Objective To investigate the curative effect of mammotome minimally invasive operation in the treatment of benign breast disease and analyse its characteristics.Methods Two hundred and five cases of benign breast disease patients admitted to the hospital in time sequence were divided into the observation group (105 cases) and control group(100 cases).Observation group used mammotome minimally invasive rotary cutting operation,and the control group used conventional breast tumor resection.The surgical results of two groups of patients,tumor complete resection or not,whether the patients for surgery satisfaction were observed.Patients of two groups were compared with intraoperative and postoperative relevant indicators,and the postoperative complications.Results In the observation group,105 patients with mammotome spiral cutting knife surgery of breast masses were completely resected,the satisfaction of patients for surgery was 96.2％ (101/ 105),significantly higher than that of control group(81.0％ (81/100),x2 =4.187,P＜0.05).The operative time,blood loss,length of incision values of observation group were significantly lower than those in the control group((17.30±6.70) min vs (57.23 ± 8.96) min,(10.43 ± 5.14) ml vs (109.16 ± 13.45) ml,(10.27 ±0.06) cm vs (1.43±0.12) cm;t=18.741,26.167,11.421;P＜0.05),the postoperative recovery time and the scar length were significantly lower than the control group((4.1±2.5) d vs (8.0±3.5) d,(0.15±0.03) cm vs (1.21±0.46) cm;t =5.176,2.647;P＜0.05),breast deformation cases,tumor residual proporation were 1.9％(2/105) and 0(0/105),fewer than that in the control group(12.0％(12/100),9.0％(9/100);x2=6.721,11.470;P＜0.05).In control group breast deformation subcutaneous hematoma and ecchymosis,wound infection,skin damage,pain,pigment calm incidence were 2.9％ (3/105),5.7％ (6/105),1.9％ (2/105),2.9％(3/105),8.6％(9/105),2.9％(3/105),significantly lower than those in the observation group(9.0％(9/100),12.0(12/100),7.0％ (7/100),16.0％(16/100),23.0％(23/100),8.0％(8/100);x2 =2.164,3.071,2.467,6.194,6.177,2.642;P＜ 0.05).Conclusion Mammotome minimally invasive rotary cut scalpel compare with conventional breast tumor excision undoubtedly has a more significant curative effect and patient satisfaction and have the characteristics of operation safety,efficiency,beautiful,fewer complications,humanized.

Objective To identify the effects of virus specific amino acids in the fusion active domains of paramyxovirus fusion proteins on the specific membrane fusion. Methods Site-directed mutagenesis was used to obtain mutants in the identified fusion active domains of Newcastle disease virus (NDV) fusion protein (F) and human parainfluenza virus (hPIV) fusion protein (F). All the mutant F genes were co-expressed with their homol-ogous or heterogenous hemagglutinin-neuraminidase (HN) genes in eukaryocytes. The fusion functions of mutants were assayed by Giemsa staining and reporter gene method. The expression efficiencies of mutants were assayed by fluorescence-activated cell sorter (FACS). Results In the NDV F mutants, N150D-L152D had 46.31% fusion activity of wide type. The fusion activities of N257D-N258D-Q259E, G271D-N272D and Q279E-Q281E almost disappeared, and they had only 1.25%, 3.14% and 2.23% of fusion activities, respectively, compared with wide type. N296D-N297D had 97.68% fusion activity of wide type. In the hPIV F mutants, D143A-E145A had 32.63% fusion activity of wide type. The fusion activity of E223Q-K224A almost disappeared, and it had only 1.91% fusion activity of wide type. K263A-R265A, D268A-D270A and R475A-R476A had 14.63%, 19.52% and 28.95% of fusion activities respectively compared with wild type. The analysis of FACS indicated that proteins of NDV F N257D-N258D-Q259E, G271D-N272D, Q279E-Q281E and hPIV F E223Q-K224A were not expressed on the cell surface, while proteins of the rest mutants were expressed nearly as the same as the wide types. Con-clusion As to NDV F, the amino acids of N257, N258, Q259, G271, N272, Q279 and Q281 were significant to the specific membrane fusion, and N150 and L152 were also important, but N296 and N297 were not. For hPIV F, the amino acids of E223 and K224 were significant to the specific membrane fusion, and D143, E145, K263, 11265, D268, D270, R475 and R476 were also important.

