Breast Neoplasms ; diagnosis ; therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Humans ; Neoadjuvant Therapy

Objective To explore clinical effects and operative experience of transanal pull-through procedure for Hirschsprung's disease (HD).Methods The clinical data of 126 children aged from 13 days to 14 years with HD were reviewed.There were 30 cases of short-segment type,85 of common type,and 11 of long-segment type.A total of 95 cases was operated with modified Soave and the other 31 cases were operated with modified Swenson.Results Except two-stage resection in 7(5.6％) cases who already underwent transanal Soave procedure early,one-stage transanal pull-through procedure was performed in the other cases.Laparotomy assisted operation was used for 5 cases and laparoscope assisted operation for 12 cases.The complications were occurred in 35 (27.8％) cases post-operation,including 15 perianatitis,9 enterocolitis,5 anastomotic stenosis,2 soiling,and 4 reoperation.The statistical analysis indicated no difference between two procedures and postoperative complications could be noted between different types (P ＞0.05).A total of 103 patients were followed up from 1 to 10 (mean 2) years.Of all patients,96 (93.2％) were cured,5 (4.9％) symptoms were improved and 2(1.9％) were failed.There were no significant differences in two procedure and the excellent rate of defecation function(P ＞ 0.05).Conclusions Two transanal procedures for HD both had a good efficacy and similar complications.By comparison,transanal Swenson procedure was simpler than Soave procedure,and did not need to enlarge anus post-operation as well.

Objective To explore the operative indication,procedure and postoperative complication of infantile intussusception.Methods Clinical data of 316 infants suffering intussusception in the past 38 years(1971-2008)were reviewed.There were 186 male,130 female.One hundred and eishty-six patients (58.9%,186/316) were younger than 6 months,and 78.2%(247/316)had suffered for more than 3 days.The proportion of abdominal intermittent pain and vomiting was 96.8%(306/316)and 87.7%(277/316),respectively.IIeum-colon ascendens was 35.4%(112/316)and ileum-ileum-colon ascendens was 37.3%(118/316).The proportion of intestinal necrosis was 36.7%(116/316).Two hundred patients (63.3%,200/316) were operated with simplified reposition and 36.7%(116/316)Was operated with intestinal resection.Results One patient with appendiceal abscess was misdiagnosed as intussucseption.Three cases of intussusception had repositioned automatically during the operation.Eight cases underwent additional operation because of postoperative complication.Three hundred and seven cases were cured, 2 cases discharged voluntarily.Seven cases died.Conclusions Currently most of acute intussusception may be cured with non-operation.Operative indication should be performed strictly.Operative procedure should be chosen on the pathological changes and the status of health.The comphcation could be reduced by intensive perioperation care.

Objective To construct an H7N9 vaccine strain by using a previously obtained Vero cell-based high-yield influenza A virus as the donor strain.Methods The recombinant virus strains, 4mut-H7N9 and PR8-H7N9, were respectively rescued with reverse genetics technique by combining the genes en-coding hemagglutinin (HA) and neuraminidase (NA) of H7N9 virus with the 6 internal genes of PR8-4mut or PR8 virus strains.The growth feature of 4mut-H7N9 virus strain was compared with that of PR8-H7N9 vi-rus strain with growth curves and plaque assays.The viral proteins produced by 4mut-H7N9 and PR8-H7N9 virus strains were measured by Western blot and Coomassie blue staining.Results The PR8-H7N9 and 4mut-H7N9 virus strains were successfully rescued.The virus titer of 4mut-H7N9 strain was about 3000 times higher than that of PR8-H7N9 strain at 72 hours after infecting Vero cells.The 4mut-H7N9 virus strain formed plaques of about 1 mm in diameter on Vero cells, while the PR8-H7N9 virus strain only formed pin-point plaques on Vero cells.The levels of viral proteins encoded by purified 4mut-H7N9 virus strain were significantly higher than that of the PR8-H7N9 virus strain as indicated by both Western blot and Coomassie blue staining.Moreover, the 4mut-H7N9 virus strain was less pathogenic than PR8-H7N9 strain in mice, and retained the trypsin dependence for infecting cells.Conclusion The reassortant 4mut-H7N9 vaccine strain as established by reverse genetics technique grew faster and better in Vero cells, suggesting the possi-bility of using it as a candidate vaccine strain whenever facing a potential epidemic of H7N9 virus.

