Cardiomegaly ; Humans ; Signal Transduction

Objective Pulmonary embolism is a common cardiovascular emergency with the characteristics of high incidence,high mortality.This study compared pulmonary artery catheter thrombolysis with peripheral intravenous thrombolysis for acute pulmonary embolism in the mid-term clinical efficacy.Methods From June 2011 to September 2015,68 patients were given pulmonary artery interventional therapy,54 cases received peripheral intravenous thrombolysis;discharged patients were followed up for 3-12 months to evaluate the curative rate,effective rate,recurrence rate and the incidence of complications.Results Follow up rate was 79.5％.The cure rate of the treatment group was higher than that of the control group (47.3 ％ vs 23.8 ％,P ＜ 0.05);The significant effective rate of the treatment group was higher than that of the control group (81.8％ vs 52.4％,P ＜ 0.05);The incidence of Chronic pulmonary hypertension (1.8％) was lower than that of the control group (16.7％);There was no significant difference in improvement rate,recurrence rate and mortality.Conclusion The medium-term efficacy of pulmonary artery catheter directed thrombolysis is superior to that of peripheral intravenous thrombolysis;it can effectively reduce the incidence of chronic thromboembolic pulmonary hypertension.

The application of minimally invasive esophagectomy in the treatment of esophageal carcinoma has drawn much attention. At present, results of quite a number of clinical researches show that minimally invasive esophagectomy is helpful to reduce trauma and complications of esophageal surgery, especially cardiopulmonary complications with shorter length of hospital stay. However, there are still controversies on resection extent, lymph node dissection and survival as compared to traditional open esophagectomy. This paper discusses the minimally invasive esophagectomy on the telescopic esophagectomy of primary lesion, lymph node dissection and survival based on the worldwide reports of telescopic esophagectomy researches.
Carcinoma ; surgery ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Length of Stay ; Lymph Node Excision ; Minimally Invasive Surgical Procedures ; Postoperative Complications

Background and purpose:Triple-negative breast cancer (TNBC) is currently the focus of breast cancer research. Researches demonstrated that the molecular biological characteristics of different ethnic groups are not the same. This study mainly probed into the expression of endothelial growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) in Han and Uygur TNBC patients, and the relationship between the expression and prognosis of patients.Methods:From Jan. 2007 to Jan. 2009, 167 patients were admitted. Among those, 121 were Han and 46 were Uygur patients. The expressions of EGFR, and VEGF were detected by PV-9000 immunohistochemical staining, and compared with lymph node metastasis and clinical staging. The results were analyzed by SPSS 18.0 statistical software.Results:Five-year disease-free survival (DFS) of two groups had no indifferent (P>0.05). EGFR and VEGF positive rate of Han patients was lower than that of Uygur patients (P<0.05). Their expressions were correlated with TNM staging and lymph node metastasis (00.05). Uygur TNBC patients might have a different prognostic factor as compared with Han patients. Further studies need to be carried out.

Objective To investigate the change of levels of related cytokines,including transforming growth factor-β2 (TGF-β2),basic fibroblast growth factor (bFGF),platelet-derived growth factor (PDGF),interleukin-6 (IL-6),interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) and behavior in streptozotocin-induced diabetic rats between the before and after fracture,at the same time,to analyse the relativity of them.Methods The rat models of diabetic were induced by intraperitoneal injection of streptozotocin,which were divided into different diabetes mellitus group (DM group) randomly.The right tibiofibula of all the rats of diabetes mellitus group and normal control group(NC group) were broken,and then treated with external fixation.The bone callus formation was evaluated by X-ray.When all the operation above was completed,the rats were domesticated in different cages.The concentration of related cytokines of the DM groups and NC group was detected at different time.Results The behavior changes of diabetes fracture rats were distinct and appeared a series symptoms such as bradykinesia,dull,polydipsia,polyphage,polyuria,emaciated obviously.The concentration of related cytokines (TGFβ2,BFGF,PDGF,IL-6,IL-8 and TNF-α) of the two groups was detected at 1,2 and 4 weeks.The difference between them was significantly(TNF-α:the concentration of NC group were (9.87 ± 1.06) ng/ml,(14.07 ± 1.43)ng/ml and(12.02 ± 1.02) ng/ml; the concentration of DM group were (11.65 ± 1.18) ng/ml,(16.29 ± 1.24)ng/ml and(13.87 ± 1.25)ng/ml ; P ＜ 0.05).X-ray films showed that the fracture healing of NC group was more superior than that of DM group.Conclusion The reduction of TGF-β2,BFGF,PDGF and the increase of IL-6,IL-8,TNF-α in early fracture are one of important reasons for delayed union and nonunion in diabetic rats.At the same time,there is a cooperative action between them.Dynamic observation of the concentration of related cytokines will provide eliable experimental data to estimate fracture healing,delayed union and nonunion.It is favourable to acquaint the regulatory mechanism of fracture healing at molecular level.

