Objective To investigate the clinical values of extracapsular invasion at sentinel lymph nodes in patients with breast cancer.Methods From Jan,2010 to Jan,2013,80 patients underwent axillary lymph node dissection due to sentinel lymph nodes invasion were enrolled in this prospective study.Patients were signed to extracapsular at sentinel lymph nodes positive group (n =45)and control group (n =35)according to the intra -operative pathology.The primary outcome was rate of positive non -sentinel lymph nodes and the second outcomes were 3 -year recurrence -free survival,mortality and health -related quality of life.Results Compared with the control group,the patients in extracapsular at sentinel lymph nodes positive group got a significantly higher rate of positive non -sentinel lymph nodes (91.11% vs.28.57%,χ2 =33.321,P <0.001 );a significantly lower rate of 3 -year recurrence -free survival(57.78% vs.88.57%,χ2 =9.114,P =0.003);a significantly higher rate of mortality (17.78% vs.2.86%,χ2 =4.390,P =0.036);and a significantly lower level of health -related quality of life[(78.43 ±12.43)vs.(87.54 ±11.89),t =11.324,P =0.000].Conclusion Extracapsular invasion at sentinel lymph nodes was a reliable predictor for non -sentinel lymph nodes invasion and long -term clinical outcomes.

OBJECTIVE: To study the effects of fibroblast growth factor-21 (FGF-21) on acute inflammation induced by lipopolysaccharide (LPS) and its mechanism. METHODS: Mouse model of acute inflammation was established by injection of LPS and treated with FGF-21 at high, medium and low doses, the pathological changes were detected with HE staining, the expression level of TNF-α, IL-1β, IL-6 and IL-17 in serum and peritoneal macrophage were determined by ELISA and Real-time PCR. NF-κB p65 in macrophage cells was analyzed by confocal laser scanning microscope and Western-blotting. RESULTS: FGF-21 treatment reduced lung damage and inflammatory cell infiltration and decreased the expression level of TNF-α, IL-1β, IL-6 and IL-17 in both serum and peritoneal macrophage. The results of confocal laser scanning microscope and Western-blotting both showed that FGF-21 could inhibit NF-κB transferring to the nucleus. CONCLUSION: FGF-21 could regulate the immune system by acting on macrophage. Relieving the inflammatory response in mice through NF-κB signal pathway may be one of the mechanisms FGF-21 regulating immune system.

The progress in integrative medicine (IM) of coronary heart disease (CHD) in 2013 was summarized in this paper. Gratifying progress has taken place both in clinical studies and basic research of IM on CHD during 2013. We got some innovation in Chinese medical etiologies and pathogeneses of CHD. We also got some improvement in researches on Chinese medical syndromes in various fields. Many clinical studies have proved Chinese medicine and pharmacy is playing a role in preventing and improving CHD patients. In-depth basic researches on preventing and treating CHD by IM are gradually undergoing. Acting targets and mechanism are further clarified. Besides, we also pointed out the developing tendency of CHD researches and the current deficiency in CHD researches, hoping to provide reference for further studies in this field.
Coronary Disease ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Integrative Medicine

Background Whether the wearing of bifocal lenses can delay the development of myopia in school childhood is in controversy.To assess the effect of bifocal lenses using evidence-based medicine method is of important significance.Objective Present study was to compare the effect of bifocal lenses with single vision lenses in retarding myopia progression in school-aged myopic children.Methods This was a evidence-based medicine study.The systematical literature search was performed from MEDLINE(1966 to October 2010),EMBASE(1974 to October 2010),Cochrane Library,Chinese Biomedical Database(1978 to October 2010),and Chinese Clinical Trial Registry combined with hand searching of related bibliographies of journals and books were applied to collect the randomized-controlled clinical trial about bifocal lenses.Screening,evaluation and data extraction of the retrieved literature were performed by two investigators independently.Mata-analysis was used to assess the progression of refraction and axial length among included randomized clinical trials.Results Three high-quality randomized-controlled clinical trials meeting the inclusion criterion were included in this meta-analysis.The results showed that the weighted mean difference in progression of refraction was 0.22D between bifocal lenses and single vision lenses(95% CI:-0.24-0.67),and the difference was statistical insignificance(P=0.35).The weighted mean difference in progression of refraction during the follow-up durations of 6,12,18,24 and ＞30 months were 0.15(95% CI:-0.09-0.38),0.17(95% CI:-0.05-0.39),0.42(95% CI:-0.14-0.98),0.23(95% CI:-0.21-0.66) and 0.03(95% CI:-0.40-0.46),respectively without statistical significance.The weighted mean difference in elongation of axial length between two interventions was -0.17mm(95% CI:-0.26-0.08) with a statistically significance(P=0.000).Conclusion Based on currently available studies,bifocal lenses could not significantly slow the progression of myopia in myopic school-aged children in comparison with single vision lenses.Because only few high-quality studies are currently available,this conclusion need to be supported by more large-sample-size clinical trials.

