Construction and application of resuscitation and transfer modules in field medical unit / 医疗卫生装备

Objective To construct and apply resuscitation and transfer modules in the field medical unit.Methods Two modules of resuscitation and transfer were developed according to the objective,principle and method of resuscitation and transfer modularity.Totally 3 modes were used during the application of the modules,including independent deployment,combined deployment by brigade and regiment treatment facilities as well as separate deployment.Studies were executed on classification of professional equipment,generalization,integration,portability and etc.The efficacy of establishing the modules was verified in the practical application.Resultd The modules enhanced the efficiency of the field medical unit while saved medical resources.Conclusion The resuscitation and transfer modules and their equipment systems in the field medical unit meet the requirements for rapid deployment,supply,withdrawal and etc of emergency mobile medical unit,and thus raise the medical service support ability.

A novel technique for scintigraphic visualization of internal mammary sentinel lymph nodes in breast cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the effects of different injection techniques of radiotracer on the visualization rate of internal mammary sentinel lymph nodes (IMSLN) in breast cancer patients.</p><p><b>METHODS</b>A series of 137 consecutive breast cancer patients was included in this prospective study. Fifty-eight patients (group A) received the radiotracer (99)Tc(m)-sulphur colloid injected only into 1-2 points in the breast parenchyma in one quadrant, and seventy-nine patients (group B) received the radiotracer injection into the breast parenchyma in two quadrants of the breast. The differences of IMSLN visualization rates of the two groups were compared and the relevant affecting factors were analyzed.</p><p><b>RESULTS</b>The IMSLN visualization rate of the group B (70.9%, 56/79) was significantly higher than that of the group A (13.8%, 8/58) (P < 0.001). Both techniques seemed to be reliable to identify sentinel lymph node in the axilla (98.7% vs. 98.3%, P = 0.825). In addition, the visualization rate of internal mammary hotspots (82.2%) was more commonly seen in patients receiving injection of a larger volume of radiotracer ( ≥ 0.5 ml/point) than those receiving a smaller volume of radiotracer (<0.5 ml/point, 55.9%, P = 0.011).</p><p><b>CONCLUSIONS</b>The modified injection technique (two quadrants, large volume radiotraver, and ultrasound guidance) can significantly improve the visualization rate of IMSLN. Our findings should make the biopsy of IMSLN widely implemented and provide an effective and minimally invasive technique to evaluate the internal mammary lymph node status.</p>

Effect of oxymatrine on hepatic gene expression profile in experimental liver fibrosis of rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of oxymatrine on hepatic gene expression profile in a rat model of liver fibrosis.</p><p><b>METHODS</b>Forty healthy male SD rats were randomly divided into three groups, a normal group (n=8), a model group (n=16), and an oxymatrine treatment group (n=16). Experimental hepatic fibrosis was induced by subcutaneous injection of carbon tetrachloride (CCl(4)). The rats in the treatment group received oxymatrine via celiac injection at a dosage of 40 mg/kg once a day at the same time. The rats in the model and normal groups received saline at the same dosage via celiac injection. Serum levels of aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase (AKP), hyaluronic acid (HA), and laminin (LN) were assayed. The deposition of collagen was observed with HE and Masson staining. Effect of oxymatrine on hepatic gene expression profile was detected by oligonucleotide microarray analysis with Affymetrix gene chip rat U230A. Quantitative real-time polymerase chain reaction (QRT-PCR) was carried out to confirm the expression changes of six genes.</p><p><b>RESULTS</b>Oxymatrine significantly improved liver function, lowered serum levels of HA and LN, and decreased the degree of liver fibrosis, compared with the model group (P<0.05). A total of 754 differentially expressed genes were identified by gene chip between the model group and the normal group, among which 438 genes increased and 316 genes decreased over two folds. Compared with the model group, 86 genes were downregulated markedly in the oxymatrine group (P<0.05), including collagen I and other genes related to extracellular material (ECM), integrin signal transduction genes, early growth response factor genes, and proinflammatory genes; 28 genes were upregulated significantly (P<0.05), including cytochrome P450 (CYP450) superfamily genes, glycolipids metabolism and biological transformation related genes. Six genes were confirmed with QRT-PCR, consistent with the result from microarray.</p><p><b>CONCLUSION</b>Oxymatrine could affect the expression of many functional genes and may be useful in the prevention and treatment of liver fibrosis.</p>

