Objective To evaluate the clinical efficacy of intraarterial infusion chemotherapy in patients with advanced and/or recurrent breast cancer. Methods From February 2000 to March 2003, 18 patients with advanced and/or recurrent breast cancer were treated with interaarterial chemotherapy (IAC). The Seldinger's technique was used in all patients. IAC was administered for 2-3 courses every 3-4 weeks for each patient. Results The proceduce was successfully performed in all 18 patients including one with a complete response, 12 of a partial response, none in 3, and with progression in 2. The overall response rate was 72.2%. The frequent adverse effects were fever, leukopenia, nausea, and vomiting but no severe complication occurred. Conclusion Intraarterial infusion chemotherapy is a safe, simple, complication-free and effective in the patients with advanced and/or recurrent breast cancer.

Folic acid-O-carboxymethyl chitosan ultrasmall superparamagnetic iron oxide nanoparticles (FA-OCMCS-USPIO-NPs) are a novel molecular targeting MR contrast agent. This paper reperts the pharmacokinetics and magnetic resonance response characteristics of FA-OCMCS-USPIO-NPs in normal rats and mice, and discussed its distributing regularity in animals, providing basis for tumor targeting imaging. O-phenanthroline method was used to determine iron content in rats' plasma and mice's organs following high and low doses of nanoparticles injected through tail vein, and the blood concentration-time curve was drawn, the calculated t1/2 of two groups were greater than 7 h. The results of tissue distribution showed that only a small part of nanoparticles were swallowed by the liver and spleen, while none in the heart, lung and kidney. At the same times, the phagocytosis of nanoparticles did not change with the dose. The results of MRI showed that renal excretion occurred 4 hours after injection, and signal to noise ratio (SNR) of liver and kidney returned to normal levels 24 hours after injection. There were no nanoparticles in the lungs. So a part of nanoparticles escaped from phagocytosis of liver and spleen, and it owned lower toxicity and longer half-life. indicated its use for tumor-targeting imaging. All of these indicated its use for tumor-targeting imaging.

Background Many ophthalmologists have proved that the intravitreal injection of plasmin can safely induce posterior vitreous detachment(PVD),but if it can generate the complete PVD need further to seek confirmation.Researches showed that the safe dose and toxicity dose of dispase are very near,so its application is limited.Whether hyaluronidase can induce PVD is still in controversy.Objective This study is to clarity the mechanism of pharmacological vitreolysis with plasmin and hyaluronidase.Methods Plasmin 4μmol/L,2μmol/L and 1μmol/L,plasmin 1μmol/L+ hyaluronidase 20μmol/L,hyaluronidase alone were intravitreally injected in lateral eye of 4 clean New Zealand white rabbits respectively,and 0.1mL BSS was injected as control group.Electron immunocytochemical technique was used to detect the laminin and fibronectin of interface between vitreous and retina in 7 days after intravitreal injection.Other 14 eyes of 7 clean New Zealand white rabbits were used in this study.Plasmin 1μmol/L + hyaluronidase 20μmol/L was intravitreally injected in the lateral eyes,and only plasmin 1μmol/L was injected in the fellow eyes.Plasmin activity in vitreous was evaluated in 15 and 30 minutes,1 hour,2,3,6,12 hours after intravitreal injection.The use of animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The amounts of laminin and fibronectin in the vitreoretinal interface were decreased in 4μmol/L plasmin group,2μmol/L plasmin group,1μmol/L plasmin group,1μmol/L plasmin+20μmol/L hyaluronidase group compared with control group(P＜0.01).No significant difference was seen in the density of gold particles of anti FN between 20μmol/L hyaluronidase group and control group (P＞0.05).The change of amounts of fibronectin in the vitreoretinal interface was similar to that of laminin.Plasmin activity remained the highest level 1 hour after injection and thereafter gradually decreased and extincted in 12 hours and presented the same trend between plasmin 1μmol/L+hyaluronidase 20μmol/L group and only plasmin 1μmol/L group.Conclusion The mechanism of pharmacological vitreolysis is to dissolve laminin and fibronectin in the interface between vitreous and retina and therefore induce PVD.Combination of plasmin with hyaluronidase can increase the efficiency of pharmacological vitreolysis.The optimum selection of drug in inducing PVD should consider not only its role of lysis laminin and fibronectin but also the role of liquefying the vitreous.

