, osteogenesis-targeting HU-308 drug delivery implant by the layer-by-layer electrostatic self-assembly (LBL) technique, and observe the features of its delayed release in vitro.

METHODSA heparin (Hep) and chitosan (Chi) multilayer was coated on pure titanium using the LBL technique, and the titanium implants were dipped into the solution to load HU-308. The amount of loaded drug and release rates were measured using a UV-Vis spectrophotometer. The relationships between the loading efficiency, release time, and multilayer films were evaluated. The morphology of all the multilayers was characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM).

RESULTSThe results showed that the Hep/Chi self-assembly multilayer was gradually fabricated on the titanium surface. HU-308 was successfully loaded on the titanium implants. The amount of loaded drug increased with the amount of multilayer films, except in the T20 group. In vitro drug release study showed that drug release was more difficult in the system with thicker films, and large amounts of multilayer films decreased the release speed. Both SEM and AFM measurements showed typical LBL deposition of Hep and Chi.

CONCLUSIONThe HU-308 drug delivery implant is successfully fabricated via LBL technology. It could provide sustained release of HU-308 over 30 d. This type of implant may provide a new possi- bility of promoting implant-bone osseointegration for osteoporotic patients.

Objective To evaluate a minimally invasive procedure for intertrochanteric fracture treatment in elderly patients. Methods Total 46 elderly patients with intertrochanteric fracture were treated with a minimally invasive procedure from September 2008 to February 2010. The fractures were fixed with multiple K-wires combined with skeletal traction through supracondyle of femur. All procedures were undertaken under local anesthesia. Results All the patients were followed up for 8.8-months in average, and 42 patients recovered with independent walking, and the good rates was 91.3%, without severe complications in this group. Conclusions Minimally invasive procedure including fixation with multiple K-wires combined with traction through femoral supracondyle, is a safe and effective treatment for intertrochanteric fracture in elderly patients, avoiding high risks of intra-and post-operative complications.

Objective To evaluate the clinical efficiency and seeurity of SilverHawk directional atherectomy device in treating arteriosclerosis obliterans of lower extremity.Methods Seyen patients with lower extremity ischemia were treated with SilverHawk directional atherectomy.The lesions length varied from 1.8 to 14.5 cm.Clinical symptoms(Fontaine classification)included 4 cases of grade Ⅱ b,1 case of grade Ⅲ,2 cases of grade Ⅳ.The ABI varied from 0.28 to 0.65.Patency was evaluated with color duplex sonography or CTA besides clinical examination during follow-up.Results Seven occlusive lesions were recanalizated successfully.The technical success(residual stenosis<30%)rate was 100%. Clinical symptoms were obviously improved or disappeared.The ABI varied from 0.82 to 1.18(P=0.002),and Fontaine classification included 6 cases of Ⅰ:1 case of Ⅱ a.Patency rate was 100%and the ABI varied from 0.75 to 1.14(P=0.938).Fontaine classifications keep consistent l-6 nonths after operation.Conclusion SilverHawk drectional atherectomy Was a safe and effective way for treatment of lower arteriosclerosis obliteran.

After the reform from "4+1" to "3+2",an undergraduate teaching model of clinical medicine,has been implemented in our university,higher demands are set on the training of students' abilities and creativity.This paper explored the basic medicine teaching from the perspectives of creative concepts,teaching staff,curriculum design and practice.

Objective To assess the effects of eszopiclone (ESZ) on the pentobarbital sodium-induced sleeping time and spontaneous activity in mice exposed to acute hypobaric hypoxia.Methods 120 mice were randomly divided into 6 groups by using two factors 2×3 levels factorial design,in which two factors were interventions (ESZ and 0.9％ sodium chloride,2 levels) and altitudes (800 m,3500 m and 6000 m,3 levels).The pentobarbital sodium-induced sleeping test and the open field test were engaged to assess the effects of ESZ on sleeping time and spontaneous activity.Results (1) The drug and altitude had no interaction in the results of both the pentobarbital sodium-induced sleeping test and the open field test(P＞0.05).(2)The time of pentobarbital sodium-induced sleeping of mice in the groups of ESZ at each altitudes were (37.77± 18.22) min,(37.02± 13.67) min,(95.67±47.68)min and in the groups of NS were(17.78± 14.10) min,(15.09± 12.46) min,(39.54±28.24) min respectively,and the sleep time in ESZ groups were significantly longer than those in the groups of NS (P＜0.05).The time of pentobarbital sodium-induced sleeping were longer in group of 6000 m than those in the other two groups,both the ESZ and NS groups (P＜0.05).(3)No significant difference was found in the open field test between the ESZ and NS groups in the same altitude(P＞0.05) ; while the mice at the altitude of 6000 m in groups of ESZ and NS decreased compared with the groups at the altitude of 800 m after the relevant drugs intra-perineally for 6 h (P＜0.05).Conclusion ESZ may prolong pentobarbital sodium-induced sleeping time especially at the altitude of 6000 m and with no influence on the spontaneous activity in mice exposed to acute hypobaric hypoxia.High altitude at 6000 m may prolong the sleep time induced by pentobarbital sodium and reduce the spontaneous activities.