Objective To study the clinical value of preserving intercostobrachial nerve(ICBN) during axillary lymph node dissection.Methods The clinical data of 146 cases of operated breast cancer of stage Ⅰ、Ⅱ、Ⅲa were analyzed.All cases were divided into twe groups randomly:preserved group(n=67) preserved ICBN in axillary lymph node dissection operation;control group(n=79) resected ICBN regulary in the operations.The number of lymph node dissection and the incidence of abnormal sense on the skin of inside upper arm were compared between groups.Results In one month,three months and six months followed up:the incidence of ahnormal sense on the skin of inside upper arm was 17.9%,11.9%,7.4% in preserved group,which was lower than that (74.9%,60.7%,59.5%) in control group significantly (P＜0.01).The diflrence between the two groups was significant.No local recurrence was occurred after opreations from eight months to five years examined.It was none difference that period of operation and the number of lymph node dissection between the groups.Conclusions Preserving ICBN in axillary lymph node dissection for breast cancer of stage Ⅰ、Ⅱ、Ⅲa could decrease the incidence of abnormal sence on the skin of inside upper arm.It eouldnt increase the incidence of local recurrence.It can improve the life quality of the patients after operations.

Objective To assess the clinical efficacy of butylphthalide sequential therapy(BST)as an adjuvant therapy for delayed onset encephalopathy caused by acute carbon monoxide poisoning(DEACMP).Methods DEACMP patients who visited the department of neurology at Yan'an People's Hospital from January 2018 to June 2023 were selected as the research subjects.Using a random number table method,DEACMP patients were randomly divided into hyperbaric oxygen therapy(HBOT)group,glucocorticoid(GC)group(GC combined with,HBOT),and BST group(HBOT,GC combined with BST),all of which were treated continuously for 30 days.The incidence of adverse reactions and clinical efficacy during the treatment among three groups of DEACMP were observed and compared.Inflammation indicators,neurological damage indicators,cognitive function,neurological function,and daily living ability before and after treatment among three groups were compared.Results A total of 120 patients were included in the study,with 40 patients in each group.During the treatment period,no serious adverse reactions were observed in any of the three groups of patients,and no patient terminated treatment due to adverse reactions.The total effective rate of BST group was significantly higher than those of GC group and HBOT group,while the total effective rate of GC group was higher than that of HBOT group(P<0.05).Before treatment,there was no statistically significant difference(P>0.05)in the scores of inflammation indicators,neurological damage indicators,cognitive function,neurological function,and daily living function among the three groups.After treatment,the serum LP-PLA2,SIRI,TNF-α,S100-β,and the NSE levels decreased compared to before treatment(P<0.05),and the indicators of the BST group was lower than those of the HBOT group and GC group,while the indicators of the GC group was lower than those of the HBOT group(P<0.05).After treatment,the MMSE,MoCA,and BI scores of the three groups increased compared to before treatment(P<0.05),but the NIHSS score decreased(P<0.05).In addition,the MMSE,MoCA,and BI scores of the BST group were higher than those of the HBOT and GC groups(P<0.05),while the NIHSS scores were lower than those of the HBOT and GC groups(P<0.05).The MMSE,MoCA,and BI scores in the GC group were higher than those in the HBOT group,while the NIHSS scores were lower than those in the HBOT group(P<0.05).Conclusion Compared with HBOT treatment and HBOT combined with GC treatment,BST adjuvant therapy can improve the clinical efficacy,inflammatory status,cognitive function,and daily living ability of DECAMP patients.

Objective To investigate the relative mechanism of Maimendong Tang (Ophiopogon Decoction) in amelioration of lung function and endoplasmic reticulum stress (ERS) in rats with bleomycin-induced pulmonary fibrosis.Methods Male healthy SD rats were randomly divided into normal group, model group, Maimendong Tang group 1 and Maimendong Tang group 2.The rat model of pulmonary fibrosis was established by bleomycin pulverization via tracheal intubation.On the 14 t h d after modeling, Maimendong Tang was intragastrically given to Maimendong Tang group1 and Maimendong Tang group 2 twice a day for 20 d continuously.The general conditions were observed, and pathological changes of lung tissue were observed after HE and Masson staining.The forced vital capacity (FVC) , 0.4 second rate (FEV0.4/FVC) , mass FVC, inspiratory resistance (Ri) , expiratory resistance (Re) and dynamic pulmonary compliance (Cydn) were detected by using spirometer.The expressions of glucose regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP) protein in lung tissue were analyzed by using Western blotting assay and immunohistochemistry staining technique.Results Compared with normal group, FVC, FVC/lung mass and Cydn decreased, and 0.4 second rate increased in model group.Compared with model group, FVC increased and 0.4 second rate decreased and Cydn increased in Maimendong Tang group 1 and Maimendong Tang group 2, and mass FVC increased in Maimendong Tang group 2.Pathological sections showed that there were chronic inflammatory cell infiltration in consolidation zone of lung tissue and massive collagen deposition, GRP78 and CHOP with high expressions were mainly positioned in vesicular type Ⅱ alveolar epithelial cells (AECⅡs).The inflammation was relieved, collagen deposition was decreased, protein expressions of GRP78 and CHOP were reduced and in Maimendong Tang group 2.Conclusion Maimendong Tang can significantly improve lung function and reduce lung interstitial collagen deposition, which may be related to regulation of protein expressions of GRP78 and CHOP in AECⅡs in consolidation zone of lung tissue, relief of ERS, and recovery of normal AECⅡs function.