Objective To investigate the breast cancer neoadjuvant chemotherapy for clinical applica-tion.Methods Given suitable breast cancer patients anthracycline-based combination chemotherapy, 2 ～ 4 cy-cle after the surgery were observed to assess their clinical efficacy and conform to conditions and are compatible with the same period did not receive neoadjuvant chemotherapy for a comparative analysis of cases.Results Ac-ceptance of neoadjuvant chemotherapy group of cases the total effective rate was 89.47%, 1-year and 3-year over-all survival rate significantly improved, 17 cases due to neoadjuvant chemotherapy benefit received axillary lymph node dissection to narrow the scope of the modified radical mastectomy for breast cancer, five cases of implemen-tation of the breast retain on the radical operation of breast cancer.Conclusions Neoadjuvant chemotherapy can effectively reduce the clinical stage of breast cancer, some patients benefit from breast-implementation, such as radical mastectomy or surgery to narrow the scope, postoperative survival and prognosis of breast cancer is there-fore improved.

Objective To study the gene expression of Wnt signal transduction pathway in experimental liver fibrosis and to investigate its role in liver fibrosis. Methods Liver fibrosis model was induced with carbon tetrachloride in 8 SD rats. Another 8 healthy rats were served as control. The gene expression in liver tissues of models and controls were examined using real time PCR array. The differential gene expression was identified as either up- or down-regulated 2-fold. The expressions of smooth muscle actin (SMA), Wnt4, Frizzled2 and β-catenin in the tissues were examined by immunohistochemistry and Western blot. Results The examination confirmed that 36 genes were differentially expressed, including 25 genes up-regulated and 11 genes down-regulated. Compared with the controls, the expressions of Wnt4, Wnt5 a and W nt11 were up-regulated more than 13.9-, 16.5-and 2.17-fold respectively, while the expressions of Wntl and Wnt3 were down-regulated more than 2.32- and 2.15-fold respectively in fibrotic liver. Immunohistochemistry and Western blot showed that the expressions of SMA, Wnt4 and Frizzled2 in fibrotic liver were remarkably higher than those in normal controls. While the level of phosphorylated β-catenin was decreased. Conclusion Both canonical and noncanonical Wnt signal transduction pathway may involve in the mechanism of liver fibrogenesis.

Objective To assess the value of tomographic ultrasound imaging (TUI) for prenatal analysis of the relative orientation of fetal heart and great arteries. Methods Volume datasets acquired from 12 patients of transposition of the great arteries (TGA) and 13 normal fetal heart were evaluated offline with TUI. The aortic valves (AV) and pulmonary valves (PV) were respectively showed on the two parallel slices. According to the pivot point in the middle of the PV in one slice, the relative orientation of the AV on another slices were analyzed. Results In the 12 patients of TGA confirmed postnatally, 7 were concomitant with single ventricle anomaly, AV was on the anterior-right orientation of the PV in 5, and was relatively on the anterior and anterior-left orientation in other 2 of them.In the remained 5 with seeming normal 4 chamber view, AV was found on the anterior-right of the PV in 3, and was relatively on the anterior and upright orientation.in other 2 patients. In 13 normal fetuses, TUI showed that all AV located on the posterior-right orientation to the PV. Conclusion TUI can provide detailed spatial information of the great arteries both in normal and abnormal fetal heart. It may be a convenient and veracious tool for prenatal exploring the morphology of the great arteries.

Objective To investigate the clinical,neuroradiologic characteristics and possible causes in 3 patients with combined developmental venous anomalies (DVAs) and cerebral cavernous malformations (CCM).Methods The clinical examination,magnetic resonance imaging (MRI) T1-weighted (T1 WI),T2-weighted (T2WI),susceptibility-weighted imaging (SWI) or T2 fast field echo (T2 FFE),contrast-enhanced MRI at 1.5 T field strength and digital substrate angiography were performed in 3 patients.Results Three patients presented with the seizure,vertigo,and dizziness respectively.MRI findings of reticulated “popcorn like” lesion with complete hemosiden rim showed typical sign of CCM.DSA,contrast-enhanced MRI and MRI-SWI revealed the caput medusae of the medullary veins and collected veins which was drained into subcortical and deep venous system,which indicated DVAs in 3 patients.The angulated medullary veins and collected veins in approaching distal zone of CCM were observed.Conclusion DVAs can be combined with CCM.The angulated medullary veins and collected veins combined with CCM in same territory reveals that the angioarchitectural factors is a key factor in pathogenesis of cavernous malformation.