BRCA1 germ line mutations in Chinese early-onset breast cancer patients / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the role of disease associated germ line mutations in BRCA1 gene among Chinese early-onset breast cancer patients.</p><p><b>METHODS</b>A total of 188 early-onset breast cancer patients, who were diagnosed with breast cancer before 41-year-old, were enrolled from four breast cancer clinical centers in China. Thirty-nine of them (20.7%) also had family history of breast/ovarian cancer. DNA extracted from lymphocytes was amplified by polymerase chain reaction (PCR) for the entire exons and the splicing sites of BRCA1. Twenty-two of the patients were screened by single strand conformation polymorphism (SSCP), and the other 166 of them were screened by denaturing high performance liquid chromatography (DHPLC). The abnormal fragments recognized were ascertained by DNA direct sequencing. For those samples with the same recurrent mutation, five BRCA1-linked markers (D17S855, D17S1322, D17S1323, D17S1326 and D17S1327) were used for the allelotype analysis.</p><p><b>RESULTS</b>Twelve disease-associated mutations were identified in 15 (8.0%) patients, among which BRCA1 1100delAT and 5589del8 were identified in 3 and 2 patients respectively. Nine (23.1%) of them were identified in those with breast/ovarian cancer family history. The difference of BRCA1 mutation frequency between the patients with and without family history was statistically significant (P=0.001). Allelotype analysis showed the two BRCA1 5589del8 mutation carriers shared the same allelotype in all the 5 STR sites, and two of the three 1100delAT mutation carriers, who came from the northern China, also shared the same allelotype in all the 5 STR sites, which were different from those of the 5589del8 mutation carriers'.</p><p><b>CONCLUSION</b>This is a relatively very large scale multi-hospital-based study of BRCA1 mutations in Chinese early-onset breast cancer patients up to now. It seems reasonable to give genetic consultations and genetic test of BRCA1 gene to early-onset breast cancer patients in China, especially for those with breast/ovarian cancer family history. The two recurrent mutations might be founder mutations of Chinese population. It might be cost-effective to analyze these two mutations before whole gene analysis.</p>

Flow cytometry-pathology combined study of breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the relation between histopathologic grading and some of the cytogenetic and molecular biology characteristics of breast cancer.</p><p><b>METHODS</b>On the basis of estrogen receptor (ER) expression, DNA content, S-phase fraction (SPF), bcl-2 and mutant p53 protein (mtp53) expression were examined by FCM in 121 breast cancer patients. In 66 patients with invasive ductal breast cancer, histopathologic grading was also examined.</p><p><b>RESULTS</b>The aneuploidy rate and DNA index (DI) were significantly different in grade I, II and III breast cancer. SPF and mtp53 expression significantly increased with increase in histopathologic grading (P < 0.05), but bcl-2 did not show this trend. SPF and mtp53 expression were significantly more in breast cancer with negative ER than in those with positive ER (P < 0.05). Again, no such differences in bcl-2 regardless of ER expression. Correlations existed between DI vs SPF, DI vs mtp53, and SPF vs mtp53 expressions (P < 0.01) but bcl-2 did not correlate with any one of them.</p><p><b>CONCLUSION</b>Cytogenetic and molecular biology studies on the basis of histopathologic grading may provide more information in prognostic prediction of breast cancer.</p>

The value of delta model of end stage liver disease in predicting the prognosis of patients with decompensated liver cirrhosis / 中华消化杂志

Objective To evaluate the prognostic value of dynamic delta model of end stage liver disease(MELD)in patients with decompensated liver cirrhosis.Methods Ninty-seven patients with decompensated liver cirrhosis were enrolled in the study and followed for 1 year followed up.Child-Turcotte- Pugh(CTP)score and MELD score were calculated twice for each patient on the first day of admission and one month later.The difference between two MELD scores represented the delta MELD.The predictive value related with delta MELD,MELD and CTP scores was determined by the area under receiver operating characteristic(ROC)curve.Results Ten patients died within 3 months,whose delta MELD(3.23?2.77) were higher than those of survivors(0.15?0.39)(P