The incidence rate of young women with breast cancer is increasing.Because of distinct biological characteristics of breast cancer in young patients,it is reasonable to identify who is the best one for breast-conserving surgery.Patients with systemic chemotherapy should be fully considered about fertility requirements.In addition,endocrine therapy combined with ovarian function inhibition can improve the effect,meanwhile,there should increase the proportion of patients with targeted therapy.

Pneumatic pipe logistics delivery is feasible and important. The role and merits of pneumatic pipe logistics delivery are analyzed and scientifically demonstrated. Type 110 and type 160 systems are compared. Problems are solved. Pneumatic pipe logistics delivery promotes infrastructure service.

Objective To investigate the protective effect of Ca 2+ channal blocker(Verapamil)on the testis following testicular torsion in rats.Methods Forty healthy male Sprague-Danley rats were randomly divided equally into five groups:group A(sham operation),group B1(the left testis underwent 720? positive torsion,2 h later detorsion was performed),group B2(the process as group B1 except at 30 min before detorsion,intraperitoneal injection of physiological saline was performed),group B3(the process as group B1 except at 30 min before detorsion,intraperitoneal injection of 2 mg/kg Verapami was performed),group B4(the left testis underwent 720? positive torsion,and 2 h later the left testis was excised).Five days after operation,the bilateral testes(the right testis in group B4)were extracted and nitric oxide(NO),nitric oxide synthase activity(NOS),total antioxygen capacity(T-AOC)were measured.Results After detorsion,NO and NOS activity increased greatly,T-AOC decreased significantly in bilateral testes,but more obvious in the torsive testis;Verapamil could inhibit the changes.Conclusion The excessive production of NO and the decreased T-AOC may be the main causes of the contralateral testicular injury after unilateral testicular torsion.Verapamil can reduce the testicular injury in bilateral testes after testicular torsion/detorsion in rats.The resection of the torsive testis has protective effect on the contralateral one.

BACKGROUND:Majority of patients appeared different degrees of hip joint bursitis and gradual y developed into femoral head necrosis in the early rehabilitation process of severe acute respiratory syndrome. OBJECTIVE:To analyze various causes of the severe acute respiratory syndrome sequela, and to review the treatment method of femoral head necrosis. METHODS:The PubMed database, China Journal Ful-text database (CNKI), VIP database and Wanfang database were retrieved by the first author with computer for the related articles from January 1997 to August 2012. The key words of“infectious atypical pneumonia, sequela, femoral head necrosis, bone ischemia, etiology, infectious atypical pneumonia virus, conservative treatment, operation treatment, total hip replacement”in English and Chinese were put in the title and abstract to search articles. A total of 872 articles were screened out after primary retrieval, and eventual y 56 articles were included for review. RESULTS AND CONCLUSION:Severe acute respiratory syndrome sequela, femoral head necrosis, was related with the dose and duration of hormone, patient’s sensitivity to hormone, using method, the secretion of leptin and bone calcitonin, and also infectious atypical pneumonia virus. The femoral head necrosis caused by the above factors can be treated with conservative treatment to slow down the process of femoral head necrosis and delay prosthesis replacement. Eventual y, most of the patients wil receive surgical method. For the treatment of advanced severe acute respiratory syndrome sequelae femoral head necrosis, prosthesis replacement can get the best effect.

Objective To explore clinical characteristics and treatment for unexpected gallbladder carcinoma during laparoscopic surgery . Methods A retrospective analysis was made on clinical data of 12 cases of unexpected gallbladder carcinoma out of 4620 cases of laparoscopic cholecystectomy (LC) in our hospital from September 1997 to September 2015.Intraoperative frozen pathological diagnosis showed gallbladder cancer Nevin stage Ⅲin 1 case, and a conversion to open surgery of gallbladder cancer was conducted .The remaining 11 cases of gallbladder carcinoma were diagnosed by pathology after surgery .One case of Nevin stage Ⅰand 1 case of stage Ⅱwere not surgically treated .Of the other 9 cases of Nevin stage Ⅲ, there were 5 patients who refused surgery and 4 patients received open radical resection of gallbladder cancer at 10-18 d (mean, 14 d) postoperatively. Results The 5 cases of Nevin stage Ⅲwho refused open radical surgery were lost to follow-up.Two cases of stage Ⅰand Ⅱwere followed up for 63 months and 6 months after LC without recurrence .Of the 5 cases of stageⅢundergoing open radical surgery , 2 cases dead at 8 and 10 months postoperatively because of abdominal extensive metastasis and cachexia , and 3 cases dead at 10, 28, and 32 months postoperatively because of gallbladder carcinoma liver transfer . Conclusions The occurrence of unexpected gallbladder cancer should be taken into consideration during laparoscopic cholecystectomy .Timely and appropriate complementary therapy should be given .

OBJECTIVETo observe the effect of postoperative analgesia with dexmedetomidine on the survival rate of amputated finger replantation.

METHODS91 cases, who was going to receive amputated finger replantation, were randomly divided into group A (n = 48) and B (n = 43). PCIA (patient-controlled intravenous analgesia) was set immediately after operation in group A (fentanyl 1.0 mg + tropisetron 4.0 mg + 10 mg + dexmedetomidine 200 microg + saline 100 ml) and group B (same as group A except dexmedetomidine). Background infusion is 2 ml/h with a bolous of 0.5 ml and lockout time is 15 min. postoperative VAS score, Ramsay score, condition of replanted fingers and other adverse events at the 0-6 h, 6-12 h, 12-24 h and 24-48 h were recorded and analyzed.

