Objective To evaluate the effect of preserving the intercostobrachial nerve(ICBN) during modified radical mastectomy for breast cancer.Methods Preservation of ICBN during modified radical mastectomy was performed in 100 patients with stage Ⅰ or stage Ⅱ breast carcinoma.All patients were followed up after operation.Results Ninty-one patients had normal sensation of the skin of upper arm on operated side,while medial side paresthesia of the upper arm occurred in 9 cases within the postoperative follow up period.Conclusions Preserving the intercostobrachial nerve in modified radical mastectomy for patients with breast cancer can decrease the incidence of abnormal sensation of the skin of affected upper arm,and improve the quality of life of patients after operation.

Objective To observe the relationship between impaired glucose regulation(IGR)and the degree of atherosclerosis(AS)on Lacunar Infact(LI)patients.Methods A total of 83 patients with LI confirmed by CT or MRI were collected and divided into 3 groups by their fasting blood glucose,and their medical history and physical examination,the fasting blood lipid,acidum uricum and INI profile were evaluated with an automatic biochemistry machine.By employing a high resolution B-mode ultrasonography the intimae smoothness,intimae-media thickness(IMT)and plaque(s)were observed in bilateral common carotid arteries.Results The hypertension history,smoke history,waistline body mass index(BMI)and the atherosclerosis were all more marked in subjects with IGR than those in NGT(all P

Objective　To observe the influence of intravenous anesthesia with ketamine or propofol on intraocular pressure (IOP) in pediatric patients. Methods　27 pediatric patients, ASA grade Ⅰ～Ⅱ, were divided into ketamine and propofol groups. Basic anesthesia was conducted with ketamine 4～6 mg*kg-1 combined droperidol 0.04～0.1 mg*kg-1 intramuscularly. Anesthesia maintained with continous infusion of 0.04% ketamine or 0.04% propofol following intravenous bolus of ketamine 1 mg*kg-1 or propofol 1 mg*kg-1 in ketamine group and propofol group respectively. IOP, systemic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) and pulse oxygen saturation(SpO2) were measured at 10 minutes after basic anesthesia, 3 minutes after intravenous bolus of ketamine or propofol and end of surgery. Results　There were no differences in IOP between two groups after basic anesthesia. IOP increased or decreased significantly after intravenous bolus of ketamine or propofol respectively. IOP in ketamine group decreased near to the level in propofol group at end of surgery. There were no statistic differences in SBP, DBP and HR between two groups priopration. SpO2 did not change (but in one patient decreasing to below 95% ) and significantly decreased within 5 minutes of intravenous bolus of ketamine and propofol respectively. Conclusion　Ketamine increases IOP propofol decreases IOP. Ketamine combined propofol can keep from increase of IOP but strength respiration inhibition.

Objective To investigate the protective effect of insulin glargine in myocardium of diabetic rats. Methods Male Wistar rats were randomly divided into normal control group (NC), diabetes mellitus group After 6 weeks, we weighed rats and calculated the heart body weight ratio (H/B), Immunohistochemical technique was used to estimate the expression of transforming growth factor beta 1 (TGF-β_1) and the type-Ⅲ collagen (collagen Ⅲ). Myocardial pathologic changes were observed under expression of TGF-β_1 and collagen Ⅲ of DM group and DI group were significantly higher than those in NC group (P<0.05); the levels of H/B and the expression of TGF-β_1 and collagen Ⅲ of DI group were lower than myofibrils were arranged disorderly, mitochondria increased, with swelling and degeneration, while the changes of myocardial ultrastructure were obviously lightened after treatment with insulin glargine. Conclusion Insulin glargine may partly suppress the increased expression of TGF-β_1 and collagen Ⅲ in myocardial of diabetic rats, and it may decrease significantly the myocardial injury of diabetic rats.

0.05). After operation about 50% cases (11/22) improved the menstrual dysfunction, and most cases avoid doing operation again in short period. Conclusion While cases chosen properly and adequate operative preparation, it is feasible and valuable to carry out cesarean section and myomectomy at the same time.

