Objective To investigate the value of clinical application of interventional ultrasounography in the diagnosis and treatment of abdominal viscera cysts(AVCs). Methods (1)One hundred and three cases of AVCs were examined by percutaneous fine-needle aspiration biopsy(FNAB) guided by ultrasonnography;the cytologic results were compared with the pathological results after operation in 28 cases. (2) The AVCs were treated with injection of 99.5% ethanol after aspiration or draining with a tube gnided by ultrasounography. Results (1) The diagnosis rate in FNAB group(91.5%) was significantly higher than that in single ultrasounogrophy group(85.4%) (P

Objective To explore the optimal indication and safety of managing ectopic pregnancy by intramuscular injection of high dose of methotrexate.Methods The patient with unruptured ectopic pregnancy was injected with 50mg/m 2 of methotrexate, the injection of methotrexate was repeated at the same dose if the level of the ?-subunit of human chorionic gonadotropin continues to rise or maintain at a high level 7 days after the primary injection.Results Of 109 cases,100 the patients with ectopic pregnancy were succeeded by conservative therapy. The total success rate was 91 7%. The success rate was 97 7% in patients with a level of the ?-subunit of human chorionic gonadotropin less than 2 5 nmol/L (the normal value is less than 0 82nmol/L), whereas it was 66 7% in patients with a level of the ?-subunit of human chorionic gonadotropin greater than 2 5nmol/L, the difference was statistically significant (P

Objective To investigate clinical effects of neoadjuvant chemotherapy of TAC scheme in breast cancer.Methods 82 patients with locally advanced breast cancer receiving neoadjuvant TAC chemotherapy program were retrospectively analyzed.The total efficiency,toxicity,and recent surgical cases were evaluated.Results There were 21 cases of CR in 82 cases with breast cancer,accounting for 25.6％,47 PR(57.3 ％),14 SD(17.1％),so the clinical total effective rate was 82.9％.The major toxic reactions was bone marrow suppression and neutropenia occurrence rate was 81.7％.Other adverse effects include gastrointestinal symptoms and liver dysfunction,and alopecia.All patients after symptomatic treatment can be tolerated.Conclusion TAC program neoadjuvant chemotherapy for locally advanced breast cancer patients can improve the cure rate,increase breast-conserving opportunities.

Objective To evaluate the immune function and the degree of bone marrow suppression of ubenimex tablets on the treatment of patients with triple-negative breast cancer underwent chemotherapy.Methods108 cases in Jiaxing hospital of traditional Chinese medicine were randomly divided into the control group and the experimental group, 54 cases in each group.The two group were all treated with AC-T chemotherapy (pirarubicin+ cyclophosphamide + docetaxel).At this basis, the experimental group were given ubenimex.Flow cytometry was used to detect the changes of T lymphocyte subsets, natural killer cell (NK cell) immune function and peripheral blood cell parameters in the two groups before and after the treatment and 6 months after the treatment.ResultsCompared to the control group, the T lymphocyte subsets and NK cell changes in the experimental group before and after chemotherapy were significantly smaller (P<0.05).The T lymphocyte subsets and NK cells in the experimental group were more accurate than those in the control group (P<0.05).The peripheral blood cells in the experimental group were significantly smaller than those in the control group (P<0.05).Compared with the control group, the whole blood cells increased significantly in the experimental group 6 months after chemotherapy(P<0.05).ConclusionIt can help to reduce the effect of chemotherapeutic drugs on the immune function and bone marrow suppression which ubenimex tablets was used on the treatment patients with triple-negative breast cancer c.Patients can be successfully complete the chemotherapy process, and the long-term and short-term adverse reactions were less, prognosis is good, clinical promotion value is significant.

