Objective To investigate the preventive effect of treating cardiotoxicity induced by adriamycin (ADM) with the method of nourishing yin. Methods 90 cancer patients underwent adriamycin therapy were randomly recruited intoa treatment group (45 cases) and a control group (45 cases). The treatment group was treated with Wushen decoction, while the control group was treated with antioxidant drugs. The changes of ECG, blood SOD, GSH-Px, MDA content etc were observed after one course of four weeks' treatment. Results The incidence of cardiactoxicity was 15.56% in the treatment group and 40.00% in the control group, showing significant difference ( U=2.02, P<0.05 ) ; the incidence of ECG abnormalities was 13.33% in the treatment group and 37.78%, in the control group, showing significant difference (U= 2.18, P< 0.05 ) : the effective rate was 82.22% in the treatment group and 62.22% in the control group, showing significant difference ( U=2.18, P <0.05) ; and SOD, GSH-Px, MDA content at the 1, 7, 14, and 28days between the two groups also demonstrated significant differences (P<0.05) . Conclusion The method of nourishing yin has excellent attenuation to adriamycin-induced cardiotoxicity, besides it enhances therapeutic effects of chemotherapy.

Objective To evaluate the prognostic significance of lymph node ratio (LNR) in axillary lymph node positive breast cancer.Methods Eight hundred and three cases axillary lymph node positive breast cancer patients without distant metastasis were systematically treated in the Obstetrics and Gynecology Hospital of Fudan University from 2006 to 2014,at least 10 lymph node removed in each case.Clinicopathological data including 5-year disease-free survival rate (5y-DFSR) and 5-year overall survival rate (5y-OSR) were described.Factors related with prognosis were analyzed by univariate analysis.Prognostic difference was compared among different LNR stage in each axillary lymph node pathological stage(pN).Prognostic significance of pN and LNR was compared by multivariate analysis.Results Mean lymph nodes removed were 15.47±4.70 lymph,and median positive lymph nodes were 4 lymph in 803 cases axillary lymph node positive breast cancer patients.Altogether 159 cases of local recurrence and distant metastasis and 99 cases of breast cancer-related death occurred during median follow-up of 61 months.Five-year DFSR was 77％ and 5y-OSR was 83％.Log-rank univariate analysis showen that pT,pN,LNR,lymphovascular invasion and ER status were related to DFS and OS.Five-year DFSR and OSR for pN1,pN2,pN3 were 89％,68％,59％ and 93％,78％,63％,respectively,whereas 5y-DFSR and 5y-OSR for LNR1,LNR2,LNR3 were 90％,69％,56％ and 94％,80％,57％,respectively.There was statistically significant difference among different LNR in pN1 and pN2 (pN1:DFS:P=0.005,0S:P=0.024;pN2:DFS:P=0.017,0S:P=0.000),but not in pN3,inspite of difference tendency (DFS:P =0.165,OS:P =0.075).In multivariate analysis,when pN or LNR were entered into the Cox regression mode respectively,both were the independent prognostic factors of DFS(P＜0.001) and OS(P＜0.001).When pN and LNR were entered into the Cox hazard regression model at the same time,LNR remained as the independent prognostic factor of DFS and OS (P ＜ 0.001),but pN lost significance (DFS:P =0.461,OS:P=0.162).Conclusion LNR is independent prognostic factor for positive axillary lymph node breast cancer.

Objective To evaluate the clinicopathological characteristics of mucinous breast carcinoma (MBC) and its prognosis.Methods 112 cases of MBC treated in Obstetrics and Gynecology Hospital of Fudan University between Jan 2005 and Dec 2014 were enrolled retrospectively together with 1 157cases of invasive ductal carcinoma (IDC) for comparison.There were 71 cases of pure MBC (PMBC) and 41cases of mixed MBC (MMBC).PMBC and MMBC were compared with each other,and were also compared with IDC respectively.Results PMBC had smaller tumor mass,higher expression rate of hormone receptors (all P＜0.05),lower rate of lymph node metastasis (7.0％ vs.40.6％,x2 =32.663,P ＜0.001) when compared with IDC.The 5 year disease free survival (DFS) and overall survival (OS) of PMBC were both better than those of IDC (DFS:94.6％ ±3.0％ vs.81.3％ ± 1.1％,x2 =7.265,P =0.007;OS:92.4％ ±5.3％ vs.88.5％ ± 1.0％,x2 =4.059,P =0.044).MMBC had relatively larger tumor mass,higher expression rate of hormone receptor,but had no difference in the rate of lymph node metastasis (48.8％ vs.40.6％,x2 =3.417,P =0.332) when compared with IDC.There was no statistically significant difference in 5 yearDFSandOSbetweenMMBCandIDC (DFS:79.1％ ±7.1％ vs.81.3％±1.1％,x2 =0.167,P=0.683;OS:84.5％ ±7.2％ vs.88.5％ ± 1.0％,x2 =0.123,P =0.726).PMBC had relatively smaller tumor mass,lower rate of lymph node metastasis,but had no difference in the expression rate of hormone receptors.The 5 year DFS and OS of MMBC were both better than those of MMBC (DFS:94.6％ ± 3.0％ vs.79.1％±7.1％,x2 =6.772,P =0.009;OS:92.4％ ±5.3％ vs.84.5％ ±7.2％,x2 =6.401,P=0.036).Lymph node status was the only statistically significant prognostic factor of MBC by COX multivariate analysis.Conclusions PMBC has better prognosis than MMBC and IDC owing to its lower rate of lymph node metastasis.MMBC has higher rate of node metastasis than PMBC,hence similar prognosis with IDC.