Objective To study the allocation and requirements of ICU nurses in the intemal medicine department of National Medical Emergency Rescue Team,and explore more reasonable ICU nurses allocation method.Methods 40 patients were randomly divided into the observation group and the control group with 20 cases in each group.The control group adopted even allocation method,while the observation group allocated nurses according to ICU nursing evaluation system.The nursing effect was compared between two groups.Results ICU nursing score between two groups showed no significant difference,but the ICU indwelling time of the observation group was shorter than that of the control group.Conclusions ICU nurses need higher comprehensive quality.ICU nursing evaluation system can facilitate the allocation of nurses.Better allocation and higher overall qualities of internal medicine ICU nurses can improve ICU treatment efficiency.

ObjectiveTo summarize the ultrasonic features of endometrial carcinoma in transvaginal color Doppler sonography (TVCDS), and to analyze the supplementary function of serum CA125and CA199in diagnosing endometrial carcinoma.MethodsFrom January 2006 to October 2012, fourteen thousand and twenty-seven women underwent TVCDS in GZ Women & Children Medical Centre, serum CA125 and CA199 were determined by chemiluminescence immunoassay. The ultrasound characteristics of 131 cases of endometrial carcinoma (including 64 cases of early-stage and 67 cases of advanced endometrial carcinoma) who were accurately diagnosed by pathology and the value of serum CA125 and CA199 were analyzed.ResultsIn groups 131 patients were accurately conifrmed by pathology, including 64 cases early-stage and 67 cases advanced carcinoma. The diagnositic coincidence of ultrasound and ultrasound combined with serum tumor markers was 56.3% (36/64) and 78.1% (50/64) respectively. On ultrasonography, 64 patients with early stage endometrial carcinoma showed uterine enlargement in 38 cases and endometrial thickening in 53 cases. In 9 cases, endometrial lesions were heterogeneously hypoechoic. In 55 cases, the halo between endometrium and muscle was interrupted and disappeared. In 56 cases, endometrial lesions had muscular layer inifltration. In 13 cases, endometrial lesions had cervical inifltration. In 61 cases, sparse punctuate or reticular flow signals were detected within lesions. In 3 cases, there was no blood flow signal in lesions. All these patients had not lymph node metastasis. Sixty-seven cases with advanced endometrial carcinoma showed more obviously uterine enlargement and significant endometrial thickening. In 61 patients, tumor spread outside the uterus. Reticular or dendritic flow signals were detected in 67 cases lesions. There were hypoechoic lymph node mestastasis in 53 cases. In 31 cases of early stage endometrial carcinoma, preoperative CA125 increased. In 27 cases of early stage endometrial carcinoma, preoperative CA199 increased. In 24 cases CA125 and CA199 increased meanwhile. In 61 cases of advanced endometrial carcinoma, preoperative CA125 increased. In 59 cases of advanced endometrial carcinoma, preoperative CA199 increased. In 56 cases CA125 and CA199 increased meanwhile. Sixty-four cases of early-stage endometrial carcinoma were diagnosed by TVCDS assisted with CA125 and CA199 and were confirmed by pathology. The detective rate was 78.1% (50/64). To compared with TVCDS, the difference was statistical signiifcance (χ2=6.95,P=0.01).ConclusionsThe ultrasonic features of early-stage endometrial carcinoma in TVCDS were uterine enlargement, endometrial thickening, heterogeneous hypoechoic endometrial lesions, interrupted or disappeared hypoechoic halo between endometrium and musclar layer, and sparse punctuate or reticular flow signals within lesions. Serum CA125 and CA199 may be helpful in improving diagnosis coincidence rate when early-stage endometrial cancer is ifnd or suspected on ultrasonography.

