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The improvement of comprehensive therapy of breast cancer, not only improve the prognosis of patients, but also affect the strategy of surgical treatment, especially the widespread development of preoperative neoadjuvant chemotherapy. The timing of sentinel lymph node biopsy and the incision margin of breast-conserving surgery in patients treated with neoadjuvant chemotherapy are hot topics for surgeons. And for patients who cannot accept total breast resection, stage I reconstruction after mastectomy is the best surgical method to preserve the cosmetic breast shape. Methods and materials of reconstruction are another hot topic of surgical treatment. This article reviews the hot issues of surgical treatment of breast cancer in 2019, with a view to arousing the thinking of surgical colleagues on standardized treatment of breast cancer and strengthening multidisciplinary collaboration.
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The improvement of comprehensive therapy of breast cancer,not only improve the prognosis of patients,but also affect the strategy of surgical treatment,especially the widespread development of preoperative neoadjuvant chemotherapy.The timing of sentinel lymph node biopsy and the incision margin of breast-conserving surgery in patients treated with neoadjuvant chemotherapy are hot topics for surgeons.And for patients who cannot accept total breast resection,stage Ⅰ reconstruction after mastectomy is the best surgical method to preserve the cosmetic breast shape.Methods and materials of reconstruction are another hot topic of surgical treatment.This article reviews the hot issues of surgical treatment of breast cancer in 2019,with a view to arousing the thinking of surgical colleagues on standardized treatment of breast cancer and strengthening multidisciplinary collaboration.
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Objective To observe the efficacy of biofeedback behavioral cognitive and vestibular re-habilitation treatment in patients with chronic subjective dizziness( CSD) . Methods 60 patients with chro-nic subjective dizziness were divided into two groups: study group ( 30 cases) treated with drug,vestibular rehabilitation and biofeedback behavioral cognitive therapy,and the control group (30 cases) was treated with drug treatment by random number table method,and all the 60 patients in the study were assessed by DHI,HADS and SF-36. Results After four and six weeks of treatment,the DHI and HADS scale scores of the study group were(4 weeks:DHI(9.07±3.18),HADS(3.17±1.56);6 weeks:DHI(4.67±3.08),HADS (2.03±1.10)),and the scores of the control group were(4 weeks:DHI(13.20±4.48),HADS(4.90±2.40);6 weeks:DHI(12.13±3.60),HADS(4.57±2.06)),and the differences were statistically significant(all P<0.05).After 6 weeks treatment,SF-36 scores in eight aspects about physiological function,role-physical,bodi-ly pain,general health,vitality,social-functioning,role-emotional,and mental health,in the study group were (96.17±5.20),(95.00±5.72),(96.67±4.79),(95.17±5.33),(95.50±5.14),(94.58±9.10),(88.90± 18.21),(96.67±4.59)and the control group were(85.33±11.29),(82.67±9.07),(88.53±8.63),(80.83± 7.44),(88.00±8.47),(80.00±14.90),(64.44±27.60),(81.73±14.04),the differences were statistically significant(P<0.05).Conclusion The study indicates that vestibular rehabilitation and biofeedback behav-ioral cognitive therapy can significantly improve symptoms of dizziness,anxiety,depression and quality of life.
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OBJECTIVE@#To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew.@*METHOD@#Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them.@*RESULT@#Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 case of phase II and 6 case of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years.@*CONCLUSION@#The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.
