Background and purpose:Nipple secretion is one of the frequent symptoms in mammary gland disease.Clinically,about 1% breast cancer patients demonstrate with nipple secretion as initial symptom.It could be used as a screening tool for the patients with nipple secretion but no palpated mass and increase the possibility of early diagnosis for breast cancer.In 1997,our country developed a new technique——breast fiberoptic ductoscopy(FDS). It uses a ?(0.7) millimeter optic scope to insert into the nipple discharge canal orifice,and depends on introscope technology to observe and record the normal or abnormal changes in mammary gland ductus.Its advantages are not only in highly diagnostic sensitivity(above 90%),but also in accurate location of tumor,so it can be used to diagnose early breast cancer and mammary gland ductal diseases.This study evaluated the clinical effect of breast FDS in diagnosis and treatment of abnormal nipple secretion.Methods:1 000 patients had been under examination by FDS.Results:Of the 1 000 cases,there were 33 cases((3.3%)) of early breast cancer;412 cases(41.2%) of papilloma and papillomatosis;and 480 cases(48%) of either ductal ectasia and or chronic inflammation.Duct endoscoptic biopsy was successfully performed on 30 cases,220 cases(55%) with chromic inflammation were cured by perfusion.453 cases were received operation.The accordance rate with pathologic eiagnosis was 90.7%.Conclusions:FDS is a very important and new method to diagnose breast.FDS could be inserted into 5th ducta lumen of breast and significantly increase the positive detection of breast cancer.Because the position and nature of the lesions can be determined accurately by FDS,tt is used as intervening treatment for some intraductal papilloma and chronic inflammatory disease.FDS will be of great influence on early diagnoses and treatment of the breast cancer.

Objective This study was to evaluate breast fiberoptic ductoscopy (FDS) in the diagnosis and treatment of abnormal niple discharge(AND). [WT5”HZ]Methods [WT5”BZ] FVS 3500 superfine fiberscopy system was used to treat and diagnose 200 cases with AND. [WT5”HZ]Results [WT5”BZ] 210 orifices of nipple discharge were found in this group. FDS was successfully inserted into 204 orifices(97 0%).Early breast cancer was found in 9 cases(4 5%), papilloma and papillomatosis in 66 cases(33 0%),ductal ectasia and/or chronic inflammation in 96 cases(48 0%); “normal duct” in 29 cases(14 5%). Duct endoscopic biopsy was carried out in 10 cases. Chronic inflammation was cured by perfusion in 25 cases. 67 cases underwent surgery, diagnosis was confirmed by pathology in 95 0% with a positive rate 3 times as high as that of smear cytology.Conclusions FDS enables the evaluation on 4th ductal lumen and detection of early breast cancer. Interventional treatment was successful in some intraductal papilloma and chronic inflammatory disease.

We prepared silver nanoparticles/polyethyleneimine-reduction graphene oxide (AgNP/rGO-PEI) composite materials, and evaluated their quality performance in our center. Firstly, we prepared AgNP/rGO-PEI, and then analysed its stability, antibacterial activity, and cellular toxicity by comparing the AgNP/rGO-PEI with the silver nanoparticles (PVP/AgNP) modified by polyvinylpyrrolidone. We found in the study that silver nanoparticles (AgNP) distributed relatively uniformly in AgNP/rGO-PEI surface, silver nanoparticles mass fraction was 4.5%, and particle size was 6-13 nm. In dark or in low illumination light intensity of 3 000 lx meter environment (lux) for 10 days, PVP/AgNP aggregation was more obvious, but the AgNP/rGO-PEI had good dispersibility and its aggregation was not obvious; AgNP/rGO-PEI had a more excellent antibacterial activity, biological compatibility and relatively low biological toxicity. It was concluded that AgNP/rGO-PEI composite materials had reliable quality and good performance, and would have broad application prospects in the future.
Anti-Bacterial Agents ; chemistry ; Graphite ; chemistry ; Light ; Nanoparticles ; chemistry ; Oxides ; chemistry ; Particle Size ; Polyethyleneimine ; chemistry ; Silver Compounds ; chemistry

