Breast cancer is one of the most common malignant tumor in the world. medical delay always leads to more advanced stage, larger tumor and more metastasis. This literature review dealt about status, influencing factors and intervention related to medical delay of breast cancer, as a reference to promote health- seeking behavior of breast cancer.

Aim To study the inhibitory effects of ex-tractive pericarpium trichosanthes ( EPT) on high glu-cose-induced apoptosis in human umbilical vein endo-thelial cells ( HUVECs ) and its underlining mecha-nisms. Methods HUVECs were cultured. Effects of EPT at different concentrations on the high-glucose-in-duced apoptosis in HUVECs were observed. The cell viability of HUVECs was determined by MTT colori-metric method. Cell apoptosis was identified by Ho-echst staining. The intracellular activity of Caspase-3 was detected with colorimetry. Protein expression and p65 nuclear translocation of NF-κB were detected by Western blot and immunofluorescence staining. Re-sults Treated with 30 mmol · L-1 glucose for 48 hours had a significantly decrease on cell viability com-pared with control, and the apoptotic rate and Caspase-3 activity were increased markedly, the protein expres-sion of NF-κB was upregulated and p65 nuclear trans-location in HUVECs increased; Pre-incubation with EPT(12. 5,25,50 mg·L-1 ) for 1 hour enhanced the cell viability, and decreased the apoptotic rate and Caspase-3 activity and downregulated the expression of NF-κB in a dose-dependent manner. Moreover, EPT could inhibit p65 translocation. Conclusion EPT can protect HUVECs against the apoptosis induced by high glucose in vitro,and its mechanism may be related with downregulation of NF-κB expression and inhibition of the intracellular activity of Caspase-3 .

Objective To study the correlation between isokinetic parameters and modified Ashworth Scale (MAS) in ankle spasticity as-sessment. Methods 18 stroke patients (spasticity group) and 16 healthy subjects (control group) in our hospitals from August 2014 to March 2015 were included. MAS was used to assess the ankle muscular tension. The ankle passive movement of both groups was measured with BIODEX isokinetic motor assessment system under 10 °/s, 60 °/s, 120 °/s, 180 °/s, 240 °/s. The peak torque (PT), peak torque/body weight (PT/BW), average torque (AT), and slopes of the linear regression curve of torque-velocity (SLOPE) were recorded. The correlation of the isokinetic paramenters and the MAS were tested with Spearman correlation analysis. Results The PT, PT/BW and AT were higher in the spasticity group than in the control group (P<0.05). And they increased as the angular velocity increased, and slowed after 120 °/s. The corre-lation coefficient of MAS and PT, PT/BW, AT, SLOPE were from 0.3043 to 0.7632 (P<0.01). Conclusion The isokinetic parameters were speed-dependent and closely related to MAS. 120 °/s was of the highest sensitivity, and the SLOPE under this anglular velocity was highly correlated with MAS.

Objective:To observed the effects of electroacupuncture frequency on the nerve function and postsynaptic destination-95 (PSD-95), growth associated protein-43 (GAP-43) in brain tissue of rats with cerebral ischemia were observed.Methods:Healthy adult male SD rats were randomly divided into the blank group, sham operation group, model group and 2 Hz, 50 Hz, 100 Hz electroacupuncture groups. MCAO models were prepared in each group, except blank group and sham operation group. After modeling, Qiansanli and Waiguan acupoints were given stimulation with 2 Hz, 50 Hz and 100 Hz respectively in 2 Hz electroacupuncture group, 50 Hz electroacupuncture group and 100 Hz electroacupuncture group, 1 time/d and 20 min/time for 21 consecutive days. All groups were scored by Bederson score on the 1st, 3rd, 7th, 14th and 21th day after operation. The ultrastructure of synapses was observed by transmission electron microscope, and the positive expression of PSD-95 and GAP-43 was detected by immunohistochemistry. Results:After modeling 7, 14 and 21 days, compared with the model group, the Bederson behavioral score (1.70 ± 0.52 vs. 2.40 ± 0.56, 1.20 ± 0.65 vs. 2.30 ± 0.46, 0.70 ± 0.72 vs. 2.00 ± 0.86) in 50 Hz electroacupuncture group significantly decreased ( P<0.01 or P<0.05). The expression of PSD-95 (58.67 ± 1.72, 55.22 ± 2.45, 60.10 ± 2.49 vs. 70.87 ± 2.34) intergral optical density of rats’ cortex in 2 Hz, 50 Hz, 100 Hz electroacupuncture groups significantly decreased ( P<0.01), the expression of GAP-43 in 2 Hz and 50 Hz electroacupuncture groups (58.89 ± 1.28, 64.76 ± 3.94 vs. 53.24 ± 2.58) significantly increased ( P<0.01). Conclusions:Electroacupuncture with different frequency can improve motor nerve disfunction of cerebral ischemia rats, and 50 Hz electroacupuncture group showed the most obvious effect. It can regulate PSD-95 and GAP-43 expressions of ischemic area, lower neural excitatory toxicity, increase neuronal axon regeneration and exert the neural protect function.

