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.

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 Investigate the relation between decrease of apoptosis caused by delayed preconditioning and expression of SMAC and XIAP.Methods Sprage-Dawleyt rats were divided into four groups: control,sham,I/R and IPC/SWOP.The rats in I/R group underwent ischemia for 1 hour by classic artery ligation and reperfusion for 1 hour.The rats in IPC/SWOP group underwent tree cycles of 5-minute ischemia and 5-minute reperfusion 24 hours prior to the index occlusion.Cell apoptosis was measured by flow cytometry,the activity of caspase-3 was also measured.The expression of SMAC and XIAP in cytosol of myocardial cell was measured by Western blot.Results Cell apoptosis rate,activity of caspase-3 and expression of SMAC significantly increased in I/R as compared with control(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.

Objective To study the clinical characteristics of multi-drug resistance bacterias(MDROs) isolated from hospitalized patients in the Second People′s Hospital of Longgang District,to provide strategies for the prevention of MDROs infection.Methods The MDROs data of hospitalized patients from January 2015 to December 2016 were analyzed retrospectively.The multi-drug resistance incidence of each bacterias,each types of specimens and each clinical departments were analyzed and compared by SPSS16.0.Results A total of 104 strains of MDROs were isolated,and the top five bacteria were E.coli(32 strains,30.77%),coagulase negative staphylococcus(24 strains,23.08%),pseudomonas aeruginosa(16 strains,15.38%),staphylococcus aureus(10 strains,9.62%),kiebsiella pneumonia(10 strains,9.62%) respectively.There was significant difference in the multi-drug resistance incidence of each bacterias(χ2=20.62,P<0.05),the average incidence was 25.12%,and the top three incidence were E.coli(36.78%),pseudomonas aeruginosa(33.33%),coagulase negative staphylococcus(28.24%) respectively.There was significant difference in the multi-drug resistance positive rate of each types of specimens(χ2=43.68,P<0.05),the average positive rate was 5.84%,and the highest positive rate were wound secretion and pus(11.00%),followed by urine(8.25%).There was significant difference in the multi-drug resistance positive rate of each clinical departments(χ2=40.36,P<0.05),and the highest positive rate were in department of urinary surgery(12.63%),followed by department of gynaecology and obstetrics(11.16%).Conclusion E.coli coagulase negative staphylococcus and pseudomonas aeruginosa were mainly epidemic MDROs,and the MDROs are mainly distributed in urological surgery,obstetrics and gynecolog in this hospital.The occurrence of MDROs should be for the prevention and control strongly in the hospitalized patients with all kinds of trauma or diseases of urinary system and in the clinical department of urinary surgery,gynaecology and obstetrics.

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 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 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 detect the expression of cyclooxygenase(COX) in human gastric cancer cell lines and its subcellular location of the isoforms. Methods Immunohistochemistry、RTPCR combined with laser scanning cofocal microscopy (LSCM) were used to investigate expression and distribution of COX. Results Positive staining of COX2 and COX1 protein was seen in human gastric cancer cell line MKN45、SGC7901 and AGS. However, the COX2 staining was absent and COX1 staining was weak in MGC803; though their mRNA in all the four cell lines. When compared to COX1,COX2 showed a stronger signal at both protein and mRNA levels of the gastric cancer cell lines, which was confirmed by double labeling and LSCM. The quantitative analysis of fluorescein intensity indicated the pixel intensity peak of COX2 reached 50～70, while COX1 only 10. LSCM also showed that COX2 was both cytoplasmic and nuclear envelope staining but COX1 only in cytoplasm. Conclusions In human gastric cancer, there is stronger expression of COX2 than COX1, and different distribution of the two isoforms implies their distinct roles in cell function.

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.