Objective To explore the surgery methods for multiple fibroadenoma of breast,provide a ref erence for the surgical treatment of breast multiple fibroadenoma.Methods The clinical data of 152 cases of breast multiple fibmadenoma admitted from January 2008 to October 2012 in Department of Breast Surgery,Obstetrics and Gynecology Hospital of Fudan University were analyzed retrospectively.All the cases were applied intraoperative B-ultrasound guided,taken the areola incision through breast subcutaneous layer approach for resection of multiple breast fibroadenoma.The surgical incision design,surgical procedures and results of operations were analyzed.Results All 152 cases fibroadenoma were resected which were guided by B-ultrasound with areola incision.One month and three months after operation,the assessment of physician-patient for the scars were different.There was no significance in the Pearson Correlations which were 0.894 (P =0.106) and 0.905 (P =0.065),respectively.But twelve months later,it satisfied with the appearance of scar,either the patients or the doctors (P ＜ 0.05).The Pearson Correlation was 0.946 (P ＜0.001).Conclusions B-ultrasound guided areola incision through the breast subcutaneous layer approach could removal multiple breast fibroadenoma at one time,patients were satisfacted with the good cosmetic results,we believe this operation method has short operation time and good clinical value.

[Objective]To investigate the effect of pantoprazole on skeletal muscle wasting in cancer cachexia and the possible mechanism.[Methods]24 male BALB/c mice were randomly divided into control group(NN),cancer cachexia group(CC),pantrop?razole treatment group(PPI). The mice in CC and PPI were inoculated subcutaneously with mouse colon adenocarcinoma C26 cells to establish a model of cancer cachexia. The mice in PPI group were gavaged with 75 mg/kg pantoprazole dissolving in physiological saline,while those in NN and CC group were gavaged with 0.1 mL/10 g physiological saline. The mice were killed 12d after treatment. The weight of gastrocnemius and tumour and the size of tumour were measured. The morphological change of skeletal muscle were evalu?ated by the method of stain with hematoxylin and eosin(H&E). The levels of IL-6 and TNF-αin serum were tested by ELISA. qRT-PCR was used to assess the expression of mRNA of Myod1 and myf5 in skeletal muscle. The protein expressions of MuRF1,MAFBx, Myod1 and myf5 were measured by Western blot.[Results]Compared with CC group ,pantoprazole can increase the weight of mice and gastrocnemius(39.8% and 24.2%,respectively),cross section area(25.4%),levels of mRNA and protein of Myod1 and myf5(P<0.05),while the levels of IL-6 and TNF-αdecreased(30.7%and 18.9%,respectively),as well as the levels of protein ex?pression of MuRF1 and MAFBx(P < 0.05).[Conclusion]Pantoprazole can attenuate the wasting of skeletal muscle,the potential mechanism may be related to the inhibition of inflammatory factors and UPS ,and up-regulation of Myod1 and myf5.