RESULTSThe age, sex, height, weight, amputated time (Ts), revascularized time (Tt) in the two groups were not statistically different (P > 0.05). Postoperative VAS score in the two groups was significantly different at the 0-6 h, 6-12 h, 12-24 h and 24-48 h (P < 0.05), but Ramsay score was not (P > 0.05). The highest and lowest postoperative VAS score and Ramsay score were markedly different between two groups (P < 0.05). 3 of the 60 fingers in group A experienced vascular crisis and 2 underwent vascular explore surgery. 13 of 56 fingers in group B occurred vascular crisis, and 10 underwent vascular explore surgery, showing significant difference between the two groups (P < 0.05). PCIA adverse reactions showed no difference between the two groups (P > 0.05). Bradycardia and hypotension didn't happen in any patients in the two groups. 4 weeks after surgery, the survival rate was 96.7% (58/60) in group A, and 83.9% (47/56) in group B (P < 0.05).

CONCLUSIONPostoperative analgesia with dexmedetomidine as an adjuvant can increase the survival rate of replantation fingers with high safety.

Adolescent ; Adult ; Analgesia ; Dexmedetomidine ; therapeutic use ; Double-Blind Method ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Postoperative Care ; Replantation ; Young Adult

Objective To investigate the operative procedure and the clinical result of the modified rectangle cross-finger flap based on the dorsal branches in the middle phalange to repair degloved avulsion of fingertip.Methods From January 2006 to March 2010,26 patients with the avulsions of fingertip were treated by the modified rectangle cross-finger flap based on the dorsal branch in the middle phalange of adjacent finger.There were 21 men and 5 women,with an average age of 31.6 years(range,17-56 years).Fourteen cases were crushed by machine,8 cases were pressed and 4 cases were tied.There were 8 index fingers,9 long fingers,4 ring fingers and 5 little fingers.The length of the avulsion was 1.1-2.6 cm.The flap was harvested from the dorsal of contiguous digital of their middle and proximal segment.The both dorsal branches of the both proper palmar digital nerves were cut off and were anatomized with the nerve end of the injured digit.The area of flaps ranged from 3.6 cm×2.3 cm-6.5 cm×3.2 cm.The donors were closed by skin graft.Results The pedicels were cut when 13-23 d after operation.Twenty-five patients were followed up for 6-28 months(mean,16.3 months).All flaps survived with satisfactory appearance,sensation and function.All flaps and donors were primary healing.Two point discrimination was 6-9 mm with an average of 7.8 mm.The postoperative outcomes were evaluated by the total active movement.The results were excellent in 17fingers,good in 7,and fair in 1.The rate of excellent and good was 96%.Conclusion The treatment of degloved avulsion of fingertip with the modified rectangle cross-finger flap based on the dorsal branch in the middle phalange is recommendable.The operative procedure of harvesting the flap is simple.There is enough blood to supply the flap and the surviving rate is high.The postoperative function of the injured hand can be recovered satisfactorily.The figure of flap is well and the sense of flap is sensitive.The technique can be operated in the last 4 fingers without thumb.

Objective To investigate the clinical efficacy and safety of 5-aminolaevulinic acid-photodynamic therapy(ALA-PDT) in treatment of anorectal condyloma acuminatum.Methods 95 cases who suffered from male multiple condyloma acuminatum were randomly divided into two groups.There were 50 cases in the treatment group and 45 cases in the control group.There were no statistically significant between two groups in age,sex,course of disease,skin lesions,the size and the distribution.The treatment group was treated by photodynamic therapy combined with recombinant human interferon α-2b Gel while the control group was treated only by photodynamic therapy.The treatment time lasted 7-10 days later if the Lesion was not completely removed.Totally,1-4 treatment sessions were given.Then the rate of recovery and recurernce of the two groups were compared.Results The recovery rate in treatment group was 94.0％ (47/50) and 88.9％ (40/45) were found in control group.There were no significant difference in the two groups (x2 =0.290,P ＞ 0.05) ;The recurernce rate of the treatment group was 2.0％ (1/50) and the control group was 13.3％ (6/45),the two groups had significant differences (x2 =4.457,P =0.035).Conclusion ALA-PDT combined with recombinant human interferon α-2b Gel in the topical treatment of anorectal condyloma acuminatum is safe and effective,whcih may serve a therapeutic option for anorectal condyloma acuminatum.

Objective To investigate the therapeutic effect of human umbilical cord blood nucleated cell therapy(HUCBNCT) in patients with chronic severe viral hepatitis,and the effect of HUCBNCT on ductular proliferation and hepatic oval cell proliferation.Methods A total of 90 patients with chronic severe viral hepatitis were divided into two groups randomly,and the two groups were treated with adult plasma transfusion(control group),and HUCBNCT(treatment group),respectively.The therapeutic effect in all patients was evaluated by determination of liver function.Some patients had liver biopsy and CK19,CD34,albumin and AFP of the biopsy tissues were detected.Results Liver necrosis in treatment group was milder than that of control group,and the positive rate of CK19 staining in treatment group was higher than that of control group.Co-expression of CK19 and albumin were observed in some atypical ductular proliferation cells,which were like the oval cells in shape and immunohistochemical characteristics.Conclusion HUCBNCT,which can promote liver ductular and oval cell proliferation,may have promising therapeutic effect on patients with chronic severe viral hepatitis.

OBJECTIVE To explore the relationship between cytokines(IL-1?,mIL-2R,IL-10) and hepatatis B virus(HBV) serum markers in patients with chronic hepatitis B(CHB).METHODS The serum level of IL-1?,mIL-2R and IL-10 in 65 patients with CHB was measured with chemiluminescence immunoassay(CLIA).RESULTS Of the patients with positive and negative HBeAg,the serum IL-1? and IL-10 levels were significantly higher than normal controls(P