Objective: To explore the advantages and evaluate feasibility of sentinel lymph node (SLN) biopsy and axillary lymph node dissection under mastoscopy for patients with early stage breast cancer in clinical diagnosis and treatment. Methods: 200 patients with breast cancer stage I and II diagnosed by breast surgery were divided into observation group (100 cases) and control group (100 cases) as different surgery method. The patients of observation group were treated by SLN biopsy and axillary lymph node dissection under mastoscopy, while those of control group were treated by traditional open surgery. To analyze the detection rate and accuracy rate, and compare the bleeding volume during operation, the operation time and hospitalization time between the two groups. And series of indexes, such as incidence of post-operative complication, recurrence rate and good appearance rate of breast were compared between the two groups. Results: The difference of accuracy rate between the two groups was no significant. The incidence of complication, good appearance rate of breast and recurrence rate of observation group were, respectively, 4%, 92% and 4%. And the differences between those results of observation group and those of control group were significant (x2=25.25, x2=16.61, x2=170.40; P<0.05). Other some indexes, such as the bleeding volume during operation, the operation time and hospitalization time, the differences between observation group and control group also were significant (t=9.73, t=13.86, t=11.66; P<0.05). Conclusion:Sentinel lymph node (SLN) biopsy and axillary lymph node dissection under mastoscopy are feasibility in clinical practice based on its series advantages, such as better detection rate, lower incidence of complication, better protection for breast appearance and so on.

One hundred and twenty stroke patients were randomly divided into rehabilitation group (n =60) and control group (n =60).Patients were assessed with National Institute of Health Stroke Scale (NIHSS) ,Fugl-Meyer Assessment (FMA),Bathel Index (BI) and World Health Organization Quality of Life Assessment Instrument Brief Version(WHOQOL-BREF) before and 6 weeks after treatment by the same doctor.The scores of NIHSS,FMA,BI and WHOQOL-BREF were improved significantly in rehabilitation group after treatment; while those of control group were no improved.The scores after treatment of rehabilitation group were significantly higher than those of control group ( P ＜ 0.05 ).

Aim To establish method and main evaluation indexes of collagen induced arthritis ( CIA) model in DBA/1 mice. Methods CIA was induced by chicken type Ⅱcollagen ( C Ⅱ) in DBA/1mice. Arthritis was evaluated by arthritis index. X-ray of the paws was taken. Histology pathology of ankles and spleen was observed and scored. Results Immunization d31,the paws of CIA mice appeared red and swelling,the scores of arthritis index increased,the period of swelling peak was from d40 to d60; immunization d35,the weight of CIA mice began to decrease. X-ray of paws showed that the paw joints of CIA mice deformed,and there was osteophyte formation associated with osteolysis. Histo-logical pathology of ankle joints showed that the synovium of CIA mice were hyperplasia,cartilage was destroyed,pannus was formed,and inflammatory cells infiltrated into synovium. Histological pathology of spleen showed more germinal centers and lymphoid follicular hyperplasia were observed,cell density of lymphatic sheath increased,scores of ankle joints and spleen histological pathology in CIA mice were higher than those in normal mice significantly. Conclusions The methods of CIA model induced by chicken C Ⅱ in DBA /1 mouse were reliable and reproducible. CIA incidence was high. Arthritis index,X-ray of paws,ankle joints and spleen histological pathology and so on were the principal indexes of evaluation for CIA model.

AIM:To investigate the effect of Notch-1 knockdown on the growth of dihydroartemisinin-inhibited human osteosarcoma cell line U-2OS.METHODS:U-2OS cells treated with different concentrations of dihydroartemisinin (5, 10, 15 and 20μmol/L) were collected.The expression of Notch-1, MMP-2, MMP-9 and Hes-1 at mRNA and protein levels was measured by real-time PCR and Western blotting, respectively.U-2OS cells were transfected with Notch-1 siRNA for 24 h and incubated with dihydroartemisinin for another 24 h.The cell apoptotic rate , protein expression of MMP-2, MMP-9 and Hes-1, and the migration ability were measured by MTT assay , Western blotting and Transwell experiment , respectively.RESULTS:Dihydroartemisinin (5, 10, 15 and 20 μmol/L) decreased the expression of Notch-1, MMP-2, MMP-9 and Hes-1 at mRNA and protein levels in a dose-dependent manner .Down-regulation of Notch-1 significantly en-hanced the effect of dihydroartemisinin on the cell apoptosis , the protein expression of MMP-2, MMP-9 and Hes-1, and mi-gration ability ( P<0.05 ) .CONCLUSION: Notch-1 pathway is involved in the process of dihydroartemisinin-inhibited U-2OS cell growth.Knockdown of Notch-1 augments the inhibitory effect of dihydroartemisinin on U-2OS cell viability.