Objective To evaluate the effects of early tracheostomy and late tracheostomy on the prognosis of patients with cervical spinal cord injury,so as to provide evidence based guidance for the timing of tracheostomy.Methods Relevant literatures studying the timing of tracheostomy in patients with cervical spinal cord injury were searched in PubMed,Embase,Medline,Cochrane Library,Chinese Biological Medical Literature database (CBM),China National Knowledge Infrastructure database (CNKI),and VIP journal database with time range from journal establishment to March 2018.The retrieved articles were screened according to the inclusion and exclusion criteria.The article quality was rigorously evaluated according to the Newcastle-Ottawa scale (NOS).Meta analysis was conducted using Review Manager 5.3 software to compare the mechanical ventilation time,ICU stay,incidence of pneumonia,incidence of complications,and mortality between early and late tracheostomy in patients with cervical spinal cord injury.Results A total of eight articles of cohort study including 466 patients were included,with 241 patients in the early tracheostomy group and 225 patients in the late tracheostomy group.The eight articles were all determined as high quality studies according NOS.The results of Meta analysis showed that there were significant differences between the two groups in terms of the total mechanical ventilation time (MD =-12.28,95％ CI-20.09--4.47,P ＜ 0.01),post tracheostomy mechanical ventilation time (MD =-9.92,95％ CI-14.27--5.57,P ＜ 0.01),total ICU stay (MD =-10.30,95％ CI-17.12--3.47,P ＜ 0.01),post tracheostomy ICU stay (MD =-5.79,95％ CI -6.53--5.05,P ＜ 0.01),incidence of complications (RR =0.56,95％ CI 0.38-0.83,P ＜ 0.01),and mortality (RR =0.34,95％ CI 0.15-0.78,P ＜ 0.05).However,no significant differences were detected between the two groups in the incidence of total pneumonia (RR =0.77,95％ CI 0.57-1.05,P ＞0.05) and the incidence of post tracheostomy pneumonia (RR =0.80,95％ CI 0.51-1.26,P ＞0.05).Conclusion Early tracheostomy can shorten the mechanical ventilation time,ICU stay,incidence of complications,and mortality,but it cannot reduce the incidence of pneumonia.

Objective To investigate the therapeutic effect of lateral homodigital flap combined with pedicled cross finger flap for repairing degloving injury of fingertip.Methods From February 2012 to July 2015,14 cases with degloving injury of fingertip were treated with lateral homodigital flap combined with vascular pedicled cross finger flap.21 days after operation,the pedicle was cut off,followed by functional exercise.Results All of the 14 patients were followed up for 3 to 9 months.The texture and appearance of all the flaps were satisfactory.Sense and function of finger recovered well.Two-point discrimination distance ranged from 10 to 13 mm (mean,11.5 mm).Conclusions Degloving injury of fingertip can be treated by lateral homodigital flap combined with pedicled cross finger flap with satisfactory results.

Objective To investigate the therapeutic effect of lateral homodigital flap combined with pedicled cross finger flap for repairing degloving injury of fingertip.Methods From February 2012 to July 2015,14 cases with degloving injury of fingertip were treated with lateral homodigital flap combined with vascular pedicled cross finger flap.21 days after operation,the pedicle was cut off,followed by functional exercise.Results All of the 14 patients were followed up for 3 to 9 months.The texture and appearance of all the flaps were satisfactory.Sense and function of finger recovered well.Two-point discrimination distance ranged from 10 to 13 mm (mean,11.5 mm).Conclusions Degloving injury of fingertip can be treated by lateral homodigital flap combined with pedicled cross finger flap with satisfactory results.

Objective:To observe the effect of hypocaloric parenteral nutrition (PN) regimen on the postoperative recovery in aged patients with gastric cancer .Methods:Sixty aged patients with gastric cancer were divided into observation group (n=30) and control group (n=30) on the basis of postoperative PN feeding strategies .The observation group received hypocaloric PN which contained calorie 18 kcal/kg/d and nitrogen 0 .1 g/kg/d .And the control group received calorie 30 kcal/kg/d and nitrogen 0 .2 g/kg/d .Both groups have been provided with PN for 6 days continuously .The differences regarding C‐reactive protein(CRP) ,serum albumin ,blood glucose ,infectious complications and duration of hospital stay were compared between the two groups .Results:CRP level on the 6th day in observation group was significantly lower than that in control group , while levels of serum prealbumin and transferrin in observation group were higher than those in control group (P< 0 .05) . There was no significant difference regarding blood glucose concentration between the groups , but the dose of insulin administered on the 6th day in observation group was significantly lower than that in control group (P< 0 .05) .And both infectious complications and duration of hospital stay in observation group were fewer than those in control group (P<0 .05) . Conclusions :Hypocaloric PN regimen was conducive to postoperative recovery in aged patients with gastric cancer .