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Adult , Humans , Male , Middle Aged , Aerospace Medicine , Methods , Meniere Disease , DiagnosisABSTRACT
BACKGROUND: +Gz-induced acute dysencephalia and its protection is one of the significant topics in Aero-medical researches. Its pathological mechanism, however, is still unclear and protective measures should be developed further. OBJECTIVE: To observe the expression of inducible nitricoxide synthase (iNOS) in brain tissue after +Gz exposure and to analyze the protective effects of danshen and basic fibroblast growth factor (bFGF) on repeated +Gz exposure-induced brain injury. DESIGN: Randomized controlled animal study. SETTING: Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA.MATERIALS: The experiment was carried out at the Researching Center of Molecular Biology, Air-force General Hospital of Chinese PLA from April to August 2000. A total of 20 healthy SD rats of clean grade were divided into 5 groups according to randomly digital table, including control group, +Gz exposure group, bFGF group, danshen group and saline group with 4 in each group.METHODS: All rats were fixed on rotatory arm of centrifugal apparatus,and their heads were towards core of the apparatus. Except the rats in control group, the value of +Gz exposure was +14 Gz, and the growth rate was 1.5 G/s. The exposure at peak value lasted for 45 s. +Gz exposure was done for three times, and the interval was 30 minutes. Rats in the control group were also treated with the same +Gz exposing procedure, but the G value was +1 Gz. Rats in bFGF group and danshen group were intraperitoneally injected with 100 μg/kg of bFGF and/or 15 g/kg of danshen solution, respectively, at 30 minutes before centrifugation and immediateness after centrifugation; moreover, rats in saline group were injected with the same volume of saline. Six hours after exposure, rats were cut off their heads to obtain the brains which were maintained in liquid nitrogen for RNA extraction. The expression of iNOS mRNA in brain tissues of the rats in each group was detected with semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) and calculated on the basis of ratio between iNOS and glyceraldehyde-3-phosphate dehydrognase.MAIN OUTCOME MEASURES:Expressed level of iNOS mRNA in brain tissue of rats.RESULTS: Expression of iNOS mRNA in brain tissue was higher in repeated +Gz exposure group than that in control group (0.452 ±0.014,0.065±0.008, P ＜ 0.01); however, that was lower in bFGF group and dan-shen group than that in +Gz exposure group (0.196±0.010, 0.183±0.011,0.452±0.014, P ＜ 0.01).CONCLUSION: Repeated +Gz exposure can increase the expression of iNOS mRNA, this plays an important role in cerebral injury induced by repeated +Gz exposure. Moreover, bFGF and danshen have protective effects on cerebral injury induced by +Gz exposure.
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BACKGROUND: Brain injury can be induced by repeated high positive acceleration ( + Gz) exposure, but the mechanism was still unclear.OBJECTIVE: To investigate the role of apoptosis in higher + Gz exposures induced brain injury by observing the changes of mRNA expression of bcl-2,bax, p53, and interleukin-1β(IL-1β) hydroxylase in rat brain.DESIGN: Randomized control experimental study based on experimental SD rat model.SETTING: Aviation medicine research center of a hospital.MATERIALS: Twenty-six healthy male SD rats, weighed from 180 to 220 g,were randomly divided into control group(4 rats) and + Gz exposure group (22 rats).INTERVENTIONS: Rats were fixed on the rotating arm of animal centrifuger with their heads towards axis. Rats in + Gz exposure group were exposed to + 14 Gz for three times, each for 45 seconds with 30 minutes interval in between. Rats in control group were subject to the same experiment in + 1 Gz. The rat brains were taken 30 minutes, 6 hours, 24 hours and 48 hours after the last centrifuge run, and then fixed and embedded. Changes of bcl-2, bax, p53, and IL-1β hydroxylasein mRNA expressions in rat brain were measured with semi-quantitative reverse transcription polymerase chain reaction(RT-PCR) . Apoptotic cells were detected by terminal deoxynucleotide(correction of deoxynuleotide) transferase-mediated dUTP nick end labeling(TUNEL) technique.MAIN OUTCOME MEASURES: The changes of bcl-2, bax, p53, and IL-1 β hydroxyalse mRNA expressions at each time points.RESULTS: After repeated + Gz exposures for 6 hours, bcl-2 mRNA expression in rat brain tissue(0. 32 ± 0. 08) was found significantly lower than in control group(0. 69 ± 0. 15), while mRNA expressions of bax, p53, and interleukin-1β converting enzyme(ICE) 0.55 ±0. 09, 0. 48 ±0. 12, 0.79 ±0. 12were significantly higher than in control group 0.33 ±0. 09, 0. 31 ±0.05,0.51 ± 0.09 ( P ＜ 0. 01 ) . After 24 hours of exposure, mRNA expression of bcl-2 in rat brain tissue (0. 28 ± 0.05) was significantly lower than in control group, while the mRNA expressions of bax, p53, and ICE 0.61 ±0. 15,0.54 ± 0. 07, 0. 84 ± 0. 15 were significantly higher than in control group ( P ＜ 0.01); but the difference of brain bcl-2, bax, p53 and ICE mRNA expressions had no statistical significance when exposed for 0.5 hour and 48 hours( P ＞ 0.05). Partly apoptotic cells were observed at exposure for 6 hours and 24 hours.CONCLUSION: Changes of bcl-2, bax, p53 and ICE mRNA expressions, as well as apoptosis in rats brain can be induced by repeated + Gz exposures and may be involved in the molecular mechanisms of brain injury.
