AIM: To study the effect of garlicin on protecting nonalcoholic fat liver in rats induced by high fat diet and explore the pathogenesis involved. METHODS: According to the dosage of garlicin and diet, fifty SD rats were randomly divided into five equal groups: normal control group, model control group and garlicin (10, 20, 30 mg/kg) groups. Apart from the rats in normal control group, the rats were all fed with high fat and high cholesterol diet. After 12 weeks, the levels of serum endotoxin (ETX), total cholesterols (TC), triglyceride (TG), superoxide dismutase (SOD), malondialdehyde (MDA), transaminase and free fatty acids (FFA) were detected. The levels of MDA, SOD, glutathione hormone (GSH) in hepatic tissue were also detected. Then the features of live pathology were observed. RESULTS: The levels of ETX, TC and TG in garlicin groups were significantly lower than those in model control group (P

OBJECTIVETo summarize the clinical manifestation and diagnosis of ganglioneuroma in spine and investigate the clinical effect of surgical treatment.

METHODSThe clinical data of 6 patients underwent a surgery for ganglioneuroma in spine from January 2008 to January 2015 were retrospectively analyzed. There were 4 males and 2 females, aged from 2 to 63 years old with an average of 34.6 years. The courses of disease were from 3 days to 17 years. Five patients complicated with superficial hypesthesia in correlative level of tumor, and the muscle strength under tumor plane had decreased at different levels, with the strength of grade II-IV. Two cases complicated with hypermyotonia and positive bilateral Hoffmann's and Babinski sign. Five cases were sporadic lesion in correlative spinal canal and one case complicated with the giant occupying lesion in thoracic cavity.

RESULTSSix operations had been performed including 5 en bloc and 1 subtotal resection. Postoperative pathological results showed tumor cells scattered or fasciculated inserted into Schwann cells in the stroma. In 2 patients complicated with radiculalgia before operation, 1 case was relieved and 1 was invariant after operation. All 4 patients with preoperative dyscinesia in the limbs obtained improvement after operation. All the patients were followed up from 0.3 to 6.8 years with an average of 2.5 years. At the final follow-up, according to ASIA grade, 5 cases were good and 1 case was invariant. During the follow-up, only 1 patient experienced chemoradiation because of merging ganglioneuroblastoma and receiving subtotal resection. No recurrence in other 5 cases.

CONCLUSIONGanglioneuroma is a benign and rare tumors in spine. Clinically, radicular pain and sensory-motor disorders are the main manifestations. Its diagnosis depends on pathological examination. Prognosis of surgical treatment is good.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Ganglioneuroma ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Neoplasms ; diagnosis ; surgery

To investigate the application of a recently developed metallic oxide semiconductor field effect transistor(MOSFET)detector for use in vivo desimetry.Methods The MOSFET detector was calibrated for X-ray beams of 8 MV and 15 MV,as well as electron beams with energy of 6,8,12 and 18 MeV.The dose linearity of the MOSFET detector was investigated for the doses ranging from 0 up to 50 Gy using 8 MV X-ray beams.Angular effect was evaluated as well in a cylindrical PMMA phantom by changing the beam entrance angle every 15?clockwise.The MOSFET detector was then used for a breast cancer patient in vivo dose measurement, after the treatment plan was verified in a water phantom using a NE-2571 ion chamber,in vivo measurements were performed in the first and last treatment,and once per week during the whole treatment.The measured doses were then compared with planning dose to evaluate the accuracy of each treatment.Results The MOSFET detector represented a good energy response for X-ray beams of 8 MV and 15 MV,and for electron beams with energy of 6 MeV up to 18 MeV.With the 6 V bias,Dose linearity error of the MOSFET detector was within 3.0% up to approximately 50 Gy,which can be significantly reduced to 1% when the detector was calibrated before and after each measdurement.The MOSFET response varied within 1.5% for angles firm 270?to 90?.However,maximum error of 10.0% was recorded comparing MOSFET response between forward and backward direction.In vivo mea surement for a breast cancer patient using 3DCRT showed that,the average dose.deviation between measurement and calculation was 2.8%,and the maximum error was less then 5.0%.Conclusions The new MOSFET detector,with its advantages of being in size,easy use,good energy response and dose linearity,can be used for in vivo dose measurement.

