Purpose: To examine the drug concentration in axillary nodes after regional injection of carboplatin-activated carbon suspension (CP-CH) in patients with breast cancer, and compared the result with what happened after regional injection of carboplatin solution ( CP-Sol). Methods: 32 patients with breast cancer were divided into 2 groups randomly with 16 patients in each group. One group received regional subcutaneous injection of CP-CH adjacent to the primary tumor. The contrast group received CP-Sol under the same conditions. Modified mammectomy was done 1, 12, 24, 72 hours later. The carboplatin concentration in axillary lymph nodes was examined by atom absorbing spectrometry. Results: At 1, 12, 24, 72 hours after injection of CP-CH, the carboplatin concentration in lymph nodes was 11.23?5. 66u,g/g, 26.40?11. 18u.g/g, 18.72?7. 14u.g/g, 15. 44?6. 92u,g/g, respectively. At 1, 12, 24 hours after injection of CP-Sol, the carboplatin concentration was 0. 24? 0. 06ug/g, 0. 13? 0. 08ug/g, 0. 12? 0. 04ug/g, respectively. No carboplatin was found at 72 hours after injection. The differences between the two groups were very significant (P

AIM:To investigate the findings of the eyes which were examined preoperatively by three mirror contact lens before the implantation of implantable collamer lens ( ICL) . To analysis the retinal pathological changes and to explore the clinical analysis of early diagnosis and treatment in retinopathy on fundus examination before operation.
METHODS:The retrospective case series study included 127 eyes of 64 patients who underwent phakic intraocular lens implantation were received the fundus examination by three mirror from April 2011 to April 2012 in our hospital. The age, refractive diopter, the findings of Goldmann three mirror examination and the condition of retinal photocoagulation were analysed and concluded.RESULTS:A total of 34 eyes (26. 8%) out of all 127 eyes ( 64 cases ) were found to have peripheral retinal pathological changes. Eight eyes ( 6. 3%) with retinal holes, 15 eyes(11. 8%) with retinal lattice degeneration, 5 eyes ( 3.9%) with retina cream degeneration, 3 eyes (2.4%)with retinal paving stone degeneration,2 eyes with vitreoretinal adhesion and traction, 1 eye ( 0. 8%) with retinal hemorrhage. Twenty-five cases were given retinal photocoagulation and then received the ICL implantation after 3mo. The follow - up time was 1a. No retinal detachment happened.
CONCLUSION: Phakic before intraocular lens implantation for fundus examination by three mirror is contributed to find the peripheral retinal pathological changes and abnormity. And make the appropriate treatment before operation for improving the security of operation, it can also give help to the postoperative follow-up of the fundus of these patients.

OBJECTIVE: Based on the overview of progress regarding seed cells and scaffolds for skin tissue engineering, to introduce the research of three dimensional nanofiber scaffolds prepared by electrospinning technique, and its application prospect in tissue engineered skin.DATA SOURCES: The databases of CNKI, Sciencedirect, and I.S.I were retrieved by the first author with key words of "tissue-engineering, skin, wound healing, seed cell, scaffold, electrospunning" in both Chinese and English from 1992 to 2009.DATA SELECTION: Major accomplishments of research on skin tissue engineering published in recent years.MAIN OUTCOME MEASURES: ①Papers related to treating skin destruction using tissue engineered materials. ②Articles correlative to seed cells and scaffold materials. ③Papers regarding electrospinning technique.RESULTS: The preparation of artificial skins is the research direction of tissue-engineered skin, in particular, studies regarding epidermal stem cells, bone marrow mesenchymal stem cells, hair follicle stem cells, and adipose-derived stem cells are attracted more attention. As tissue engineering, it is a key problems to prepare a scaffold to meet the needs of mechanical property,physical composition and biocompatibility. Scaffold materials comprise micrometer porous scaffold and nano-fiber scaffolds. The electrospinning technique is newly developed method for preparing nano-fiber scaffolds with the advantage of fast and convenience, and the scaffolds possess greater porosity, which not only benefit for the blood circulation and oxygen exchange,but also prevent the loss of water content and protein from wound surface.CONCLUSIONS: Tissue engineered skin is an important ingredient of regenerative medicine, seed cells and scaffold matrixes are two core problems that call for long term investigation. With the incessant development and integration among life sciences,nanotechnology and computer technology, marvelous progress has been achieved in the perspective of comprehending the interaction between seed cells, the mutual regulation mechanism and how the architecture and properties of scaffold materials affecting the regenerative procedures.

