Objective To evaluate the clinical value of color ultrasound guided coarse needle bioptic histo-pathology in the diagnosis of retroperitoneal solid mass. Methods 32 cases with retroperitoneal solid mass accepted coarse needle biopsy (CNB) guided by color ultrasound, and followed to surgical mass resection. The histopathologi-cal result of CNB was compared to the post-operative pathological diagnosis. Results CNB were successful in all ca-ses and no complications occurred. Compared with the pest-operative pathology,the accuracy of CNB was 93.75% (30/32). There was no false-negative and very low rate of false-positive (3.13% ,1/32) of CNB in diagnosing ma-lignant tumor. Conclusions CNB guided by color ultrasound is a safe and an effective method in diagnosis of retro-peritoneal solid mass.

Objective To investigate effect of anthracyclines of VEGF-C, VEGFR-3, ER and E-cadherin in serum of patients with breast cancer.Methods 43 patients with breast cancer were selected and randomly divided into experimental group and control group, 40 cases in each group.According to the experimental program based on the treatment, serum VEGF-C, VEGFR-3 levels and breast tissue ER and E-cadherin were detected after the end of the treatment.Results Compared with the control group, VEGF-C, VEGFR-3 levels of the experiment group were lower( P<0.05),ER level was lower(P<0.05) and E-cadherin level was higher(P<0.05).Conclusion the ER, VEGFR-3 and VEGF-C levels in breast cancer patients can significantly decrease the E-cadherin level, and it has a guiding significance for clinical.

Objective To investigate expression of TPS, VEGF of beast cancer patients and relationship with clinical pathological.Methods 68 cases of breast cancer were selected as experiment group, 36 cases with breast fibroma were selected as control group.TPS and VEGF were detected by elisa of patients before and after treatment.Serum TPS and VEGF levels and TNM staging were compared after operation.Results TPS and VEGF of the experiment group were higher than control group(P<0.05).TPS and VEGF of experiment group after operation were higher than before operation.TPS and VEGF increased with the grade of tumor, but there was no significance between grade Ⅰ and 0.The expression of VEGF in tumor diameter≤2 cm group was significantly lower than >2 cm group(P<0.05).TPS and VEGF of axillary lymph node metastasis group and axillary lymph node metastasis had significant difference(P<0.05).The concentration of TPS was significantly higher than that of estrogen and progesteronepositive group in estrogen receptor negative, progesterone receptor negative (P<0.05).Conclusion TPS, VEGF levels in the serum of breast cancer patients showed high expression, the expression of TPS, VEGF levels related to axillary lymph node metastasis, estrogen receptor, progesterone receptor.

Objective To research the impact of axillary limph node group dissection oriented by senti-nel lymph nodes instead of axillary dissection on upper limb lymph edema and disease -free survival ( DFS ).Methods We designed a randomized controlled research , which included 205 cases of operatable breast cancer (AJCC 7th:stage I or stage IIa)from Jan.2011 to Jan.2013.Those cases were separated into 2 groups randomly ( random number method ):group A underwent mastectomy ( or lumpectomy ) and axillary group lymphadenectomy oriented by sentinel lymph node biopsy ( SLNB) ( if positive continued for ALND ) while group B underwent mastec-tomy(or lumpectomy)and axillary lymph node dissection(ALND).All patients underwent SLNB by blue dye method and received adjuvant therapy after surgery according to National Comprehensive Cancer Network ( NCCN) guideline and Chinese anti-cancer association guideline .Results There were 101 cases in group A and 104 ca-ses in group B , but 1 case in group A was excluded for false negative of SLN.The midium follow-up was 30 months.There were no significant differences of average age , tumor size, grade, estrogen receptor (ER),proges-terone receptor ( PR) and human epidermal growth factor receptor 2 ( HER2 ) expression between the 2 groups. Group A had a lower frequency of lymph edema than group B (4.0%vs 17.3%,χ2 =9.384,P=0.002), and al-so a milder degree ( mild 2%vs 11.5%,middle 2%vs 3.8%,severe 0%vs 1.9%).There were no significant differences of upper limb sensory disorder (14.0%vs 16.3%,χ2 =0.218,P=0.641), neither of DFS(Log-Rank analysis:3-year average DFS 32.89 months vs 33.72 months,χ2 =0.186,P=0.667;Cox risk model analysis:HR=1.395,P=0.495)between the 2 groups.Conclusion Axillary group lymphadenectomy oriented by SLNB can reduce the happening of lymph edema from ALND and has a comparative effect on DFS as ALND .