Background and purpose: BRCA1 and BRCA2 mutation carriers have a high lifetime risk of developing breast and ovarian cancer. Through genetic counseling, mutation carriers can take the appropriate measures to reduce such cancer risk. At present, almost all related studies were conducted in Caucasian, while, the studies in Chinese population were rare. This study aimed to investigate the risk of breast cancer in BRCA1 and BRCA2 mutation carriers in Chinese Han population. Methods:Twenty unrelated families with BRCA1 or BRCA2 mutations were re-viewed. Kaplan-Meier analyses were used to estimate the cumulative risks of unilateral breast cancer and contralateral breast cancer for female BRCA1 and BRCA2 mutation carriers. Results:Breast cancer risk to 70 years (penetrance) was 67.2%(sx 0.100) for BRCA1 and 76.8%(sx 0.079) for BRCA2, respectively. Different from BRCA1 mutation carriers, the cumulative incidence of breast cancer in BRCA2 mutation carriers remained increasing after 70 years, reaching 93.1%at age 80. The 10-and 20-year risk for contralateral breast cancer was 19.4%(sx 0.089) and 50.3%(sx 0.155) for BRCA1/2 mutation carriers. Conclusion:BRCA1 and BRCA2 mutation carriers in Chinese Han population have a high risk of developing breast cancer. Thus, it has great clinical signiifcance to test mutations in BRCA1/2 genes in Chinese high-risk population.

Objective To seek a time-saving,economical and safe method on cleaning and disinfecting endotraeheat tubes,to improve nursing work efficiency.Methods The endotracheal tubes were divided into four groups,which were sterilized by Xiaojiajing solution,3% hydrogen peroxide solution,rapid multi-enzyme cleaner in advanced and regular method respectively.Each group include 30 tubes.The germ contaminations and flora distribution of endotracheal tubes,as well as cost and time of each method were analized before and after disinfection.Results Before sterilization,the germ contaminations were insignificantly different between four groups(P ＞0.05).The sterile effects of the four groups were statistically insignificant(P ＞ 0.05).However,the time-consuming with Xiaojiajing solution,3% hydrogen peroxide solution and rapid multi-enzyme cleaner was obviously shorter compared with the regular method(P ＜ 0.05),Xiaojiajing solution group cost the least.Conclusions The methods with xiaojiajing solution,hydrogen peroxide solution and rapid multi-enzyme cleaner can shorten the time compared with the regular method in different degree.Considering the costeffectiveness,rapid multi-enzyme cleaner has a good effect but expensive,hydrogen peroxide solution was relatively longer but cheaper and Xiaojiajing solution was cheapest method overall,which is worthy to be nsedf in the hospital.

Background and purpose:Perioperative anesthetic management is thought to be critical to the success of free flap breast reconstruction. The purpose of this study was to discuss intraoperative fluid, hemodynamic and temperature management in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction.Methods:From Jun. 2011 to Dec. 2015, 126 patients underwent DIEP lfap breast reconstruction. Postoperative complications were reviewed. Intraoperative fluid infusion rate was analyzed. Mean arterial blood pressure (MAP) and core temperature were measured before induction (T0), after lfap elevation but before lfap transfer (T1), 15 min after flap revascularization (T2), and at the end of surgery (T3).Results:Nine patients developed flap compromised: 7 were salvaged and 2 failed. The mean intraoperative lfuid infusion rate was (5.44±1.66) (mL?kg-1)/h. MAP at T0, T1, T2 and T3 were (87.45±8.90), (74.19±8.63), (74.60±8.71) and (79.62±7.88) mmHg, respectively. Core temperature at T0, T1, T2 and T3 were (36.69±0.14), (36.36±0.18), (36.27±0.14) and (36.21±0.15)℃, respectively. Conclusion:Standard practice focusing on intraoperative lfuid management, hemodynamic adjustment and temperature control in microsurgical reconstruction of the breast should be established to further improve free lfap outcome.