BACKGROUND: There are no effective methods to cure Alzheimer disease (AD). Now, researches have shown that panax notoginseng saponins (PNS) play an important role in improving AD, but its mechanism is unclear.OBJECTIVE: To observe the protective effect of PNS characterized by removing blood stasis to stop bleeding and promoting blood circulation to relieve pain on pathological lesion of cholinergic neuron in rat with AD.DESIGN: Completely randomized grouping design and controlled study.SETTING: Neuroscience Institute of Guangxi Traditional Chinese Medical University.MATERIALS: This experiment was completed in the Chinese Herb Pharmacodynamic Laboratory of Guangxi Traditional Chinese Medical University between June 2003 and April 2005. A total of 90 health Wistar rats of clean grade and half gender were selected in this study. Among them, there were 75 old rats with 15 months old and 15 young rats with 3 months old. METHODS: This experiment was completed in the Chinese herb Pharmacodynamic Laboratory (Key Laboratory) of Guangxi Traditional Chinese Medical University between June 2003 and April 2005. ① A total of 90 healthy Wistar rats of clean grade and half gender were selected in this study. Among them, there were 75 old rats with 15 months old and 15 young rats with 3 months old. Fifteen young rats with 3 months old were regarded as young control group, and other 15 selected from 75 rats with 15 months old were regarded as old control group. The rest 60 rats were modeled on the basis of subacute injury induced by intravenous injection of D-galactose and bilateral cerebral Meynert basal nuclei injured by ibotenic acid. Parallel control was performed with saline on rats in young control group and old control group under the same condition. ② Two weeks later,survival modeling rats were divided randomly into 4 groups: model group,high-dosage PNS group, low-dosage PNS group and huperzine A group with 12 in each group. Rats in high-and low-dosage PNS groups were perfused with 200 and 100 mg/kg PNS (provided by Yunnan Yuxi Weihe Pharmaceutical Factory), respectively, once a day; rats in huperzine A group were perfused with 0.3 mg/kg huperzine A once a day for 4 weeks; rats in model group, young control group and old control group were perfused with the same volume of saline for 4 weeks. ③ After administration, pathological sections of brain tissue were cut, and immunologic-reaction activity of choline acetyltransferase (ChAT), morphological changes and numbers of positive neuron in cerebral sections were determined by immunohistochemistry analysis. ChAT immuno-positive neurons were analyzed with IBAS imaging analysis system to assay average area of section and average absorbance (A), and amount of ChAT immuno-positive neurons was calculated with microscope micrometer. ④ Measurement data were compared with single-factor analysis of variance.MAIN OUTCOME MEASURES: Effect of PNS on distribution of cholinergic neuron and ChAT content in cerebral tissue of AD rat models.RESULTS: A total of 75 old rats and 15 young rats entered the final analysis. ① Amount of ChAT immuno-positive neurons was the most, and the color was the deepest in young control group; amount of ChAT immuno-positive neurons was higher in high-dosage PNS group than that in huperzine A group and model group; ChAT immuno-positive neurons were smaller in model group than those in other goups, and the amount was decreased obviously. Axis-cylinder and dendrite of soma were shortened remarkably. ② Amounts of ChAT immuno-positive neurons in basal forebrain were less in model group than those in other groups (P ＜ 0.05), less in lowdosage PNS group, huperzine A group and model group than those in old control group (P ＜ 0.05), less in huperzine A group and model group than those in high- and low-dosage PNS group (P ＜ 0.05), and less in young control group than those in other groups (P ＜ 0.05). The mean A value of ChAT immuno-positive neurons in basal forebrain was similar to amounts in each group. Average area of section of ChAT immuno-positive neurons in basal forebrain was smaller in low-dosage PNS group and model group than that in young control group (P ＜ 0.05), and differences in other groups were not significant (P ＞ 0.05).CONCLUSION: PNS plays a protective role in pathological lesion of cholinergic neuron in AD rat models. PNS can also increase survival amount and quality of cell and increase content and activity of ChAT so as to protect and improve central cholinergic system, and inhibit aging and dementia through improving and repairing injured cholinergic neurons.

Objective To prepare VP1 protein vaccine of Coxsackievirus A16(CA16) and evalu-ate immunngenicity the subunit vaccines of Coxsackievirus (VP1), and to establish foundation for studying CA16 vaccine. Methods CA16 VP1 was amplified by RT-PCR and cloned into pFastBac HT A plasmid, recombinated with Bacmid DNA by transposition reaction and then transfected Sf9 cell, mixed with adjuvant AI(OH)_3. After immunization BALB/c mice, evaluating immune effectiveness after booster injections 2 weeks. Results The expressed protein was analyzed by SDS-PAGE and Western blot, mice immunized with CA16 (VP1) both induced specific IgG antibody and neutralization antibody. The best immunization antigen was 20 μg, IgG antibody was 1: 1600, neutralization antibody was 1:250, typical Th1/Th2 immune response was determined by lymphocyte proliferation assay and cytokine analysis. Conclusion The CA16 VP1 gene was cloned successfully and expressed in Sf9 insect cells, CA16 VP1 protein vaccine induced both humoral and cellular immune response, to lay solid foundation for further study on CA16 vaccine.