Objective To study the inter-rater reliability of Wisconsin Gait Scale (WGS) and Gait Abnormality Rating Scale (GARS) in patients with stroke. Methods 20 hemiplegic patients were required to walk on their comfortable speed and videotaped from frontal, backward and lateral. The video recordings were scored with WGS and GARS by 2 experienced physical therapists. Intraclass correlation coefficient (ICC) was calculated for the scores in each category and the total score. Results ICC for the WGS were 0.372~1, and were 0~0.875 for the GARS. Conclusion WGS is more appropriater to assess the gait of hemiplegic stroke patients than GARS.

Objective To investigate the effect of unfractionated heparin (UFH) on the expression of heme oxygenase-1 (HO-1) in intestinal mucosa of mice with sepsis.Methods Thirty-six male C57BL/6J mice were randomly divided into sham group,cecal ligation and puncture (CLP) group and UHF group,n =12 in each group.Model of intestinal injury in sepsis was induced by CLP.In sham group,the mice were exposed without ligation of cecum.In UFH group,the mice were treated intravenously with 8 U of UFH via the tail vein half an hour before the operation and 12 hours after the surgery respectively.Six mice in each group were randomly chosen at 4 hours and 24 hours after operation to collect inferior vena venous blood samples and terminalileum tissues.The serum levels of interleukins (IL-1 β,IL-6),and tumor necrosis factor-α (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA).The serum level of D-lactate was determined by colorimetry.Pathological changes of ileum tissue and Chiu score were observed after hematoxylin eosin (HE) staining.The HO-1 expression was detected immunohistochemically.Results In sham group,no significant changes in the serum levels of IL-1 β,IL-6,TNF-α and D-lactate were observed.Twenty-four hours after the operation,the structure of intestinal mucosa was basically normal without obvious pathology change and no HO-1 positive cells were found.The serum levels of IL-1 β,IL-6,TNF-α,and D-lactate in CLP group were gradually increased,and they were significantly increased as compared with sham group [IL-1 β (ng/L):40.87±2.88 vs.22.60±2.05 at 4 hours,113.73±3.96 vs.22.07±2.74 at 24 hours;IL-6 (ng/L):63.89±3.26 vs.44.89±3.38 at 4 hours,176.56±5.45 vs.45.76±4.02 at 24 hours;TNF-α (ng/L):194.62± 14.13 vs.152.05±6.22 at 4 hours,599.62± 10.20 vs.155.90± 14.18 at 24 hours;D-lactate (mmol/L):0.24± 0.02 vs.0.19 ± 0.01 at 4 hours,0.33 ± 0.04 vs.0.20 ± 0.02 at 24 hours,all P ＜ 0.05].Twenty-four hours after the operation,edema and inflammation in ileal mucosa,intestinal villi structural damage were observed,the Chiu score was significantly higher than those in the sham group [4.5 (3.0-5.0) vs.0 (0-1.0),P ＜ 0.05],and a small amount of HO-1 positive cells were localized in the intestinal mucosa.Compared with CLP group,the serum levels of IL-1 β,IL-6,TNF-α,and D-lactate of UFH group were significantly decreased [IL-1 β (ng/L):31.53 ± 2.90 vs.40.87 ± 2.88 at 4 hours,61.13 ± 2.80 vs.113.73 ± 3.96 at 24 hours;IL-6 (ng/L):51.16 ± 5.68 vs.63.89 ± 3.26 at 4 hours,81.16 ± 4.54 vs.176.56 ± 5.45 at 24 hours;TNF-α (ng/L):171.76± 5.60 vs.194.62± 14.13 at 4 hours,328.48 ± 10.79 vs.599.62± 10.20 at 24 hours;D-lactate (mmol/L):0.21 ±0.01 vs.0.24±0.02 at 4 hours,0.24±0.02 vs.0.33±0.04 at 24 hours,all P ＜ 0.05].Twenty-four hours after the operation,intestinal injury was ameliorated,the Chiu score was significantly lower [1.5 (1.0-5.0) vs.4.5 (3.0-5.0),P ＜ 0.05],and HO-1 positive cells in the intestinal mucosa was remarkably increased.Conclusion UFH can enhance the expression of HO-1 in intestinal mucosa,reduce the release of inflammatory factors,ameliorate the intestinal inflammatory response,and thus play a protective role in intestinal tissue in mice with sepsis.