OBJECTIVETo explore the surgical method and clinical curative effect of Ilizarov technique combined with limited surgical treatment for neurotrophic malnutrition equinovarus accompanied with weight-bearing area ulcer.

METHODSFrom July 2004 to December 2011, 21 cases of neurological disorders equinovarus with skin ulcer in weight-bearing area were treated including 14 males and 7 females with an average age of 21.3 years old ranging from 8 to 32 years. Among them,19 cases with talipes equinovarus were on account of spina bifid and 2 cases on account of spinal cord injury of lumbar sacral segment. Nine cases were on the left foot and 12 cases were right foot. The ulcer area in out-below side of the fifth metatarsal bone was in 6 cases, in basement of the fifth metatarsal bone in 5 cases,in lateral of calcaneocuboid joint 2 cases, and in lateral of subtalar joint in 8 cases. Surgical procedure included plantar medial release technique, tendo-chilles lengthenning, and three-joint partial osteotomy. During operation,the skin and soft tissue of ulcer were resected and the incision was sutured when the ulcer was in the lateral of subtalar joint, and ankle Ilizarov external fixation for extension was installed after correcting talipes equinovarus partially. For the legacy skin ulcer in weight-bearing area,the Shenrg-ji cream (Chinese characters) was used after operation for one time per day until the wound healed. Adjusting Ilizarov external fixation for correcting residual deformity until it is satisfaction. During this process weight-bearing walking was keeping.

RESULTSAll cases were followed up from 6 to 52 months with an average of 28 months. All ulcers were healing and no recurrence. The ulcer healing time was 14 to 36 days postoperative (26 days in average). Eighteen deformity feet were corrected satisfactorily, and recovered fully plantar foot, 3 feet appeared mild deformity after 1 year. Ankle joint activity appeared limited in 15 cases and got completely rigidity in 6 cases. The AOFAS increased from preoperative 34.0±7.2 to 86.0±8.5 postoperatively; 8 feet got excellent, 10 good,3 fair.

CONCLUSIONThe clinical effect of Ilizarov technique combined with limited operation and the Sheng-ji cream in correction of the talipes equinovarus with skin ulcer in weigh-bearing area on account of neurotrophic malnutrition is satisfactory, the surgical method is simple and the treating course in security, and serious complications can be avoided.

Adolescent ; Adult ; Child ; Clubfoot ; surgery ; External Fixators ; Female ; Foot Ulcer ; surgery ; Humans ; Ilizarov Technique ; Male

To explore the effects of psychological capital social support and their interaction on job satisfaction in Methods natural gas field workers. A total of 1 473 workers from a natural gas field were selected as the research subjects ， using convenient sampling method. Job Satisfaction Questionnaire Psychological Capital Questionnaire and Social Support ， Results Scale were used to investigate the scores of job satisfaction psychological capital and social support level. The ， ， detection rates of job satisfaction psychological capital and social support in the high level group were 55.9% 52.5% and ， 48.1% respectively. The detection rates of job satisfaction of workers in the high level psychological capital group and high level （ social support group were higher than those in the low level psychological capital group and low level social support group 67.4% vs ， vs ， P ） 43.3% 71.9% 41.2% all <0.01 . The results of multivariate logistic regression analysis showed that psychological capital ［ （CI） （ - ） and social support had positive effects on job satisfaction odds ratio and 95% confidence interval were 1.58 1.17 2.41 （ - ）， ， P ］ ， and 2.53 1.82 3.52 respectively all <0.01 . Moreover the psychological capital and social support had additive effect on ［ CI （ - ）， CI job satisfaction relative excess risk of interaction and 95% was 3.07 1.02 5.12 attributable proportion and 95% was （ - ）， CI （ - ）］， 0.48 0.35 0.61 synergy index and 95% was 2.34 1.72 3.16 but there was no multiplication interaction between （P ）Conclusion psychological capital and social support >0.05 . Psychological capital and social support can positively affect job satisfaction of natural gas workers. There is an additive interaction between psychological capital and social support on job ， satisfaction but no multiplicative interaction is found. Keywords: ； ； ； ； ； Psychological capital Social support Job satisfaction Interaction Natural gas Worker

