Objective To study the influence of aging and chemotherapeutic drugs of breast cancer patients on chemotherapy-induced amenorrhea (CIA) and to guide the further selection of drugs for chemotherapy.Methods We prospectively studied the CIA of the premenopausal breast cancer patients and compared the difference in CIA between the patients who were at different aging periods or received different chemotherapeutics. Results 137 patients were followed up.The occurrence rate of CIA and long-term chemotherapy-induced amenorrhea(LCIA)were 73.72%(101/137)and 43.80%(60/137)respectively.The rate of CIA and LCIA was significandy higher in older women(＞40 years)than young women(≤40 years,X2=25.32,18.42,P＜0.05).The recovery rate of CIA in young women was 61.90%(13/21)which was significantly higher than the older women[35.00%(28/80);X2=4.99,P=0.025].The difference in the rate of LCIA was statistically significant between the older women (＞40 years)who received different anthracyclinebased chemotherapy(X2=6.92,P=0.031).Conclusion Age is an important factor for the CIA.Chemotherapy has less influence on the menstruation of younger women(≤40) and most amenorrhea is reversible.For older women,the rate of LCIA is different in patients who receive imported epirubicin,domestic epirubicin or pirarubicin.

The majority of women diagnosed with early-stage breast-cancer have an excellent long-term prognosis, but many still suffer from worsened life quality and infertility caused by chemotherapy-induced amenorrhea(CIA). The risk of CIA varies by patient age, but is not significantly influenced by chemotherapeutic regimens. CIA will improve disease-free survival and overall survival for patients with hormonal receptor positive tumors. For low-risk patients and patients with the intention of maintaining fertility, proper treatments need to be chosen to preserve their reproductive function.

BACKGROUND:Although core decompression can contribute to the reconstruction of necrotic bone, its single use appears to have some deficiencies and cannot completely realize the reconstruction of the femoral head.
OBJECTIVE:To explore the effect of arthroscopic core decompression with autologous bone marrow induction material combined with titanium rod in the repair of stage II femoral head necrosis
METHODS:A retrospective analysis was performed on clinical data of 79 cases of stage II femoral head necrosis admitted at the South Branch of Tongchuan People’s Hospital from February 2011 to February 2013. According to the therapeutic methods, these cases were divided into control group (40 cases) and observation group (39 cases), and were given conventional core decompression and arthroscopic core decompression with autologous bone marrow induction material combined with titanium rod. Patients were fol owed up for 24 months, and the range of hip flexion and Harris scores on hip function and adverse events were observed and compared between two groups.
RESULTS AND CONCLUSION:Al the 79 patients successful y completed the 24-month fol ow-up. By the last fol ow-up, the range of hip flexion and Harris score were significantly higher in the observation group than the control group (P<0.05). There was no failure case due to surgical material rejection. To sum up, arthroscopic core decompression with autologous bone marrow induction material combined with titanium rod is safe and effective for repair of stage II femoral head necrosis.

Objective To investigate the prevention and management of portal vein thrombosis following orthotopic liver transplantation.Methods Between May 1995 to September 2005,clinical data of 137 cases subject to orthotopic liver transplantation were analyzed.Among them,there were 10 cases of portal vein thrombosis(5 cases in gradeⅠ,4 cases in gradeⅡand 1 case in gradeⅢ). All patients received an eversion thromboendovenectomy(ETEV)with occlusion of the portal flow u- sing a Forgarty balloon.Ligation of the collateral circulation,especially spontaneous or surgical sple- norenal shunt,was made as approaches to improve portal flow.Heparin or low-molecule-weight hepa- rin as a prophylactic anticoagulation therapy was maintained during and after operation if prothrombin time was less than 18 s.Follow-up Doppler ultrasonography was used daily in the early postoperative period.Results After a follow-up of 2～66 months,overall incidence of portal vein thrombosis was 2.92%(4/137).Surgical thrombectomy and revascularization was carried out in 1 case.Thromboly- sis,balloon angioplasty and stent placement via hepatic artery were performed on 2 cases.No treat- ment was given in 1 patient without hepatic dysfunction and portal hypertention.Mortality related to portal vein thrombosis was 0.Conclusions Portal vein thrombosis might be avoided by performing a complete thrombectomy as often as possible,by ligation of portosystemic shunt during surgery,and by postoperative anticoagulation.Close follow-up by Doppler ultrasonography may make a prompt di- agnosis and reduce portal vein thrombosis-derived loss of grafts.

