Breast cancer related lymphedema is the accumulation of interstitial fluid due to the lymphatic fluid load exceeds its transport ability as a consequence of the lesion of lymphatic structure.It mainly presents as swelling of the affected limb,a feeling of heaviness or tightness in the limb,aching and restricted limb motion.Its incidence is related to surgery,chemical therapy,obesity,hypertention as well as the alteration of particular genes.To prevent the occurrence and exacerbation of lymphedema,patients should avoid the overuse of the affected limb.While limb exercise step by step can solve part of this problem,but not all,doctor should also take both the patterns of exercise and risk factors that patients expose into consideration,then make a individualized exercise plan,evaluate the condition precisely,in order to achieve the best treatment purposes.

Objective To observe influence of retinoic acid on the lung damage and expression of Connexin26(Cx26) of neonatal rats suffered from hyperoxia.Methods Twenty-four 3-day SD rats were randomly divided into three groups:retinoic acid+ hyperoxia,hyperoxia,air group;rats in the group of hyperoxia were suffered 7 days hyperoxia (the level of oxygen was above 950 mL/L),air group was instead of air.All rats were weighed,value of radical alveolar counts(RAC) and microstructure of the lungs were observed by HE staining under light and electron microscope respectively;and the expression of Cx26 in the lungs was determined by immunohistochemistry.Results Compared with air group,weight,value of RAC were both decreased obviously in hyperoxia,retinoic acid+hyperoxia groups[(13.53?1.27),(13.38?1.29),(17.37?0.89)g,F=30.19 P=0;11.15?1.33,12.49?1.47,13.94?0.98,F=9.59 P=0),while the expression of Cx26 increased [(13.68?1.28)%,(17.82?1.72)%,(19.69?1.77)%,F=29.36 P=0].Conclusion Retinoic acid has a protective effection from damaged lung of neonatal rats suffered from hyperoxia,and it may be related to the alteration of expression of Cx26 protein in the lungs.

0.05). No significant association between Q/R 192 genotype and blood lipids was found.Conclusion The polymorphism of PON-1 Q/R 192 gene is not associated with CI.

In recent decades, the development of the neurosurgery has changed from the traditional anatomical model to the modern anatomical-functional model. The nerve functions are maximally protected while lesions are removed as far as possible. Neurophysiological monitoring especially somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) can directly reflect the integrity of the sensory and motor nerve conduction pathways of the nervous system. At present, it has been widely used in the neurosurgery, spinal surgery, vascular surgery and other surgical fields. In recent years, more and more clinical surgeries involved spinal surgery, intraoperative neurophysiological monitoring could timely find any reversible spinal cord damage such as mechanical stretch, ischemia, and anesthetic drugs, which not only improve the quality of surgery, reduce iatrogenic spinal cord injury, but also greatly improve the prognosis of patients and reduce postoperative neurological dysfunction and complications. In this paper, the research progress of neural electrophysiological monitoring techniques in spinal cord surgery is reviewed.

Teaching feedback has been affected by many factors including education theory, culture diversity and so on.Article analyized the teaching feedback in United States clinical education in a group of the visiting student’s experience in Harbor-UCLA Medical Center.In clinical education, the aim of teaching can only be could be successfully reached by consideration the specific teaching contact and students’idiosyncrasy and flexible teaching feedback utilization.

Objective The aim of present study was to explore the effects of plateau hypoxia on the cyanide ion metabolism and correlative toxicant mechanism.Methods 12 adult rabbits and 72 male SD rats were randomly divided into two groups separately:plain control group with NaCN intoxication and plateau NaCN intoxicant group.2mg/kg NaCN was subcutaneously injected into the back of rabbits,the femoral vein blood was then collected at different designated time points for the measurement of cyanide,hemoglobin and ferrihemoglobin concentrations.Meanwhile 3.6 mg/kg NaCN was subcutaneously injected into the back of rats,the cardiac blood and the hepatic tissue were then collected at the different designated time points for the determination of cyanide ion,cytochrome oxidase activities and for the detection of pathologic changes of hepatic tissue.Results Under the condition of plain and plateau environments,the pharmacokinetics of rabbits induced by NaCN injection was characterized by one-compartment model.The blood cyanide concentration of rats in both plain and plateau groups reached peak value at 30min,and the activity of cytochrome oxidase decreased.Furthermore,the pathologic diagnosis of rats hepatic tissue suggested that liver injury induced by NaCN intoxication at high altitude was more serious than in plain intoxicant.Conclusion Hypoxia could markedly disturb the metabolic process of NaCN in vivo,aggravate the inhibition of cytochrome oxidase activity and lead to serious pathologic injury.

Objective To evaluate the effect of Saccharomyces boulardii (SB) administration on very-low-birth-weight (VLBW) infants.Methods One hundred and ninety-eight preterm infants were prospectively randomized into observation group (105 cases) and control group (93 cases) based on the symptomatic and supportive treatment.When uncompletely stomach intestine nutrition fed,the patients of observation group took SB (50 mg/kg),the patients of control group took equivalent placebo.The times of defecation and diarrhea,the rate of neonatal necrotizing enterocolitis,hospital onset of infection (septicemia,pulmonary infection),fungal infection,the time of intravenous nutrition and length of stay were compared.Results The general data in two groups had no significant difference (P ＞ 0.05).The times of defecation,time of intravenous nutrition and length of stay in two groups had significant difference [(1.8 ± 0.4) times/d vs.(3.4 ± 0.5) times/d,(30.21 ± 3.43) d vs.(40.47 ± 4.35) d,(33.5 ± 6.8) d vs.(45.4 ± 9.3) d] (P ＜ 0.05).The rate of diarrhea,neonatal necrotizing enterocolitis,septicemia and pyemia in two groups had significant difference [14.3％ (15/105) vs.25.8％ (24/93),11.4％ (12/105) vs.19.4％ (18/93),19.0％ (20/105) vs.29.0％ (27/93)] (P ＜ 0.05).The rate of pulmonary infection and fungal infection between two groups had no significant difference(P＞ 0.05).Conclusion SB administration on VLBW infants can reduce the infection,promote enteral feeding,shorter hospital stay,and has a certain significance on the family and the community.

