Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Objective:To explore the application value of different methods of segmented latissimus dorsi myocutaneous flap in repairing chest wall defects after local advanced breast cancer surgery.Methods:The clinical data of 64 patients with unilateral locally advanced breast cancer admitted to Shanxi Cancer Hospital from Feb. 2019 to Jan. 2020 were selected. All patients underwent modified radical mastectomy for breast cancer. The patients were divided into two groups according to the random number table method. Antegrade (group A, n=32 cases) and retrograde (group B, n=32 cases) were used to design and cut the segmented latissimus dorsi myocutaneous flap to repair the defects. The range of skin island cut was 14 cm×6 cm-19 cm×7 cm; The donor area of the flap was closed directly. The application effects of the two groups of methods were compared. Results:In group A, one antegrade flap was partially necrotic, while in group B, six retrograde flaps were partially necrotic ( P>0.05). The delayed healing rate of donor site incision in group A was 6.25%, significantly lower than that in group B (25.00%) ( χ2=4.267, P=0.039). All the patients in both groups were followed up for 12 to 24 months, and the appearance and texture of the flaps were satisfactory; Only linear scar was left in the donor area, and the shoulder joint activity was not affected. The mean survival time was 20.8 months. Conclusion:The antegrade latissimus dorsi myocutaneous flap can repair the large area defect of chest wall after LABC, which can ensure the blood supply of the flap to the greatest extent, reduce the closing tension of the donor area, the incidence of postoperative complications, and promote the healing of the incision.

Objective Aiming at solving the problems of pain on the anteromedial tibia, tibial component loosening and osteoarthritis progression after unicompartmental knee arthroplasty (UKA), the influence of different geometric shapes of tibial component pegs on stress distributions in tibia was analyzed by finite element method. Methods The finite element models with UKA were established and validated. Geometric shapes of tibial component were designed. Under the same loading condition, the tibial components with double-peg, single-keel, double-keel and cross-star were studied for finite element analysis and compared with intact model, so as to evaluate the influence of tibial component with different shapes on stresses of cortical bone in anteromedial tibia, cancellous bone under tibial component and cartilage in contralateral tibia. Results Compared with the intact model, the peak stress of cortical bone in anteromedial tibia with double-peg, single-keel, double-keel and cross-star tibial components increased by 56.1%, 55.9%, 54.5% and 68-4%, respectively. The peak stress of cancellous bone under tibial component with single-keel and double-keels decreased by 8.1% and 15.6% respectively, while the peak stress of cancellous bone under tibial component with double-peg and cross-star increased by 67-9% and 121-5%, which were higher than the fatigue yield stress of cancellous bone. The peak stress of cartilage in contralateral tibia with double-peg, single-keel, double-keel and cross-star tibial components decreased by 42.1%, 26.6%, 24.2% and 28.5%, respectively. ConclusionsThe load distribution of the medial and lateral tibia changed after UKA operation, and a greater load was observed on the replacement side. Single-keel and double-keel tibial components were more effective in reducing stresses on cortical bone in anteromedial tibia and cancellous bone, while the stress distribution in tibia with single-keel tibial component was closer to that of the intact tibia. The research findings can provide theoretical references for designing single-keel tibial component of unicompartmental knee prosthesis which conforms to better mechanical properties of the knee joint.