Objective To study the effect of acupuncture cooperated with music therapy on cerebral palsy.Methods Sixty children with cerebral palsy were randomly divided into two groups with 30 in each: acupuncture group and acupuncture plus music group.The acupuncture group was treated with acupuncture only while the acupuncture plus music group treated with acupuncture at 5 groups of acupoints and music movement,once every other day,36 treatments as one course,totally 3 courses.The effect and movement improvement of both groups were observed for comparison.Results The comprehensive functions of all children were improved,but the total effective rate of acupuncture plus music group was obviously higher than that in acupuncture Group(P

Objective To investigate the molecular mechanisms of delayed ischemic preconditioning (IPC) and doxorubicin preconditioning (DPC) to induce ischemic tolerance. Methods The models of sham-operation and orthotopic liver transplantation in the Wistar rats was used. IPC was administered with a 10-min ischemia followed by a 10-min reperfusion. Animals in the DPC group were pretreatd with Doxorubicin (1?mg/kg, iv). The control rats were subjected to saline treatment. The induction of HSP70 and HO-1 protein ( Western blot), the expression of ICAM-1 transcripts (RT-PCR)and ICAM-1 protein (immunohistochemistry), the activities of serum AST, ALT, LDH, and liver myeloperoxidase (MPO) , liver wet-to-dry weight ratios (W/D) were assessed.Results HO-1 expression was maximally induced at 12?h after IPC, and hardly changed until 48?h. A strong induction of HSP70 was detected at about 24 to 72?h after IPC. The levels of HO-1 and HSP70 were obviously elevated at 24?h after IPC or DPC as compared with the control ( P 0.05 ). In the control group, the transcription of ICAM-1 was significantly increased 6?h after reperfusion. Capillary endothelial cells of the livers strongly expressed ICAM-1. Activities of liver MPO were obviously elevated. IPC and DPC could significantly decrease the transcription of ICAM-1 in the livers in concurrence with the expression of ICAM-1 protein as well as the activity of MPO at 6?h after reperfusion ( P

Objective To investigate the effect and mechanism of invigorating spleen,eliminating stasis, heat-clearing drugs(milk veteh,root of red rooted salvia,Chinese goldthread)on quality of ulcer healing (QOUH).Methods The rat models of chronic gastric ulcer was induced by acetic acid,the effects of QOUH of milk veteh,root of red rooted salvia and Chinese goldthread on the model of gastric Ulcer were observed, the expression of EGFR mRNA of mucosa were measured by in situ hybridization.Results Milk veteh,root of red rooted salvia and Chinese goldthread could improve the injury of gastric mucosa.Milk veteh,root of red rooted salvia increased the expression of EGFR mRNA in the tissue around peptic ulcer(PU). Conclusion Invigorating spleen,eliminating stasis,heat-clearing drugs can improve QOUH,it is one of possible mechanisms that the drugs increased the expression of EGFR mRNA in the tissue around PU.

Objective To explore the images and diagnostic evaluation of X-ray combined with ultrasound in paralytic intestinal obstruction caused by antipsychotic agents. Methods The data of X-ray and ultrasound of 124 cases of clinically diagnosed paralytic intestinal obstruction caused by antipsychotic agents were analyzed retrospectively, as well as their rates of confirmed diagnosis. All the 124 patients were examined by erect abdominal radiography and fluoroscopy,68 of the 124 patients by ultrasound. Results According to their typical images,the rate of X-ray confirmed diagnosis was 87.9%(109/124) with 15 missed diagnosis and the rate of missed diagnosis was 12.1%( 15/124);the rate of ultrasound confirmed diagnosis was 82.4%(56/68) with 12 missed diagnosis and the rate of missed diagnosis was 17.6%(12/68). There was no significant difference between X-ray and ultrasound (P＞ 0.05 ). Compared with X-ray or ultrasound ,X-ray combined with ultrasound in the diagnosis of paralytic intestinal obstruction could increase the rate of confirmed diagnosis (100.0% ,68/68),and decrease the rate of missed diagnosis (0),the difference was statistically significant (P＜ 0.05 ). Conclusions X-ray examination is the first choice to diagnose paralytic intestinal obstruction caused by antipsychotic agents,but ultrasound has the advantage of finding fluid in abdominal cavity. To reduce missed diagnosis, X-ray should be combined with ultrasound.

