Objective To explore the procedures of breast repair and reconstruction after mastectomy with three methods for optimal appearances of the breast.Methods Three methods were adopted in this study:(1)Two-stage breast reconstruction operation with ampliate latissimus dorsi myocutaneous flap after mastectomy;(2)One stage breast reconstruction operation with transverse rectus adbominis myocutaneous(TRAM)flap after mastectomy;and(3)Two-stage breast reconstruction and nipple repair operation with tissue expander/implant after mastectomy preserving pectoralis major museulus or implants along under pectoralis major musculus.Results All of the flaps survived well and were well-shaped in total 10 patients(10 breasts)with a flap breast reconstruetion,in which the superior ratios were 83.33%.The appearance and volume were not satisfactory in 1 patiant treated with the method of tissue expander/implant,because the volume of tissue inflation was smaller than another one and 100 ml implant was applied.The partial flap necrosis occurred in 1 case with the method of TRAM flap.Conclusions With the development of plastic surgery technique,the appearances and shapes of reconstructed breast achieve the satisfactory effects.After the ampliate latissimus dorsi myocutaneous flap is applied,the appearance and volume of reconstructed breast are similar to the healthy one.The two-stage nipple repair operation is applied with breast reconstruction operation by the tissue expander/implant after mastectomy preserving pectoralis major musculus.According to the different methods of mastectomy to choose suitable procedures of breast reconstruction,the satisfactory appearances and psychotherapy will be achieved.

Objectives To evaluate the methodology of preoperative diagnosis for Mirizzi syndrome. Methods Fifteen cases of Mirizzi syndrome were retrospectively investigated. The data of semeiology and imaging including B-type ultrasound, endoscopic retrograde cholangiopancreatography (ERCP) and MR cholangiopancreatography (MRCP) were compared with each other and analyzed. Results Preoperative data were consistent with and suggestive of Mirizzi syndrome in 93% (14/15) of cases, and in 67% (10/15) of cases, respectively. Conclusions Preoperative B-type ultrasound is the primary examination. ERCP and MRCP further elevate preoperative definite diagnosis. In patients with preoperative tentative diagnosis of Mirizzi syndrome, jaundice lasting for more than 7 week is suggestive of cholecystocholedochal fistula.

Our objective is to prevent doctors and nurses who worked on SARS ward from contracting this highly communicable disease through observing strict isolation strategies. The following measures have been taken in our hospitals. The wards for SARS patients were remodeled according to the isolation requirements for infectious diseases. They were separated into three quarters, namely clean area, semi-contamination area and contamination area. Two buffer zones were set up to separate the three quarters. Four specific passages were separately allotted to health care staffs, patients, soiled materials disposal and handling and dispatch of specimens, to avoid cross infection by contact. According to the criteria for isolation of serial A respiratory infectious diseases, every health care worker was strictly requested to wear and take off isolation garments properly when they entered and left the ward. Most importantly, specific garbs for different areas were essential for efficient isolation. Respiratory tract, skin and mucous surfaces should be effectively protected on the ward. In addition, doctors and nurses should wear special masks or helmets and waterproof suit during the performance of intubation, CPR or operation. Direction of air flow in SARS ward was diverted away from the clean area by using ventilator in order to prevent air-borne contamination. The air outlet of SARS ward was efficiently filtered to cut down pollution of the environment. Living quarters of medical staff working on SARS ward were isolated with a safe distance from the ward. Their health condition was closely monitored daily. After working in SARS ward for four weeks, they should enjoy a special vacation to assure their good health condition. In the past spring, 882 SARS patients were admitted to both the 309 hospital and Xiao Tanghan hospital. 1 632 health care workers worked for those SARS paitents by turns. To our satisfaction, none of our staffs was infected by SARS. Our experiences indicated that health care workers on the SARS ward could be effectively protected from contracting SARS infection by taking efficient and strictly observed protective measures.

