Sentinel lymph node biopsy represents the state of the art of breast surgery, but its widely application might surpass the support of available evidences. The hot spots of sentinel lymph node biopsy in breast cancer include the prognosis of micrometastases in sentinel nodes, the prediction of non-sentinel nodes metastases in positive sentinel nodes patients, and the intraoperative molecular diagnosis of sentinel nodes.These are discussed accompanying with the updated results from the 31st SABCS held in December, 2008.

LevelⅠ&Ⅱ proofs of Evidence-based medicine support the safety of sentinel lymph node biopsy (SLNB) in breast cancer. The accurate staging of axilla, the axillary recurrence rate and complication, radiologic safety and the new indications of SLNB were discussed respectively.

Sentinel lymph node biopsy has been proved to be the standard treatment for early breast cancer patients with negative axillary lymph node. The study related to the tracer has become one of the hottest topics in breast cancer research. At present, the biopsy is often performed using the tracer of isotope, blue dye or both of them. However, some deifciencies of the 2 tracers restrained their applications, which resulted that the rate of the procedure is limited to only about 60% of patients in developed countries and less than 5% of patients in China and other developing countries. In recent years, a variety of new tracers have emerged, such as indocyanine green, contrast-enhanced ultra-sound using microbubbles, superparamagnetic iron oxide nanoparticles. In this article, we introduced the characteristics of these 3 substances and reviewed the related research on the new tracers. In conclusion, the new tracers are still in the preliminary stage of research, and further research is needed for clinical application.

There are two main lymphatic drainage routes of the breast: a superficial system and a deep system, and only the deep one can drain into the internal mammary lymph node (IMLN) which receive about 25%of the lymph of the breast. As one of the important nodal sites of lymphatic spread of breast, IMLN is important for neoplasm staging and it will guide adjuvant radiotherapy. However, there still lack an effective and feasible minimally invasive diagnosis technology of IMLN, leading to inaccurate staging and over/under-treatment. The“modified injection technique” broke through the bottle-neck of the low internal mammary visualization rate with traditional injection technique, and made the internal mammary sentinel lymph node biopsy possible to be a min-imally invasive assessment for IMLN status, and further guided internal mammary radiotherapy (IM-RT). Patients with IMLN positive should accept IM-RT, with IMLN negative can avoid IM-RT. With the unceasing progress in studies on internal mammary lymph drainage area, patients may obtain the individualized diagnosis and treat-ment. The review summarizes current knowledge on the anatomy and physiology of the lymphatic system of the breast to translate this into implications for clinical practice of IM-SLNB.

The metastases status of internal mammary lymph node(IMLN) is an independent prognostic factor for breast cancer and it also is an important reference for neoplasm staging.The patients with IMLN metastases consistently have worse outcomes.The overall risk of IMLN metastases is 18 ％-33 ％.Metastases exclusively situated in the IMLN,without concurrent axillary metastases,occur in 2 ％-11％ of patients.Factors related to IMLN metastases include the status of axillary node,the age of patients,the localization and characteristics of primary tumor.Recently,with the development of sentinel lymph node biopsy(SLNB), internal mammary-SLNB may access the status of IMLN with a minimal risk. Internal mammary-SLNB procedure can improve the system for nodal staging of breast cancer,and it will contribute to the individualized treatment for breast cancer patients.

OBJECTIVE: Acute high-intensity exercise can temporarily suppress appetite, but the effect of appetite hormones in this process is inconclusive. Meta-analysis is used to explore the effects of acute high-intensity exercise on adult appetite hormones, and provide theoretical basis for the follow-up research on the effects of exercise on appetite hormones. METHODS: Chinese and International databases such as CNKI, WanFang, Web of Science, PubMed and other databases were searched for articles regarding the effects of acute high-intensity exercise on appetite hormones. The literature search time span was from inception to August 17, 2019. The subjects included in the article were all adults. The intervention measure was a single high-intensity exercise. The outcome indicators were one or combination of acylated ghrelin, peptide YY, peptide YY 3-36, pancreatic polypeptide, and pancreatic height, and glucagon-like peptide-1 expressed by area under curves. In this meta-analysis, an improved version of Cochrane risk bias tool was used to evaluate methodological quality, and Revman 5.3 and STATA15.0 software were used for the meta-analysis of the outcome indicators of the included literature. RESULTS: A total of 18 research literatures were included, with a total of 212 subjects, including 179 males and 33 females. The literature quality evaluation results showed that the overall literature quality was high. Meta-analysis results showed that acute high-intensity exercise could significantly inhibit acylated ghrelin level (standardized mean difference (SMD)=-0.27, 95% confidence interval (CI):-0.45 to-0.08, P < 0.05), and significantly increase peptide YY (SMD=-0.31, 95%CI: 0.07-0.54, P < 0.05). Although there was an increase in the levels of peptide YY 3-36 (SMD=0.29, 95%CI:-0.19 to 0.77, P 0.05), pancreatic polypeptide (SMD=0.37, 95%CI:-0.07 to 0.81, P 0.05), and glucagon-like peptide-1 (SMD=0.29, 95%CI:-0.17 to 0.75, P 0.05) after acute highintensity exercise, it had no significant significance. CONCLUSION: Overall, acute high-intensity exercise has a certain effect on the level of appetite hormones, which can significantly inhibit orexigenic hormones and increase anorexigenic gastrointestinal hormones. The results suggest that acute high-intensity exercise can effectively regulate the secretion of appetite hormones, thereby controlling appetite and food intake, and can play a positive role in weight management. But future large-sample trials are needed.