Objective To explore the curative effect of oral cancer radical surgery plus free anterolateral thigh flap repair and analyze the influence factors of skin flap necrosis.Methods The data of 98 patients who underwent oral cancer radical surgery with concurrent free anterolateral thigh flap repair in our hospital from January 2010 to June 2015 were retrospectively analyzed.The complete survival rate of skin flaps and incidence of complications in all patients were statistically analyzed.The age,diabetes,infection in implanted skin flap area,smoking and mental status,etc.of patients with survived or necrotic skin flaps were compared between patients with survival flaps and patients with flap necrosis,and multivariate Logistic regression analysis was performed.Results Among the 98 cases,86 cases of flaps survived completely and the survival rate was 87.8%.Fifteen cases with the skin flap necrosis,the incidence of complications was 15.3%,including 7 cases of surgi-cal site infection and 5 cases of skin flap necrosis with massive hemorrhage.The donor site incisions of all patients were primary healing and the patients were satisfied with the postoperative appearance.Among the patients with flap necrosis,the incidence rates of ≥60 years old,with diabetes,infection in flap implanted area,smoking and poor mental state (41.7%,41.7%,58.3%,75.0%,83.3%)were higher than those corresponding proportions in the patients with with survival flaps(P <0.05).Multivariate Logistic regression analysis showed that age,diabe-tes,infection in implanted skin flap area,smoking and poor mental status were the influencing factors for flap necrosis.Conclusion Oral cancer radical surgery with concurrent free anterolateral thigh flap repair has good curative effects.The age,combined with diabetes,smoking,infec-tion in flap implanted area and poor mental state are the risk factors for flap necrosis in patients with oral cancer after flap repair,which should be given intervention to improve the survival rate of skin flap in clinic.

BACKGROUND: Limb negative pressure treatment can dilate limb vessels and improve terminal microcirculation. P-substance has strong vasodilative activity and is involved in the sensation of the skin to traumatic stimulation and the modulation of local vascular function.OBJECTIVE: To observe the influence of limb negative pressure on cutaneous P-substance immunoreactive nerve fibers in dogs with peripheral arterial occlusive disease.DESIGN: Randomized controlled experiment.SETTING: The 3rd Department of General Surgery, Xijing Hospital Affiliated to the Fourth Military Medical University of Chinese PLA.MATERIALS: This experiment was conducted at the Animal Laboratory of Xijing Hospital Affiliated to the Fourth Military Medical University of Chinese PLA between April 2003 and May 2004. Totally 17 healthy hybrid dogs were randomized into 3 groups, namely, treatment group of 10 dogs,non-treatment group of 5 dogs, and normal control group of 2 dogs.INTERVENTIONS: Negative pressure treatment on affected limbs: After superficial anesthesia, the left hindlimbs of the animals were put into the home-made negative cabin for negative pressure treatment with pressure designed as -12kPa, for 15 minutes, once a day for consecutive 10 days.[1] Treatment group: The left hindlimb ischemic model was prepared 14days before starting 10-day negative pressure treatment; after that the animals were subjected to infusion, the skin of the 2nd toe of affected limbs, as well as L1-5 spinal cords and dorsal root ganglion were obtained for immunohistochemical (IHC) staining. Meanwhile prostaglandin E1 immunoreactive nerve fibers were detected. [2] Non-treatment group: The animals received the same treatment and examination as treatment group except for negative pressure. [3] Normal control group: No ischemic model was prepared or negative pressure treatment was given except for IHC staining.MAIN OUTCOME MEASURES: Changes of cutaneous P-substance immunoreactive nerve fiber in each group. RESULTS: Totally 17 dogs entered the result analysis. Changes of cutaneous P-substance immunoreactive nerve fibers: The cutaneous P-substance immunoreactive nerve fibers in dermis connective tissues and layer vessels were reduced in treatment group compared to those in non-treatment group[(24.70±4.6), (43.49±6.3) μm/mm2, P ＜ 0.01], but still higher than those in control group [(18.10±5.4) μm/mm2, P ＜ 0.01]; dermis P-substance immunoreactive nerve fibers in non-treatment group were more than those in normal control group (P ＜ 0.01), with P-substance immunoreactive nerve fibers increased and deeply stained in dermis connective tissues and small vessels. In contrast, P-substance immunoreactive nerve fibers were not observed in the horny layer but in the dermis of the toe in normal control group.CONCLUSION: Results of the present study suggest that limb negative pressure can enhance P-substance release from cutaneous sensory nerve fibers.