Background Recently,the number of randomized controlled trials on ophthalmic diseases that published in international journals from mainland China has increased gradually.There is no systematic summary in this field.Objective To systematically search and analyze the distribution of ophthalmic diseases related randomized controlled trials (RCT) published in SCI journals from mainland China up to November,2012.Methods The search was performed on Pubmed using “Ophthalmology”,“Eye” and all of their inferior subjective terms,with type of literature being limited as randomized controlled trial,and country as China.All retrieved papers were screened,data extracted and analyzed.Results There were 68 ophthalmic diseases related RCT papers published from mainland China since 1989.After 2005,the number of RCT papers from mainland China increased quickly with 7 in 2006,11 in 2009,and 15 in 2011.The 68 RCT papers were focused on cataract,optometry,glaucoma,corneal and conjunctival diseases,ophthalmic immune and pharmacology,and fundus diseases.The RCT papers were published in a total of 35 SCI journals including most kinds of ophthalmic journals such as Ophthalmology,IOVS and a few journals on other specialty.The journal Clin Experiment Ophthalmol had the maximum RCT papers from China (8 papers).The 68 RCT papers came from 26 departments in mainland China,mainly from the hospitals affiliated to medical university in Guangzhou,Beijing,Shanghai,Wenzhou and Hangzhou.Conclusions The number of ophthalmic diseases related RCT papers published in SCI journals from mainland China increased continuously.The papers were mainly focused on cataract,optomctry and glaucoma.The number of these papers,however,was still small and imbalance between districts existed.

Objective To investigate the changes of plasma adrenomedullin(ADM),endothelin-1(ET-1) in infants with severe pneumonia complicated by acute congestive heart failure,and its relationship with heart function.Methods Forty-seven bronchopneumonia patients in their acute phase were divided into three groups:group A1,severe pneumonia complicated by acute congestive heart failure without congenitive heart disease(CHD)(n=15);group B1,severe pneumonia complicated by acute congestive heart failure with CHD(n=12);group C1,mild bronchopneumonia(n=20).A2,B2 and C2 groups were the convalescence groups of A1,B1 and groups C1 respertively.Group D,20 healthy infants were used as control group.Plasma ADM,ET-1 levels of patients in acute phase(pre-treatment)and convalescent phase and controls were measured by specific radioimmunoassary.Results 1.The plasma ADM levels significantly increased in the acute phase of A1,B1 and C1 compared with healthy controls(Pa0.05).3.The plasma ADM,ET-1 levels in A2 and B2 groups significantly decreased compared with those in group A1 and B1(Pa0.05).Conclusions The ADM,ET-1 play very important roles in the pathophysiological processes of pneumonia and congestive heart failure in infants.ET-1 may play an important role in the pathogenesis of severe pneumonia in infants complicated with congestive heart fai-lure.The level of plasma ET-1 is related with the degree of congestive heart failure.

Cutaneous Fistula ; Digestive System Abnormalities ; therapy ; Endoscopy, Gastrointestinal ; methods ; Female ; Humans ; Infant ; Treatment Outcome

Objective To analyze the prevalence,risk factors of kidney disease in type 2 diabetic patients with KDIGO classification of chronic kidney disease,also to study cardiovascular and cerebrovascular diseases and death in these patients,so as to investigate the significance of the KDIGO classification system.Methods One thousand six hundred and forty-five type 2 diabetic patients who were in hospitalization from June 2008 to December 2012 were grouped according to the KDIGO classification of chronic kidney disease and the incidence of vascular disease was analyzed based on the classification.Clinical features were compared between patients with or without kidney disease.The risk factors of kidney disease and the death of diabetic patients were also investigated.Results There were 915 male and 730 female,aged a median (57.86±12.54) years with (6.35±6.30) years duration of diabetes mellitus among the 1645 cases,and 37.2％ of patients had concomitant kidney disease.According to the classi fi cation of CKD,patients in CKD group 3a,group 3b and CKD group 4-5 accounted for 5.7％,3.5％ and 7.6％,while 33.4％ of patients had proteinuria,among which 19.5％ with microalbuminuria,13.5％ with macroalbuminuria.On complications,patients with hypertension accounted for 49.5％,hyperlipidemia 67.7％,diabetic retinopathy 27.4％,cardiovascular and cerebrovascular diseases 18.5％ (coronary artery disease 16.5％,cerebrovascular diseases 8.8％).Statistical difference was detected in the incidence of diabetic retinopathy,coronary artery disease and cerebrovascular diseases between CKD group 3a and 3b (P ＜ 0.05).The duration of diabetes,concomitant hypertention especially with elevated systolic blood pressure,diabetic retinopathy and hyperuricemia were the independent risk factors for type 2 diabetic patients with kidney disease.Age,Scr,complicating cardiovascular and cerebrovascular diseases and advanced CKD stage were the independent risk factors for the death of type 2 diabetic patients with kidney disease.Conclusion KDIGO classification of chronic kidney disease enables better staging of kidney diseases in diabetic patients for management and prognosis.Diabetic patients have a higher prevalence of renal diseases and cardiovascular and cerebrovascular events than the general population.Early control of factors such as blood pressure and serum uric acid can delay the progression of kidney disease,and the predictive role of diabetic retinopathy should be emphasized.

Adult ; Carcinoma, Small Cell ; pathology ; Ethmoid Sinus ; pathology ; Frontal Lobe ; pathology ; Humans ; Male ; Maxillary Sinus Neoplasms ; pathology ; Paranasal Sinus Neoplasms ; pathology ; Skull Base ; pathology

Objective To analyze the impact factors for early renal damage in type 2 diabetic patients by the classification tree model.Methods A total of 601 patients with type 2 diabetes were enrolled.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 2 diabetes group (418 cases) and early diabetic renal damage group (183 cases).The clinical data of the patients were recorded to analyze the main influential factors for the microalbuminuria of type 2 diabetic patients using the Exhaustive CHAID classification tree algorithm.Results Six important explanatory variables were screened out by the classification tree model from the 34 candidate variables related to early renal damage,including fibrinogen,history of hypertension,retinopathy,Cys C levels,SBP and peripheral neuropathy.Elevated fibrinogen was the main factor.Conclusion The classification tree model can analyze the major influential factors of early renal damage in type 2 diabetic patients effectively,and it can help develop the prevention and treatment methods.