As the major contributing editor of Physician Catalogue in Cataloged Abstract of Supplement to Si Ku Quan Shu(Yijia Lei,Xuxiu Siku Quanshu Zongmu Tiyao),Xia Suntong(1857-1942) has been rarely mentioned before in academic community. This paper has documented Xia's qualification, academic association and working attitude through multi-dimension and multi-angle textual analysis. Abundant compiling experience Xia has accumulated as well as his own profound knowledge in bibliography and medicine, have brought great academic value and significant profound impact on his works.

Objective To investigate the effects of single-port laparoscopic extraperitoneal liga-tion on surgical indexes,intestinal mucosal barrier function and recurrence rate in children with pedi-atric inguinal hernia.Methods A total of 86 children with pediatric inguinal hernia in the hospital from February 2019 to June 2021 were randomly divided into control group(n=43)and study group(n=43).The study group performed single-port laparoscopic extraperitoneal ligation,while the con-trol group received traditional open surgery.The ratio of urinary lactulose to mannitol(L/M)was measured by high-performance liquid chromatography;serum diamine oxidase(DAO)level was de-tected by enzyme-linked immunosorbent assay;serum D-lactic acid level was detected by enzymatic spectrophotometry;pain was assessed by the Visual Analogue Scale(VAS);surgical indicators,com-plications and postoperative recurrence rate were compared between the two groups.Results Com-pared with the control group,the study group had significant reduction in operation time,intraopera-tive blood loss,time to first flatus,and postoperative hospital stay(P＜0.05);in both groups,the VAS score,L/M,DAO level and serum D-lactic acid level decreased significantly after operation,and these indexes after operation in the study group were significantly lower than those in the control group(P＜0.05);the incidence of complications in the study group was 4.65％(2/43),which was significantly lower than 20.93％(9/43)in the control group(P=0.024).Conclusion Single-port laparoscopic extraperitoneal ligation is benefit for the treatment of children with pediatric inguinal hernia,which has advantages of fewer bleeding,less pain,fewer complications,faster recovery of intestinal mucosal barrier function,and lower recurrence rate.

Objective To investigate the expression of chemokine receptors CCR4,CCR6,CXCR3 on Th17 cell,and analyze the correlation between chemokine receptors and serum biochemical parameters of liver function test and hepatitis B virus (HBV) DNA load in peripheral blood of chronic hepatitis B (CHB) patients.Methods Thirty patients with CHB (CHB group) and 15 healthy persons (control group) were enrolled in the study.CCR4,CCR6,CXCR3 expression levels on Th17 cell were assayed by flow cytometry.The correlation between chemokine receptors and alanine aminotransferase (ALT),total bilirubin (TBil),and HBV DNA load were analyzed using Pearson' s correlation analysis,respectively.Results CCR4,CCR6,CXCR3 expression levels on CD4 + Th17 cell in CHB group were higher than that of control group.Moreover,the difference between them was statistically significant (P ＜ 0.05).CCR4,CCR6 expression levels on CD8 + Th17 cell in CHB group were higher than that of control group (P ＜ 0.05).Although CXCR3 expression level on CD8 + Th17 cell in CHB group was higher than that of control group,there was no significant difference between them (P ＞ 0.05).CCR4,CCR6 expression levels were positively correlated with serum ALT,HBV DNA load,respectively (P ＜ 0.05),but were not correlated with TBil (P ＞ 0.05).Conclusion Expression levels of chemokine receptor on Th17 cell were increased in patients with CHB and were positively associated with degree of liver inflammation.Therefore,CCR4,CCR6 expression on Th17 cell might be involved in liver injury resulted from Th17 cell.

