Objective To discuss the clinical application of ultrasound-guided preoperative guide-wire localization in diagnosing tiny breast lesions. Methods A total of 56 patients with impalpable tiny breast lesions were enrolled in this study. Preoperative guide-wire localization of the lesion was performed under high-frequency ultrasound guidance, which was followed by tracking resection of the lesion. The clinical data were retrospectively analyzed. Results Successful localization and complete resection of the lesion was accomplished in all 56 patients. The lesions included invasive ductal carcinoma (n=11), intraductal carcinoma (n=5), ductal carcinoma in situ (n=2), mucinous carcinoma (n=2), fibroadenoma (n=24), atypical hyperplasia (n=6), intraductal papilloma (n=4) and plasma-cell mastitis (n=2). Conclusion Ultrasound-guided preoperative guide-wire localization is a safe and reliable technique for the diagnosis of impalpable tiny breast lesions. It can precisely localize the lesion, which is very helpful for making a complete resection of the lesion and avoiding unnecessary breast injury. Therefore, this technique should be recommended in clinical practice.

Objective To investigate the pathological and immunohistochemical characteristics of female bladder ectopic skene glands.Methods A female with bladder tumor was treated in our hospital in May 2013.Preoperative so(n)graphy revealed a 0.9 cm×0.6 cm round solid mass in the bottom of bladder wall.Mass was hypoechoic homogeneous with regular shape,blood flow within the mass was noted.The tumor was treated with transurethral resection.Routine pathological examination suggested bladder ectopic Skene glands.Immunohistochemical stains for prostate specific antigen (PSA),prostate spectific acid phosphatase (PSAP),androgen receptor (AR),estrogen receptor (ER),CD10,cytokeratin 14 (CK14),cytokeratin 18 (CK18),P63,high molecular weight cytokeratin (34βE12),α-methylacyl-CoA racemase (AMACR/p504s) were further performed.Results Routine pathological examination showed prostate glands composed of prostate gland epithelial cells and basal cells in a submucosal location.Immunohistochemical stains showed:PSA-,PSAP +,AR +,ER-,CD10+,CK18 +,CK14-,P63 +,34βE12 +,AMACR-.Conclusions Routine pathological examination combined with immunohistochemical stains such as PSA,PSAP,and others,can be used to diagnose ectopic Skene glands disease.Female bladder ectopic Skene glands is a benign lesion,and the prognosis is good.

0.05) at 6 hour;at 12 hour,only the highest dose,1 mg/L,significantly induced cell apoptosis;while the lowest dose,0.1 mg/L,did not significantly caused cell apoptosis for all time points.After exposure to the doses of 0.2 and 0.5 mg/L for 24 or 36 hours,a significant increase in percentage of apoptotic cells was observed(P

Objective To investigate the dose and time kinetics of induction of apoptosis induced by doxorubicin in J urkat leukemiacells, and to explore its pertinent molecular mechanisms. Methods Human Jurkat leukemia T - cells were treated with doxorubicin at theconcentration of 0.1 mg/L, 0.2 mg/L, 0.5 mg/L and 1.0 mg/L for 6,12,24 and 36 hours, respectively, of which one sample was pre-treated with zVAD- fmk (benzyloxycarbonyl - Val -Ala - Asp - fluoromethylketone) prior to addition of doxorubicin 0.2 mg/L. Apop-tosis was detected with both annexin V - FITC and propidium iodide ( PI ) staining and annexin V FITC and PI double positive cellswere analyzed by flow cytometry. Western blot was used to evaluate the level of Fas ligand (FasL) and FADD (Fas - associated death do-main) expression. Results The differences of apoptotic cells induced by all dose of doxorubicin were not significant (P＞0.05 ) at 6hour;at 12 hour, only the highest dose, 1 mg/L, significantly induced cell apoptosis;while the lowest dose,0.1 mg/L, did not significantlycaused cell apoptosis for all time points. After exposure to the doses of 0.2 and 0.5 mg/L for 24 or 36 hours,a significant increase in per-centage of apoptotic cells was observed (P ＜ 0.001 ). Apoptosis induced by doxorubicin was completely inhibited when the cells were incu-bated with doxorubicin in the presence of zVAD - fmk (P ＜ 0. 001 ). The level of FasL and FADD expression correspondingly increasedwith exposure time to doxorubicin. Conclusions Doxorubicin induces apoptosis in a dose - and time - dependent manner; upregulatedFasL may initiate the activation of the Fas signaling pathway and caspases are the ultimate executioner in the induction of leukemia cellapoptosis by doxorubicin.

