Objective:To study the change of immunological response and cell proliferation in breast tissues augmented by polyacrylamide hydrogel injection(PHI).Methods:The expression of CD68,CD25 and PCNA in 20 breast tissues with indurations,12 without indurations after breast augmentation by PHI,and 10 normal breast tissues was examined by immunohistochemistry P-V6000; analysis was also done by H-E staining.Results:Hyperplasia of fibrous tissue and infiltration of inflammatory cells and macrophages were found in the breast and adjacent tissues 3-8 years after PHI.Positive cells of CD68,CD25 and PCNA hardly existed in the normal tissues,but the breast tissues around the polyacrylamide hydrogel had many positive cells of CD68 and PCNA,especially in cases with indurations;there were significant differences between the 3 groups(P

Objective To explore the morphological characteristics of Barrett's esophagus under confocal laser endomicroscopy (CLE).Methods A total of 112 patients with suspected Barrett's esophagus (BE) under endoscopy were enrolled in this study.The lower esophageal columnar mucosa was examined with CLE to real-time forecast the histological type and extent of intestinal metaplasia of BE,followed by mucosal biopsies and histopathological examination in inspected area.The relationship between the features under common endoscopy or CLE and histopathological diagnosis was analyzed.Results A total of 94 patients were diagnosed as BE.Island type is the most common type under common endoscopy (54.3％),and the incidence of short-segment BE was higher than that of longsegment BE (86.2 ％ vs 13.8 ％).Specialized intestinal metaplasia,cardiac and fundic epithelium can be distinguished under CLE,and the accuracy was 94.7％,89.4％ and 91.5％ respectively.The histopathological examination in targeted biopsy specimens indicated that the proportion of intestinal metaplasia was higher in long-segment BE (9/13) than that of short-segment BE (33.3 ％,x2 =4.684,P=0.039),and the proportion of intestinal metaplasia was higher in circumferential(11/17) and tongue-like BE (65.4％) than that of island type (15.7％,x2 =15.217 and 19.399 respectively,P＜0.01).There were no significant difference in the extent of intestinal metaplasia among island type,circumferential type and tongue-like type in short-segment and long-segment BE.Conclusions The histological type of BE can be accurately distinguished with CLE.The most common type of BE is island type.The incidence of intestinal metaplasia is higher in circumferential and tongue-like type.The incidence of intestinal metaplasia is higher in long-segment BE than that of short-segment BE.

OBJECTIVETo investigate the clinical effects of enblock distal radius T-plate fixation in treating trailing edge fracture of tibial plateau medial condyle and posterior cruciate ligament (PCL) avulsion fracture.

METHODSFrom September 2008 to November 2011, 5 patients with trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension,were treated with surgery. There were 3 males and 2 females with an average age of 35 years old (25 to 42). Left knee injury was in 3 cases and right knee had in 2 cases; 2 cases caused by sports injury and 3 cases caused by road accident. All patients were undergone emergency treatment. Fractures were anatomically reduced and fixed with T-plate through poples approach. Complications were observed after operation. Bone healing and clinical effects were respectively evaluated by X-rays and HSS system.

RESULTSFive patients were followed up for 1 to 4 years with a mean of 2 years. All incisions obtained healing of I stage. All knee joints recovered well and were stable with inflexion more than 120 degrees, no complications such as knee joint pain, injuries of nerve and blood vessel, infection, internal fixation failure were found. The mean score of HSS system was 94.40 +/- 6.09 and all patients got excellent result.

CONCLUSIONFor the treatment of trailing edge fracture of tibial plateau medial condyle and PCL avulsion fracture caused by knee joint hyperextension, enblock distal radius T-plate fixation had advantages of good stability,higher success rate, and knee joint function can recover well.

Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Male ; Posterior Cruciate Ligament ; diagnostic imaging ; injuries ; surgery ; Tibial Fractures ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND:Deep vein thrombosis is a common complication following bone surgeries,so its prevention and treatment become critical.However,there are few studies on the incidence of deep vein thrombosis after spine surgery in the elderly.OBJECTIVE:To explore the diagnosis of deep vein thrombosis after spine surgery in the elderly and its incidence after intervention with low-molecular-weight heparin.METHODS:All patients undergoing spine surgery were randomly divided into experimental and control groups.Patients in the experimental group were subjected to the subcutaneous injection of 0.4 mL of low-molecular-weight heparin (4 100 IU) at 12 hours postoperatively,once daily for 7-14 days from the next day.Those received no intervention served as controls.The thromboplastin time,thrombin time,activated partial thromboplastin time,and level of plasma fibrinogen were detected before and after treatment.Color Doppler ultrasound results of the lower extremity vessel before and after treatment and postoperative drainage volume were recorded.RESULTS AND CONCLUSION:(1) In the experimental group,the lower level of plasma fibrinogen and slightly prolonged thromboplastin time,thrombin time and activated partial thromboplastin time were observed,but all were within the normal range.(2) The incidence of deep vein thrombosis in the experimental group (0％) was significantly lower than that in the control group (5％,P ＜ 0.05).(3) To conclude,low-molecular-weight heparin therapy significantly reduced the incidence of deep vein thrombosis after spine surgery.

20?g/L) after surgery in one month.The survival rate for 1,3,5yr were 100%(n=17),91.5%(n=16) and 84.7% (n=14) respectively in the therapy group,and in the control group 95.45% (n=21),72.7% (n=16),40.91%(n=9) respectively.Sur- vival rate between two groups showed significant difference (P

Objeetlve To identify the nurses’knowledge and attitude about HIV/AIDS,and to provide evidence for implementing the related education and training.Methods The questionnaire survey was used to collect the data of knowledge and attitude about HIV/AIDS in Sichuan,Yunnan and Guangxi Provinces.A total of 463 numes participated the study.Results Except HIV/AIDS training.training for nurses and hospital with HIV/AIDS patients.the other personnal information of nurses had significant difierence among the numes in the three areas(P<0.05).The mean score of uuraes’knowledge about HIV/AIDS Was(12.95±2.35).There were no significant difiefence between the mean scores in the three areas(P<0.05).The score of nurses’HIV/AIDS attitude Was(3.38 4±0.30),with no statistical meaning in the three areas(P>0.05).In the aspects of 18 items of work-related attitude.4 items were approved by over 80%nurses.There were signicanfly different meanings in 6 itents among the 3 area nurses.Conciusions Nurses’knowledge level and uncertain attitude to HIV/AIDS could not met the need of higher AIDS epedimic in the 3 areas.especially in Sichuan.Delivering training course for nurses about HIV/AIDS in these areas is very urgent.

Objective To establish diagnostic standards of confocal laser endomiroscopy (CLE) in pathological classifications of gastric cancer and evaluate the diagnostic value of CLE in vivo. Methods The confocal images of 36 patients, who were diagnosed as gastric cancer with confirmation of pathology, were collected and analyzed to establish diagnostic standards of CLE for pathological classifications of gastric cancer. The sensitivity, specificity and accuracy of CLE were determined with reference to histopathologic findiugs retrospectively. Results According to changes of glandular architecture and microvessels under CLE, gastric cancers were divided into differentiated and undifferentiated type. The sensitivity, specificity and accuracy of CLE in diagnosing differentiated carcinoma were 85.7%, 92. 3% and 90. 5%, respectively, which were 85.7%, 92. 3% and 90. 5%, respectively, in undifferentiated carcinoma. Conclusion CLE is a new tool to make pathological classifications of gastric cancer during routine endoscopic examination procedure, which correlates well with histopathologic fingdings.

