Objective To compare the effects of peripherally inserted central catheter(PICC)and venous port access (VPA)on the complication incidence of breast cancer.Methods A total of 191 breast cancer patients with VPA and 218 ones with PICC for chemotherapy from January 2012 to January 2014 were involved.The two groups were compared in respect of incidence of complications during intubation.Result The complication incidence in the VPA group was lower than the PICC group(P<0.05). Conclusion VPA is an ideal pathway for intravenous infusion in breast cancer patients undergoing chemotherapy.

Objective To evaluate the therapeutic effects of capsule Huoluoshugan on schistosomal hepatocirrhosis.Methods Ninety-six patients with schistosomal hepatocirrhosis were selected and divided randomly into three groups:Huoluoshugan group,interferon-?(IFN-?)group and control group,and treated with capsule Huoluoshugan,IFN-? and routine therapy,respectively.The course of treatment was 6 months in all groups.Before and after the treatment,the symptoms,physical signs,indexes of liver function and hepatic fibrosis,and changes of B-type ultrasonic images were detected for all the patients.Results The indexes of liver function,hepatic fibrosis and B-type ultrasonic image of the patients in Huoluoshugan group improved obviously compared with the control group after the treatment(P0.05).In addition,there was no obvious adverse reactions during the treatment in the patients of Huoluoshugan group.Conclusion Capsule Huoluoshugan can reduce the indexes of hepatic fibrosis and improve the liver function in patients with schistosomal hepatocirrhosis.

Objective To investigate clinieopathologic characteristics and therapy of local advanced welldifferentiated thyroid carcinoma.Methods Data of 23 cases of advanced well-differentiated thyroid carcinoma treated from Jan.1996 to Dec.2005 were retrospectively reviewed.The data included age,pathologic type,local invasion,operative plan,postoperative complications and survival duration.Results Histology showed there were 15 cases of papillary carcinoma,6 ca8es of follicular carcinoma,and 2 cases of papiIlary follicular carcinoma.8 cases had local invasion into recurrent laryngeal nerve,12 cases had invasion into trachea,3 cases had trachea and esophagus invasion,and 8 cases had suprahyoid muscle invasion.All the 23 cases underwent resection procedure.According to surgical procedure,they were divided into radical resection group(n=6),tumor resection group(n=14)and tumor debulking group(n=3).2 cases received radiotherapy after thyroidectomy in tumor debulking group.All patients were followed up.Overall survival rate after 1 year,3 years and 5 years Was 91.3%(21/23),82.6%(19/23),and 60.8%(14/23)respectively.Prognosis of radical tumor removal group and tumor resection group was obviously better than that of tumor debulking group.Conclusions Prognosis is good for local advanced well-differentiated thyroid carcinoma patients receiving resection.Protection of local organ function Can enhance postoperative life quality.

Objective To provide new information for treatment and prognosis of blastic plasmacytoid dendritic cell neoplasm (BPDCN).Methods Through one case report and literature review of 48 BPDCN cases were reviewed retrospectively.The clinical characteristics,treatment choices and prognosis were analyzed.Results BPDCN patients were mainly elderly males,mostly presented as skin rash and bone marrow infiltration.Immunophenotype was characteristically expressed as CD4,CD56 and CD123.Lymphoid-like regimens could induce higher response rate,lower relapse rate and longer overall survival compared with myeloid-like regimens.Allogeneic hematopoietic stem cell transplantation may provide long-term survival.At the onset of the disease,The counts of white blood cells (WBC) and blood platelet (Plt) may be correlated with inferior overall survival.Conclusions BPDCN is a disease with distinct clinical characteristics and immunophenotype.Lymphoid-like regimen may be the better treatment of choice,while allogeneic hematopoietic stem cell transplantation should be taken into account in the first complete remission for longterm survival.

objective To summarize the clinical experience of pancreatoduodenectomy using Da Vinci surgical system,and to investigate the methods to improve its efficacy.Methods Sixteen patients who received pancreatoduodenectomy from January to December 2009 at the General Hospital of Second Artillery of PLA were divided into robotic group(n=8)and open group(n=8).Data on the surgical procedure,perioperative management and postoperative recovery between the 2 groups were retrospectively analysed using t test and chi-square test.Result The radical resection rates of robotic group and open group were 7/8 and 8/8,respectively,with no significant difference between the 2 groups(χ~2=1.067,P＞0.05).The operation time of robotic group was (718±186)minutes,which was significantly longer than(420±127)minutes of open group(t=3.714,P＜0.05＝.The blood loss of robotic group was(153±43)ml,which was significantly less than(210±53)ml of open group(t=2.318,P＜0.05＝.The postoperative ambulation time and length of hospital stay of robotic group were(28±7)hours and(16±4)days,which were significantly shorter than(96±18)hours and(24±7)days of open group(t=9.939,2.714,P＜0.05＝.The incidences of postoperative complications of robotic group and open group were 2/8 and 6/8,respectively,with significant difference between the 2 groups(χ~2=6.349,P＜0.05＝.The incidences of anastomotic leakage of robotic group and open group were 2/8 and 3/8,respectively,with no significant difference between the 2 groups(χ~2=0.291,P＞0.05).Conclusion Pancreatoduodenectomy performed by Da Vinci surgical system is feasible and safe,and with the advantages of less trauma and rapid recovery of patients.