Objective To investigate the effects of single-port laparoscopic extraperitoneal liga-tion on surgical indexes,intestinal mucosal barrier function and recurrence rate in children with pedi-atric inguinal hernia.Methods A total of 86 children with pediatric inguinal hernia in the hospital from February 2019 to June 2021 were randomly divided into control group(n=43)and study group(n=43).The study group performed single-port laparoscopic extraperitoneal ligation,while the con-trol group received traditional open surgery.The ratio of urinary lactulose to mannitol(L/M)was measured by high-performance liquid chromatography;serum diamine oxidase(DAO)level was de-tected by enzyme-linked immunosorbent assay;serum D-lactic acid level was detected by enzymatic spectrophotometry;pain was assessed by the Visual Analogue Scale(VAS);surgical indicators,com-plications and postoperative recurrence rate were compared between the two groups.Results Com-pared with the control group,the study group had significant reduction in operation time,intraopera-tive blood loss,time to first flatus,and postoperative hospital stay(P＜0.05);in both groups,the VAS score,L/M,DAO level and serum D-lactic acid level decreased significantly after operation,and these indexes after operation in the study group were significantly lower than those in the control group(P＜0.05);the incidence of complications in the study group was 4.65％(2/43),which was significantly lower than 20.93％(9/43)in the control group(P=0.024).Conclusion Single-port laparoscopic extraperitoneal ligation is benefit for the treatment of children with pediatric inguinal hernia,which has advantages of fewer bleeding,less pain,fewer complications,faster recovery of intestinal mucosal barrier function,and lower recurrence rate.

Objective To evaluate a model for axillary lymph node involvement combining CK19 mRNA with contrast enhanced ultrasound sonography (CEUS) score in operable breast cancer.Methods Operable breast cancer patients planned for sentinel lymph node (SLN) biopsy were enrolled.Preoperative CK19mRNA expressions in peripheral blood and CEUS score of axillary lymph nodes were tested before surgery.In the training set,postoperative sentinel lymph node (SLN) and non-sentinel lymph node (nSLN) pathological results were taken as the gold standard,effective modeling variables were screened,logistic regression was used to establish the prediction model.Parallel control studies were conducted between the validation set and the MSKCC model to evaluate the prediction accuracy and prediction efficiency.Results From Oct 2015 to Nov 2016,359 cases (training set) were enrolled and mathematical formulas for predicting SLN and nSLN were established,respectively.The sensitivity,specificity and AUC of predicting SLN involvement were 91.36％,94.92％ and 0.979 respectively.The sensitivity,specificity and AUC of predicting nSLN metastasis were 91.04％,90.53％ and 0.932 respectively.From Dec 2016 to Jul 2017,219 cases (verification set) were included.The sensitivity of SLN metastasis predicted by the model was 91.84％,the specificity was 96.69％,and the AUC was 0.979,significantly superior to the MSKCC model (0.739).The sensitivity,specificity and AUC of predicting nSLN metastasis were 95.35％,92.73％ and 0.945 respectively,significantly superior to the MSKCC model (0.873).Concolusions Combined with peripheral blood CK19 mRNA and CEUS score,the prediction model for axillary lymph node involvement for operable breast cancer,SLN/nSLN involvement probability can be calculated and qualitative judgment can be made.The overall accuracy and AUC of this model are better than the prediction model of MSKCC.

Objective:To investigate the clinical effect of superthin anterolateral thigh flap(ALTF) with retrograde dissection of perforator in the interface plane between the superficial and deep layer of superficial fascia for reconstruction of soft tissue defect in the foot.Methods:The study involved 24 Side of 23 patients with foot soft tissue defects in Department of Foot and Ankle Surgery in Wuxi Ninth People’s Hospital from August 2019 to July 2021. There were 15 males and 8 females with an average of 42(range, 22-59) years old, including 9 in left foot, 13 in right foot, and 1 in both feet. The size of soft tissue defects was 4 cm×4 cm-11 cm×17 cm. The dimension of the superthin ALTF was 4 cm×5 cm-12 cm×18 cm. CTA and high-frequency CDU were used to locate the perforator in the superficial fascia plane. The perforator was exposed and dissected retrograde in the adiposal layer. The superthin ALTF was harvested to repair the foot wound. The donor site was sutured directly. All patients enter follow-up reviews at outpatient clinic or by WeChat. The appearance of flaps were recorded.Results:The superthin ALTF survived in all patients. Two cases had partial epidermal necrosis at the distal part of the flap. The thickness of the flap averaged approximately 4(range 3-6) mm. During 8-16(mean 12) months of follow-up, all superthin ALTF were soft in texture without ulceration. Two flaps required secondary defatting procedures, others showed satisfactory appearance without bulky deformity. Only linear scars left in donor areas.Conclusion:The technique of harvesting superthin ALTF with retrograde dissection of perforator in the superficial fascia plane for repairing foot wounds is reliable and is able to achieve satisfactory functional and esthetic outcome.