Objective To summarize and explore the clinical value of Mammotome technology in the diagnosis and treatment of breast neoplasms. Methods Nine hundred and eighty-seven breast neoplasms of 710patients were biopsied and excised with the aid of ultrasound-guided Mammotome system. The malignant neoplasms,according to the histological report,were radically removed during the operation without delay. All patients enrolled into the study were followed up closely on the complcations and satisfaction degree. Results All the operations except one were successful and got the sufficient specimen to perform the pathological examination,the biopsy achievement rate was 99. 8% . Both the sensitivity and specificity of the diagnosis were 100% in 16 breast tumors. Complete resection rate was 99%. The incision length was about 3 mm,showing good cosmetic outcome. Complcations were mild,mainly composed of haematoma and ecchymosis. The patients' general satisfactory rate was 93%. Conclusions This technique can help achieve biopsy of breast neplasm and excision of benign lesions at the same time with cosmetic result Further attention should be paid to reduce the lesion residue and hemorrhagic complications.

Objective To study the clinical efficacy of micro-plasma radiofrequency with joint electron-beam radiation treatment for keloids.Methods A total of 15 patients with keloids over half a year were treated with single time micro-plasma radiofrequency technology by roller tip at 80-100 watts.The hypofractionated electron-beam was used,with 9 Gy dose per time covering the scar with a 1 cm margin,within 24 hours and 1 week after the micro-plasma treatment.The Vancouver Scar Scales (VSS) were assessed before and 6 months after the treatment.Patients' satisfaction and the adverse reactions were evaluated 6 months after the treatment.Results There was astatistically significant difference between the mean VSS of 15 patients pre-and 6 months posttreatment (from 11.73± 1.12 to 3.87±2.53,P＜0.05).The degree of improvement was:excellent in 1 case,good 10 cases,fair 3 cases,and poor 1 case.Patients' assessment was:extremely satisfied in 6 cases,satisfied 6 cases,approximately satisfied 2 cases and dissatisfied 1 case.The adverse reactions included hyperpigmentation within the radiation field on the anterior chest wall in 1 case and delayed healing of 1 patient 's scar wound.Conclusions Micro-plasma radiofrequency combined with electron-beam radiation therapy is highly effective and safe on keloids with good clinical application value.

Objective To evaluate the effect and clinical value of open surgery combined ultrasound-guided Mammotome in the treatment of multiple breast lumps. Methods Four hundred and forty-four patients in our hospital from Jan. 2006 to Jun. 2008 were divided into 3 groups, who underwent classical open surgery, ultrasound-guided Mammotome operation, or combined therapy respectively and followed by post-operation visits reguarly. The operation effects were compared between the 3 groups. Results Compared with the classical open surgery, combined therapy had no difference in time of procedure and procedural bleeding, but had lower incidence of local skin, better incision condition and higher satisfaction of patients. Compared with ultrasound-guided Mammotome operation, combined therapy took less time in procedure, and in the same time had less procedural bleeding, lower post-operation complication and higher patients satisfaction. Conclusions Combined therapy has high complete removal rate, low post-operation complication as well as cosmetic effect. It has special advantages over the other two kinds of surgery, so it has wide clinical application.