Objective To observe the effects of Chinese herbal compounds (alkaloid of Coptidis Rhizoma 40%, total saponin of panax notoginseng 35%, and polysaccharide of Ophiopogonis Radix 25%) on levels of blood glucose, fructosamine, and insulin of diabetic rats, and explore mechanism of action.Methods Ten rats were randomly chosen as blank control group, and other rats were used to establish diabetic rat models by STZ intraperitoneal injection. Successfully molding rats were randomly divided into Chinese herbal compounds high, medium, low dose groups, metformin group, and model group, 10 rats in each group. Each rat received gavage for continuous 4 weeks. Then rat blood was collected by cutting head and taking caudal vein. FBG was detected by glucose oxidase method;insulin level was detected by radio-immunity double antibody method;fructosamine content was detected by fructosamine method.Results Compared with the blank control group, model group the levels of FBG, froctosamine content increased, while fasting insulin level were lower after 4 weeks'medication. Compared with the model group, the levels of FBG, froctosamine content in Chinese herbal compounds high and medium dose groups and metformin group were lower, while fasting insulin level increased after 4 weeks'medication (P<0.05).Conclusion TCM herbal compounds can increased the basic insulin level by decreasing the contents of FBG and fructosamine.

Vertebral artery hypoplasia is a frequent variation type of vertebral arteries.At present,there is no unified theory about the relationship between vertebral artery hypoplasia and posterior circulation ischemic stroke.The available evidence suggests that vertebral artery hypoplasia may be a precipitating factor for posterior circulation ischemic stroke; particularly other vascular risk factors coexist.This article elaborates the epidemiology of vertebral artery hypoplasia,the clinical manifestation and imaging features of vertebral artery hypoplasia in patients with posterior circulation ischemic stroke,and the possible mechanism of vertebral artery hypoplasia caused posterior circulation ischemic stroke.

By expounding the definition and application status quo of egg freezing with non-medical factors, this paper ethically analyzed the conflict between egg freezing with non-medical factors and assisted reproductive technology standard management. After systematic evaluation on effectiveness, safety, economy and ethics, it sug-gested that the egg freezing with non-medical factors required careful consideration.

Objective To investigate the pharmacological mechanism of LXHX capsule. Methods The skin specimens from psoriasis patients were examined with TUNEL (terminal deoxynucleotidyl trans-ferase-mediated dUTP-biotin nick end labeling) technique to detect the apoptosis of keratinocytes. PCNA (proliferating cell nuclear antigen) detecting kits was used, too. Then, the flow cytometry, with AnnexinV/PI and PI dyeing method, was used to analysis the effect of LXHX capsule on apoptosis in cultured keratinocytes. Results There was an increasing of both cell apoptosis and proliferation in psoriatic epidermis and LXHX capsule could induce apoptosis. Conclusions The keratinocyte apoptosis and proliferation both increased in psoriasis, which reach a new balance in a higher level. LXHX capsule could induce apoptosis in vitro, which may be one of the pharmacological mechanisms of LXHX in treating psoriasis.

Objective To investigate correlative complication and disorders in growth of premature infants with congenital CMV infections before one year old.Methods Fifty-eight infected premature infants and sixty control premature infants were followed up prospectively for one year.The differences were compared between two groups with incidence of correlative complication.Physical growth,liver function,neurosonographic and audiologic examination were used to identify the sequelae of CMV infections.Results The numbers of infants with infantile hepatitis syndrome,encephalopathy of premature infant and SNHL were significantly higher in infected group than in control group(x2 =4.52,15.09,12.71,P ＜0.05).No difference between groups was found on physical growth.However,the significant difference between two groups was observed on abnormal for liver function of 3 and 6 months(x2 =8.33,17.28,P ＜ 0.05),neurosonographic after birth and 3 months(x2 =15.09,5.38,P ＜0.05),audiologic examination of 3 and 6 months(x2 =17.01,8.04,P ＜ 0.05).Conclusions These data suggest that congenital CMV infections may be associated with hepatitis syndrome,encephalopathy of premature infant and SNHL in premature infants.Liver function,neurosonograpphic imaging and ABRs were useful in the evaluation of the premature infants with congenital CMV infections.

Objective To explore the function of specialized training course in training singleport laparoscopic skills.Methods The specialized training course for single-port laparoscopy included cutting rubber bands into‘Z’shape,cutting‘petaloid’folded slips and peeling oranges.Twelve residents were enrolled into traditional laparoscopy training for one week and then randomized into two groups:6 trainees performed the specialized training course for 2 h daily and the others as the control group continued to practice the traditional course for 2 h daily.One week later,the trainees were tested on performing porcine single-port laparoscopic nephrectomy.Operation time and performance was compared.T test were performed using SAS 9.1.3 statistics software,and a P＜0.05 was considered to be statistical significance.Results Operation time of the specialized group was decreased significantly(59.2±17.3)min vs.(87.0±25.5)min,P=0.049,and the total global rating scale score increased significantly(26.3±2.2 vs 18.2±2.8,P=0.000 17).Conclusion The specialized course is beneficial to the training of single-port laparoscopic skills.