Objective To investigate the effect of triptolide (TP) on the expression of hypoxia inducible factor 1 alpha (HIF1α) and vascular endothelial growth factor (VEGF) in the human umbilical vein endothelial cells (HUVECs) under hypoxia. Methods (1) HUVECs were treated with 0, 40, 80, 160 and 320 nmol/L TP (named with hypoxia group, TP40 group, TP80 group, TP160 group and TP320 group, respectively) under the hypoxic condition (37℃, 5%CO2, 1%O2, 94%N2) for culturing 12 hours. Meanwhile, cells cultured under normoxia condition (without TP added) were set as the normoxia group. Western blot assay was used to detect the expression of HIF1αin each group. (2) The cells were divided into normal control group, hypoxia group and TP80 group. The immunofluorescence method was performed to detect the localization of HIF1α in cells. (3) Expressions of VEGF were detected by Western blot assay in TP80 group and hypoxia group. (4) The cells were divided into hypoxia group, TP80 group, TP80+KF20 group (80 nmol/L TP and 20μmol/L KC7F2), and TP80+KF30 group (80 nmol/L TP and 30 μmol/L KC7F2). After 12-hour culturing, Western blot assay was used to detect the expressions of HIF1α and VEGF in each group. Results (1) Under the normoxia condition, no HIF1α was detected in HUVECs. The expression level of HIF1αwas significantly increased in TP80 group than that in hypoxia group (P<0.05), while there was no significant change in expression of hypoxia HIF1αin TP160 group and TP320 group compared with that of hypoxic group. (2) The immunofluorescence result showed that HIF1α was mainly expressed in the nucleus. (3) The expression of VEGF was significantly increased in TP80 group than that in hypoxia group (P < 0.05). (4) After the intervention of KC7F2, HIF1αand VEGF expression levels were significantly decreased in the TP80+KF20 group and the TP80+KF30 group than those in the TP80 group (P<0.05). Conclusion TP can improve the expression of HIF1αand VEGF to accelerate the proliferation of endothelial cells under hypoxia condition.

The clinical application of arthroscopic minimally invasive treatment of shoulder joint disease technology has become a routine,and it has been widely carried out around the world.Compared with the traditional open surgery,it only needs to establish a few channels in the shoulder and then the diagnosis and treatment of the structure under the acromion and glenoid joint internal lesions can be completed through the arthroscopic technique under direct vision,of course,including local collection of pathological specimens.Shoulder arthroscopic surgery has the advantages of simple operation technique,small economic burden of patients,small tissue trauma,quick recovery and high accuracy of disease diagnosis.At present,there are two main options for shoulder arthroscopy:the beach chair position (BCP) and the lateral decubitus position (LDP).The choice of surgical position for surgeons is closely related to the intraoperative operation,the risk of complications,the efficacy of surgery,and the cost of setting the posture.Shoulder arthroscopy of these two positions have their own advantages and disadvantages:in the BCP,the surgeon gets a better anatomical operation experience,if necessary,can be converted into open surgery at any time.Without continuous traction,upper limb nerve and vascular damage caused by traction can be avoid.But the incidence of cerebral ischemic events in patients may increase in the BCP.There is also possibility of the nerve damage of the pillow small nerve,great auricular nerve,lateral femoral cutaneous nerve and other nerves.In theory the risk of air embolism in the patients will increase in the BCP,and the cost of setting the position is also higher than the LDP.While in the LDP due to the patient's forearm continuous traction,the surgeon can get a more extensive operating space,and the occurrence of cerebral ischemic events is very rare.In the treatment of anterior shoulder instability after shoulder arthroscopic surgery,there is a lower recurrence rate in the LDP.The cost of setting the position is also significantly lower than the BCP.Of course,the disadvantages of the LDP is also obvious.In the LDP,the brachial plexus and other nerves or vascular injury may increase due to the continuous traction of the forearm.Meanwhile sustained traction in the LDP is also a risk factor for thrombosis,and so on.Therefore,there is still a debate about the optimal location of the shoulder arthroscopy.Many clinicians choose shoulder arthroscopic position based on their own experience and habits.

Venous thromboembolism (VTE) is a common complication of hip and knee arthroplasty and of many major orthopedic surgeries.VTE mainly includes two aspects,ie,deep vein thrombosis (DVT) and pulmonary embolism (PE).Symptomatic PE is likely to endanger patients' life,resulting in irreversible severe consequences.With the return of venous blood,DVT may also fall off at any time,forming a new PE.Therefore,the prevention of VTE in large orthopedic surgeries has been highly valued by scholars worldwide.However,the problem of VTE after arthroscopic surgery has not drawn much attention from clinicians.Researchers have not reached a consensus on whether routine anticoagulation therapy is required after surgery because of VTE's low incidence and discrepancy among various studies (0.42％-17.9％).With a large number of knee arthroscopy being performed per year,the postoperative VTE incidence can not be ignored.For these reasons,some scholars have suggested that patients after knee arthroscopy should be stratified and that patients with a higher risk of postoperative VTE need to be given anticoagulant therapy.Risk factors for VTE after knee arthroscopy may have effects on the clinical treatment of patients.Therefore,a review of the literature to explore the possible risk factors for postoperative VTE was conducted.

【Objective】 Virtual reality (VR) technology is closely related to eye vision. With the development and progress of hardware and software equipment, VR has been applied widely in the field of ophthalmology. This article describes the application of VR technology in the clinical research and ophthalmology education, reviews the current research results and advantages of this new technology, including the new curative effect in amblyopia/strabismus, myopia and glaucoma, as well as research on the technology’s application in cataract surgery training and ophthalmology education. The article also discusses the dangers and difficulties of VR application and predicts its future application trend. In view of the shortcomings of VR in current research applications, the paper discusses and looks forward to provide powerful strategies for amblyopia, myopia and other ophthalmic diseases and clinical research.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.