Objective To develop a method for dynamically observing the biological efficacy of botulinum toxin A (BTX-A) and to investigate the dose-effect relationship between BTX-A dosage and muscle strength.MethodsFifty-four male Sprague Dawley rats were randomly divided into 9 groups.Groups 1-7 were injected intramuscularly with 0.1 ml BTX-A (0.01 U to 4.0 U) into the gastrocnemius on the right side.Rats in group 8 were injected intramuscularly with an equal volume of saline solution as the control group,and group 9 was used to determine the location of injection.Gastrocnemius muscle strength was evaluated using a self-made evaluation system before and after the toxin injection and on the 3rd,7th,14th,21st,30th,45th,60th and 75th day following.ResultsMuscle strength reached its lowest level on days 3 to 7,with a significant difference in the decline of muscle strength between the test groups and the control group up to day 60.With the lower BTX-A doses (0.01 U,0.1 U,0.5 U,1.0 U),muscle strength had decreased significantly on the 21st day,but recovered to its initial levels in all groups at the same time.There was no significant difference among the 1.0 U,1.5 U,2.0 U and 4.0 U groups.ConclusionsStandardized gastrocnemius injection combined with neuromuscular functional evaluation can establish a model of BTX-A dosage and muscle paralysis which can be used to assess the evolution of the biological efficacy of BTX-A.

Objective To investigate the impact of polyclonal neural cell adhesion molecule antibody (P-NCAM-Ab) on the potency of botulinum toxin A (BTX-A).Methods Ninety male Sprague-Dawley rats were randomly divided into 3 equal groups:a normal control group,a BTX-A group and a P-NCAM-Ab group.The rats in the normal control group were injected with 100 μl of saline solution in their right gastrocnemius,while those in the BTX-A and P-NCAM-Ab groups were injected with 100 μl of BTX-A (0.5 U).In addition,the rats in the P-NCAM-Ab group were also injected with 100 μl of P-NCAM-Ab (the dosage was 20 U) at the same site on the 3rd day after the BTX-A injection.The rats' gastrocnemius muscle strength was evaluated with a self-made system for evaluating neuromuscular function before and after the toxin injection,on the 3rd day,as well as 1,2,4,6,8,10 and 12 weeks after the BTX-A injection.Any wet weight changes in the muscles were observed,and immunochemistry methods were employed to observe any structural changes in the motor endplates and nerve fibers at the different time points.Results After the saline injection,the average gastrocnemius muscle strength of the control group increased with time,while strength in the BTX-A and P-NCAM-Ab groups demonstrated a decrease in strength followed by a gradual increase.The average gastrocnemius muscle strength of the rats in the BTX-A and P-NCAM-Ab groups was significantly lower than that of the control group at all time points.Compared with the BTX-A group,the muscle strength of the P-NCAM-Ab group rats decreased further.Strength recovery in the BTX-A and P-NCAM-Ab groups was significantly slower than in the control group.The wet weight percentage in the BTX-A and P-NCAM-Ab groups at first decreased and then recovered with time.After the BTX-A injection,the average wet weight percentage of the P-NCAM-Ab group rats was significantly lower than that of the BTX-A group after 3 days,and 1,2 and 4 weeks.Karnovsky-Roots AchE staining showed that the motor endplates' color in the BTX-A and P-NCAM-Ab groups deepened gradually,though the color of the P-NCAM-Ab group was lighter than that of the BTX-A group at each time point.The mean optical density of the motor endplates' positive reaction area increased with time in both groups,but the P-NCAM-Ab group was lower than that of the BTX-A group at 1,2,4,8 and 12 weeks.Counting the nerve fibers dyed by gold chloride showed similar trends with both experimental groups significantly different from the control group.Conclusion P-NCAM-Ab can increase the potency of BTX-A and prolong its action.

Aim To observe the effect of endomorphin-1 (EM-1 )on TLR2 and TLR4 expressions of dendritic cells (DC)from human peripheral blood.Methods Monocytes isolated from human peripheral blood mono-nuclear cells were cultured in medium containing re-combinant human interleukin-4 and recombinant hu-man granulocyte macrophage colony stimulating factor. After six days of culture,the immature dendritic cells (imDC ) were divided into four groups,the control group (BLA group),EM-1 group,LPS group and LPS+EM-1 group.After 2 days of culture,the expres-sions of TLR2 and TLR4 were determined by fluores-cence activated cell sorter(FACS).The expressions of TLR2 and TLR4 at mRNA level in DC were detected by RT-PCR.Results The FACS results showed that the expressions of TLR2 and TLR4 in imDC were high-er,and their expressions were decreased with the mat-uration of DC.Compared with BLA group,the expres-sions of TLR2 and TLR4 in DC were down-regulated in EM-1 group (P<0.05 ).Compared with LPS group, TLR2,TLR4 on DC surface were significantly lower in LPS +EM-1 group (P <0.01 ). RT-PCR results showed that compared with BLA group,EM-1 interven-tion induced TLR2 mRNA expression was down-regula-ted significantly (P<0.01),there were no significant changes of TLR4 mRNA expression (P>0.05 ).mR-NA expressions of TLR2 and TLR4 on DC in LPS +EM-1 group were lower than those in LPS group (P<0.05 ).Conclusions EM-1 enables the down-regula-tion of the expressions of TLR2 and TLR4 on DC sur-face,the effects of EM-1 on immune function may be associated with TLR2 and TLR4 expressions on DC surface.