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Mutations in the parkin gene have recently been identified in familial and isolated patients with early-onset Parkinson disease (PD) and that subregions between exon 2 and 4 of the parkin gene are hot spots of deletive mutations. To study the distribution of deletions in the parkin gene among variant subset patients with PD in China, and to explore the role of parkin gene in the pathogenesis of PD, 63 patients were divided into early onset and later onset groups. Exons 1-12 were amplified by PCR, templated by the genomic DNA of patients, and then the deletion distribution detected by agarose electrophoresis. Four patients were found to be carrier of exon deletions in 63 patients with PD. The location of the deletion was on exon 2 (1 case), exon 3 (2 cases) and exon 4 (1 case). All patients were belong to the group of early onset PD. The results showed that parkin gene deletion on exon 2, exon 3 and exon 4 found in Chinese population contributes partly to early onset PD.
Subject(s)
Exons/genetics , Gene Deletion , Parkinson Disease/genetics , Point Mutation , Ubiquitin-Protein Ligases/geneticsABSTRACT
Mutations in the parkin gene have recently been identified in familial and isolated patients with early-onset Parkinson disease (PD) and that subregions between exon 2 and 4 of the parkin gene are hot spots of deletive mutations. To study the distribution of deletions in the parkin gene among variant subset patients with PD in China, and to explore the role of parkin gene in the pathogenesis of PD, 63 patients were divided into early onset and later onset groups. Exons 1-12 were amplified by PCR, templated by the genomic DNA of patients, and then the deletion distribution detected by agarose electrophoresis. Four patients were found to be carrier of exon deletions in 63 patients with PD. The location of the deletion was on exon 2 (1 case), exon 3 (2 cases) and exon 4 (1 case). All patients were belong to the group of early onset PD. The results showed that parkin gene deletion on exon 2, exon 3 and exon 4 found in Chinese population contributes partly to early onset PD.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Exons , Genetics , Gene Deletion , Parkinson Disease , Genetics , Point Mutation , Ubiquitin-Protein Ligases , GeneticsABSTRACT
To investigate the distribution of possible novel mutations from parkin gene in variant subset of patients with Parkinson's disease (PD) in China and explore whether parkin gene plays an important role in the pathogenesis of PD, 70 patients were divided into early-onset group and late-onset group; 70 healthy subjects were included as controls. Genomic DNA from 70 normal controls and from those of PD patients were extracted from peripheral blood leukocytes by using standard procedures. Mutations of parkin gene (exon 1-12) in all the subjects were screened by PCR-single strand conformation polymorphism (SSCP), and further sequencing was performed in the samples with abnormal SSCP results, in order to confirm the mutation and its location. A new missense mutation Gly284Arg in a patient and 3 abnormal bands in SSCP electrophoresis from samples of another 3 patients were found. All the DNA variants were sourced from the samples of the patients with early-onset PD. It was concluded that Parkin point mutation also partially contributes to the development of early-onset Parkinson's disease in Chinese.
