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.

Objective To determine the diagnostic value of endoscopic ultrasound-guided cholangiography(EUSGC)with fine needle puncture .Methods Twenty-six patients with obstructive jaundice failed i n previous endoscopic retrograde cholangiopancreatography(ERCP) and magnetic res onance cholangiopancrcatography(MRCP) or have metallic foreign materials in some where of body. By a linear scanning echoendoscopy in conjunction with a 22-gau ge aspiration needle, transduodenal selective cholangiography was attempted.Results Cholangiography was successfully performed in all patie nts (EUSGC success 100% vs. ERCP 0%). No complications occurred in the patients. In 19 patients, abnormalities were found from EUSGC. Choledocholithiasis have b een confirmed by sphincterotomy(n=5),common bile duct strictures were confirmed by surgical operation(n=11).Three other patients have delayed excretion of co ntract medium.Conclusion EUSGC allows a safe and accurate alternative method for obtaining cholangiography in those patients when ERCP or MRCP failed.

Air ; analysis ; Alkenes ; analysis ; Butadienes ; analysis ; Chromatography, Gas ; methods ; Environmental Monitoring ; methods ; Workplace

Objective To establish an in vitro accelerated release method of triptorelin acetate microspheres with good in vi-tro/in vivo correlation(IVIVC). Methods The in vivo release of triptorelin acetate from microspheres was obtained by residual method in rats. Influences of pH value,concentration of ethanol,temperature,rotation speed and concentration of antiseptic on the in vitro accel-erated release were studied,then the correlation between in vitro accelerated release and in vivo release of the microspheres was estab-lished by adjusting the release conditions. Results The in vitro accelerated release medium of triptorelin acetate microspheres composed of 15%ethanol solution(containing 0.06%Tween 80 and 0.1%benzalkonium chloride)at 55℃with rotating rate of 200 r/min. The cumulative release of triptorelin acetate from microspheres was 87.35%at 30 h under accelerated release condition,equivalent to in vivo release for 30 days. The established in vitro accelerated release had a good correlation with that of in vivo(y=0.8845x+12.4510, R2=0.9938). Conclusion The in vitro accelerated release of triptorelin acetate microspheres could correlate well with in vivo release and has a potential application in rapid and effective evaluation of triptorelin acetate microspheres.

Objective To investigate the safety and efficacy on early treatment of large pancreatic pseudocyst by endoscopic ultrasound (EUS)-guided transgastric drainage. Methods The clinical data of 23 cases of large pancreatic pseudocyst treated with EUS-guided transgastric drainage from 2003 to 2008 was retrospectively analyzed. Results All were of single pseudocyst. Pseudocyst was present in the head of the pancreas in 3 cases, in the body of the pancreas in 11 cases, in the tail of the pancreas in 9 cases. Mean diameter of pancreatic pseudocysts was 11 cm( range 8 - 18 cm ). The interval between the finding of pseudocysts and EUS-guided transgastric drainage ranged 17 -65 d, averaging 31 d. Two had postoperative infection of the pseudocyst, one received percutaneons external drainage and the other one received surgical internal drainage. Three had postoperative gastrointestinal bleeding and were treated with antacid and hemostatic drugs. Patients were examined by CT two to three months later. Pancreatic pseudocysts disappeared completely in 6 cases and significantly shrank in the rest. The clinical symptoms of all patients,such as abdominal pain, abdominal bloating were significantly relieved. All patients were followed-up for 1 year, there was no pseudocyst recurrence, ulcer,bleeding or infection. Conclusions Early treatment of large pancreatic pseudocyst by EUS-guided transgastric drainage is safe and effective.

Objective To measure the expression of indoleamine 2, 3-dioxygenase(IDO)in condy-loma acuminatum (CA) lesions, and to evaluate its ability to locally metabolize tryptophan. Methods Immunohistochemical study was performed to observe the protein expression of IDO in skin lesions of patients with CA, and count the number of IDO-positive cells. Immunofluorescence assay was conducted to estimate the relationship between IDO-positive cells and dendritic cells. Epidermal cells and keratinocytes were isolated from warts of 30 patients with CA and prepuces of 11 healthy controls respectively, and both in vitro incubated with tryptophan solution for 4 hours. Then, high-performance liquid chromatography (HPLC)was performed to detect the level of tryptophan metabolite, kynurenine, in the culture supernatant of the above cells, which could reflect the ability of epidermal cells to metabolize tryptophan. Results Rare IDO-positive cells were found in the normal skin, but a lot of IDO-positive cells gathered in the epidermis of the wart tissues. The IDO-positive cell/total cell ratio was significantly higher in the wart tissues than in the normal skin(48.3%± 15.4%vs. 5.2%± 2.4%, P<0.05). The fluorescence signals of IDO-positive cells and CD1a-positive Langerhans cells were not overlapped with each other, suggesting that IDO-positive cells were derived from epidermal cells of the wart tissues. Compared with the keratinocytes from the healthy skin, the epidermal cells from warts had a stronger ability to metabolize tryptophan in vitro. Conclusion A large number of IDO-positive cells exist in CA warts, and may be involved in occurrence of CA.