Aim To synthesize 8-bromo-ethoxy Rhein and investigate its mechanisms and inhibition effect on hepatitis B surface antigen ( HBsAg ) and e antigen ( HBeAg) in HepG2.2.15 cells.Methods 8-bromo-ethoxy Rhein was synthesized based on the chemical structure of Rhein , and its structure was identified by IR,1 H-NMR and 13 C-NMR spectra.MTT assay was used to test the inhibitory effect of 8-bromo-ethoxy Rhein on HepG2.2.15 cells.After the cells treatment by 8-bromo-ethoxy Rhein , the HBsAg and HBeAg in cell supernatant were detected by ELISA .The expres-sion of hepatitis B virus X gene ( HBx) was detected by Western blot .The cell cycles were examined with flow cytometry.The intracellular free calcium concentration was detected by laser scanning confocal microscopy . Results The structure of 8-bromo-ethoxy Rhein was confirmed by IR,1 H-NMR and 13 C-NMR.MTT results showed that synthetic product and Rhein could inhibit the cell proliferation in HepG2.2.15 cells.After trea-ted with 8-bromo-ethoxy Rhein and Rhein for 72 h,the half inhibitory concentration 50%( IC50 ) was 14.29 mg? L-1 and 11.59 mg? L-1 , respectively .Using non-cytotoxic dose of 8-bromo-ethoxy Rhein , the inhibitory effect on HBsAg and HBeAg was gradually enhanced with increasing 8-bromo-ethoxy Rhein concentration . The inhibitory effect of synthetic product on hepatitis B virus was better than that of Rhein .8-bromo-ethoxy Rhein could down-regulate the expression of HBx , in-tracellular calcium ion concentration and block the hepatitis B virus ( HBV ) replication.Flow cytometry results showed 8-bromo-ethoxy Rhein didn′t affect the cell cycle .Conclusions Compare with Rhein , the synthesis of 8-bromo-ethoxy Rhein shows stronger inhi-bition on hepatitis B virus in HepG2.2.15, and its mechanisms may involve down-regulating the expres-sion of HBx and reducing calcium ion concentration .

Objective We conducted a survey on the awareness rate of stroke in Yangquan residents and analyzed factors affecting awareness to provide basic information for Yangquan residents to prevent and treat stroke in Shanxi.MethodsA questionnaire regarding awareness and basic knowledge of stroke was used in this study and applied to Yangquan residents.A cluster stratified sample of 7983 residents were questionnaired by cross-sectional method.Results7921 returned copies were valid.The awareness rate of stroke in 7921 selected Yangquan residents was 30.14％ (2387/7921). Upon the occurrence of stroke,the awareness rates of the way to see a doctor,the right department to look for medical care and test manners to diagnose the illness as stroke were relatively high in these investigated people,which were 74.03％ (5864/7921),78.17％ (6192/7921) and 84.04％ (6657/7921),respectively.However,the number of people who knew characteristic symptoms and complications of stoke,risk factors that cause stroke and how to treat stroke was 2021 (25.51％),841 ( 10.62％ ),and 902 ( 11.39％ ),respectively,which was relatively low. After multivariate analysis,the awareness rate of stroke in Yangquan residents was positively correlated with an education degree.ConclusionsYangquan residents know little about stroke.Therefore,it is necessary to increase the level of their knowledge regarding stroke by extended propaganda and encourage them to live a healthy life to be able to treat stoke in time and to reduce the possibility of stroke occurring.