Objective To discuss the clinicopathological features and prognostic factors of patients with triple negative breast cancer (TNBC) in Shanxi province. Methods The medical records of 958 female TNBC patients who were admitted to Shanxi Provincial Cancer Hospital and the First Hospital of Shanxi Medical University from January 2005 to December 2015 were retrospectively analyzed. The clinicopathological features and prognostic factors were summarized. Results The median age of TNBC patients in Shanxi province was 46 years old (21-87 years old), the median body mass index (BMI) was 24.42 kg/m2 (15.0-37.5 kg/m2), and the rural population was slightly more. The left breast cancer was more than the right breast cancer, and 492 patients (51.4％) were in stage T2. The main histological type was invasive ductal carcinoma. The main surgical method was modified radical mastectomy. Univariate Cox regression analysis showed that the patient's place of residence, fertility status, age at first birth, breastfeeding history, tumor size, American Joint Committee on Cancer Staging, lymph node metastasis, and surgical approach were associated with the risk of death in TNBC patients (all P<0.05);but the BMI, menstrual status, menarche age, and family history were not associated with the risk of death (all P>0.05). Multivariate Cox regression analysis showed that rural residents (HR= 1.46, P= 0.044), positive lymph node metastasis (HR= 2.51, P< 0.01), non-fertility (HR=1.08, P= 0.009) and no surgery (HR= 2.53, P= 0.004) were independent risk factors affecting the risk of death, a history of breastfeeding was a protective factor affecting the risk of death in TNBC patients (HR=0.44, P=0.013). Conclusions In Shanxi province, TNBC is more common in premenopausal women and the main pathological type is invasive ductal carcinoma. Rural population, lymph node positive, non-fertility, and no surgical treatment are independent risk factors for the prognosis of TNBC patients.

Objective: To evaluate the usage of ultrasound guided wire-localization, nano-carbon staining and the combination of the above two methods in detecting sentinel lymph node (SLN) in breast cancer. Methods: A total of 159 cases of breast cancer from May 2015 to December 2017 in Shanxi Provincial Cancer Hospital were selected, and they were treated with ultrasound guided wire-localization, nano-carbon staining and combination of the two methods separately to detect SLN before the operation. After the operation, SLN and axillary lymph node in each group were marked and made pathological diagnosis. Results: There were 69 cases with pathological diagnosis of SLN metastasis and 90 cases without abnormal representation. With the patient as the unit, the sensitivity of ultrasound guided wire-localization was 100.0% (69/69), the sensitivity of nano-carbon staining was 98.6% (68/69), and the sensitivity of combination of the two methods was 97.1% (67/69). The specificity of ultrasound guided wire-localization was 3.3% (3/90), the specificity of nano-carbon staining was 2.2% (2/90), and the specificity of combination of the two methods was 5.6% (5/90). With the count of SLN as the unit, the combination of the two methods had the highest diagnostic efficiency in detecting SLN, and the difference was statistical significant (χ² = 34.31, P < 0.001). Conclusions Ultrasound guided wire-localization and nano-carbon staining are safe and accessible methods for detecting SLN. It provides a precise treatment for early breast cancer, and it can protect medical staff from radiation, which is expected to be the best method for detection of SLN in breast cancer.

OBJECTIVE:To investigate the effects of 4 polar parts extracts from Li medicine Alpinia oxyphylla fruit on model mice with experimental colitis,and screen the effective parts of A. oxyphylla fruit in the treatment of colitis. METHODS:After 70% ethanol extract dispersed by water,petroleum ether,trichloromethane,ethyl acetate and n-butanol were used in turn to obtain extractions in related parts. 42 mice were randomly divided into modeling group(36 mice)and blank group(6 mice). Mice in mod-eling group were taken 2,4,6-nitrobenzne sulfonic acid method to replicate the experiment colitis. After modeling,model mice were randomly divided into model group,positive group(Sulfasalazine enteric coated tablets,52 g/kg),petroleum ether,trichloro-methane,ethyl acetate,n-butanol extract from A. oxyphylla fruit groups(10 g/kg,calculated by crude drug),6 in each group,in-tragastrically administrated once a day,for 9 d,0.2 mL/10 g;mice in blank group and model group were intragastrically given nor-mal saline. After administration,body mass of mice was determined,disease activity index(DAI)was scored and colonic myelo-peroxidase(MPO),superoxide dismutase(SOD),malondialdehyde(MDA)activities in colon tissue were detected,and the colon pathological changes were observed and scored. RESULTS:Compared with blank group,decrease percentage of body mass,DAI score,MPO and MDA activities in colon tissue in model group were increased(P<0.05 or P<0.01);colon tissue was pathologi-cally changed. Compared with model group,body mass was increased,DAI score,MPO activity and pathological score in each ad-ministration groups were decreased;SOD activities in positive group,n-butanol extract from A. oxyphylla fruit group and ethyl ace-tate extract from A. oxyphylla fruit group were significantly increased,MDA activities in positive group and ethyl acetate extract from A. oxyphylla fruit group were significantly decreased,with statistical significances (P<0.05 or P<0.01). CONCLUSIONS:The 4 polar parts extracs from A. oxyphylla fruit have certain improvement effects on model mice with experimental colitis, in which ethyl acetate and n-butanol parts are preferred.