Objective To analyze the correlation between the position and the removal extent of the tumor and the postoperative sodium metabolic disturbance in patients with craniopharyngiomas. Methods Retrospective analysis of the postoperative sodium metabolic disturbance in craniopharyngioma patients admitted from Feb.2006 to Oct. 2010 was performed. Results In the 30 casese,10 cases occurred hypernatremia,9 with hyponatremia and, 2 with fluctuating hyponatremia and hypematremia. One cases died in the population. No sodium metabolic disturbance occurred in patients with craniopharyngiomas located in the interasellar region, whereas 8 occurred in the inter and suprasellar region(61.5% ,8/13) , and 3 occurred post and beside assellar region(60.0% ,3/5) , 10 occurred in the third and lateral cerebral ventricle (100.0%, 10/10). Sodium metabolic disturbance occurred in 15 cases(62. 5% ) among 24 cases underwent total resection,in all 4 cases underwent sub-total resection (100.0% ) ,and all 2 cases underwent paritical resection ( 100. 0% ). The degree of resection was not correlated with Sodium metabolic disturbance(x2 = 3.21 ,P>0.05). Conclusion Sodium metabolic disturbance after craniopharyngioma surgery may be correlated with the position of tumor, but not correlated with the removal extent.

Objective To study the potential efficacy of transplanted bone marrow-derived mesenchymal stem cells (MSCs) in treating and repairing the acute lung injury in animal models. Methods MSCs were isolated from mouse bone marrow, cultrued and amplified in vitro. The lipopolysaccharide (LPS) was inhaled through postnasal tract to cause acute lung injury in mice and the MSCs labeled by Brdu were administrated via vein into the mice. The migration and differention of the cells were identified by immunostaining and double immunostaining. The pathological changes, pulmonary edema index and the content of IL-1β in lung homogenate were used to accese the therapeutical effect of MSCs. Results The cultured MSCs dispalyed a positive CD44 and a negative CD34. The Brdu-labeled cells were detected in the lungs of the recipient 4 days after transplantation, indicating its origin of MSCs. Theses cells also exhibited characteristics of aveolar epithelials, expressing the cytokeratin-the marker of epithelium. Compared with the injuried ones, the mice treated with MSCs showed a decreased pulmonary edema in-dex and IL-1β content in the lung homogenate. Conclusion These data suggest a therapeutical effects of MSCs in treating and repairing the mouse acute lung injury.

AIM To study oridonin induced apoptosis in human leukemia HL 60 cells. METHODS Cell morphology, agarose gel electrophoresis and flow cytometry were used. RESULTS Oridonin had significant apoptotic inductive effect on HL 60 cells in both concentration and time dependent fashion. The marked morphological changes including condensed chromatin, nuclear fragmentation and apoptotic body were observed. Typical DNA ladder in agarose gel electrophoresis and pre G 1 peak in flow clytometric analysis were also observed in the cells exposed to Ori. CONCLUSION Oridonin can induce apoptosis in human leukemia HL 60 cells.

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.

OBJECTIVETo investigate the risk factors of postoperative perineal wound complications after abdominoperineal resection for rectal cancer.

METHODSThe databases of Medline, Embase, Web of Science, Ovid, Cochrane Library, CBM, CNKI, VIP and WANFANG were searched for the studies of abdominoperineal resection up to October 2016. The quality of the included studies was assessed by using "Cochrane collaboration's tool for assessing risk of bias" and "the Newcastle-Ottawa Scale". The meta-analyses were performed with Review Manager 4.3 software.

RESULTSEight randomized controlled trials and 33 non-randomized controlled trials with 15 287 patients were enrolled. Meta-analyses showed that neoadjuvant radiotherapy (OR=2.55, 95%CI: 1.66 to 3.93, P<0.01) and obesity (OR=2.12, 95%CI: 1.05 to 4.26, P=0.04) significantly increased the morbidity of perineal wound complication after abdominoperineal resection for rectal cancer; omentoplasty(OR=0.30, 95%CI: 0.14 to 0.67, P=0.003), presacral space clysis (OR=0.11, 95%CI: 0.01 to 0.94, P=0.04), abdominal drainage (OR=0.36, 95%CI: 0.21 to 0.63, P<0.01), perineal skin drainage(OR=41.72, 95%CI: 2.39 to 727.90, P=0.01) and local application of antibiotics (OR=0.17,95%CI: 0.07 to 0.40, P<0.01) significantly decreased the morbidity of perineal wound complication; however, extralevator abdominoperineal excision (OR=0.88, 95%CI: 0.57 to 1.35, P=0.56), laparoscopic procedure (OR=1.02, 95%CI: 0.47 to 2.21, P=0.96), biologic mesh reconstruction (OR=1.81, 95%CI: 0.95 to 3.46, P=0.07), myocutaneous flap reconstruction (OR=1.32, 95%CI: 0.18 to 9.91, P=0.79) and negative pressure drainage(OR=0.69, 95%CI: 0.35 to 1.34, P=0.27) had no influence on the healing of perineal wound.