Objective To investigate the clinical effect of improved nursing intervention in blood glucose control of critical patients. Methods By means of historical control, 258 critical patients undergone intense insulin therapy were divided into the control group (n = 126) and the test group (n = 132). The control group was given conventional intensive insulin therapy. The test group was given improved guidelines on the use of insulin and improved nursing intervention. The following indexes of the two groups were documented and compared: the time required to achieve target blood glucose level [(11.95 ± 1.97) h vs (18.85 ± 3.59) h, t =19. 237 3 ,P ＜0. 01]; frequency of blood glucose measuring in four days, the range of everyday blood glucose and the occurrence of hypoglycemia during therapy. Results The test group had shorter time required to achieve target blood glucose level, lower frequency of blood glucose measuring, less fluctuation range of blood glucose and reduced occurrence of hypoglycemia during therapy than the control group (P ＜ 0. 01). Conclusions The use of improved guidelines on the use of insulin and improved nursing intervention in intensive insulin therapy of critical patients can effectively control blood glucose, reduce frequency of hypoglycemia and improve prognosis.

OBJECTIVETo evaluate the available surgical treatment modalities so as to explore the optimal strategy of managing early breast cancer.

METHODSThe clinical data of 2173 consecutive early-stage breast cancer patients treated by surgery treatments were retrospectively reviewed in order to clarify the indications and contraindications of different modalities. Therapeutic outcome of different surgical treatment modes were compared in terms of recurrence-free survival ( RFS) , disease-free survival ( DFS) , overall survival (OS). The cosmetic results of breast conservation and reconstruction were also evaluated .

RESULTSThe median age of these patients was 51 years ranging from 18 to 91. Of 2173 patients, 547 had stage 0- I lesions and 1626 stage II , and 1155 (53. 2% ) premenopausal. The proportion of patients who received radical surgery, breast conservation and reconstruction after mastectomy was 83. 6% (1817/2173), 10. 5% (229/2173) and 2. 5% (55/2173) , respectively. Younger and premenopausal patients prefer conservative and reconstructive surgeries, which are reasonable for stage 0-I and non-invasive breast cancer patients. Conservative surgery was not suitable for Paget's disease of breast (P = 0. 004) , mastectomy followed by reconstruction in this type of cancer was up to 38. 5%. The recurrence and metastasis rate of conservation or mastectomy were similar with a comparable 3-year RFS of 97. 4% and 95. 4% , respectively; there were also no significant differences in RFS(P =0. 2435) , DFS( P =0. 1395) and OS(P =0. 9406) after having been followed for 3 to 64 months. Similarly, immediate reconstruction did not show any negative effects with only 1 recurrence and 1 metastasis. Aesthetic outcomes were assessed as excellent or good in 90. 0% of breast conservation surgery, and the acceptability of reconstruction was 94. 5%.

CONCLUSIONBreast conserving surgery not only has comparable survival as mastectomy, but also has better cosmetic outcomes. Immediate breast reconstruction can be a suitable option without compromising survival. It is very important in the management for early breast cancer by selecting the most suitable surgery mode for every individual patient not only to cure her disease but also to satisfy the patient psychologically. Conservation should be preferred prior to reconstruction whenever possible.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; pathology ; surgery ; Carcinoma, Ductal, Breast ; pathology ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; pathology ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Mastectomy ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Paget's Disease, Mammary ; pathology ; surgery ; Reconstructive Surgical Procedures ; Retrospective Studies