Objective To investigate the possibility and accuracy of idenfication of the sentinel lymph node(SLN) in breast cancer(BC) by using methylene blue intra operatively.Methods 4～6ml methylene blue dye was injected around the breast mass intra operatively. 5～10 minutes after injection,the operation for BC was performed. All blue stained lymph nodes found during operation were considered as SLN, and removed for pathological examination. All patients had axillary lymphadenectomy(ALDN),and the acquired nonsentinel lymph nodes(NSLN)from them were also examined. Results The SLN were identified in 45 of 50 patients(90.0%).There were all 117 SLNs in this series. Of 117 SLNs,111 were located in stage I lymph nodes in axilla(95.0%),and 6 SLNs in stage II(5.0%). Of the 5 cases of the unidentified SLN,the primary tumor was located in the inferior quadrant in 4 cases,and in the uper quadrant in 1 case (P0.05). Histologic status of the SLNs accurately predicted axillary nodes status with an accuracy rate of 91.0%. 4 cases or SLN examination were negative while their NSLN were positive with false negative rate 8.9%. Conclusions This technique can identify SLN accurately;the histology of SLN can predict axillary status correctly. Sentinel lymph node has correlation with the location of the primary tumor but has no correlation with the size of the tumor or breast operation before.

Background:Gemcitabine is the first-line drug for chemotherapy of pancreatic cancer. However,owing to the inherent and acquired resistance,gemcitabine does not change obviously the prognosis of patients with pancreatic cancer. Exploration of the mechanism of acquired resistance to gemcitabine is of great clinical importance. Aims:To establish a gemcitabine-resistant human pancreatic cancer cell subclone and to explore preliminarily the resistance mechanism. Methods:Human pancreatic cancer cell line SW1990 was stimulated continuously with 0. 5 μmol/ L gemcitabine in vitro to establish the gemcitabine-resistant subclone SW1990-0. 5. The resistance index of SW1990-0. 5 cells was counted by CCK-8 assay. Proliferation and invasion of SW1990 and SW1990-0. 5 cells were detected by cell doubling time assay and scratch wound healing assay in vitro;cell cycle and cell apoptosis were detected by flow cytometry;expressions of multidrug-resistance related genes(MDR-1,MRP-1,and BRCP)and gemcitabine metabolic enzyme related genes(dCK,RRM1, and RRM2)were determined by real-time PCR. Results:The resistance index of SW1990-0. 5 cells was 9. 32. Compared with the parental SW1990 cells,the proliferation capacity but not the invasion capacity of SW1990-0. 5 cells in vitro was reduced. When treated with gemcitabine,the cell cycle of SW1990-0. 5 cells was similar to that of parental cells,whereas the cell apoptosis was significantly inhibited;expressions of MRP-1,BRCP and dCK mRNA were down-regulated,while expressions of MDR-1,RRM1 and RRM2 mRNA did not change. Conclusions:A stable gemcitabine-resistant human pancreatic cancer cell subclone SW1990-0. 5 was successfully established. Inhibition of cell apoptosis and down-regulation of dCK expression might contribute to the acquired resistance to gemcitabine of pancreatic cancer.

Background:Gemcitabine is the main drug for chemotherapy of advanced pancreatic cancer,however,the prognosis of pancreatic cancer patients has not been changed obviously because of the high innate and acquired resistance of cancer cells to gemcitabine. Aims:To investigate the correlation of DNA repair and expression of human APE1 / Ref-1(apurinic/apyrimidinic endonuclease 1 / redox factor-1),the key enzyme in base excision repair pathway,with the resistance of pancreatic cancer to gemcitabine. Methods:A gemcitabine-resistant human pancreatic cancer cell line SW1990-0. 5 with a resistance index of 9. 32 and its parental cell line SW1990 were treated with gemcitabine. DNA injury was assessed by comet assay. Expressions of APE1 / Ref-1 mRNA and protein were determined by real-time PCR and Western blotting, respectively. Results:In comet assay,after treated with gemcitabine for 24 hours,OTM value of SW1990-0. 5 and SW1990 cells were 0. 32 ± 0. 13 and 26. 96 ± 6. 83,respectively. Expression level of APE1 / Ref-1 mRNA in SW1990-0. 5 cells was 2. 48 ± 0. 49;and expression levels of APE1 / Ref-1 protein in SW1990-0. 5 and SW1990 cells were 1. 57 ± 0. 08 and 0. 84 ± 0. 06,respectively. Statistically significant differences were existed in all these parameters between SW1990-0. 5 and SW1990 cells(P all < 0. 05). Conclusions:DNA repair might be correlated with the resistance of pancreatic cancer to gemcitabine,and up-regulation of APE1 / Ref-1 might contribute to this resistance by its function on DNA repair.