Objective To analyze serum levels of C1q in children with nephrotic syndrome (NS),and investigate the clinical significance and the relationship among the altered serum C1q levels and other lipid/lipoprotein and renal function parametersin children with NS inacute and remission phases.Methods Serum levels of C1q were measured in 78 NS children with acute phase,in 64NS children with remission and in 77 healthy control children.The other lipid/lipoprotein and renal function parameters were also analyzed in these children,including TP,ALB,TC,TG,LDL-C,HDL-C,Urea,Cr and Uric.Results Compared with the healthy control children [173.00(161.00～185.00)mg/L],children with NS inacute [203.50(183.75 ～ 223.75) mg/L] and remission phases [185.00 (161.00 ～ 202.00) mg/L] all had a significantly increasedserum levels of C1q.Compared with NS children in remission,those in acute phase showed a significantly increased C1q (P＜0.001).In all the NS children,the serum levels of C1q were positively correlated with the levels of TC (r=0.483,P＜0.001),TG (r=0.423,P＜0.001) and LDL-C (r=0.450,P＜0.001),while negatively correlated with the levels of TP (r=-0.276,P=0.001 ＜0.01) and ALB (r=-0.410,P＜0.001).Multiple linear regression analyses showed that serum levels of C1q were independently associated with serum TG levels (β=9.235,P＜0.001;adjusted R2 =0.215) after adjustment of other related factors.Conclusion Serum levels of C1q were significantly increased in NS children in association with their conditions and the levels of lipid/lipoprotein parameters,and may be function as anovel parameter for assessing the development of NS.

Objective:To evaluate the pregnancy outcomes of fetal tethered cord (TC) prenatally diagnosed by MRI.Methods:Clinical data of 38 fetuses diagnosed as having TC by MRI, including 36 singletons and two fetuses who were both one of dichorionic diamniotic twins, were retrospectively collected and analyzed in the Obstetrics and Gynecology Hospital of Fudan University from January 2015 to August 2019. According to whether conus medullaris was located above the bladder or reached the lower edge of the bladder, all cases were divided into high or low groups. Pregnancy outcomes were compared between the two groups using Fisher's exact test and Student's t-test. Results:(1) The gestational age at MRI was (25.5±4.7) weeks. Among the 38 cases, 14 (36.8%) were isolated TC, 24 (63.2%) were complicated by other anomalies. The meningocele was responsible for the most (39.5%, n=15). The results of the ultrasound were consistent with those of MRI in 24 cases (63.2%). While in the other 14 cases (36.8%), the ultrasound only showed vertebral body's abnormal morphology, after which further MRI examination revealed a tethered cord. (2) Twenty-nine women (76.3%) chose to terminate the pregnancy. One patient (2.6%) underwent fetal reduction at 23 gestational weeks (one normal twin was delivered prematurely), and one (2.6%) was lost to follow-up. Seven (18.4%) cases continued the pregnancies to delivery. The postnatal follow-up period was 8.1 months (4.0 to 54.9 months). Two infants without comorbidities showed normal growth and development. Another three cases underwent surgeries after birth, and two cases died in the neonatal period. (3) The average width of the medullary cone was (2.5±0.8) cm. There was no significant difference in the spinal cord width between the high [(2.5±0.8) cm, n=34] and low group [(2.7±1.1) cm, n=4]. Six pregnancies (17.6%) in the high group was continued to delivery, and one of the neonates died of severe hydrocephalus. One patient in the low group (1/4) was delivered, while the baby died of neonatal asphyxia. Conclusions:Fetuses with isolated TC are prone to have a good prognosis. Further study should focus on the relation between the high or low position of the conus medullaris and pregnancy outcomes.