Objective The purpose of the present study was to examine the reliability and validity of the Chinese version of the impulsive-premeditated aggression scale (IPAS) in a sample of Chinese adolescents with aggression. Methods 126 adolescents completed the IPAS,Barratt impulsive scale and self-report questionnaires. In order to assess test-retest reliability, the IPAS was re-administered to 30 participants 3 weeks later.Results Item analysis showed that IPAS had satisfactory item discrimination, 6 items were excluded in the later analysis. The internal consistency of the IPAS Cronbach alpha was 0.77 and the test-retest reliability was 0.74.Exploratory factor analysis demonstrated two stable factors of aggression with good internal consistency and construct validity, the value of KMO was 0.646, the χ2 value of Bartlett test was 691.93 ( P <0.001). The confirmatory factor analysis showed that the value of χ2/df,GFI,AGFI,RMSEA were 1.42,0.874,0.837 and 0.058 respectively.The whole scale and the two secondly scales all correlated with BIS-11 and MOAS.Conclusion The results of the current study indicate that the Chinese version of the IPAS is a useful tool to subtyping aggressive behavior among adolescents, but it still need to be modified to apply in China.

Objective To study the treatment method of giant neurofibromatosis on body surface.Methods Replantation of the tumor skin,full-thickenss skin grafting and transferring of expanded flap were used to reconstruct the appearance and function after the excision of giant neurofibroma.Results Sixteen cases gained primary healing while other 2 cases with delayed healing after onestage or fractionated resection of giant neurofibroma on body surface.All the 18 patients resumed selfcare and working ability.Conclusions Giant neurofibromatosis has significant damage to the appearance and body shape and also greatly limits the patient's life and work.Patients can resume physical and psychological rehabilitation by surgical resection and plastic surgery treatment.

Objective To evaluate four tumor markers of insulin-like growth factor 1((IGF-1), CEA, cytokeratin fragment antigen 21-1 (CYFRA21-1), neuron-specific enolase (NSE) for the diagnosis and prediction of treatment response in human lung cancer. Methods Serum samples were taken from three groups: 91 patients with lung cancer, 30 healthy adults and 15 patients with benign pulmonary diseases. Serum IGF-1 was assayed by radioimmunoassay and CEA, CYFRA21-1, and NSE by electrochemiluminescence immunoassay. The differences among the three groups were determined by Kruskal-Wallis one-way analysis of variance (ANOVA) and with Mann-Whitney rank-sum test. Diagnostic efficacy was evaluated by ROC curves. Results The four serum tumor marker levels were significantly higher in lung cancer group, as compared with the benign and the healthy (IGF-1:χ2=26.95,P<0.001, CEA:χ2=49.11,P<0.001; CYFRA21-1:χ2=40.63,P<0.001; NSE:χ2=14.76;P<0.001). The diagnostic sensitivities of IGF-1, CEA, CYFRA21-1 and NSE was 75.6% (34/45), 53.3% (24/45), 66.7% (30/45) and 42.2% (19/45) respectively for lung cancer. The diagnostic sensitivity of IGF-1 combined with CYFRA21-1 was 95.5 %( 43/45) and that of IGF-1 combined with CEA and CYFRA21-1was 97.8%(44/45). Only IGF-1 and CYFRA21-1 showed significant changes before and after treatment (IGF-1: χ2=5.99,P=0.014; CYFRA21-1:χ2=4.99, P=0.025) in cancer group. Conclusions Serum IGF-1, CEA, CYFRA21-1 and NSE are all valuable for lung cancer diagnosis and the combination of those parameters can enhance the diagnostic efficiency. Serum IGF-1 and CYFRA21-1 may also be useful for evaluating the treatment response in lung cancer.

Objective To detect the serum level of complement 1q (C1q) and anti-C1q autoantibodies (C1qAb) in systemic lupus erythematosus (SLE) patients to analyze the correlation of serum level of C1q and C1qAb with renal lesion and disease activity in SLE. Methods The serum level of C1q and C1qAb were detected by single radial lmnmnodiffusion and enzyme-linked immunosorbent assay respectively. Results The serum level of C1q in SLE patients was significantly lower than that of the control groups. The serum level of C1qAb in SLE patients was significantly higher than that of the control groups. There was a strong correlation between the serum level of C1q and C1qAb in SLE patients. SLE patients in flare stage showed a significantly higher level of serum C1qAb and a lower level of serum C1q than stable patients. Lupus nephritis(LN) patients showed a significantly higher level of serum C1qAb and a lower level of serum C1q than non-LN patients. Conclusions Low level of serum C1q and the high level of serum C1qAb are correlated with SLE. The serum level of C1q and C1qAb are significantly correlated with renal lesion and disease activity of SLE patients.

