ObjectiveTo determine the role of mammary ductoscopy in the evaluation and intraductal therapy for nipple discharge.MethodsIn this study 3280 patients with nipple discharge underwent mammary ductoscopy. Ductoscopy revealed space occupying lesions in 1018 patients who subsequently underwent surgery; 2260 patients with no-space occupying lesion underwent ductoscopically guided duct lavage.ResultsSpace occupying lesion was often seen in patients with bloody discharge,single duct nipple discharge,discharge in unilateral breast and lesions located in general or levelⅠ - Ⅱ duct.Non-bloody discharge,multiple duct with nipple discharge and bilateral breast involved and lesions at multi-level ducts were common in patients with no-space occupying lesions. Ductoscopically guided duct lavage was curative in 88.72％ among 2260 cases undergoing lavage.ConclusionsSpace occupying lesion should be suspected in patients with bloody discharge,single duct nipple discharge and unilateral breast involving lesion and lesions located in the general or level Ⅰ - Ⅱ duct system;Mammary ductoscopy is useful tool in the intraductal therapy for non-space occupying lesions.

Objective To assess the relationships among the autologous serum-induced skin wheal-andflare reaction,ex vivo serum-induced basophil histamine release, and serum levels of IgG anti-FcεRI autoantibodies in patients with chronic idiopathic urticaria (CIU).Methods Sixty patients with CIU collected from the Renmin Hospital of Wuhan University were recruited for this study.Sera were obtained from the subjects,and ASST was performed in all of the subjects.The results of ASST were determined according to a recommended criterion described by Sabroe et al,and the positive results were further subclassified into wheal plus flare (W+F) pattern and wheal-only (W) pattern,negative results into flare-only (F) pattern and no response pattern.Enzyme linked immunosorbent assay was used to quantify the content of histamine released by autologous serum-induced basophils and serum levels of IgG anti-FcεRI autoantibodies.Results Of the 60 patients,19 (31.7％)were positive for ASST,including 16 (84.2％) presenting W+F pattern and 3 presenting W pattern; 41 were negative for ASST,including 3 (7.3％) giving F pattern and 38 giving no response pattern.The histamine release rate was significantly higher in ASST-positive patients than in ASST-negative patients (33.38％ ± 9.83％ vs.4.06％ ±1.44％,t =5.13,P＜ 0.01),and was nearly twice as high as that in basophils induced by 10 μmol/L formylmethionyleucylphenylalanine (Fmlp).The serum levels of IgG anti-FcεRI autoantibodies were high in only patients giving (W+F) pattern (757.64 ± 168.99 ng/L),but low in the normal human controls (43.25 ± 16.63 ng/L).Conclusions The positive ASST result of wheal plus flare pattern is associated with high serum levels of IgG anti-FcεRI autoantibodies,and is suggestive of a clinical diagnosis of autoimmune chronic urticaria (ACU).

Objective:To explore whether microRNA-21-5p (miR-21-5p) has the effect of anti-apoptosis of human alveolar typeⅡ epithelial cells (ATⅡ).Methods:ATⅡ cells derived from the human were cultured in vitro and used for experiments when the cells were grown until the presence of lamellar bodies and microvilli were observed by light microscope. The cells were divided into blank control group (direct culture), hydrogen peroxide (H 2O 2) injury group (cultured with 0.5 mmol/L H 2O 2), and miR-21-5p overexpression group (using miR-21-5p with a multiplicity of infection (MOI) of 100 lentiviral overexpression vector with 0.5 mmol/L H 2O 2) and miR-21-5p empty virus control group (miR-21-5p lentiviral blank vector was co-cultured with 0.5 mmol/L H 2O 2). In each group, cell proliferation was detected by cell counting kit-8 (CCK-8) at 0, 12, 24, 36, and 48 hours of cell culture; cell apoptosis was detected by flow cytometry at 24 hours of culture. Results:① Cell proliferation activity test results: with the extension of cell culture time, the cell proliferation activity of the blank control group gradually increased, while the cell proliferation activity gradually decreased after the addition of 0.5 mmol/L H 2O 2. However, the cells proliferation activity in the miR-21-5p overexpression group decreased more slowly than that in the H 2O 2 injury group and the miR-21-5p empty virus control group, and the cell proliferation activity at 48 hours was significantly higher than the H 2O 2 injury group and the miR-21-5pempty virus control group ( A value: 0.295±0.005 vs. 0.184±0.005, 0.169±0.002, both P < 0.05). It showed that both H 2O 2 and lentivirus accelerated cell damage, while miR-21-5p could reduce cell apoptosis. ② Apoptosis rate test results: compared with the blank control group, the apoptosis rate increased significantly after adding 0.5 mmol/L H 2O 2; while the apoptosis rate of the miR-21-5p overexpression group was lower than that of the H 2O 2 injury group and miR-21-5p empty virus control group [early apoptosis rate: (14.31±0.12)% vs. (24.50±0.12)%, (23.41±0.13)%; late apoptosis rate: (8.12±0.13)% vs. (9.71±0.11)%, (10.41±0.15)%; overall apoptosis rate: (22.33±0.12)% vs. (34.21±0.10)%, (33.82±0.14)%; all P < 0.05], which further proved that miR-21-5p had anti-apoptotic effects. Conclusion:miR-21-5p has an anti-apoptotic effect on human ATⅡ.