Objective:To prepare specific IgY production using Actinobacillus actinomycetemcomitans(A.a) immunizing hen, and then to investigate anti-Actinobacillus actinomycetemcomitans IgY inhibiting growth of A.a and Capnocytophaga gingivalis(C.g). Methods:Using immunization method, water-dilution method, two-step ammonium sulfate precipitation, inhibiting bacteria growth test in liquid anaerobic culture, and ELISA, IgY were induced, extracted, purified, and inhibiting growth of A.a and C.g by the IgY was roundly evaluated. Results:The IgY purity reached to 85.6%~90.3% through 550 g/L and 330 g/L ammonium sulfate precipitation, and efficacy value was 1∶32 000. The IgY efficacy value of anti- A.a was 1∶8 000 against C.g in cross-reactivity.When IgY concentrations of anti-A.a were in the 5.0,1.0,0.1 g/L and concentration of A.a was in the 5?108 CFU/L, the suppression rate of A.a growth were 31.60%(P=0.004),10.24%(P=0.024),-3.30% respectively during 24 h culture and were 64.20%(P=0.004),53.21%(P=0.002),11.20% respectively in 72 h culture. When the concentration of A.a was in the 1?108 CFU/L, the suppression rate of A.a growth were 35.71%(P=0.004),30.95% (P=0.012),11.11% respectively during 24 h culture, and were 65.11%(P=0.005),54.04%(P=0.002),16.17% respectively during 72 h culture. When 5.0 g/L IgY of anti-A.a was cultured with 1?108 CFU/L C.g for 24 h, the suppression rate of C.g growth was 41.61%(P=0.005), and for 72 h it was 86.99%(P=0.014). Conclusion:The hen is able to be induced to produce high efficacy value IgY of anti-A.a by A.a. The specific IgY of anti-A.a is capable of inhibiting A.a and C.g growth. There are common antigens and cross immunizing reactivity between A.a and C.g.

Objective To investigate the correlation of platelets-to-lymphocyte ratio (PLR) with neutrophil-to-lymphocyte ratio (NLR) from pretreatment in the Xinjiang Uygur patients with nasopharyngeal carcinoma.Methods In this retrospective analysis,96 cases of nasopharyngeal carcinoma patients with pathologically diagnosis were collected.Receiver operating characteristic (ROC) curve analysis suggested that optimum PLR and NLR cut-off point for nasopharyngeal carcinoma.The patients were divided into high-PLR and low-PLR groups,high-NLR and low-NLR groups,respectively.The survival rate was calculated with Kaplan-Meier method.The Log rank statistics was used to test differences between groups.The prognostic factors that may affect patients with nasopharyngeal carcinoma in Uighur population of Xinjiang were analyzed by COX proportional hazards models.Results For high-PLR and low-PLR groups,5-year overall survival,and progression-free survival were 46.6％ and 79.3％,49.8％ and 82.7％,respectively;the difference was statistically significant (all P ＜ 0.01).For high-NLR and low-NLR groups,5-year overall survival rate,and progression-free survival rate were 41.3％ and 41.3％,50.8％ and 82.5％,respectively;the difference was statistically significant (all P ＜ 0.01).Univariate analysis showed that N stage,clinical stage,NLR,and PLR had significantly impact on overall survival and progression-free survival (all P ＜ 0.05);multivariate analysis showed that PLR and clinical stage had statistical significance in Uighur patients with nasopharyngeal carcinoma for progression-free survival and overall survival (all P ＜ 0.05).Conclusions PLR may be independent factor that influences the prognosis of patients with nasopharyngeal carcinoma in Uighur population of Xinjiang.

Objective To investigate the correlation between preoperative anxiety and emergence agitation(EA)in children after sevoflurane anesthesia.Methods A total of 120 children who were going to receive an elective surgery were recruited in this study.The preoperative anxiety in these children was measured through the Modified Yale Preoperative Anxiety Scale(mYPAS)at the following time:during the preoperative interview(T1),waiting period in surgery waiting room(T2),after the children entered the operating room(T3)and at the beginning of sevoflurane inhalation induction(T4).The emergence agitation(EA)scores were obtained by using the Pediatric Anesthesia Emergence Delirium(PAED) Scale after the surgery.Results After adjusting for the effect of age,it was found that the anxiety scores at T1 and T2 had no significant correlation with EA,while those in T3 and T4 showed a statistically significant correlation with EA.The level of anxiety at the beginning of induction showed a strong positive correlation with EA,and the correlation coefficient was 0.708(P<0.01).Conclusion The preoperative anxiety in the operating room and at the beginning of induction of anesthesia is correlated with EA in children receiving sevoflurane anesthesia.