Objective To find the plantar pressure readings which best indicate foot inversion during the stance phase of walking among hemiplegic stroke survivors.Methods Twenty-two hemiplegic stroke survivors who were able to walk without extra aid were recruited as the experimental group, while 17 healthy elderly men of similar age and body weight were selected as the control group.Those in both groups were asked to walk at their preferred speed over a Footscan device which measured medio-lateral pressure ratios, maximum plantar pressures and the contact areas of both feet.The Clinical Spasticity Index (CSI) was used to evaluate the affected feet.Results The average medial forefoot pressure of the affected side in the experimental group was significantly lower than that of the control group, but their average mesopodium and heel pressure was significantly higher.The average pressure applied by the great toe on the uninjured side in the experimental group was significantly smaller than that of the control group, but the average mesopodium and heel pressure of both feet among the hemiplegics were significantly higher than those of the control group.Among the experimental group, the average medial forefoot pressure of the affected foot was significantly greater than that of the healthy foot.The average contact area of the great toe on the affected side was significantly bigger than was observed in the control group.That of the medial forefoot was, however, significantly smaller than in the control group.There was no significant difference in the contact area between the healthy and affected feet in the experimental group, though the maxmium medio-lateral pressure ratios of their full feet and forefeet on the affected side were significantly lower than those in the healthy group.No significant differences in the maxmium medio-lateral pressure ratios of the heel were observed between the two groups, nor of the full feet, forefeet and heels of the affected and unaffected sides in the experimental group.The patients demonstrated consistently reduced joint mobility on both sides during the stance phase, coinciding with increased inversion.A significant negative correlation was found between the maxmium medio-lateral pressure ratios of the full foot and the maximum pressure of the lateral part of forefoot in the experimental group, but there was no significant correlation with contact area or CSI.Conclusions Plantar pressure data can be used to describe the amount of foot inversion in the stance phase of walking with hemiplegic patients after stroke.The maxmium medio-lateral pressure ratios can effectively reflect their foot inversion.

Objective To evaluate the safety and efficacy of carbon dioxide (CO2) used as an alternative to air in the gastric endoscopic submucosal dissection (ESD). Methods 80 cases underwent ESD treatment were randomly as-signed to two groups, 40 cases in CO2 group and 40 in air group. Arterial blood CO2 partial pressure was measured preoperative, intraoperative and postoperative respectively. Visual analog scale (VAS) was used to record patients the degree of abdominal pain and distention at 1 h, 6 h and 24 h after operation in each group. The incidence of com-plications were evaluated. Regular follow up were scheduled in all the patients. Results There was no significant dif-ference in degree of abdominal pain score and the CO2 partial pressure between the two groups. The abdominal dis-tension scores of CO2 group were significant lower than air group at 1 h, 6 h after the ESD procedure. There were no statistically significant difference in the incidence rate of complications. Conclusion The utilization of CO2 in gas in-sufflation during gastric ESD is safe. CO2 insufflation can significant reduce the postoperative abdominal distension and improve the quality of postoperative recovery.

