ObjectiveTo evaluate the potential prognostic factors, and to better define appropriate treatment strategies for patients with phyllodes tumor of the breast. MethodsFourteen patients treated primarily for phyllodes tumor of the breast were reviewed retrospectively.Results The median age was 35 years. According to the histologic criteria of WHO, there were 5 benign cases(36%), 5 borderline cases(36%), and 4 malignant cases(29%). Seven patients underwent local excision, 4 cases did simple mastectomy, and 3 cases did modified radical mastectomy. Follow-up was obtained for 11 cases, with an average of 19 months. One patient died from metastasis 2 years after a modified radical mastectomy. Three patients treated by local excision presented local recurrence.Conclusion The outcome of phyllodes tumor appears to be determined by the biology of the tumor rather than by treatment modality. A wide local excision, with an adequate margin of normal breast tissue is the preferred initial therapy for phyllodes tumor of the breast.

AIM: To investigate the relation between the changes of the cerebral microvasculature and the expression of plasminogen activator inhibitor-1 (PAI-1) in ischemic focal and perifocal areas after 2 hours focal cerebral ischemia with reperfusion in rats. METHODS: The changes of cerebral microvascular structure were observed by optical microscope and electric microscope, the expression of PAI-1 were assessed by immunohistochemical staining, Western blotting in ischemic focus and perifocal areas after focal cerebral ischemia with reperfusion. RESULTS: The edema of extra-cellular matrix and the hemorrhage of extravessels in ischemic focus and perifocal areas were most severe, and degradation and the defect of basement membrane were also observed after 6 hours and 3 days reperfusion following focal cerebral ischemia. The expression of PAI-1 decreased significantly compared with control group (P

Objective To observe the effects of cyclovirobuxinum D(Cvb-D)on the myocardium cell apoptosis of myocardial ischemia rats.Methods The rats were given Cvb-D 0.55,1.1 and 2.2 mg/kg orally per day for 21 days respectively.The myocardial ischemia model was induced by isoprenaline intraperitoneal injection.Myocardium tissue was observed under light microscope and end labelling TUNEL method was used to determine the cell apoptosis.Then the average percentage of apoptosis cell was figured out to evaluate the effect of Cyb-D.Results Cvb-D obviously lightened isoprenaline-induced myocardial pathological changes such as turbulence of myocardial fiber,plasmolysis of necrotic cell,inflammatory cell infiltration of necrotic interstitial region.Cvb-D remarkably inhibited myocardium cell apoptosis of myocardial ischemia rats caused by isoprenaline.Conclusion Cvb-D has the action of ameliorating myocardium cell apoptosis caused by myocardial ischemia.

0.05 compared with group B);ZT and Youjiangtang Tablets had similar effect in promoting the synthesis of hepatic glucose and the release of serum insulin(P

Cryptorchidism is one of the most common congenital malformations in the urogenital system of boys.It can be an isolated disease,and may also be combined with other congenital malformations.It is a risk factor for testicular cancer and male infertility.Orchidopexy is the main treatment method.Although undergo early orchidopexy is becoming more common,there are still some infertility after adulthood.In this review,long-term appearance of the scrotum,fertility and malignancy after operation are reviewed.

AIM: To explore the structural changes of brain microvasculature and mechanism in microvascular lesion after focal cerebral ischemia with reperfusion. METHODS: Using the techniques of immunohistochemical staining, in situ hybridization,optical microscopy and transmission electron microscopy, the expression of uPA, uPA mRNA, and changes in miocrovascular structure were examined in ischemic focus and perifocal areas after focal cerebral ischemia 2 hours with various time points of reperfusion in stroke-prone renovascular hypertensive rats (RHRSP). RESULTS: The brain edema and hemorrhage were severe 12 hours to 3 days after reperfusion. Ultrastructural change showed that the damage characterizations of the basement membrane were degradation, defection, and exfoliated of basement membrane, while uPA, which attack the basememt membrane around cerebral capillaries and extra-cellular matrix, and uPA mRNA expression increased significantly in ischemic and perifocal areas 12 hour to 3 day after reperfusion. CONCLUSION: The main pathologic mechanism of brain edema and hemorrhage after cerebral ischemia with reperfusion may result from the basement membrane lesion of brain microvasculature. The increase in the expression of uPA in reperfusion area may be the main cause of the basement membrane lesion .