OBJECTIVE: To explore the factors affecting the successful rate of nano-carbon in sentinel lymph node biopsy.
 METHODS: A total of 270 patients with breast cancer, who were treated in First Affilitated Hospital of Henan University of Science and Technology from January 2013 to March 2015, were chosen and given sentinel lymph node biopsy (SLN) with nano-carbon, and the influencial factors were examined by logistic analysis.
 RESULTS: Successful rate of biopsy, accuracy, sensitivity and false negative rate was 92.2%, 97.6%, 93.1% and 6.8%, respectively. Age, primary tumor lesions, body mass index, axillary lymph node status, number of SLN and pathological grade were the factors affetcing successful biopsy (all P<0.05), and body mass index, age, and number of SLN were three independent factors affecting the successful rate of biopsy (all P<0.05). The history of biopsy, tumor location, affected sides, injection sites and chemotherapy showed little effect on the successful rate of biopsy (all P> 0.05).
 CONCLUSION Nano-carbon tracer method is a reliable method in sentinel lymph node biopsy. The body mass index, age, and number of lymph node metastasis greatly impact the successful rate of biopsy.
Axilla ; Breast Neoplasms ; diagnosis ; Carbon ; chemistry ; Female ; Humans ; Logistic Models ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Nanoparticles ; chemistry ; Neoadjuvant Therapy ; Neoplasm Grading ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy

Objective To explore the influence of health education combined with traditional Chinese medicine ( TCM ) constitution identification on anxiety and satisfaction of inpatients with chronic liver diseases .Methods A total of 84 inpatients with chronic liver diseases were randomly divided into observation group and control group , each of 42 cases.The patients of control group were given routine health education , and the TCM constitution identification was used for the patients of observation group . Individualized health education were carried out after evaluating patients , TCM constitution type .The anxiety scores of the two groups before and after intervention were compared by using Hamilton anxiety scale ( HAMA ) .The satisfaction of patients in the two groups were taken by questionnaire investigation . Results The score of satisfaction in the observation group was 97.62%while it was 73.81%in the control group (χ2 =6.17,P<0.05).On the day before discharge , HAMA scores in the observation group was (5.17 ±1.89) lower than (8.36 ±2.01) in the control group (P<0.05).Conclusions Health education for TCM constitution identification according to different constitution of the inpatient with chronic liver diseases can improve the satisfaction of inpatients , reduce the degree of anxiety .It is worth of promoting and applying in infectious department .

Objective To explore the expressions and clinical significance of epidermal growth factor receptor (EGFR),COOH-terminus tensin-like molecule (CTEN)and epithelial cadherin (E-cad)in non-small cell lung cancer (NSCLC).Methods The expressions of EGFR,CTEN and E-cad in 36 cases of normal lung tissue and 82 cases of NSCLC tissues were observed with immunohistochemical SP method and their correlation with NSCLC invasion,metastasis and prognosis was analyzed.Results The positive rate of EGFR,CTEN and E-cad was 58.5% (48/82),69.5% (57/82)and 28.1% (23/82)in 82 cases of lung cancer,while 13.9% (5/36),0.0% (0/36)and 100% (36/36)in normal tissues;the differences were all significant (P<0.05).EGFR,CTEN and E-cad expressions in NSCLC tissues were significantly correlated with tumor differentiation,TNM stage and lymph node metastasis (P<0 .0 5 ).The expressions of EGFR and CTEN were correlated with each other in NSCLC (r=0 .5 3 0 , P<0.001),while the expressions of EGFR and CTEN were correlated with that of E-cad (r=0.499,P<0.001;r=0.333,P=0.001 ).Multivariate Cox regression analysis showed that CTEN expression in NSCLC was an independent prognostic factor (P<0.05 ).Conclusion EGFR,CTEN and E-cad may play a role in the development,invasion and metastasis of NSCLC and have some significance in predicting the prognosis of NSCLC.