Objective This study aims to analyze if high sensitivity C Reactive Protein (hs-CRP) was a independent risk factor of acute kidney injury(AKI) after A type aortic dissection surgery.Methods Clinical data of the 169 patients who underwent A type acute aortic dissection surgery from February 2009 to October 2010 were collected.Patients without preoperative detection of hs-CRP,patients with preoperative infection and patients diagnosed infection before AKI were excluded.Enrolled patients were divided into AKI group and non-AKI group,and according to using RRT or not,the patients were divided into RRT group and non-RRT group.All the factors were evaluated by means of univariate and multivariate logistic regression analysis to identify relative risk factors of AKI.Results AKI occurred in 95 cases(56.2％),Using RRT in 8 cases (4.7％).hsCRP is an independent risk factor of AKI(OR =0.975,95％ CI 0.952-0.999,P =0.041).hs-CRP and aortic cross clamping time were the independent risk factors of using RRT,The in-hospital mortality was significant difference between RRT group and non-RRT group (P ＜ 0.05).The area under the ROC curve of hs-CRP on RRT diagnosis was 0.733,95％ CI 0.570-0.896,P =0.026.The sensitivity of CRP ＞ 30.42 mg/L warning AKI need RRT was 87.5％,the specificity was 53.4％.Conclusion AKI after A type aortic dissection surgery was a severe complication and RRT associated with in-hospital mortality,hs-CRP was higher in acute aortic dissection patients.The level of hs-CRP and aortic cross clamping time were independent risk factors of AKI and RRT.

Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction clinical disease. Surgery is the main therapeutic tool for CSM. However, there are obvious differences in clinical functional recovery after operation. For the past few years, the influence factors of prognosis in cervical spondylosis myelopathic has been widely concerned. Age, nerve function, course of desease, imaging findings,surgical method and related factors became the investigative point for prognosis of cervical spondylotic myelopathy. Present viewpoint showed that the older patient, preoperative worse nerve function, longer the course of disease would result in worse outcomes. Imaging examination maybe can indicate the prognosis, but the correlation is unclear. Selection of surgical method and approach should be based on the principles of sufficient decompression, stabilize the alignment of the cervical spine, keeping backward extension of cervical spine, maintain effective decompression, preventing complications. Therefore, the treatment of cervical spondylotic myelopathy should be on the basis of pathogenic condition and imaging examination at early stage and a suitable usrgical procedure should be performed to obtain a better prognosis.
Cervical Vertebrae ; surgery ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Radiography ; Spinal Cord Diseases ; diagnosis ; diagnostic imaging ; surgery ; Spondylosis ; diagnosis ; diagnostic imaging ; surgery

OBJECTIVETo study the clinical effect of arthroscopic excision of popliteal cysts through a combined anterior and posterior approach.

METHODSFrom January 2010 to December 2012,20 patients with popliteal cysts were treated with arthroscopic excision. There were 14 males and 6 females, with an average age of 49.5 years old, ranging from 45 to 65 years old. The lump has been found for 4 to 18 months,with a mean time of 12 months. Their mean sagittal diameter was 4.5 cm (ranged from 3 to 7 cm). There were 12 popliteal cysts in the left and 8 popliteal cysts in the right. The main clinical manifestation included lump at popliteal fossa, swelling and pain at knee joint and some extent of dysfunction. All diagnoses were determined according to MRI, which clearly showed the communication of cyst and articular cavity. The cyst was removed under arthroscopy, through the posterior approach and then the intra-articular lesion was treated via the anterior approach. According to Rauschning and Lindgren classification, 2 patients were grade I, 6 patients were grade II, and 12 patients were grade III. The guidelines of Rauschning and Lindgren were used to evaluate the clinical effects.

RESULTSNo complications such as the injury of blood vessel and nerve, or incision infection occurred in all patients. All the patients were followed up, and the duration ranged from 8 to 24 months, with a mean time of 16 months. According to the criteria of Rauschning and Lindgren, there were 14 cases of grade 0, and 6 cases of grade I after operation, which was improved obviously compared with that pre-operation. No cyst reoccurred and the knee joint pain was relieved.

CONCLUSIONTreatment of popliteal cysts with arthroscopic excision through a combined anterior and posterior approach is effective to remove the cyst sac and treat intra-articular diseases simultaneously, resulting in the decrease recurrence rate of cyst.