Objective To study the pulmonary surfactant (PS) on prevention of neonatal respiratory distress syndrome (NRDS) in neonates delivered via caesarean section. Methods From selective cesarean section infants (gestational age 34-38+6 W), 80 cases whose test tube oscillation tests were negative and amniotic fluid pulmonary surfactant associated protein A (SP-A) concentrations were lower than <10μg/L, and were randomly divided into PS prevention group and control group, with 40 cases in each group. PS prevention group within 1 h of birth were administrated poractant alfa injection by endotracheal tube (dose 100 mg/kg), but the control group was not given special treatment, leaving only the observation. The incidence of NRDS, treatment status and clinical progression were compared between two groups. Results The incidence of NRDS in control group was 82.5%(33/40), in PS prevention group was 37.5%(15/40), and there was significant difference (P<0.05). The degree of NRDS in control group was more severe. The incidence rate of persistent pulmonary hypertension of the new-born (PPHN), pulmonary air leak, patent ductus arteriosus and oxygenation index above 25 mmHg (1 mmHg=0.133 kPa) in control group were significantly higher than those in PS prevention group (P<0.05). The time of mechanical ventilation, the time of oxygen inhalation, ratio of arterial partial pressure of oxygen (PaO2) before mechanical ventilation to fraction of inspired oxygen (FiO2), and costs of hospitalization in control group were significantly higher than those in PS prevention group (P<0.05). Conclusions PS prevention can reduce the incidence of NRDS of neonates delivered by elective caesarean section, can alleviate the symptoms of NRDS, shorten length of stay and reduce the cost of hospitalization.

Objective To study the effect of mild hypothermia combined with edaravone on the expressions of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in cerebrospinal fluid(CSF)of patients with severe traumatic brain injury(sTBI)and on their prognoses. Methods A prospective randomizd controled trial was conducted. Seventy-seven patients in the Center for Neurology and Neurosurgery of Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces were randomly assigned into control group(38 cases)and treatment group(39 cases)according to random number table. All the patients were treated with routine treatments such as dehydration of intracranial pressure(ICP),neural nutrition,anti-infection,mechanical ventilation and maintenance of water and electrolyte balance in control group,while in treatment group,the patients received mild hypothermia combined with edaravone on the basis of routine treatment within 24 hours after injury. The contents of TNF-αand IL-6 in CSF were measured by radio-immunoassay(RIA)at different time points in both groups. In the meantime,the ICP was also measured. The prognosis was evaluated after 6 months of injury according to Glasgow outcome scale(GOS). Results Compared to control group,in the treatment group,the expression levels of TNF-αand IL-6 in CSF had no significant difference(both P>0.05)on the 1st day after injury,but they were significantly increased on the 3rd day after injury,began to decline on the 7th day,and reached to the valley value on the 14th day after injury,the degree of descent in treatment group being more significant than that in control group〔TNF-α(μg/L):2.43±0.39 vs. 3.12±0.47,IL-6(ng/L):83.53±11.48 vs. 101.69±13.64,both P<0.01〕. Before the treatment,the level of ICP in treatment group had no significant difference from that of control group(P>0.05),but it was gradually increased on the 1st day after injury in both groups,it reached the peak value on the 3rd day after injury,and began to decline on the 7th day after injury,the degree of descent being more significant in treatment group〔mmHg(1 mmHg=0.133 kPa):14.88±3.73 vs. 21.76±4.78,P<0.01〕. The favorable prognosis rate was significantly higher〔35.9%(14/39)vs. 21.1%(8/38),P<0.05〕,and the mortality was obviously lower in treatment group than those of control group〔28.2%(11)vs. 42.1%(16),P<0.05〕. Conclusion In patients with sTBI,mild hypothermia combined with edaravone can protect brain tissue through alleviating high ICP and decreasing the expression levels of TNF-αand IL-6 in CSF, resulting in promoting the recovery of nerve functions and improving prognosis.

Objective To investigate the long-term efficacy of autologous stem cell transplantation for systemic lupus erythematosus (SLE). Methods Long-term follow up of 48 SLE patients with autologous stem cell transplantation were studied. All patients were followed up for 10 years. Among the patients, 24 cases were treated with purified CD34+ cells transplantation and 24 cases were treated with non-CD34+ cell transplantation. Comparison between groups was performed by x2 test. Results Among 5 dead patients, 4 died of transplantation related complications including 3 cases treated with CD34+ transplantion. The survival rate of those patients with more than 10 years duration of lupus was 90%(43/48). Among 43 patients, 7 had disease flare, 6 were treated with non-CD34+ cell transplantation. Eight patients went to college, 26 returned to normal life and 4 of them had children. Conclusion The long-term effect of SLE treated with autologous hematopoietic stem cell transplantation and anti-thymocyte globulin (ATG) is good. The recurrence of CD34+ transplant patients is lower than those treated with non-CD34+ transplantation. The quality of life in SLE patients treated with transplantation is better than those treated with conventional therapy.