Objective To investigate the effect of insulin-like growth factor 1 antibody (IGF-1Ab) on motor endplate function after injection ofbotulinum toxin A (Btx-A).Methods The total 90 male SD rats were randomly divided into 4 groups:control group,Btx-A group and 2 ug and 20 ug IGF-1Ab groups.In Btx-A and IGF-1Ab groups,a volume of 0.5 U (0.1 mL) Btx-A was intramuscularly injected into a site in the fight gastrocnemius muscle;on day 3,equal volumes (0.1 mL) of IGF-1Ab with a dosage of 2 ug and 20 ug were injected to the 2 ug and 20 ug IGF-1Ab groups respectively at the same site.The gastrocnemius muscle strength and the mean optical density (MOI) value of the positive reaction zone of acetylcholine esterase staining were evaluated at different time points.Results The gastrocnemius muscle strength increased from 12.34±0.16 g before injection to 7.70±0.90 g after injection in the Btx-A group;the gastrocnemius muscle strength decreased in other groups after injection of Btx-A;on day 14,28,42,56 and 70,the muscle strength oflGF-1Ab groups was significantly lower than that of Btx-A group (P＜0.05),and on day 42-70,the value of muscle strength of 20 ug IGF-1Ab group was signficantly lower than that of 2 μg IGF-1Ab group (P＜0.05).The MOI values of the positive reaction zone changed with the same trend.Conclusion IGF-1Ab can suppress the restore of motor endplate function after injection of Btx-A.

Objective To establish a Chinese expert consensus of the surgical management for type A aortic dissection (TAAD) by using the Delphi method.Methods A systematic review of the previously published literature related to management of TAAD at home and abroad was conducted to formulate a questionnaire of clinical consensus of the surgical treatment for TAAD.This questionnaire including seven aspects of surgical management for TAAD,namely contraindications to operative management,cannulation site,target temperature during circulation arrest,cerebral perfusion strategy,surgical procedure,distal anastomotic technique and surgical management for patients with connective tissue disease such as Marfan syndrome.From October 2015 to April 2016,we performed two rounds Delphi survey in which the current professional opinions from 55 experienced and representative cardiovascular surgeons in China,were gathered and analysed.Results The responses rates of two rounds were 80.0％ (44/55) and 77.27％ (34/44).The scores of authoritative coefficient was 0.87 and 0.83.The coefficient of concordance were 0.31 (P ＜ 0.05) and 0.32 (P ＜ 0.05).After two rounds of consultation,consensus of the surgical management for TAAD was reached on 16 items of seven aspects.Conclusion This Delphi study established an initial Chinese expert consensus concerning the surgical management for TAAD,which drew credible results and reliable conclusions.This study will helo to standardize the surgical management of TAAD in China.

Objective To evaluate the efficacy and safety of tacrolimus extended-release (Tac-ER) in the early stage after kidney transplantation. Methods Clinical data of 68 recipients undergoing kidney transplantation from 34 pairs of renal allografts were retrospectively analyzed. Two recipients who received bilateral kidneys from the same donor were treated with Tac-ER (Tac-ER group) and tacrolimus immediate-release (Tac-IR) (Tac-IR group) as one of the basic immunosuppressant. The changes of tacrolimus dosage and blood concentration, intra-patient variability (IPV), renal function, incidence of acute rejection, recipient and allograft survival rates and adverse events were statistically compared between two groups. Results The average daily dose of tacrolimus in the Tac-ER group was significantly higher than that in the Tac-IR group (F=8.386, P=0.005). In the Tac-ER group, the mean trough concentration at postoperative 4 d was (6.14±4.04) ng/mL, did not reach the target concentration, significantly lower than (9.41±5.47) ng/mL in the Tac-IR group (F=7.854, P=0.007). In the Tac-ER group, the IPV of trough concentration of tacrolimus within postoperative 1 month was significantly higher than that in the Tac-IR group (0.44±0.15 vs. 0.36±0.12, P=0.032). At postoperative 6 months, there was no significant difference in the renal function between two groups [serum creatinine level was (126±26) μmol/L vs. (120±28) μmol/L, and the estimated glomerular filtration rate was (56±13) mL/(min·1.73 m²) vs. (60±15) mL/(min·1.73 m²), both P > 0.05]. The allograft and recipient survival rates were 100% in both groups. The incidence of acute rejection within postoperative 1 month was 18% in the Tac-ER group and 3% in the Tac-IR group, with no significant difference (P > 0.05). The overall incidence of adverse events was 94% in the Tac-ER group and 97% in the Tac-IR group, with no significant difference (P > 0.05). Conclusions The efficacy and safety of Tac-ER are equivalent to those of Tac-IR, whereas a higher dose of Tac-ER should be orally given to reach the blood concentration similar to that of Tac-IR. During early-stage drug treatment, Tac-ER should be orally given before kidney transplantation or inittally with loading dose, aiming to increase the systemic exposure to tacrolimus early after kidney transplantation and prevent acute rejection caused by insufficient exposure.