BACKGROUND: Transplantation of bone marrow mesenchymal stem cell and vascular endothelial growth factor(VEGF) can promote vascular regeneration and improve heart function. However, whether the combined application is superior to single application or not is still unclear.OBJECTIVE: To observe the effect of allogenetic bone manow stem cells transplantation combined with VEGF transfection on vascular regeneration and heart function of rats with acute myocardial infarction.DESIGN: Simple sample observation was used in culturing bone marrow mesenchymal stem cell of rats; Randomized controlled animal experiment was used in cell transplantation and gene transfection.SETTING: Department of Cardiology, Union Hospital of Huazhong University of Science and Technology; Cardiovascular Institute of Tongji Medical College MATERIALS: Totally 94 healthy male Wistar rats and expression vector PAdTrack/VEGF165 were used in this experiment.METHODS: This experiment was carried out at Cardiovascular Institute of Tongji Medical College between June 2004 and June 2005. ①Bone marrow mesenchymal stem cells of rats were isolated, purified and cultured in vitro, then labeled with bromodeoxyuridine(BrdU). ② Preparation , extraction, purification and identification of plasmid PAdTrack/VEGF165. ③Two weeks after coronary artery was ligated to create acute myocardial infarction model, rats were randomly divided into 4 groups (n=12 in each group): stem cell + plasmid group(50 μL BrdU-labeled bone marrow mesenchymal stem cell solution and 100 μL plasmid PAdTrack/VEGF165 were injected into the rats through multiple sites), stem cell group (50 μL bone marrow mesenchymal stem cell solution was injected through multiple sites), plasmid group (100 μL plasmid PAdTrack/VEGF165 was injected through multiple sites) , control group(100 μL serum-free DMEM was injected through multiple sites). ④ Immunohistochemistry andechocardiography were performed 4 weeks later.MAIN OUTCOME MEASURES: ①Immunohistochemical and haematoxylin-eosin stainings were conducted in the infarcted and ischemic areas of rats in each group; ② Blood vessel counts; ③Echocardiography.RESULTS: Totally 48 rats entered the stage of result analysis. ① BrdUlabeled transplanted cells could be seen at the infarcted and ischemic myocardium in the stem cell+plasmid group and stem cell group. Some transplanted cells at ischemic myocardium differentiated into vascular endothelial cells and formed newborn blood capillary. ②Density of Ⅷ factor positively-stained newborn blood capillary took stem cell +plasmid group ＞ plasmid group ＞ stem cell group ＞ control group in order (all P＜ 0.01).③Wall thickness and wall motion range improved after cell transplantation and gene transfection therapy. The increased range of ejection fraction took stem cell +plasmid group ＞ stem cell group ＞ plasmid group ＞ control group in order (all P ＜ 0.01) .CONCLUSION: Allogenic bone marrow mesenchymal stem cell transplantation and VEGF gene transfection could further boost vascular regeneration of infarcted ischemic area and improve wall thickness and heart function of rats.

Objective:To evaluate the effect of fluoride on the viability of rat ameloblast HAT-7 cells and calcium concentration in the cells.Methods:HAT-7 cells were exposed to NaF at 0,0.4,0.8,1.6,3.2 and 6.4 mmol/L for 24,48 and 72 h respectively. CCK-8 assay was performed to examine the cells proliferation;the apoptosis rate was determined by flow cytometry;Ca2 +concentration in the cells was detected by laser scanning confocal microscopy.Results:The cell proliferation was increased by NaF at 0.4 mmol/L and 0.8 mmol/L,whereas inhibited at 1.6 mmol/L and above.The effects were in a time-dependent manner.NaF increased apoptosis of the cells and increased Ca2 + concentration in the cells in a concentration-dependent manner.Conclusion:Fluoride at low doses promotes proliferation,at high doses inhibits proliferation of HAT-7 cells.NaF of 1.6 mmol/L or more induces apoptosis of HAT-7 cells and in-duce Ca2 + overloading in the cells.