Objective To investigate the clinical significance of BRCA1/ 2 mutation in breast cancer patients with different malignant tumor family history. Methods We studied 98 cases of diagnosed breast cancer patients with malignant tumor family history. BRCA1/2 screening was performed by PCR-DHPLC sequencing method. All mutations were confirmed by using direct DNA sequencing. Results The prevalence of BRCA1/2 germline mutation was 20.41%.The BRCA1/2 mutation was 55.6% in patients with family breast and ovarian cancer, and was 20.0% and 17.9% in patients with family breast and in patients with ovarian cancer, respectively. In correspondence to 2 and 3 and 4 people withof the breast or ovarian cancer in family , the BRCA1/2 mutation was 16.25%、33.3%、66.67% ,respectively. Conclusion The BRCA1/2 mutation rate increased in the patients with breast and ovarian cancer family history, and the detection of BRCA1/2 mutation increased with the number of patients with cancer in a family.

Objective Discussion the relationship of PALB2 and AR expression in triple negative breast cancer and its clinical pathological features. Methods The SP immunohistochemical staining was adopted to detect the expression of PALB2 and AR in 178 cases of TNBC, PALB2 divided into two groups according to the expression of different, and to analyze the clinical pathological features and prognostic impact of different AR expression status. Results 178 cases of TNBC, that PALB2 missing expression 47 cases (26.4%), AR expression of 60 cases (33.7%), between of them were negatively correlated (-1≤r<1, P<0.05), in PALB2 negative group, AR expression associated with family history, lymph node metastasis, clinical stage and recurrence and metastasis (P<0.05), and 5-year disease-free survival lower than AR negative expression, Log rank = 4.453, P = 0.035. Conclusion PALB2 negative expression while AR positive expression in TNBC have synergistic effect with disease progression, PALB 2 and AR combined detection may provide a new basis for the prognosis of TNBC interpretation, and recommending take further studies to confirm.

Objective To evaluate the outcome of percutaneous K-wire leverage reduction and fixation for O'Brien Ⅱ,Ⅲ pediatric radial neck fracture.Methods From March 2010 to February 2013,16 children with O'Brien Ⅱ,Ⅲ pediatric radial neck fracture were operated in our hospital.There were 6 females and 10 males aged from 6 to 14 years old.There were 12 left arms and 4 right arms.Concomitant injuries included proximal ulna fractures in 2 cases and medial epicondyle fracture of humerus in 1 case.All children present a swollen and painful elbow with loss of rotation and pain on pronation and supination.The mean visual analogue score (VAS) was 7.9 (range,6.5-9.2).The flextion,extention,pronation and supination of elbow were 78°±3°,-54°±4°,9°±3° and 5°±3° in average.All cases were classified by the O'Brien system,including 9 cases of Ⅱ type and 7 cases of Ⅲ type.Mechanism of injury was fall from a height.The interval between injury and surgery averaged 2.8 days.Percutaneous leverage reduction and fixation were performed for 16 patients.After confirming successful reduction,the wire was advanced to the far cortex of the radius and penetrated into the far cortex to maintain the reduction status.4 weeks of long-arm cast followed by functional exercises were carried out for all patients.We analyzed radiographs and clinical results according to the criteria suggested by Metaizeau.Results 16 patients were followed up for 11.8 month in average after operation.14 patients were gained anatomical reduction.No patient had posterior interosseous nerve injury,fracture redisplacement and pin site infection.All fractures healed in a mean of 4.1 weeks.The follow-up flextion,extention,pronation and supination of elbow were 136°±4°,-2°±2°,81 °±4° and 75°±4° in average.Follow-up radiographs showed no patient had avascular necrosis of radial head.One patient had physeal arrest after 15 months of operation and outpatient follow-up observation were conducted.According to Metaizeau function scale,8 were excellent,7 good and 1 fair.The healing rate was 93.8％ (15/16).Conclusion Percutaneous joystick reduction and fixation technique have good effect for O'Brien Ⅱ,Ⅲ pediatric radial neck fracture,which is simple and easy to master.

Objective By analyzing the characteristics of PI system in the US,especially its advantages,to learn the ways and means in the cultivation of postgraduates' innovative ability.Combined with the current situation of medical postgraduate training in China,some countermeasures in line with the actual situation of our country and the cultivation characteristics of medical graduate students' innovative ability were proposed.Methods Conducting literature review by using the CNKI and logging on to the official website of relevant agencies to collect and summarize related research data.Results Concrete suggestions from four aspects were proposed:Encourage medical graduate students to participate in scientific and technological research,well-planning of scientific research resources,optimizing and perfecting the mentor-mentee system and constructing a reasonable mechanism for achievement distribution.Conclusions The PI system in American scientific research field can be used for reference in the form and content of cultivating the innovative ability of medical postgraduates in China.