Objective To observe the effects of microRNA-21 (miR-21) inhibitor on apoptosis of type Ⅱalveolar epithelial cells (AEC Ⅱ) in rats with hyperoxia-induced acute lung injury (HALI).Methods Eighty Sprague-Dawley (SD) rats were divided into air-control group,hyperoxia injury group,empty-virus control group (200 μL solution with lentivirus was dropped into the nasal) and miR-21 inhibitor pretreatment group (200 μL solution with lentivirus contained miR-21 inhibitor was dropped through the nasal) by random number table.After treatment,the rats in all groups were fed in the hyperoxia incubator with oxygen concentration exceeding 90％ for production of HALI model,and the rats in air-control group were fed normally without any treatment.Ten rats were selected at 0,24,48 and 72 hours after exposure in hyperoxia environment respectively,and the general changes of lung tissues were observed in light microscope.The right lung tissues were harvested to observe the pathological changes under light microscopy.The left lung tissues of other 10 rats in each group were harvested at 48 hours after execution,the miR-21 expression was determined by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-qPCR),the protein expression of cysteinyl aspartate-specific proteinase-3 (caspase-3) was determined by Western Bolt,and apoptosis of AEC Ⅱ was detected by TdT-mediated dUTP nick end labeling (TUNEL).Results ① No abnormal appearance in lung tissues was observed at all time points in the air-control group.In hyperoxia injury group,the lung injury would be more severe if the exposure time was longer,and lung tissues turned dark red after exposure for 72 hours,with patchy hemorrhage in several places;the structure of lung tissues was disordered,the alveolar wall was broken,the alveolar septum was significantly edematous and broadened,and there was plenty of inflammatory cell infiltration and edema fluid appeared inside the alveolar space.In miR-21 inhibitor pretreatment group,the degree of lung tissue injury was more severe than that of the hyperoxia injury group,and there was no significant change in empty-virus control group.(②) Compared with air-control group,miR-21 expression of the hyperoxia injury group was significantly decreased (2-△△Ct:0.021 ± 0.005 vs.0.037 ± 0.006),and the protein expression of caspase-3 was significantly increased (A value:0.423±0.081 vs.0.123±0.023,both P ＜ 0.05).After pretreatment with miR-21 inhibitor,the expression of miR-21 was further decreased (2-△△Ct:0.014±0.003 vs.0.021 ±0.005),while the protein expression of caspase-3was further increased (A value:0.691 ±0.085 vs.0.423 ±0.081,both P ＜ 0.05).There were no statistically significant differences in the expression of miR-21 (2-△ △ct:0.025 ± 0.007 vs.0.021 ± 0.005) and caspase-3 (A value:0.475 ± 0.062vs.0.423 ±0.081) between empty-virus control group and hyperoxia injury group (both P ＞ 0.05).(③) Compared with air-control group,the apoptosis cells in hyperoxia injury group were increased,which was further increased after pretreatment of miR-21 inhibitor,but no changes were found in empty-virus control group.Conclusion Inhibition of miR-21 expression in vivo could aggravate the injury of lung tissue in HALI rats,and increase the apoptosis of AEC Ⅱ.

Objective To investigate the expression and significance of transforming growth factor beta receptors (TGF?RⅠ, TGF?RⅡ) in basal cell carcinoma and squamous cell carcinoma. Methods The expression of TGF?RⅠand TGF?RⅡwere assessed by quantitative real-time PCR and streptavidin -peroxidase (SP) immunohistochemical techniques in specimens of basal cell carcinoma, squamous cell carcinoma and normal control skin. Results Eighteen patients with basal cell carcinoma and twenty-four with squamous cell carcinoma were enrolled in the study. The expression levels of TGF?RⅠand RⅡmRNA were significantly down-regulated in basal cell carcinoma and squamous cell carcinoma in comparison with those in control skin specimens (P

ObjectiveTo observe the effect of comprehensive therapy on forearm extensor myotenositis.Methods72 cases were divided into two groups: a control group of 36 cases who were given routine treatment,and an experiment group of 36 cases who were given thermotherapy,computerized medium-frequency electrotherapy,physiotherapy,and ADL instruction,etc.After two courses,a simple grading score(for forearms) was used to assess the effect.ResultsOf the control group,22 cases were cured,10 remarkably effective,4 effective;of the experiment,30 cured,4 remarkably effective,2 effective(u=2.04, P<0.05).The difference of average score for forearms before and after the treatment were(6.58±3.17) points for the control and(8.19±3.55) for the experiment(t=2.03,P<0.05).The average days of cure were(5.60±2.54) d for the experiment group,shorter than those for the control(7.00±2.27) d(t=2.05,P<0.05).ConclusionComprehensive therapy is effective on forearm extensor myotenositis.