The biological effects mediated by vitamin D and vitamin D receptor (VDR) are involved in the regulation of multiple pathophysiologic processes,including calcium phosphorus metabolism,immune regulation,anti-inflammation,anti-infection and cancer prevention,etc.Autophagy is a eukaryotic cell lysosome-mediated catabolic pathway,which is classified into 3 different types:macroautophagy,microautophagy,and chaperone-mediated autophagy.Since autophagy is vital to maintain energy and metabolism in cells,autophagy dysfunction is closely associated with various pathological processes such as inflammation,infection and tumor.Studies have shown that vitamin D/VDR can affect the different stages of autophagy and regulate inflammation in autophagy.Moreover,vitamin D/VDR and autophagy play an important role in autoimmune disease,diabetes,cardiovascular disease,cancer and other inflammatory diseases.

Objective To observe the expressions ofα-catulin and E-cadherin in tongue squamous cell carcinoma (TSCC)tissue, and to explore their relationship with the occurrence and development of TSCC.Methods The expressions ofα-catulin and E-cadherin in 55 cases of TSCC tissue and 10 cases of normal tongue tissue were examined by immunohistochemistry SP method. The relationship between the expressions and the clinicopathological characteristics and the relevance of the expressions ofα-catulin and E-cadherin in TSCC tissue were analyzed.Results The positive expression rates ofα-catulin in TSCC tissue and normal tongue tissue were 69.09% and 20.00%,respectively,and there was difference between them (P<0.01).The expression ofα-catulin was correlated to the histological differentiation,clinical stage and lymph node metastases of TSCC (P<0.05).The positive expression rates of E-cadherin in TSCC tissue and normal tongue tissue were 38.18% and 80.00%,respectively, and there was significant difference between them (P< 0.01 ). The expression of E-cadherin was correlated to the clinical stage and lymph node metastases of TSCC (P<0.05 ). There was a negative correlation between the expressions ofα-catulin and E-cadherin in TSCC tissue (r=-0.466,P<0.01). Conclusion The expressions ofα-catulin and E-cadherin may be associated with the occurrence and development of TSCC,and they could be used as the parameters which predict the malignant degree and prognosis of TSCC.

Objective To explore the influence of Akt inhibitor MK2206 in the proliferation and apoptosis of tongue squamous cell carcinoma TCA-8113 cells,and to clarify the possible mechanism.Methods The tongue squamous carcinoma TCA-8113 cells at the logarithmic phase were randomly divided into control group and 1,5,25,125, 250 nmol·L-1 MK2206 groups.The inhibitory rate of proliferation of TCA-8113 cells was detected with MTT method,and the apoptotic rate of TCA-8113 cells was determined with flow cytometry(FCM),and the expressions of caspase-9,Bad,GSK-3β,p-Akt and T-Akt proteins in the TCA-8113 cells were detected with Western blotting method.Results The IC50 of tongue squamous cell carcinoma TCA-8113 cells after treated with MK2206 for 12, 24,and 36 h were (112.54±1.67),(79.67±2.01),and (33.33±1.98)nmol·L-1 .The FCM results showed that the apoptotic rates of TCA-8113 cells after treated with 1,5,25,125,and 250 nmol·L-1 MK2206 for 12 h were (14.2±0.74)%,(19.3±0.45)%,(35.1±0.45)%,(39.6±0.48)% and (52.1±0.19)%;there were significant differences compared with control group(P<0.01).The Western blotting method results showed that the expressions of p-Akt, Bad and GSK-3βwere decreased with the increasing of dose and time of MK2206;compared with theβ-actin in control group,the bands got darken;the expression level of caspase-9 was increased, compared with theβ-actin in control group, the bands got darken;the T-Akt protein expression did not change significantly;compared with the β-actin in control group, the color of bands had no significant difference.Conclusion Akt inhibitor MK2206 can inhibit the proliferation of tongue squamous cell carcinoma TCA-8113 cells and induce apoptosis.