Objective To estimate the value of confocal laser endomicroscopy (CLE)for differential diagnosis of gastric ulcer. Methods Patients diagnosed as gastric ulcer by conventional endoscopic mode of CLE were enrolled. The eonfocal endoscopic mode of CLE was used to observe the borderline and/or the surface of the ulcers. Biopsy specimen was taken for histopathological examination and the result of CLE was compared with histopathological finding. Results A total of 12 769 CLE images were obtained from 150 sites of 43 patients. The sensitivity and specificity of CLE for phlegmonosis process were 83.54% and 85.92%, respectively, with positive predictive value of 86.84% and negative predictive value of 82.43%. Whereas the sensitivity and specificity of CLE for intraepithelial neoplasia were 53.57% and 88.52%, respectively, with positive predictive value of 51.72% and negative predictive value of 89.26%. As for diagnosis of gastric cancer, the sensitivity and specificity of CLE were 88.37% and 93.46%, respectively, with positive predictive value of 84.44 % and negative predictive value of 95.24%. The kappa values for agreement of histopathological findings and CLE for diagnosis of phlegmonosis process, intraepithelial neoplasia and gastric cancer were 0.69,0.42 and 0.81, respectively. Conclusions CLE can provide a real-time histopathological diagnosis of the gastrointestinal tract with high sensitivity, specificity, positive and negative predictive values. Targeted biopsy can be done under CLE and the detective rates of precancerous lesions and tumors will be increased.

Objective To analyze the clinical characteristics of urinary tract infection after kidney transplantation and to analyze the distribution of pathogenic virulence factors.Methods From January 2014 to June 2016,a total of 255 cases were subjected to DCD renal transplantation in our center,and 45 cases of urinary tract infection occurred after operation.Among them,urinary tract E.coli infection occurred in 32 cases.The virulence factors gene aer,hly,irp2 and iucD in the 32 strains of E.coli isolated from urine were tested using PCR and multiple PCR.Results Thirty-two cases (71.1％) of urinary tract infection after renal transplantation was caused by E.coli,and divided into 9 cases of nosocomial infection group,and 23 cases of community-acquired group.The positive rate for aer,hly,irp2 and iucD in Nosocomial infection group was 66.7％,33.3％,88.9％ and 77.8％,and that in community-acquired group was 30.4％,8.70％,39.1％ and 34.7％,respectively.There were statistically significant differences among four kinds of virulence factors between two groups (P＜0.05).The positive rate of virulence factors was significantly higher in nosocomial infection group than in community-acquired groups.The total resistance rate was 84.38％,and there was significarit difference in multi-drug resistance rate between two groups (P＜0.01).Conclusion E.coli is the main pathogenic bacteria of urinary tract infection after renal transplantation,especially nosocomial infections.The detection rate of virulence factor is high,and the multiple drug resistance is outstanding,so the attention should be paid clinically.

Objective To investigate the metabolic profile of uric acid and the significance of the altered renal expression of urate trans-porter 1(URAT1) in patients with uric acid nephrolithiasis. Methods The data of 24 patients in our hospital from January 2012 to October 2013 were analyzed retrospectively. Participants in the research were divided into three groups:patients with uric acid nephrolithiasis,other patients with nephrolithiasis and normal participants. The basic clinical data and the related data of uric acid metabolition of participants were collected,URAT1 gene expression in renal tissures of three groups was detected by Real-time PCR technique. All data were statistically ana-lyzed and compared between these groups. Results Uric acid levels in plasma,body mass index and age were significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05),but urine PH value was significantly reduced in patients with uric acid neph-rolithiasis. Urine and uric acid output of 24 hours urine were no significant difference among the three groups (P>0. 05). The result of Real-time PCR suggested that the URAT1 renal expression was significantly higher in patients with uric acid nephrolithiasis than other two groups (P<0. 05). Conculusion Patients with uric acid nephrolithiasis are closely related with hyperuricemia,but unrelated with renal over-ex-cretion of uric acid. The upregulated URAT1 expression in the kidney may be an important molecular mechanism of the clinical features.