BACKGROUNDPulmonary blastoma is a rare primary malignancy of the lung. It is now recognized in two forms: adult type pulmonary blastoma and childhood pleuropulmonary blastoma. The clinical characteristics, diagnosis and treatments of adult type pulmonary blastoma are discussed in this article.

METHODSThe clinical records of 5 patients with adult type pulmonary blastoma admitted in Cancer Center, Sun Yet-sen University from 1964 to 2004 were analyzed and the literature on pulmonary blastoma was reviewed.

RESULTSThree patients were male and two were female with the ages ranged from 22 years old to 70. Their symptoms consisted mainly of cough, hemoptysis and chest pain. The pulmonary blastomas were mainly manifested as a solitary parenchymal mass of the lung on chest radiograph and CT. None of these patients was diognosed by fibrobronchoscopy nor sputum cytology. Three patients underwent lobectomy, one underwent pneumonectomy, and these four patients underwent mediastinal lymph node resection also. The fifth one received wedge resection and postoperative chemotherapy. At the end of follow-up, three patients died and two was alive, and the survival time was from 6 months to 11 years.

CONCLUSIONSPulmonary blastoma is difficult to be diagnosed before operation. Surgery is the best therapeutic choice up to now. It has poor response to radiotherapy and chemotherapy. The prognosis of patient with pulmonary blastoma is variable.

Objective To evaluate the therapeutic value of endoscopic band ligation in gastric stromal tumors.Methods Twenty-nine patients with small gastric stromal tumors(diameter<12mm)underwent endoscopic band ligation,and were followed up with routine endoscopy and EUS.Results Twentyeight patients recovered completely,with the surface healing up 4-6 weeks(average 4.8 weeks)thereafter.The neoplasm did not slough off in one patient,so he underwent a second ligation.Hemorrhage occurred in one patient three days after ligation,but was successfully managed with hemoclips.Other patients showed no complications.All the patients were followed up for 36 to 51 months,and there was one case of recurrence.Conclusion Endoscopic band ligation is an effective and safe treatment for small GISTs of less than 12 mm.

Objective　To investigate the prognostic significance of N1 stage in non-small cell lung cancer (NSCLC) by comparing is survival with N0 and N2 stages. Methods　From Jan. 1982 to Dec. 1994, 138 NSCLC patients with surgical-pathological N1 stage had received complete mediastinal lymph node dissection. Two subgroups of N1 node were identified by using New Regional Lymph Node Classification for Lung Cancer Staging. Their prognostic significances were tested and 5-year survival rates were compared with those of surgical-pathological N0 (307 cases) and N2 (176 cases) patients received radical operation during the same period. Results　The overall 5-year suvival rate of N1 patients was 30.4 %. five-year survival was significantly better when N1 involvement was intralobar as compared with extralobar involvement, 50.3 % versus 26.5 % (P=0.001). Intralobar N1 5-year survival was similar to that of N0 (51.4 % vs 50.3 %), and extralobar N1 5-year survival was similar to that of N2 with singl focus (26.5 % vs 23.5 %). Conclusion　N1 stage in NSCLC is a compound with two subgroups; the prognostic significance of intralobar subgroup is related to N0 stage and extralobar subgroup is related to that of single focus N2.

Objective To investigate the influences of grape seed proanthocyanidin extract (GSPE) on cardiovascular system, nervous system and respiratory system of experimental animals, and provide general pharmacological data for further research and application. Methods The influences of GSPE on blood pressure, heart rate, electrocardiogram, breathing frequency and tidal volume in anesthetic dogs after duodenal administration were observed, the impacts on spontaneous activity, coordinated motion, and the sleep situation with threshold dose and subthreshold dose of pentobarbital sodium in mice after intragastric administration were observed. Results GSPE showed no side effects on blood pressure, heart rate, electrocardiogram, breathing frequency and tidal volume in anesthetic dogs at the dosage of 857.00, 214.29, 42.86 mg/kg (P>0.05). At the dosage of 428.57, 214.29, 42.86 mg/kg, GSPE had no obvious influence on spontaneous activities and coordinated movements in mice (P>0.05). GSPE did not evidently change the number of sleeping animals, the sleep latency and the sleeping duration with subthreshold dose and threshold dose of pentobarbital sodium (P>0.05). Conclusion GSPE has no evident adverse effects on central nervous system, cardiovascular system and respiratory system in animals.