Subject(s)
DNA Mutational Analysis , Exons , Genotype , Parkinson Disease/genetics , Point Mutation , Polymorphism, Single-Stranded Conformational , Ubiquitin-Protein Ligases/biosynthesis , Ubiquitin-Protein Ligases/geneticsABSTRACT
To investigate the distribution of possible novel mutations from parkin gene in variant subset of patients with Parkinson's disease (PD) in China and explore whether parkin gene plays an important role in the pathogenesis of PD, 70 patients were divided into early-onset group and late-onset group; 70 healthy subjects were included as controls. Genomic DNA from 70 normal controls and from those of PD patients were extracted from peripheral blood leukocytes by using standard procedures. Mutations of parkin gene (exon 1-12) in all the subjects were screened by PCR-single strand conformation polymorphism (SSCP), and further sequencing was performed in the samples with abnormal SSCP results, in order to confirm the mutation and its location. A new missense mutation Gly284Arg in a patient and 3 abnormal bands in SSCP electrophoresis from samples of another 3 patients were found. All the DNA variants were sourced from the samples of the patients with early-onset PD. It was concluded that Parkin point mutation also partially contributes to the development of early-onset Parkinson's disease in Chinese.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , DNA Mutational Analysis , Exons , Genotype , Parkinson Disease , Genetics , Point Mutation , Polymorphism, Single-Stranded Conformational , Ubiquitin-Protein Ligases , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the distribution of possible novel mutation of parkin gene in variant subset patients with Parkinson's disease (PD) in China and to explore the role of parkin gene in the pathogenesis of PD.</p><p><b>METHODS</b>Seventy patients were divided into early onset and late-onset groups, and 70 healthy subjects were included as controls. Genomic DNA from 70 normal controls and from those of PD patients were extracted from peripheral blood leukocytes with standard procedures. Mutations of parkin gene (exons 1-12) in all subjects mentioned above were screened by PCR-SSCP. And in the samples with abnormal SSCP result, further sequencing was performed to confirm the mutation and its location.</p><p><b>RESULTS</b>A new missense mutation (Gly284Arg) on exon 7 was found in a sample, while 4 samples from all subjects exhibited abnormal mobility shift on SSCP electrophoresis. All mentioned DNA variants were sourced from the samples of the patients with early-onset PD.</p><p><b>CONCLUSION</b>Point mutation in parkin gene also contributes partly to the development of early-onset Parkinson's disease in Chinese population.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Age of Onset , Base Sequence , China , DNA , Chemistry , Genetics , DNA Mutational Analysis , Ligases , Genetics , Mutation, Missense , Parkinson Disease , Genetics , Point Mutation , Polymerase Chain Reaction , Polymorphism, Single-Stranded Conformational , Ubiquitin-Protein LigasesABSTRACT
Objective To study the changes of mRNA expression of heat shock protein 70 (HSP70) in the rat brain exposed to repeated +Gz. Method The mRNA expression levels of HSP70 in rat brain were measured by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Result The HSP70 mRNA expression levels in rat brains taken 30 min and 6 h after repeated +Gz exposures were significantly higher than those in control group, while the difference between the levels of control group and those of experimental rat brains taken 24 h after +Gz exposure was not significant. Conclusion It is suggested that HSP70 mRNA expression in rat brain can be induced by repeated +Gz exposures and the increased HSP70 mRNA expression may play an important role in self-protection against brain damage induced by+Gz exposures.
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To study changes in mRNA expression of induced nitric oxide synthase (iNOS) in the brain of rat repeatedly exposed to +Gz, and to explore the prevention and treatment effect of basis fibroblast growth factor (bFGF) and radix salviae miltiorrhizae (RSM) on the brain injury induced by repeated +Gz exposures. The mRNA expression levels of iNOS in brain were measured by semi quantitative reverse transcription polymerase chain reaction (RT PCR). The results showed the iNOS mRNA expression level in brain of rats repeatedly exposed to +Gz was significantly higher than that of control, but bFGF and RSM could alleviate the expression change of iNOS. It suggested that the iNOS mRNA expression in rat brain was induced by repeated +Gz exposures and it might play an important role in the pathologic course of brain damage induced by +Gz exposures.The bFGF and RSM possessed prevention and treatment on the brain injury induced by repeated +Gz exposures.
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The purpose of this study is to observe the changes in gene expressions of bcl 2, bax, p53 and interleukin 1? converting enzyme (ICE) in the cerebral tissue of rat exposed to repeated +Gz, and to explore the pathogenetic role of apoptosis in brain damage induced by repeated +Gz exposures. The expression levels of bcl 2, bax, p53 and ICE in cerebral tissue of rats exposed to repeated +Gz were measured by semi quantitative reverse transcription polymerase chain reaction (RT PCR), and the apoptotic cells in brain tissue were detected by terminal deoxynuleotidyl transferase mediated dUTP nick end labeling technique. The results showed that the bcl 2 expression levels in the brain 6h and 24h after repeated +Gz exposures were significantly lower than those of control group, whereas the bax, p53 and ICE expression levels in the brains tissue 6h and 24h after repeated +Gz exposures were significantly higher than those of control group. Apoptotic cells could be observed in cerebral cortex, CA1 subregion of hippocampus and striatum at 6h and 24h after repeated +Gz exposures. It is suggested that the changes in bcl 2, bax, p53 and ICE expressions in rat brain can be induced by repeated +Gz exposures and apoptosis might be one of the molecular mechanisms of brain damage induced by repeated +Gz exposures