Objective To investigate the effect of lacosamide on expression of Nav1 .8 in dorsal root ganglia (DRG) in a rat model of chronic neuropathic pain.Methods Thirty-six female specific-pathogen-free (SPF)SD rats were randomly assigned into 3 groups ( n = 12 each): sham operation group (group S), model group (group M) and lacosamide group (group L) . Chronic neuropathic pain was produced by insertion of a small stainless steel rod (4.00 mm in length and 0.63 mm in diameter) into the L, intervertebral foramen in the rat, producing a chronic steady compression of the DRG in M and L groups. The mechanical threshold was measured 2 days before operation and on the 2, 4, 6, 7, 8, 9 and 10 days after operation (T0-7 ) . Intraperitoneal lacosamide 20mg/kg (in normal saline 0.5 ml) was injected at T4-7, twice a day in S and L groups. In group M, normal saline 0.5 ml was injected at T4-7 twice a day and the mechanical threshold was measured after the last administration everyday . The L, DRG on the operated side was removed after measurement of pain threshold to detect the expression of Na, 1.8 mRNA and protein by RT-PCR and immuno-histochemistry respectively. Results Compared with group S, the mechanical pain threshold was significantly decreased at T1-7 and the expression of Navl .8 mRNA and protein was up-regulated in M and L groups ( P < 0.05) . Compared with group M, the mechanical pain threshold was significantly increased at T4-7 and the expression of Nav 1.8 mRNA and protein was down-regulated in group L ( P < 0.05) . Conclusion The mechanism by which lacosamide reduces chronic neuropathic pain is related to the down-regulation of the expression of Nav 1.8 in rat DRG.

Objective To evaluate the value of tomographic ultrasound imaging(TUI)in the fetal heart screening.Methods One hundred and ten volume datasets acquired from normal fetal heart in the second trimester with spatio-temporal image correlation(STIC) were evaluated offline with TUI. The Bmode and CDFI static images as well as the dynamic loops of one cardiac eycle could be reviewed simultaneously. The visualizing rate and ultrasonic scores of the 4 chamber view,outflow tracts and 3 vessels (and trachea)view obtained from TUI and routine ultrasonography for fetal heart screening were respectively compared. Results Among all 110 cases,the visualizing rate of 4 chamber view,outflow tracts and 3 vessels(and trachea) view were respectively 100%(67),88.9%(45),80.0%(45),84.4%(32)in Bmode and 100%(33),86.2%(25),50.0%(14),100%(4)in CDFI under the same fetal Dositi.n.No significant differences of the visualization rate were found between TUI and routine screening either in Bmode or in CDFI(P＞0.05). The median score of 4 chamber view of TUI in B-mode was little higher than that in routine screening,while the right outflow tract of screening in CDFI significantly higher than that of TUI(P＜0.05). Conclusions The visualizing rates and qualities of TUI are sufficient for fetal heart screening offline as well as routine ultrasonography online in second trimester.

Objective To observe the effect of electroacupuncture(EA) in combination with small dose of clozapine on clinical symptoms of refractory schizophrenia patients so as to evaluate its validity and security.Methods Eighty schizophrenia patients were randomized into medication group and EA+medication group(n=40/group).Patients of medication group were treated with conventional oral administration of clozapine(50-100 mg/d to 200-500 mg/d,for 8 weeks) and those of EA+ medication group treated by EA of Baihui(GV 20) and bilateral Taiyang(EX-HN 5) and oral administration of clozapine(50 mg/d to 100-150 mg/d).EA was given to the patients,3 times a week for 8 weeks.Scores of the Positive and Negative Symptom Scale(PANSS) and the Untoward Effect Symptom Scale(TESS) were used to assess the therapeutic effect.Results Following treatment,PANSS scores for positive symptoms and the common psychiatric symptoms of the medication and EA+medication groups all decreased evidently from the 2rd week on(P0.05).But TESS score of EA+medication group was evidently lower than that of medication group(P