A total of 120 patients with initial stroke at a community health service center in Shanghai from January 2009 to March 2011 were divided randomly into intervention group (n =60) and control group (n =60).Individual comprehensive rehabilitation was carried out based on the evaluations in the intervention group.Routine therapy was given to the patients in the control group.General data evaluations were conducted at pre-intervention and 1 year post-intervention respectively.The levels of blood pressure,blood glucose and blood lipid(LDL-C) were all lower in the intervention group than those in the control group (P ＜ 0.05).The rates of proper behavior were all higher in the intervention group than those in the control group (P ＜ 0.05).And the rates of recurrence and mortality were lower in the intervention group than those in the control group (P ＜ 0.05).

Objective To evaluate the clinical effect and safety of percutaneous closure of patent foramen ovalein treatment of migraine.Methods We studied 23 patients with migraine who were tested positive in Contrast Transcranial Doppler (TCDc) at the Department of Neurology in Bethune First Hospital of Jilin University between 2010 May and 2011 November.Procedures of transcatheterclosure of patent foramen ovale were performed at Department of Cardiovascular Surgery.At varied time points post-surgery,the patients were re-examined by TCDc and transthoracic echocardiograph (TTE) and followed up by phone interviewed with Headache Impact Test-6 (HIT-6) questionnaire to elevate improvement of migraine.The data was analyzed statistically.Results Percutaneous closure was successful in all patients without major long-term side-effects.At follow-ups at 48-542 days ((247 ± 145) days) post-surgery,the scores of HIT-6 were reduced to 38-70 (51 ± 9),compared to the pre-operative scores of 42-76 (61 ± 8).Disability by migraine had significantly improved (t =4.80,P ＜ 0.05).In 6 patients with migraine with aura,the scores of HIT-6 were reduced to 46-56 (51 ± 3),from preoperative scores of 63-76 (69 ± 4) and their disability affected by migraine had significantly improved (t =6.80,P ＜0.05).In 17 patients with migraine without aura,the scores of HIT-6 after surgery were reduced to 36-70 (52-10) from the preoperative scores of 42-69 (60 ± 8) and disability affected by migraine in this group had significantly improved (t =3.77,P ＜0.05).Among 18 patients having MRI or CT examination before the operation,8 patients had neurological events (such as cerebral infarction,cerebral ischemia) with average age of (44 ± 7) years old.In this group,disability affected by migraine had significantly improved (the HIT-6 scores:49 ± 7 vs 58 ± 10,t =2.49,P ＜ 0.05).Conclusion Percutaneous closure of PFO showed significant improvement in migraine treatment and it is a safe procedure.

Objective To investigate the expressions and effects of interleukin-4(IL-4) and its alternative spliced variant(IL-4?2) in patients with atopic asthma.Methods The expressions of IL-4 and IL-4?2 were detected in 10 cases of patients with atopic asthma using a quantitative nested reverse-transcription polymerase chain reaction(RT-PCR) protocol.Result The expression level of IL-4 was higher in the patients with atopic asthma than that of the healthy controls.The median ratio of IL-4 to IL-4?2 was much higher in the patients with atopic asthma compared with that of the healthy controls.Conclusion The relative expression of IL-4 and IL-4?2 may play an important role in the mechanism of the pulmonary pathology in patients with atopic asthma,and may be one of the reason for the functional diversity of Th2 cells in different clinical conditions.