OBJECTIVE To explore the audiological characteristics in children with autism. METHODS Agroup of 20 children with autistic disorder were included in an investigation of auditory brain stern responses(ABR)and distortion product otoacoustic emissions(DPOAE).The results were compared with those in 18 normal children of agematched. RESULTS①As compared with the values in the control group,the latency of waveⅤfor both ears,waveⅠ-Ⅴand waveⅢ-Ⅴintervals for the right were significantly prolonged(P

[Objective]Discussion on clinical experience and academic ideas of Professor FU Weimin in treatment of viral encephalitis sequela.[ Method] From the etiology and pathogenesis, and the treatment method to expound the clinical experience and academic viewpoints of Prpfessor FU Weimin, summarize his law of characteristic medication and diagnosis thought,and put an example to exemplify that. [Results] Professor FU Weimin is good at treating this disease from phlegm and blood. He believes that the real standard based on six exogenous pathogenic factors or plague pathogen and other than evil not clear, long into the blood collaterals, phlegm heat and blood stasis obstruction, disturbing the brain orifices, are the symptoms of disease;and the virtual caused by the empty brains, heart and kidney failure and the losed senses and deities, are the causative organism. The pathological features are mainly composed of real or virtual inclusions.Treatment with the kaiqiao huatan tongyu methods are the basic principles, combined with tonifying the kidney and marrow, trafficing heart and kidney, which embodies the compatibility characteristics of eliminating pathogen without forgetting the acual. [Conclusion] Professor FU Weimin 's treatment of viral encephalitis sequela is effective, and can effectively control the disease, reduce the recurrence rate and improve patients ' self-care ability and quality of life.It's worthy of our study and promotion.

OBJECTIVETo observe the differences in clinical effect on menstrual migraine between subgaleal acupoint injection with metoclopramide and oral administration of medication.

METHODSSixty-four patients of menstrual migraine were randomized into a subgaleal acupoint injection group and a medication group, 32 cases in each one. In the subgaleal acupoint injection group, the acupoint injection started 10 days before menstruation. Eight acupoints on the head were selected and injected alternatively in two groups, once every 2 days, 4 treatments made one session and 3 sessions (3 menstrual cycles) were required. In the medication group, flunarizine was applied with oral administration, 2.5 mg each time, once every night. The duration of treatment was 3 months. The analgesic effect, frequency and time of pain attack were observed in 3 and 6 months after treatment in the two groups.

RESULTSAfter treatment, VAS scores were lower than those before treatment in the two groups (P<0.01, P<0.05), the attack frequency and pain time were all reduced as compared with those before treatment (all P<0.01). After treatment, VAS score, the frequency and time of pain attack in the subgaleal acupoint injection group were improved significantly as compared with the medication group (all P<0.01).

CONCLUSIONThe subgaleal acupoint injection with metoclopramide achieves the superior preventive effect in clinical treatment of menstrual migraine as compared with flunarizine.

Acupuncture Points ; Adolescent ; Adult ; Female ; Humans ; Menstruation ; drug effects ; Metoclopramide ; administration & dosage ; Migraine Disorders ; drug therapy ; physiopathology ; prevention & control ; Young Adult

Objective To investigate the related risk factors referred to hematoma enlargement in acute stage of spontaneous cerebral hemorrhage.Methods 104 stroke patients were divided into the observation group(hematoma enlarged group) and control group (without hematoma enlarged group).The course of disease,mean arterial pressure,the bleeding amount of the first time,hematoma shape and mortality were compared between the two groups,and the risk factors of hematoma enlargement of cerebral hemorrhage patients were analyzed.Results (1) The course of disease,mean arterial pressure,hematoma shape and the bleeding amount were significantly different between the two groups(t =9.5431,11.4499,6.1847,10.7233,all P ＜ 0.05).(2) The multivariate logistic regression analysis showed that factors of influence on hematoma enlargement were mean arterial blood pressure,the course of disease and hematoma shape.(3)The mortality of the observation group was 36.53 ％,which was significantly higher than that of the control group (19.23 ％) (χ2 =3.8731,P ＜ 0.05).Conclusion High level of mean arterial blood pressure,short time of interval to onset,irregular shape of hematoma and frequent vomiting are main risk factors of hematoma enlargement in patients with intracerebral hemorrhage at acute stage.