Objective To evaluate the safety and feasibility of totally thoracoscopic anatomic pulmonary segmentectomy (TTAS) for the treatment of the peripheral stage ⅠA non small cell lung cancer(NSCLC).Methods The study involved 50 consecutive patients undergoing totally thoracoscopic anatomic segmentectomy (TTAS) from September 2010 to November 2012 in the First People's Hospital affiliatied to Nanjing Medical University.The diameter of the tumors were less than 2 cm [(mean diameter(1.35 ±0.48) cm].All lymph node sampling of N1 and N2 were neglive,All patients received symtematic lymph node dissection.The pulmonary vessels were individually ligated,and the bronchi were closed using an endoscopic stapler.The intersegmental plane was identified using the demarcation between the resected(inflated) and preserved(collapsed) lungs.Staplers were used for intersegmental dissection.Results The mean operative time and intraoperative bleeding were (191.5 ± 50.4) min and (49.2 ± 54.6) ml respectively.The chest tube drainage duration was (3 ± 1) days.The number of stapler cartridges used for intersegmental division was 3.9 ±0.8.The mean number of lymph nodes and nodal stations dissected were 12.6 ± 2.8 and 6.0 ± 1.5 respectively.No mortality and complications were observed 30 days after the surgery.Further,no local recurrence or metastases were observed during follow-up.Conclusion Totally thoracoscopic anatomic segmentectomy(TTAS) is a feasible and safe technique.With systematic lymph node dissection,TTAS can be a reasonable therapeutic option for stage ⅠA NSCLC.

BACKGROUND: Tiantai I consists of gastrodia, Chinese angelica root, areca seed. It has been considered as the roles of invigorating the liver, nourishing marrow, heightening the intelligence and causing resuscitation. OBJECTIVE: To observe the effects of Tiantai Ⅰ on the abilities of learn ing and memory and the activity of central cholinergic system in mice withspontaneous Alzheimer disease. DESIGN: A randomized control observation. SETTING: Shenzhen Institute of Integrated Chinese and Western Medicine. MATERIALS: Male Kunming mice of 13 months old were raised to 21 months old, of which 52 with spontaneous Alzheimer disease werescreened. They were randomly divided into blank control group, westerndrug control group, Tiantai Ⅰ 6.80 and 20.41 g/kg groups, 13 mice in eachgroup. Another 13 aged mice with normal learning and memory abilitieswere selected as the normal control group at the same time. METHODS: Mice in the western drug control group were treated with0.6 mg/Kg Hydergine, those in the Tiantai Ⅰ 6.80 and 20.41 g/kg groupswere given intragastric administration of Tiantai Ⅰ of 6.80 and 20.41 g/kg, respectively, and those in the normal control group and blank control groupwere given double distilled water of the same volume. The learning andmemory results were examined by the step-down test. Freezing sections ofbrain tissue were prepared, acetylcholinesterase (AChE) fiber was showedaccording to the Hedreen method, and choline acetyltransferase (ChAT) was detected with Burt and Silver methods, the automatic image analysissystem for biomedical application was applied in the quantitative analysisof AChE fiber and ChAT activity. MAIN OUTCOME MEASURES: ① Effect of Tiantai Ⅰ on the abilities of learning and memory in mice with Alzheimer disease; ② AChE fiberarea density in temporal cortex and hippocampal CA1 region; ③ ChAT ac tivity in Meynert nuclei of basal forebrain. RESULTS: ① Tiantai Ⅰ in ameliorating the abilities of learning and mem ory in mice with spontaneous Alzheimer disease: The error times in theTiantai Ⅰ 6.80 and 20.41 g/kg groups, normal control group and westerndrug control group were obviously fewer than that in the blank controlgroup (5.08±2.18, 3.77±1.48, 3.25±1.27, 6.17±3.12, 9.31±3.65, P ＜ 0.05). ② AChE fiber area density: The AChE fiber area densities in temporalcortex were obviously higher in the Tiantai Ⅰ 6.80 and 20.41 g/kg groups, normal control group and western drug control group than in the blankcontrol group (20.19±4.18, 25.01±6.44, 26.38±6.52, 19.44±4.33, 14.36±3.21, P ＜ 0.05). The AChE fiber area densities in hippocampal CA1 region were obviously higher in the Tiantai Ⅰ 20.41 g/kg groups and nor mal control group than in the blank control group, western drug controlgroup and Tiantai Ⅰ 6.80 g/kg group (13.88±3.07, 14.11±4.36, 6.57±2.30, 10.13±2.94, 9.63±2.40, P ＜ 0.05). ③ ChAT activity: It was obviously high er in the TiantaiI 20.41 and 6.80 g/kg groups, western drug control groupand normal control group than in the blank control group (0.683±0.179, 0.589±0.179, 0.552±0.173, 0.705±0.141, 0.354±0.131, P ＜ 0.05). CONCLUSION: Tiantai Ⅰ can significantly improve the disturbances oflearning and memory in mice with spontaneous Alzheimer disease, and itcan increase the activity of central cholinergic system in a dose-dependentmanner.