Objective To introduce a self-developed computer-assisted design/rapid prototyping and guidance system used for precise placement of the acetabular component in total hip arthroplasty.Methods We collected the preoperative pelvic CT scanning data of 10 hips with aeetabular dysplasia that had undergone primary total hip arthroplasty from January 2016 to January 2017.The total time for import of radiographic images,model reconstruction,model segmentation,acetabular component position design and STL model export was calculated and compared between our self-designed software and Mimics vl 7.0.Three kinds of STL model from each case were imported into our self-developed 3D printing device,Stratasys Objet30 and Stratasys Demension SST1200es respectively for rapid prototyping.The printing efficiency and accuracy were compared among the 3 printers.The accuracy of placing acetabular component with guidance system was evaluated.Results The average time forpreoperative planningwas7.7±1.3 minbyourself-designedsoftware and 52.5 ± 15.9 min by Mimics v17.0,showing a significant difference (P ＜ 0.001).In morphological point-based comparison for each case,the 3D models exported by the 2 different kinds of software showed an average difference of 0.072 1 ± 0.069 1 mm.The average durations for rapid prototyping by the 3 different printers were 5.3 ± 0.6 h,10.8 ± 0.5 h,and 9.3 ± 0.6 h,respectively,showing significant differences (P ＜ 0.001).The guidance system resulted in precise placement.The locations of the acetabular component achieved by guide-assisted placement were not significantly different from the target ones (P ＞ 0.05).Conelusion Our self-developed preoperative planning software,rapid prototyping device and guidance apparatus for acetabular component placement may lead to good accuracy and high efficiency.

Objective:To examine the potential influence factors of abdominal aortic aneurysm (AAA).Methods:A 1∶2 pair-matched, case-control study was conducted from July 2011 to December 2012 .A pair was composed of one AAA patient recruited from the Vascular Surgery Department , Chinese PLA General Hospital and two gender-and age-matched non-AAA subjects , one from the same hospital and the other from the community in Fangshan District in Beijing .Demographic data , medical history and the lifestyle of each subject were collected .Moreover , all the participants underwent abdominal ultra-sound or computed tomography ( CT ) and peripheral venous blood samples were obtained .Results:There were 155 case/control pairs .The multivariate conditional logistic regression model confirmed that suffering from hypertension conferred a 1.98-fold (95%CI 1.12-3.18) increased likelihood of AAA. Smoking was a strong independent risk factor of AAA , with odds ratios ( 95% confidence intervals ) of 5.23 (2.44-11.23).Dyslipidemia(OR=2.61,95%CI 1.45-4.70), a higher level of serum hs-CRP (OR=2.43,95%CI 1.37-4.31) and homocysteine (OR=2.73,95%CI 1.61-4.65) were all asso-ciated with AAA.Conclusion: Hypertension and smoking are the risk factors of AAA .Dyslipidemia, hsCRP and Hcy are associated with AAA .

Objective To investigate the efficacy of micro?surgery for the treatment of medulla oblongata cavernomas. Methods A retrospective analysis was conducted on the clinical data of 21 patients with cavernous hemangioma who received micro?surgical treatment. Of the 21 patients, 13 were men and 8 women,aged 22 to 63 years. The preoperative Karnofsky performance status(KPS)score was 76.5 ± 10.2. The main clinical manifestations included sensory disorder and difficulty swallowing etc. According to the location of the lesions ,the posterior transchoroidal fissure approach was employed for 16 patients;far?lateral approach,5 patients. Electrophysiological monitoring and nervous system navigation were supple?mentarily adopted in both types of surgery. Further ,KPS scoring was conducted to evaluate the patients 'quality of life. Results The medulla cav?ernous hemangioma was excised in all cases. For 17 patients with primary neurological disorders ,their symptoms were alleviated or resolved;4 pa?tients had severe symptoms and 8 presented with new clinical symptoms. A follow?up visit was conducted 8 to 97 months post?surgery(average 47.6 months). All patients were found capable of caring for themselves in daily life and performing simple or normal learning and working activities without recurrence or bleeding. The mean postoperative KPS score was 83.7 ± 15.5. Conclusion Patients with medulla cavernous hemangioma bleeding or severe symptoms should actively seek surgical treatment. Repeated bleeding is the absolute indication for surgery. Surgical skills ,elec?trophysiological monitoring,and nervous system navigation can reduce nervous system damage and protect the brainstem. The patient's quality of life is expected to significantly improve after surgery.