Objective:To compare the difference between serum lipoprotein(a) [Lp(a)] particle concentration and mass concentration in chronic kidney disease (CKD) patients and healthy controls, and to analyze the concentration distribution of the deviations between the two measurement methods.Methods:Serum Lp(a) particle concentration and mass concentration were respectively detected in 196 patients with CKD and 97 healthy controls from Eastern Theater General Hospital during June 2018 to December 2019. The upper limit of reference value for Lp(a) particle concentration was set as 75 nmol/L and the upper limit of reference value for mass concentration was set as 300 mg/L, the difference on the positive rates of Lp(a) particle concentration and mass concentration in each group were compared. According to the quartile of Lp(a) concentration in patients with CKD, the patients were divided into 4 groups, and the results derived from the two methods were compared among groups.Results:Serum Lp(a) particle concentration (25.7 [10.5, 75.4] nmol/L vs 19.2[8.1-50.2] nmol/L, P=0.021) and mass concentration (157[64, 432] mg/L vs 127[50-274] mg/L, P=0.023) were significantly higher in patients with CKD than those in healthy controls. The positive rate of Lp(a) particle concentration was significantly lower than that of mass concentration (25.0%[48/196] vs 37.2%[73/196], P=0.009) in CKD patients. The positive rate of Lp(a) particle concentration and mass concentration was similar in healthy controls (18.6%[18/97] vs 22.7%[22/97], P=0.478). The overestimation rate of Lp(a) mass concentration in CKD patients was significantly higher than that in healthy controls (12.8%[25/196] vs 4.1%[4/97], P=0.020). Lp(a) mass concentration of group Ⅲ in CKD patients was between 157.00-432.25 mg/L, the positive rate of Lp(a) particle concentration was significantly lower than that of mass concentration (4.1%[2/49] vs 49%[24/49], P<0.001), and the overestimation rate (44.9%[22/49]) of Lp(a) mass concentration in this group was also the highest (all P<0.001). According to the conversion factor provided by the reagent manual of Lp(a) particle concentration, the test results were converted into mass concentration. The actual mass concentration of Lp(a) in CKD patients grouped by quartile was significantly higher than that after Lp(a) particle concentration conversion (all P<0.05). Conclusions:The positive rate of serum Lp(a) particle concentration is significantly lower than that of mass concentration in CKD patients and the obvious overestimation deviation of Lp(a) mass concentration is observed in this analysis.

Objective To determine the expression levels of serum miR-25 in the patients with non-small cell lung cancer (NSCLC),and evaluate its clinical significance in the screening of NSCLC.Methods Serum samples from 82 untreated NSCLC patients,including 4 with TNM satge Ⅰ,10 with TNM stage Ⅱ,11 with TNM stage Ⅲ,53 with TNM stage Ⅳ and 4 with unknown stage,and 82 healthy controls with matched age and gender were collected,and the levels of miR-25 in these samples were determined by quantitative reverse transcription PCR (qRT-PCR).The diagnostic value of miR-25 in NSCLC was evaluated by the receiver operating characteristic (ROC) curve.Results Serum miR-25 levels in NSCLC patients were significantly higher than that in healthy controls (0.017 ± 0.028 vs 0.004 ±0.004,t =4.098,P ＜0.01).The area under the ROC curve (AUGROC),sensitivity and specificity of miR-25 for the diagnosis of NSCLC were 0.818 (95％ CI:0.753-0.882),70.7％ and 80.7％,respectively.In addition,the AUCROC,sensitivity and specificity of serum miR-25 for the screening of stage Ⅰ/Ⅱ NSCLC were 0.852 (95％ CI:0.728-0.976),78.6％ and 87.8％,respectively.Logistic regression analysis showed that miR-25 was an independent risk factor of NSCLC (OR =10.84,95％ CI:5.07-23.19,P ＜ 0.01).Conclusion Serum miR-25 levels in NSCLC patients increase significantly,indicating that it may be a novel molecular biomarker for the screening of NSCLC.