CONCLUSIONSNumerous factors can affect the occurrence of perineal wound complication after abdominoperineal resection for rectal cancer. Due to the limitations of enrolled studies, multicenter large scale and high-quality randomized controlled trials are required to validate the current results.

Objective: To investigate the risk factors of perineal incision complications after abdominoperineal resection (APR) for rectal cancer, and to establish a nomogram model to predict the complications of perineal incision. Methods: A case-control study was conducted to retrospectively collect the medical records of 213 patients with colorectal cancer who underwent APR at the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2016. The complications of perineal incision after APR were classified according to the modified Clavien-Dindo classification of surgical complications (Version 2019), and the complications of grade II and above were defined as "clinically significant complications" .Twenty-two factors related to complication of perineal incision, such as gender, age, surgical procedure, surgical approach, perineal repair, placement of drainage tube, skin position of drainage tube, operation time, intraoperative blood loss, preoperative radiotherapy and chemotherapy, intraoperative local perfusion chemotherapy, tumor classification, pathological grade, tumor T stage, tumor TNM stage and so on, were analyzed by chi-square test for univariate risk factor of complication in all variables, and variables with P<0.2 in univariate analysis were further included in multivariate analysis. Logistic regression analysis was used to screen out independent risk factors. R software (R 3.3.2) was introduced. The rms software package was used to construct a nomogram prediction model. The C-index was calculated (higher meaning better consistency with actual risk) to evaluate the discriminant degree of the model. The Bootstrap method was used to repeat the sampling for internal verification. A total of 42 patients with colorectal cancer who underwent APR from January 2017 to December 2017 at the First Affiliated Hospital of Nanjing Medical University were externally validated, and the corrected C-index was calculated. The model conformity was determined by comparing the C-index calibration difference between the predicted and actual risks. Results: Of the 213 patients with colorectal cancer, 131 were male and 82 were female, with mean age of (59.6±11.6) years. The incidence of postoperative perineal incision complications was 20.2% (43/213), including 27 cases of Clavien-Dindo II and above complications. Univariate analysis showed that the Eastern Cancer Cooperative Group (ECOG) score, preoperative albumin, skin position of drainage tube, intraoperative blood loss, preoperative radiotherapy and chemotherapy were associated with complications of postoperative perineal incision (All P<0.05) . Multivariate analysis showed that preoperative albumin levels ≤38 g/L (OR=105.261, 95% CI: 7.781 to 1423.998, P<0.001), perinead drainage (OR=11.493, 95% CI: 1.379 to 95.767, P=0.024), intraoperative blood loss >110 ml (OR=6.476, 95% CI: 1.505 to 27.863, P=0.012) and preoperative radiotherapy and chemotherapy (OR=7.479, 95% CI: 1.887 to 29.640, P=0.004) were postoperative clinically significant independent risk factors for perineal incision complications. The nomogram model was established. Preoperative albumin level <38 g/L was for 100 points, the preoperative chemoradiotherapy was for 52.5 points, the intraoperative blood loss >110 ml was for 28.5 points, and the perineal drainage was for 17.5 points. Adding all the points was the total score, and the complication rate corresponding to the total score was the predicted rate of the model. The model had a C-index of 0.863. After internal verification, the C-index dropped by 0.005. External verification showed a C-index of 0.841. Conclusions Preoperative nutritional status, skin position of drainage tube, intraoperative blood loss and preoperative radiotherapy and chemotherapy may affect the occurrence of perineal wound complications after APR for rectal cancer. The nomogram model constructed in this study is helpful for predicting the probability of clinically significant complications after APR.