BACKGROUND: Harmful stimuli induce increased production of calcitonin gene-related peptide(CGRP) in the spinal cord and dorsal root ganglion, causing also intense dilation of the microvessels. But it remains unknown whether vessel dilation and pain relief were accompanied by increased CGRP production when negative pressure is applied on the limbs for treatment of peripheral arterial occlusion diseases (PAOD).OBJECTIVE: To examine the changes of calcitonin gene-related peptide (GGRP) -immunoractive nerve fibers in the spinal cord and dorsal root ganglion in dogs with PAOD treated with negative pressure on the limbs.DESIGN: A randomized controlled retrospective study.SETTING: The department of general surgery of a military medical university.MATERIALS: This study was carried out at Xijing Hospital of the Fourth Military Medical University of Chinese PLA between January and August 2003. Seventeen adult male dogs weighing 12 - 18 kg, regardless of the gender, were selected.INTERVENTIONS: Seventeen dogs were randomly divided into three groups, namely the treatment group( n = 10), model group( n = 5), and the normal control group( n = 2). Posterior left leg ischemia was induced in dogs in the treatment and model groups, and those in the treatment group, but not the model group, were treated with negative limb pressure for 10 days 14days after model establishment. The spinal cord and dorsal ganglion at L1-5of these two groups were collected and stained immunohistochemically for observing the changes of GGRP-immunreactive nerve fibers. The dogs in the normal control group were also sampled in similar manner for immunohistochemical staining.MAIN OUTCOME MEASURES: Distribution of CGRP-immunoreactive nerve fibers in the spinal cord and dorsal ganglions of the three groups of dogs.RESULTS: In the dogs of the model group, GGRP-immunoreactive nerve fibers in the spinal cord and dorsal ganglions was significantly more numerous[ (75. 00 ±4. 30)%, (68.20 ± 2.60)% ] than those in the treatment and normal control groups[ (58. 20 ±5. 10)%, (52. 20 ±6.20)%; (37.00±4. 20)%, (34. 00 ± 1.40)%, P ＜ 0.01]. The positive nerve fibers were less strongly stained in the treatment group than those in the model group,but still stronger stained those in the normal control group, with significant difference between the three groups( P ＜ 0.01).CONCLUSION: Negative pressure on the limbs may attenuate the synthesis of CGRP-immunoreactive nerve fibers in the spinal cord and dorsal root ganglion and pain conduction following PAOD in dogs, so that harmful afferent stimuli are inhibited to relieve the pain in the limbs.

Heuristic teaching is propitious to cultivating students' ideation. We have used different heuristic modes for example problems, stories, contrast, associationin and so on to cultivate medical students' ideation in pathobiology and immunology teaching and acquired good effect.