Objective To evaluate preoperative multislice CT angiography (MSCTA) in guidance for laparoscopic right colon cancer the complete mesocolon resection (CME).Methods From September 2014 to May 2016 data of 24 patients undergoing laparoscopic CME right colon cancer surgery,were reviewed for the guidance of MSCTA over operative surgery.Results Preoperative MSCTA clearly showed superior mesenteric vascular anatomical variation and its branch,which was in closely consistent with that seen during the operation.The superior mesenteric arteries and veins (SMA/SMV) and the ileum colon arteries and veins (ICA/ICV) were seen in all the 24 cases.There are four main types anatomic variation of gastrocolic trunk (Henle trunk),of which most often consisting of three branchs (type B),accounting for about 46％.The time of completely dissecting anatomical Henle trunk was significantly longer than that for the ileum colon vessels and the middle vessels dissection (P ＜ 0.05).Conclusion Preoperative MSCTA can clearly present anatomic variation of SMV/SMA and its branch,precisely navigate the laparoscopic right colon cancer CME surgery,reducing the incidence of intraoperative vascular complications and improving the quality of surgery.

FXYD6, FXYD domain containing ion transport regulator 6, has been reported to affect the activity of Na(+)/K(+)-ATPase and be associated with mental diseases. Here, we demonstrate that FXYD6 is up-regulated in hepatocellular carcinoma (HCC) and enhances the migration and proliferation of HCC cells. Up-regulation of FXYD6 not only positively correlates with the increase of Na(+)/K(+)-ATPase but also coordinates with the activation of its downstream Src-ERK signaling pathway. More importantly, blocking FXYD6 by its functional antibody significantly inhibits the growth potential of the xenografted HCC tumors in mice, indicating that FXYD6 represents a potential therapeutic target toward HCC. Altogether, our results establish a critical role of FXYD6 in HCC progression and suggest that the therapy targeting FXYD6 can benefit the clinical treatment toward HCC patients.
Animals ; Antibodies, Monoclonal ; pharmacology ; Antineoplastic Agents ; pharmacology ; Carcinoma, Hepatocellular ; drug therapy ; metabolism ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Female ; HEK293 Cells ; Humans ; Ion Channels ; antagonists & inhibitors ; metabolism ; Liver Neoplasms ; drug therapy ; metabolism ; Mice, Inbred BALB C ; Mice, Nude ; Sodium-Potassium-Exchanging ATPase ; metabolism ; Tumor Burden ; drug effects ; Xenograft Model Antitumor Assays

Objective To investigate the transmission of blaNDM-1 gene in carbapenem-resistant Citrobacter freundii. Methods A total of 18 strains of NDM-1-producing C. freundii were collected from the First Affiliated Hospital of Kunming Medical University during the period from June 2012 to October 2014. The isolates were identified and subjected to antimicrobial susceptibility testing with VITEK 2 System. Conjugation experiments, pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to determine the transferability of plasmids. Results The antibiotic susceptibility results showed that all the NDM-1-producing C. freundii isolates were resistant to penicillins, cephalosporins and carbapenems. All isolates exhibited different level resistance to other antibiotics. Conjugation experiments revealed that the plasmids harboring blaNDM-1 in 13 strains were transformed into E. coli 600, and exhibited carbapenem resistance. PFGE and Southern blot hybridization found that blaNDM-1 was located on a 33.3 kb plasmid in 16 isolates and on 33.3-54.7 kb plasmid in 2 isolates. Conclusions Our findings suggest that plasmids contribute to the horizontal dissemination of blaNDM-1 gene in carbapenemresistant C. freundii.

Objective To explore the clinical application of case teaching method combined with clinical pathway in pediatrics teaching.Methods 103 students in pediatric practice from September 2016 to September 2017 were enrolled as the study object,who were divided randomly into observation group (52 cases) and control group (51 cases).Routine teaching method was adopted in the control group,while case teaching method combined with clinical pathway was adopted in the observation group.In addition,100 cases of children in need of rescue were selected for each group and the students were divided into two or three in a group to participate in the rescue.If the student could complete the rescue with the assistance of supervisor,he will be considered as playing a leading role in rescue process.Otherwise,another supervisor would join to lead the rescue,and the student would assist by the side,who will be considered as playing an auxiliary role in rescue process.The results of examination,classroom participation,homework,the rescue performance and the satisfaction of teaching were compared between two groups.Results The scores of theoretical course,case analysis and skill operation in the observation group was significantly higher than that of the control group (P＜0.05).The scores of classroom attendance,classroom activity and homework quality in the observation group was significantly higher than that of the control group (P＜0.05).Success rate of rescue conducted by students in the observation group was significantly higher than that in the control group(P＜0.05).The teaching satisfaction of the observation group was also significantly higher than that of the control group (P＜0.05).Conclusion The application of case teaching method combined with clinical pathway teaching model in pediatrics teaching is effective and worthy of popularizing,which can obviously improve teaching quality,arouse students' interest in teaching process,and improve students' professional quality.

Objective To evaluate the change of clinicopathological features and prognosis of papillary thyroid cancer over a 15-year period.Methods The clinicopathological features and outcomes of papillary thyroid cancer patients were analyzed in three groups according to the time of diagnosis:group Ⅰ (1997-2001),group Ⅱ (2002-2006),and group Ⅲ (2007-2011).Results As time advanced,the average age of papillary thyroid cancer patients increased,tumor stage,like size,extrathyroid invasion and lymph node metastasis decreased dramatically (P ＜ 0.01).The percentage of multifocality and bilaterality increased.The long-term follow up data (median follow up time was 6.6 years),indicated that the 15-year over all survival was 97.8％ and the 15-year disease-free survival was 90.2％.Tumor ≥3 cm,bilaterality,extrathyroid invasion,lymph node metastasis and AJCC stage were correlated with tumor recurrence.By multivariate COX-regression analysis only lymph node metastasis and bilaterality were independent risk factors.Conclusion The clinicopathological features of papillary thyroid cancer changed over 15 years,with the percentage of early-staged patients increased.Lymph node metastasis and bilaterality are two risk factors for tumor recurrence.