Objective To investigate effect of low molecular weight heparin (LMWH)on oxidative stress and renal function in elderly patients undergoing gastrectomy of stomach neoplasms. Methods 90 elderly patients undergoing radical surgery were randomly divided into LMWH group (Ⅰ group,n=45)and control group (Ⅱ group,n=45). Patients inⅠ group received a subcutaneous injection of LMWH(100 u/kg,1/d)from the time before anesthesia induction to postoperative 5 days,and patients in Ⅱ group were given equal volume of saline. Venous blood samples were collected to determine level of malondialdehyde(MDA),aldose reductase(AR)activity level,superoxide dismutase(SOD)activity level,catalase (CAT)activity level,creatinine(Cr)and blood urea nitrogen(BUN)before anesthesia induction(T0 ),at the end of the surgery(T1 ),on postoperative 1 day(T2),3 days(T3)and 5 days(T4)respectively;urine specimen were also collected to measured albumin(Alb)and N-acetyl-beta-D-amino glycosidase enzymes(NAG)at the same time points. Results There were obvious statistical differences in MDA,AR,SOD and CAT at different time points by intra-group comparison (P<0.05 ). MDA and AR rose first and then fell in two groups,and both reached the peak at T2 ,whereas SOD and CAT had the opposite trends. There were obvious statistical differences in MDA,AR,SOD and CAT at T1 ~T3 (P<0.05 ). MDA and AR inⅠgroup at T1 ,T2 and T3 was lower than those in groupⅡ(P<0.05 ),whereas SOD and CAT inⅠgroup at T1 ,T2 and T3 were significantly higher than those in group Ⅱ(P<0.05). Cr and BUN of both groups were found no significant statistical difference within the group and between groups(P>0.05).Alb/Cr of both groups at T1 and T2 were significantly higher than those at T0 (P<0.05 ),while Alb/Cr in Ⅰ group at T1 was obviously lower than Ⅱgroup(P<0.05 ).NAG/Cr in both groups at T1 ,T2 and T3 were significantly higher than those at T0 (P<0.05 ),while NAG/Cr inⅡ group at T4 was still higher than that at T0 (P<0.05 ),and NAG/Cr inⅠgroup at T1 ~T4 was obviously lower thanⅡgroup (P<0.05 ). MDA and AR in both groups at T1 ,T2 were positively correlated with Alb/Cr and NAG/Cr respectively(P<0.05 ),whereas SOD and CAT in both groups at T1 ,T2 were negatively correlated with Alb/Cr and NAG/Cr respectively(P<0.05 ). Conclusion Oxidative stress reaction resulted from radical surgery of elderly patients is associated with perioperative renal damage. LMWH could reduce oxidative stress in elderly patients,and alleviate the kidney damage,as well as protect the renal function.

PurposeSpinal cord is one of the most frequently involved sites of multiple sclerosis (MS), which seriously affects the life quality of patients. In this paper, we investigate the application value of voxel-based morphology (VBM) and resting-state magnetic resonance imaging (RS-fMRI) in multiple sclerosis patients with single spinal cord involvement (MS-SSCI).Materials and Methods Three-dimensional T1WI data and RS-fMRI data were acquired from 20 patients with MS-SSCI and 20 normal controls, grey matter volume (GMV), changes of white matter volume (WMV), total intracranial volume (TIV) and local nuclei volume were compared between the two groups using VBM, posterior cingulate cortex (PCC) was regarded as the seed point and the functional connectivity about whole brain was compared between the two groups by using resting-state functional connectivity analysis, the relationships between MS-SSCI structure, function change parameters and expanded disability states scale (EDSS) scores were further explored.Results①Compared with the control group, GMV, WMV, TIV of MS-SSCI group were not significantly reduced, only the volume of some regions (bilateral middle temporal gyrus, left inferior temporal gyrus) showed significant atrophy (P<0.01); MS-SSCI exhibited increased functional connectivity (FC) in the left medial prefrontal cortex, left inferior temporal gyrus, left caudate nucleus and right supplementary motor area (two-sample t test, after AlphaSim correction,P<0.01, voxel size >40).②There was no significant correlation (P>0.05) between MS-SSCI structure change parameters and EDSS; while a significant correlation between EDSS scores and FC was noted in the left inferior temporal gyrus (r=0.633,P<0.05).Conclusion Both structural abnormalities and altered FC with PCC can be detected in MS-SSCI, but only functional parameters are associated with clinical abnormalities, which are more sensitive than microstructural changes.

Objective To estimate blood lead level of children in Jinchang city of Gansu province.Methods According to relevant request,256 children(male 133,female 123) aged 2-7 years from some kindergartens in Jinchang city were randornly selected from Oct. 2004 to Jun. 2005. Blood lead level was measured by atom-absorbing graphiteingle method.Results The average blood lead level of 256 children was(126.30?52.98)?g/L.The lowest blood lead level was 28.3 ?g/L while the highest was 268.0 ?g/L.And 160 children(62.54%) were found with a blood lead level ≥100 ?g/L(the diagnostic level of lead poisoning in children).The blood lead level became higher with the increase of children′s age,as groups aged 2-3 years group were lower than aged 5-6 years and 6-7 years groups,of which the differenes had statistical significance(P0.05).Conclusion Blood lead levels of children in Jinchang city and prevalence of lead poisoning are both relatively higher,to which enough attention shall be paid.