Aged ; Arthroscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Popliteal Cyst ; surgery

OBJECTIVETo evaluate the clinical efficacy of mini-open repair for the treatment of acute closed achilles tendon ruptures.

METHODSFrom April 2012 and October 2013,14 patients (14 feet) with acute closed achilles tendon ruptures were treated in our department. They were 9 males and 5 females, with an average age of 30.5 years old (ranged, 25 to 49 years old). The interval between injury and operation ranged from 1 to 13 days (8 days on average). A longitudinal incision approximately 1.5 to 2.0 cm in length was made around the ruptured achilles tendon for mini-open repair after insertion of oval clamp. Postoperative rehabilitation was carried out.

RESULTSThe wounds healed at the first stage except 2 cases with slow recovery. All the patients were followed up for 6 to 24 months, with an average of 11 months. According to the ankle-hindfoot scoring system of American Orthopaedic Foot & Ankle Society (AOFAS),the score was 92.71 ± 6.58 (82 to 100).

CONCLUSIONThe surgical treatment of acute achilles tendon rupture with mini-open repair has advantages of little invasion, a low rate of incision problems, quick function recovery, and simple operation, and it is suitable for primary hospital.

Achilles Tendon ; injuries ; physiopathology ; surgery ; Adult ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tendon Injuries ; physiopathology ; surgery ; Treatment Outcome ; Wound Healing

Spider silk is a natural protein fibroin with excellent character as it is light and tenacious. It has a wild potential applications in the biomedical field due to its good biocompatibility and degradation. Arginine-glycine-aspartic acid (RGD) is a highly conserved amino acid sequence of many adhesion protein. Biological materials binding with RGD peptide in the surface can promote cells adhesion, migration and proliferation. Our lab had constructed the 16 muhimers with the introduced RGD peptide codons which involve cell adhesion for the first time. It was found that the mechanical capability of the 16 mulimer protein was very limited because of the big gap in molecular weight with nature spider proteins when it was used to made biomaterial scaffold.In this paper,based on the 16 multimers of the highly, repetitive sequence of spider dragline silk and with RGD peptide condons which has been constructed by our lab forestall, it was used to construct the 32 and 64 multimers sequence of spider dragline silk by the strategy of "head to tail". The 32 and 64 multimers were ligated into prokaryotic expression vector pET-30a, and then the B121 (DE3) pLysS. The fragments were in agreement with the desired through digestion, agarose gel electrophoresis respectively. By registration into the GenBank data-base, the serial numbers of DQ469929 and DQ837297 were gained respectively. The expression of recombinant protein was introduced by the addition of IPTG. SDS-PAGE analysis shows that the molecular weight of products expressed here are 102 kD and 196.6kD in agreement with the desired respectively. It was the first time for the high polymer spider dragline silk protein expressed in prokaryotic biology. Furthermore, a larger quantity of synthetical proteins with high density fermentation were searched after, and a suit of high efficient purification methods for 32 multimers protein were established.
Animals ; Escherichia coli ; genetics ; metabolism ; Fermentation ; Fibroins ; biosynthesis ; genetics ; Molecular Sequence Data ; Oligopeptides ; biosynthesis ; chemistry ; genetics ; Polymers ; metabolism ; Protein Engineering ; Recombinant Proteins ; biosynthesis ; genetics ; isolation & purification ; Transformation, Bacterial

Objective To investigate the significance of B7-CD28/CTLA-4 (CD152),co-stimulatory molecules of T lymphocytes,in the onset,development and prognosis of genital congdyloma acuminatum (CA) in females.Methods Flow cytometry was utilized to detect the expression levels of CD80/CD86 in peripheral blood lymphocytes and of CD28/CD152 (CTLA-4) in CD4~+/CD8~+ T lymphocytes from 30 CA patients (17 primary CA,13 recurrent CA,15 at recovery stage of CA) and 15 healthy volunteers as con- trols.Results No significant difference was found for the frequencies of CD80~+,CD86~+,CD4~+/CD28~+ and CD8~+/CD28~+ lymphocytes between the primary or recurrent group and the control group.The frequencies of CD8~+/CD28~+,CD4~+/CD28~+ and CD80~+ lymphocytes were significantly higher in the recovery group than those in the recurrent group (P0.05).Conclusions There is an abnormal expression of co-stimulatory molecules B7-CD28/CTLA-4 (CD152) in periphoral blood lym- phocytes,CD4~+ and CD8~+ T lymphocytes in female patients with genital CA,and the expression abnormaility is closely linked with different disease stages of CA.