Objective To study the management for haemobilia from the intrahepatic biliary duct due to the biliary tract infection.Methods Selective hepatic angiography, cholangiography,fib erotic choledochscope were used to confirm the pathology and diagnosis in 11 cases. Partial liver resection, transcatheter mobilization,common bile duct exploration and T-tube drainage were performed respectively.Results Of the 11 patients,3 treated by transcatheter,2 by left external lobectomy,6 by common bile duct exploration and T-tube drainage.Definitive control of the bleeding was achieved in all the patients.No complications were observed.10 of the patients are alive and well at follow-up for 2 years.Conclusions The treatment of choice depends on the underlying pathology of haemobilia,location diagnosis and the patient's general condition. The therapeutic principle is effective for hepatic haemobilia resulting from the billiard infection.

Objective:To study the effects of a potassium channel blocker 4-Amino pyridine(4-AP)on the proliferation of human tongue squamous cell carcinoma Tca8113 cells.Methods:CCK-8 assay was used to detect the proliferation of Tca8113 cells cultured with 4-AP at the concentration of 1,5,10,20,50 and 100 mmol/L for 12,24 and 48 h respectively,the cell proliferation inhibition rate was calculated,the cell cycle distribution was examined by flow cytometry.Data were analyzed by SPSS19.0 software.Results:With the increase of 4-AP concentration and culture time,cells showed some morphologic changes.4-AP at 5 -100 mmol/L dose and time dependently inhibited the proliferation,with 24 h exposure dose dependenty decreased S-phase population and increased G0 /G1 phase population of Tca8113 cells.Conclusion:4-AP may inhibit Tca8113 cell proliferation by regulation of the cell cycle distribution.

Objective To evaluate the effects of fentanyl and lidocaine on hypnotic effect of propofol in total intravenous anesthesia(TIVA) Methods One hundred and sixty ASAI Ⅲ patients(86 male,74 female) aged (55 0?12 4)yr,weighing (58 0?9 8)kg,scheduled for elective surgery were randomly divided into propofol group(group P,n=30), propofol fentanyl group(group PF,n=52) and propofol lidocaine group (group PL,n=78) Patients with kidney and liver dysfunction, hypertension, neurological and mental disease were excluded All patients were premedicated with intramuscular phenobarbital 0 1g and atropine 0 5mg BP,HR,SpO 2 and BIS were continuously monitored The patients were anesthetized by TIVA with TCI The target plasma concentration for fentanyl was 2?g/L(group PF) and for lidocaine 4mg/L(group PL) The initial target plasma concentration of propofol was set at 1mg/L When pre set concentration was reached, target propofol plasma concentration was increased by increments of 0 5mg/L until loss of consciousness Blood samples were taken before anesthesia(T 0), loss of consciousness(T 1), immediately after intubation(T 2), at skin incision(T 3), 5 and 10 min after skin incision(T 4,T 5), when TIVA was ended (T 6) and when the patient waked up(T 7) for determination of plasma concentrations of propofol, fentanyl and lidocaine Results ED 90 and ED 50 of propofol for loss of consciousness were lower in group PF and PL than those in group P but the difference was of no statistical significance (P

OBJECTIVE To investigate whether efflux mechanism is involved in fluoroquinolone-resistant Klebsiella pneumoniae strains isolated in China. METHODS We compared the ciprofloxacin accumulation in clinically isolated K. pneumoniae with or without CCCP by fluorospectrophotometry. Use reverse transcriptase-polymerase chain reaction (RT-PCR) to measure the mRNA expression level of acrAB-tolC efflux gene. RESULTS The accumulation of ciprofloxacin in resistant strains was lower than that in susceptible ones, and it could increase to a high level nearly to the susceptible strains. The mRNA level of efflux gene acrA was higher in resistant strains than in susceptible ones. CONCLUSIONS Efflux mechanism is associated with the resistance to fluroquinolones in K. pneumoniae strains isolated in China and CCCP can inhibit its active efflux mechanism , which provides a sensitive method to detect the active efflux system of K. pneumoniae.