The successes with immune checkpoint blockade (ICB) and chimeric antigen receptor(CAR)-T-cell therapy in treating multiple cancer types have established immunotherapy as a pow-erful curative option for patients with advanced cancers.Unfortunately,many patients do not derive benefit or long-term responses,highlighting a pressing need to perform complete investiga-tion of the underlying mechanisms and the immunotherapy-induced tumor regression or rejection.In recent years,a large number of single-cell technologies have leveraged advances in characterizing immune system,profiling tumor microenvironment,and identifying cellular heterogeneity,which establish the foundations for lifting the veil on the comprehensive crosstalk between cancer and immune system during immunotherapies.In this review,we introduce the applications of the most widely used single-cell technologies in furthering our understanding of immunotherapies in terms of underlying mechanisms and their association with therapeutic outcomes.We also discuss how single-cell analyses help to deliver new insights into biomarker discovery to predict patient response rate,monitor acquired resistance,and support prophylactic strategy development for toxicity man-agement.Finally,we provide an overview of applying cutting-edge single-cell spatial-omics to point out the heterogeneity of tumor-immune interactions at higher level that can ultimately guide to the rational design of next-generation immunotherapies.

Objective To compare the surgical effects between minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider and open anterior ondontoid screw fixation in the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ.Methods From July 2011 to July 2016,28 adults with odontoid fracture of Anderson-D'Alonzo type Ⅱ were treated at Department Ⅱ of Spinal Surgery,Hospital of 89 Army Group of Chinese PLA.Of them,15 were treated by minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider (guider group) while the other 13 by open anterior ondontoid screw fixation (open group).All the patients were male,aged from 31 to 59 years (average,42.7 years).The 2 groups were compared in terms of incision length,operation time,intraoperative bleeding,intraoperative fluoroscopic frequency and hospital stay.Results There were no significant differences between the 2 groups of patients in their preoperative general data,indicating they were compatible (P ＞ 0.05).All the patients were followed up for 12 to 45 months (average,22.1 months).The internal fixation was in good place and clinical union achieved in all the 28 patients.The incision length (2.2 ± 0.1 cm),operation time (45.0 ± 3.1 min),intraoperative bleeding (29.0 ± 2.3 mL) and intraoperative fluoroscopic frequency (15.5 ± 1.9 times) for the guider group were all significantly less than those (2.9 ±0.7 cm,61.6±3.8 min,51.6±3.9 mL and 21.7±3.2 times,respectively) for the open group (P ＜0.05),but there was no significant difference between the 2 groups in hospital stay (6.5 ± 0.5 d versus 6.5 ± 0.6 d) (P ＞ 0.05).Conclusion In the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ,compared with open anterior ondontoid screw fixation,the minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider may lead to a smaller incision,shorter operation time,less blood loss and a lower fluoroscopic frequency.

Objective:To investigate the clinical effect of saphenous artery perforating branch flap in repairing anterior knee soft tissue defects with patella exposure.Methods:From July 2010 to September 2017, 12 patients whose patella exposed due to anterior soft tissue defects of knee were treated. The 12 cases included 8 males and 4 females, aged from 24 to 60 years (42.6 years on average). The causes of injury included car accident in 5 cases, rolling injury in 3 cases, burn and scald in 2 cases, and postoperative patella fracture in 2 cases. The areas of the wounds ranged from 6 cm × 5 cm to 8 cm × 7 cm. The wounds were repaired by saphenous artery perforating flaps with the area ranged from 7 cm × 6 cm to 9 cm × 8 cm, and the donor sites were repaired with free skin grafting.Results:All the 12 cases ended up with the wounds healed primarily and no postoperative complications. The 12 cases were followed up for 6 months to 24 months, with an average of 12 months. The color, texture and appearance of the flaps were good, the thickness of the flap were moderate, and the function of knee joint was recovered well. Skin flap sensation was graded according to the criteria of the British Medical Research Society: 2 cases for Grade S 3+, 6 cases for Grade S 3 and 4 cases for Grade S 2. Conclusions:Saphenous artery perforating flap is an effective method to repair anterior knee soft tissue defect and patella exposure.