ObjectiveTo investigate the value of a digital three-dimensional reconstruction technique in the treatment of hepatic alveolar echinococcosis (HAE).MethodsThe computed tomography scan data for 13 patients with HAE who were admitted to the First Affiliated Hospital of Xinjiang Medical University from February 2011 to October 2011 were reconstructed and analyzed by a three-dimensional reconstruction system to assess resectability,and to facilitate surgical planning and individualized virtual surgery.The results of preoperative analysis were compared with the results of actual operations.ResultsThe three-dimensional models of the liver were reconstructed successfully,and intrahepatie lesions and vessels were clearly displayed.One patient received an autologous liver transplantation,10 underwent hepatectomy,and 2 received percutaneous transhepatic cholangial drainage.Virtual operation planning was carried out for 11 patients using the three-dimensional reconstruction system.The mean volume of the liver to be resected was predicted to be 920 ml (range,339-2678 ml),and the mean percentage of liver to be resected to the total liver volume was predicted to be 45％ ( range,23％ -68％ ).The mean volume o[ the actual liver resection was 834 ml (range,315-2250 m[),and the mean percentage of actual liver resected to the total liver volume was 42％ (range,22％ -70％ ),which was consistent with the results of preoperative three-dimensional reconstruction.All patients were followed up for 2-8 months,and no severe complications such as liver failure,hemorrhage and bile leakage were detected.ConclusionDigital three-dimen-sional reconstruction is helpful in the diagnosis and treatment of HAE and effectively reduces surgical risks.

OBJECTIVETo observe the effect of purgation and detoxification therapy on gastrointestinal dysfunction of critically ill patients undergoing abdominal surgery.

METHODSTotally 56 inpatients with severe gastrointestinal dysfunction after abdominal surgery at ICU of Guangdong Provincial Hospital of Traditional Chinese Medicine were assigned to the treatment group and the control group, 28 in each group. All patients received routine Western medical treatment. Patients in the treatment group additionally took Modified Huanglian Jiedu Decoction (MHJD) and received electroacupuncture (EA) for 7 days. The first exhaust time, defecation time, scores for gastrointestinal dysfunction, mechanical ventilation time, ICU hospitalization time, and 28-day fatality rate were observed. Furthermore, serum levels of diamine oxidase (DAO) and D-lactic acid were detected at day 1, 3, and 7 after treatment.

RESULTSThe first exhaust time and the first defecation time in the treatment group were ahead of schedule, when compared with those of the control group (P <0. 05). Scores for gastrointestinal dysfunction, mechanical ventilation time, serum levels of DAO obviously decreased in the treatment group (P <0. 05). There was no statistical difference in serum levels of D-lactic acid, ICU stay time, the incidence of pulmonary infection, and 28-day mortality between the two groups (P >0. 05). Results of Logistic analysis showed that scores for gastrointestinal dysfunction were related with the incidence of pulmonary infection (P <0. 05).

CONCLUSIONMHJD combined EA could promote the recovery of gastrointestinal function in critically ill patients after abdominal surgery via improving intestinal barrier function, which was benefit for shortening mechanical ventilation time.

Critical Illness ; Defecation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electroacupuncture ; Gastrointestinal Diseases ; drug therapy ; Humans ; Lactic Acid ; Medicine, Chinese Traditional

Adenocarcinoma ; diagnosis ; pathology ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; Cervical Intraepithelial Neoplasia ; diagnosis ; pathology ; Female ; Humans ; Precancerous Conditions ; diagnosis ; pathology ; Retrospective Studies ; Uterine Cervical Neoplasms ; diagnosis ; pathology ; Vaginal Smears ; methods

Objective To explore the clinical value and safety of early enteral nutrition support in patients after liver transplantation.Methods We retrospectively analyzed the clinical data of 86 cases who used early enteral nutrition support therapy after liver transplantation between January 2008and October 2011.All of patients were uproot the gastric tube at the first day after the operation,and gradual to the normal diet.The patients who used parenteral nutrition support therapy were as the control group(n＝112).Then we compared the data of patients in the two groups.Results The early enteral nutrition is more useful to the patients after liver transplantation than intravenous nutrition [In the seventh day after the operation,the control group's ALT was (45.2 ± 12.9) U/L,AST was (40.2±9.4) U/L,ALBwas (35.6±2.5) g/L,P＜0.05].The early enteral nutrition also can decrease hospital stay and hospital costs [(14.2±3.4) d,P＜0.05].Conclusion The early enteral nutrition is useful and safe to the patients after liver transplantation.