Objective The aim of this study was to analyze risk factors which may affect prognosis of patients with hepatits B virus (HBV)-related liver failure,and to construct a model for prognostic evaluation and further assess its predictive ability.Methods In this retrospective cohort study,569 hospitalized patients who were diagnosed with HBV-related liver failure from January 2007 to December 2010 were enrolled.All the patients were followed up and survival analysis was performed using the Kaplan-Meier method.Univariate and multivariate COX proportional hazards regression analyses were applied to variables such as age,sex,complications,biochemical markers,coagulation markers,and HBV DNA levels to construct a model for prognostic evaluation,and 79 independent cases of HBV-related liver failure were used to confirm the model's predictive ability.Accuracy of the constructed model and model for end-stage liver disease (MELD) was evaluated by receiver operating characteristic (ROC) curves.Results The median survival time for all the patients was 59 days.The survival rates at 1,3,6 months were 58.9％,46.2％ and 45.5％,respectively;and survival rates at 1 and 3 years were 44.9％ and 44.5％,respectively.Hepatic encephalopathy,pulmonary infection,upper gastrointestinal bleeding (UGIB),albumin (Alb),aspartate aminotransferase (AST),creatinine (Cr),international normalized ratio (INR) were determined to be independent risk factors (all P＜0.01) which may affect survival of patients with HBV related liver failure.Accordingly,the prognostic index (PI) of the constructed model for prognostic evaluation 4.98 × assignment of hepatic encephalopathy + 4.57 × assignment of pulmonary infection + 4.41 ×assignment of UGIB-9.69 ×lm[Alb (g/L)]+2.46 ×ln[AST (U/L)]+5.18×ln[Cr (mmol/L)]+3.35×ln (INR) 15.36.The area under receiver operating characteristic curve was 0.838 for the constructed model assessing 90-d survival of the patients,and was 0.751 for model for end-stage liver disease,with no significant difference between the two models (Z=1.085,P =0.278).Conclusions Prognosis of patients with HBV-related liver failure can be accurately predicted by the constructed prognostic assessment model,which is consisted of hepatic encephalopathy,pulmonary infection,UGIB,Alb,AST,Cr,and INR as independent risk factors,and is able to predict the 90 d survival.

Objective: To assess the accuracy and application value of type III portable monitor (III PM) of sleep apnea (SA) for in-hospital patients with cardiovascular disease (CVD). Methods: A total of 101 CVD patients received sleep apnea monitoring by both type II polysomnography ( II PSG) and III PM were enrolled to compare the apnea-hypopnea index (AHI) measured by 2 instruments. AHI was assigned into 4 grades: Normal (AHI<5), Mild grade (5≤AHI<15), Moderate grade (15≤AHI<30) and Severe grade (AHI≥30). Kendall correlation coefficient and Kappa value were calculated, pair wise t test was conducted in relevant patients. Results: II PSG and III PM measured AHI were (18.0±16.6) events/h and (18.6±17.4) events/h, P>0.05. Kendall correlation coefficient for 4 AHI grades was 0.701, P<0.01 which assumed strong correlation; Kappa value of consistency was 0.493, P<0.01 which assumed medium strong correlation. Using AHI≥15 as cut-off point, Kappa coefficient for the consistency between II PSG and III PM was 0.679, P<0.05, which meant high consistency. Taking II PSG as standard and AHI≥15 as cut-off point, the AUC of III PM measured AHI was 0.918 with the specificity at 80.4% and sensitivity at 87.3%. The best diagnosing cut-off value of III PM was AHI=15.70, at this point, the maximum Youden's index was obtained as 0.695. Conclusion: Using AHI≥15 as standard, III PM and II PSG had the favorable consistency and accuracy for monitoring the severity of SA for in-hospital patients with cardiovascular disease. AHI=15.7 was the best cut-off point of III PM in diagnosing moderate and severe SA in relevant patients.

Objective To study the pharmacokinetics of tamoxifen at a high dosage, which will offer a theoretical support for an appropriate clinical use of the medicine in non-small cell lung cancer (NSCLC) patients. Methods Three qualified NSCLC patients are selected and given tamoxifen (TAM) 160 mg per Os. Blood samples were collected at different times and then analyzed by high-performance liguid chromatography. The PK-GRAPH program was used to obtain the parameters. Results The concentration-time courses of the TAM 160 mg were fitted to one-compartment model. The pharmacokinetic parameters were estimated as follows: Tmax (6.35±1.24)h, Cmax (217.39±7.71)ng/Ml, AUC (12 127.39±636.16)ng·h/Ml and T1/2ke (34.13±2.97)h. Conclusion TAM 160mg one day per Os cannot reach the effective maintenance concentration in vivo required for reversing MDR in vitro. Loading-maintenance dose strategy is recommended to study the pharmacodynamics of tamoxifen at a high dosage in NSCLC patients.