Objective To investigate the effects of dilute concentration and acting time of pronase on quality of gastroscopy.Methods A total of 448 patients were randomly divided into two groups : sodium bicarbonate group and pronase with sodium bicarbonate group.Pronase was diluted into 50 ml (400 U/ml)and 100 ml (200 U/ml) using sodium bicarbonate.The patients were pretreated by pronase of different concentrations 10 min, 20 min, 30 min, 60 min and 120 min before gastroscopy.Diluent of same quantity were taken by the control group.Visibility of gastroscopy, procedure times and positive rates of lesions were compared.Results Pretreatment of pronase significantly improved visibility of gastroscopy, raised positive rates of lesions, and reduced procedure times of gastroscopy, compared with the control group (each P ＜ 0.05).The visibility of gastroscopy were over 80％ 20,30, and 60 minutes before the examination with no significant difference(P ＞ 0.05).The visibility of gastroscopy decreased sharply 30 minutes after taking pronase, especially after 60 minutes.There was no significant difference in the quality of gastroscopy between the 200 U/ml and 400 U/ml group 20-60 minutes before gastroscopy (P =0.640).Conclusion Pronase (200 U/ml-400 U/ml) significantly improves visibility of gastroscopy, raises positive detection rates of lesions, and reduces procedure time of gastroscopy 20-60 minutes before pretreatment.

Objective To discuss the application of microsurgery in the treatment of male infertility.Methods From March 2007 to March 2012,there were totally 853 infertile men received microsurgical treatments in our department.Among them,344 patients with unilateral or bilateral varicocele underwent microsurgical varicocelectomy,60 underwent vasovasostomy (VV) and 192 underwent vastoepidystomy (VE)in microsurgical methods due to obstructive azoospermia.257 non-obstructive azoospermia (NOA) patients were performed microdissection of testicular sperm extraction (MD-TESE),at the same time,pathologic examination was done.Results ①For the varicocele patients,the pre-operative sperm density was (10 ±6) × 106/ml,the progressive sperm percentage was (16 ± 9)％.The post-operative density was (15 ± 8) ×106/ml,the progressive sperm percentage was (28 ± 14)％.The natural pregnant rate was 10.8％ (37/344).②In 60 patients undergone VV,the patent rate was 80.0％ (48/60),the natural pregnant rate was 35.0％ (21/60).In 192 VE patients,the patent rate was 53.1％ (102/192),the natural pregnant rate was 19.8％ (38/192).③In 257 NOA patients,the testicular volume,sperm retrieval rate of MD-TESE was significantly higher than that of conventional testicular sperm extraction (60.3％ vs.38.1％).Conclusion The microsurgery techniques in male infertility treatments could have some advantages such as explicit effects and decreased injuries.

Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer. Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer.

Objective To retrospectively summarize the diagnosis and treatment experience of acute renal failure caused by urinary calculi obstruction in infants under the age of 6 months in order to improve the level of treat-ment. Methods Between January 2010 and December 2014,15 infants under the age of 6 months with bilateral urinary tract calculi obstruction leading to acute renal failure were treated in West China Hospital,Sichuan University. All cases were Tibetan(10 males,5 females). The ages ranged from 1 month 15 days to 5 months 24 days. The weights ranged from 3. 5 to 7. 0 kg. The clinical characteristics,treatment and clinical outcome were analyzed. Results A total of 9 infants(5 males,4 females)were assessed to be able to tolerate general anesthesia surgery and received positive conservative treatment before operation,and obstruction relief within 6 hours of admission. Six infants (5 males, 1 female)with serious internal milieu disorder,pneumonia,and shock,were assessed as critical cases,who could not tolerate general anesthesia surgery temporarily. Under the emergency blood purification support,they received anti -infection,spasmolysis,rehydration,to correct the internal milieu disorder and obstruction relief within 12 hours of admis-sion. Serum potassium,creatinine returned to normal 12 - 48 hours after obstruction relief. Stone specimens were obtained from 5 cases,and the stone compositions were calcium oxalate stone in 3 cases,calcium oxalate and carbonate apatite mixed stone in 2 cases. A total of 13 cases need further urolithiasis treatment. Conclusions The infants under the age of 6 months with bilateral urinary tract calculi obstruction are more severe with more complications. The emergency treatment principle is to save lives,then relieve the obstruction;surgery should be as brief as possible,since removing the stones is not the primary purpose. If the infants are in critical,life - threatening circumstances,and cannot tolerate general anesthesia surgery,the blood purification will be helpful to gain time and create conditions for treatment.