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 investigate the application value of continuous irrigation and vacuum suction by subcutaneous drainage tube for prevention of abdominal type Ⅳ incision infection.Methods A prospective,single-blind, randomized, controlled study was conducted based on the clinical data of 123 patients with abdominal type Ⅳ incision infection who were admitted to the First People's Hospital of Foshan between January 2008 and July 2014.Patients were divided into the experimental group and the control group based on the random number table and received open surgery.Patients in the experimental group were placed subcutaneous drainage tube with postoperative continuous irrigation and vacuum suction, while patients in the control group adopted the method of traditional abdominal closure without subcutaneous drainage tube.The levels of preoperative hemoglobin (Hb) and albumin (Alb), severity grading according to the American Society of Anesthetheologists (ASA), levels of Hb and Alb at postoperative day 1, 3, 7 were recorded and postoperative incision infection and bacteria culture were observed.Patients received bi-weekly regular return visit by outpatient evamination after discharged up to 3 months after suture removal.Measurement data with normal distribution were presented as x-± s and comparison between groups was analyzed by t test.Measurement data with skew distribution were presented as M (Qn) and comparison between groups were analyzed by rank sum test.Repeated measures data were analyzed by the repeated measures ANOVA.Count data were analyzed by the chi-square test.Results One hundred and twenty-three patients were screened for eligibility, and 65 were allocated into the experimental group and 58 into the control group.The levels of Hb and Alb at postoperative day 1, 3, 7 were (111 ± 15) g/L, (107 ± 18) g/L, (108 ± 13) g/L and 30 g/L (26 g/L,32 g/L), 31 g/L(28 g/L,33 g/L), 35 g/L(32 g/L,37 g/L) in the experimental group and (112 ± 13)g/L, (106 ±16)g/L, (106 ± 12)g/L and 30 g/L(25 g/L,32 g/L), 32 g/L(29 g/L,33 g/L), 37 g/L (32 g/L,38 g/L) in the control group, with no significant difference in the changing trends of the above indexes between the 2 groups (F =0.124, 0.007, P ＞ 0.05).There were 4 patients with incision infection in the experimental group and 12 patients in the control group, showing a significant difference (x2=2.723, P ＜ 0.05).The infections occurred at postoperative 4-6 days confined to subcutaneous tissues and unreached to muscular and below layers, and then were cured by incision open drainage without recurrence.Patients without incision infection were removed the stitches at postoperative 7-9 days.Incision bacteria cultures showed that Escherichia coli was detected in 8 cases (including 1 complicated with Enterococcus faecalis and 1 complicated with Klebsiella pneumonia and Pseudomonas aeruginosa), Pseudomonas aeruginosa in 1 case, Klebsiella pneumonia in 2 cases, Acinetobacter baumanii in 1 case, Enterobacter cloacae in 1 case and no bacteria in 3 cases.All the patients were followed up for 3 months after incision healing and survived well without recurrence and complications such as incision split and incision fistula.Conclusion Continuous irrigation and vacuum suction by subcutaneous drainage tube can be operated easily and effectively reduce the postoperative infection rate in abdominal type Ⅳ incision.

Objective To evaluate high resolution manometry in the diagnosis of hiatal hernia.Methods Clinical data were reviewed on 20 patients suffering from gastroesophageal reflux who had laparoscopic Toupet fundoplication for preoperative tentative diagnosis of hiatal hernia.Preoperative diagnosis of hiatal hernia was made collectively by endoscopy,X-ray examination,24 hour esophageal pH monitoring and high resolution manometry before surgery.Results Preoperative diagnosis of hiatal hernia was made in 3 patients by X-ray examination,in 9 patients by high resolution manometry.11 patients were finally diagnosed with hiatat hernia intraoperatively.X ray was consistent with intraoperative diagnosis in 27％ cases.Intraoperative and endoscopic diagnoses were 55％.High resolution manometry and intraoperative diagnoses were consistent in 82％.Lower esophageal sphincter length was (1.92 ± 0.38) cm in hiatal hernia group and (2.10 ± 0.92) cm in non-hiatal hernia group (t =0.60,P ＞ 0.05),lower esophageal sphincter pressure (respiratory min) was (0.64 ±0.55) kPa in hiatal hernia group and (1.31 ± 1.07) kPa in nonhiatal hernia group(t =1.80,P ＞ 0.05),and lower esophageal sphincter pressure (respiratory mean) was (1.43 ±0.92) kPa in hiatal hernia group and (2.57 ± 1.33) kPa in non-hiatal hernia group(t =2.26,P ＜0.05).The reflux parameters,including the percent total time pH ＜ 4,and DeMeester score,were significantly greater in hiatal hernia group than in non-hiatal hernia group (all P ＜ 0.05).Conclusions Hiatal hernia patients are with poor esophageal antireflux competency and severe reflux.High resolution manometry is more valuable in the diagnosis of hiatal hernia than endoscopy or X-ray examination.