Objective To investigate the effect of exogenous apelin-13 on oxidative stress, myocardial inflammatory cytokines and apoptosis in diabetic model rats.Methods A total of 40 male Wistar rats were randomly divided into 2 groups: normal control group (NC, n=8) and experimental group (EX, n=32).Diabetes was induced by feeding with high-sugary and high-fat diet for 8 weeks and a single intraperitoneal injection of streptozotocin (STZ) (30 mg/kg).The wellestablished 28 diabetic model rats were then randomly divided into 2 subgroups: model group (DM, n =14) and apelin-13 administration group (AP, n =14).The rats in AP group were given intraperitoneal administration of apelin-13 at a single dose of 0.1 μtmol · kg-1 · d-1 for 10 weeks, while NC group and DM group were given 0.9％ NaCl in the same way.All rats were sacrificed at the end of the week 10.Blood hydrogen peroxide (H2O2), nitric oxide (NO) and malonaldehyde (MDA) were measured by colorimetry, and superoxide dismutase (SOD) was measured by enzyme-linked immunosorbent assay (ELISA).The expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in rat myocardium were detected by immunohistochemistry.Masson staining was used to observe the myocardial fibrosis in rats of different groups.Cardiomyocyte apoptosis was determined by TUNEL.Results (1) Compared with NC groups, DM group showed that MDA, H2O2 and NO were significantly increased, while SOD was significantly decreased (F=22.400, 6.230, 4.267 and 8.901, all P＜0.0167).There was a statistically significant difference in the levels of MDA, H2O2,SOD between DM group and AP group.(2) The expression of TNF-α and IL-6 was significantly higher inDMgroup than inNCgroup (0.0599±0.0208 vs.0.0076±0.0031, F=35.139;0.0503±0.0243 vs.0.0071± 0.0024, F=15.946, both P＜0.0167).After 10 weeks of apelin-13 administration, the levels of inflammatory cytokines were significantly decreased in AP group than in DM group.(3) The myocardial apoptosis and fibrosis were significantly increased in DM group than in NCgroup [0.0293±0.0061 vs.0.0030-t-0.0013 and 0.0708±0.0420 vs.0.0013±0.0003, F=84.930 and 19.420, both P＜0.0167].The myocardial apoptosis and fibrosis were significantly decreased in AP group than in DM group (both P＜0.0167).Conclusions To some extent, apelin13 reduces the levels of oxidative stress and myocardial inflammation reaction in type 2 diabetes.Moreover, it may play a vital role in the improvement of myocardial apoptosis and fibrosis.

Objective To evaluate out-patient individual health education prescription by diabetes nurse specialist on related knowledge of type-2 diabetes mellitus and blood glucose.Then combined with patient satisfaction surveys to explore the intervention value of out-patient individual health education prescription.Methods 100 out-patients with type-2 diabetes mellitus were chosen,and gave them individual health education prescription by evaluate individual condition and existing problems with previous treatment protocol unchanged,the prescription content included individual condition,diet,exercise,medication instructions and disease condition monitoring.The grasp of related knowledge of type-2 diabetes mellitus and satisfaction degree with diabetes nurse specialist were investigated by questionnaires.Results 3 months after individual health education,The grasp of related knowledge of type-2 diabetes mellitus,blood glucose and 2 hours' postprandial blood glucose greatly alleviated.Total satisfaction degree of patients reached 94%.Conclusions Paying attention to individualized instruction and out-patient individual health prescription in prevention and treatment of type-2 diabetes mellitus accords with humanization of nursing service,and is a powerful measure to improve health education quality.

Crude glycosaminoglycan(CPG) from the whole viscera of Pinctada martensii was isolated with the two-enzyme hydrolysis and purified by the chromatograph.And the antitumor activity was studied with MTT colormetric assay. The CPG could be separated into two fractions(GAG-1, GAG-2) by the DEAE-52-cellulose ion exchange chromatograph. The contents of hexosamine of CPG,GAG-1, GAG-2 were 54.6%,50.0%,35.4%,respectively. The sulfate of GAG-2 was 13.8%. The inhibiting rates of CPG, GAG-1 and GAG-2 to HL-60 cells were 54.6%, 50.0% and 35.4%,respectively. The inhibition to HL-60 of 5-Fu could be increased by combined use with CPG, GAG-1 and GAG-2, GAG-1 was the main active fraction.