Objective:To analyze serum levels of complement 1q (C1q) in patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA), and to assess the association of serum C1q with the neurological deficit severity of AIS and the subsequent stroke risk after TIA, and to investigate the predictive and discriminative values of serum C1q for AIS and TIA.Methods:Clinical case-control study. Serum C1q levels were determined in 65 AIS, 61 TIA patients and 66 healthy controls from Jinling Hospital affiliated to Medical School of Nanjing University during January 2016 to March 2017. Their serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, glucose, high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6) and procalcitonin (PCT) were also detected. The NIHSS scores of AIS patients and ABCD3-I scores of TIA patients were calculated. Spearman correlation analyses and stepwise linear regression analyses were performed to investigate the association of serum C1q levels with NIHSS and ABCD3-I scores. Logistic regression analyses were performed to investigate the predictive and discriminative values of serum C1q for AIS and TIA patients. Results:Compared with controls [C1q:175.50(164.00-196.50)mg/L, TG: 0.91(0.71-1.19)mmol/L, HDL-C:(1.43±0.23)mmol/L], serum levels of C1q [AIS: 199.00(180.00-218.00)mg/L; TIA: 184.00(174.50-202.75)mg/L) and TG(AIS: 1.36(0.91-2.00)mmol/L; TIA: 1.31(0.90-2.01) mmol/L] were significantly increased in AIS and TIA patients(all P<0.05), while HDL-C[AIS: (1.08±0.41) mmol/L; TIA: (1.08±0.42) mmol/L] were significantly decreased(all P<0.001). Levels of C1q, hs-CRP[AIS:4.10(2.15-15.05)mg/L; TIA:1.40(0.63-3.88)mg/L],IL-6 [AIS: 10.88(7.21-32.96) ng/L; TIA: 7.07(6.18-9.82)ng/L] and PCT [AIS: 0.06(0.04-0.11)μg/L; TIA: 0.20(0.20-0.04)μg/L] in AIS patients were significantly higher than that in TIA patients(all P<0.05). C1q levels [AIS:203.00(183.25-219.75)mg/L; TIA: 181.00(1 666.50-206.00)mg/L] in severe AIS patients (NIHSS≥6) were significantly higher than that in mild AIS patients (NIHSS<6)( P=0.031). C1q levels[AIS:197.00(180.00-219.00)mg/L; TIA: 182.00(167.50-195.50)mg/L] in high-risk TIA patients (ABCD3-I>3) were significantly higher than that in low-risk TIA patients (ABCD3-I≤3)( P=0.018). After adjusting for age, gender, other lipid/lipoprotein and glucose parameters, C1q levels in AIS patients were independently linked(adjusted R2=0.704) to TC (β=0.524, P=0.078),TG (β=0.0.439, P=0.0.017) levels and NIHSS (β=0.372, P=0.039); C1q levels in TIA patients were independently linked (adjusted R2=0.505) to TG (β=0.535, P<0.001) levels and ABCD3-I (β=0.406, P<0.001); high C1q levels were closely associated with AIS( OR=1.035, 95 %CI1.014-1.056, P=0.001) and TIA ( OR=1.023, 95 %CI1.003-1.044, P=0.025) presence, and could also clearly differentiate between AIS and TIA( OR=1.013, 95 %CI1.000-1.026, P=0.049). Conclusions:Serum C1q levels were significantly elevated in AIS and TIA patients, especially in AIS patients. Serum C1q were independently linked to NIHSS of AIS patients and ABCD3-I of TIA patients, and may be function as a novel risk biomarker for predicting and differentiating AIS and TIA.

In the aftermath of the pandemic,the government is accelerating the development of top-tier medical resources to broaden the supply and deliver superior healthcare services.However,during this transitional phase,hospitals are experiencing operational challenges due to concurrent construction activities.Notably,a shortage of parking facilities and increased traffic con-gestion continue to impactmedial consultation experience of patients.This paper tries to explore strategies and methods for dynam-ic parking management during hospital campus expansions,offering insights for other medical institutions into grappling with pa-tient parking issues.