This study was aimed to analyze the proportion of T cell subsets, CD4(+) CD25(high) regulating T cells (Tr) in peripheral blood of B-NHL patients and their change regularity, and to investigate the immunosuppression mechanism and influence of chemotherapy on immunosuppression function of B-NHL patients. The peripheral blood was collected from 42 patients with B-NHL, 36 patients with B-NHL who achieved partial remission (PR) or complete remission (CR) after 4 - 6 cycles of chemotherapy and 15 healthy controls. By using monoclonal antibodies, the blood samples were evaluated with the flow cytometry for lymphocyte subsets and Tr cells. The results showed that the proportion of CD3(+) and CD4(+) T cells, and the ratio of CD4/CD8 in patients with B-NHL group was significantly less than those in the healthy controls, i.e. (68.33 +/- 15.27)% versus (72.06 +/- 9.26)%; (34.47 +/- 12.84)% versus (42.45 +/- 9.2)%; 1.36 +/- 0.26 versus 1.92 +/- 0.20, but the prevalence of the CD4(+) CD25(high) Tr cells was significantly higher than those in the healthy group [(4.10 +/- 1.21)% versus (2.04 +/- 1.03)%, P < 0.001]. The ratio of CD4/CD8 in chemotherapy group was lower than that in control, but the proportion of CD4(+) CD25(high) Treg cells in chemotherapy group was higher than those before chemo-/radio-therapy and the control. It is concluded that the relative increase of CD4(+) CD25(high) Tr cells in peripheral blood of B-NHL patients may be related to immunosuppression and tumor progression.
Adolescent ; Adult ; CD4 Antigens ; analysis ; Female ; Humans ; Immune Tolerance ; immunology ; Interleukin-2 Receptor alpha Subunit ; analysis ; Lymphoma, B-Cell ; blood ; immunology ; Male ; T-Lymphocyte Subsets ; immunology ; T-Lymphocytes, Regulatory ; immunology

Objective To evaluate the effect of ultrasound-guided vacuum-assisted minimal invasive resection(Mammotome procedure)of breast lumps through the retromammary space. Methods Seven hundred and eighty-seven patients in Obstetrics and Gynecology Hospital Affiliated to Fudan University from Jan. 2011 to May 2012 were underwent ultrasound-guided Mammotome operation through the retromammary space (retromammary space group,385 cases),or adjacent the lumps,and followed by post-operation visits regularly (Mammotome operation adjacent the lumps group,402 cases). The operation effects were compared between the two groups. Results All cases were followed up for 12 months. The period of Mmmotome operation through the retromam mary space and the rate of resection were(48 ± 6)min and(52 ± 4)min,99. 48%(383 / 385), 99. 25%(399 / 402),perspectively,in group of Mammotome operation through the retromammary space and Mammotome operation adjacent lumpsand. There was no significant difference between the two groups( P> 0. 05). The amount of procedural bleeding,the incidence of ecchymosis,local hematoma and the number of incision in group of Mammotome operation through the retromammary space were(8 ± 3)ml,2. 34%(9 / 385), 0. 52%(2 / 385),(1. 3 ± 0. 6)respectively,which were significantly lower than those in Mammotome operation adjacent the lumps group((14 ± 6)ml,8. 71%(35 / 402),2. 74%(11 / 402),(2. 4 ± 0. 3)respectively). There were statistical difference between two groups( P = 0. 003,P < 0. 001,P = 0. 001,P = 0. 006). The rate of satisfaction in group of Mammotome operation through the retro-mammary space was 98. 70%(380 / 385),which is significantly higher than in group of Mammotome operation adjacent the lumps(89. 30%(359 / 402),P< 0. 01). Conclusion The therapy approach of ultrasound-guided Mammotome operation through the retromammary space has lower hemorrhagic complication,as well as the better effect with special advantages. Therefore it has prospective clinical application.

Objective To investigate the clinical effect of 3D printing assisted percutaneous vertebroplasty (PVP) in treating severe osteoporotic vertebral compression fracture (OVCF) in elder patients.Methods A retrospective case series study was conducted on the clinical data of 58 elderly patients (58 vertebrae) with severe OVCF who underwent PVP treatment in spinal surgery department of Henan Provincial People's Hospital from June 2014 to June 2016.According to the treatment method,the patients were divided into Group A which adopted 3D printing of injured vertebrae before PVP and Group B which adopted routine PVP operation.Group A consisted of 28 cases (28 vertebrae),including eight males and 20 females,aged 64-91 years [(78.1 ±8.5) years].In terms of the distribution of injured vertebrae,there were four cases of T10,six cases of Tu,eight cases of T12,four cases of L1,and six cases of L2 in Group A.Group B consisted of 30 cases (30 vertebrae),including 10 males and 20 females,aged 65-90 years [(77.8 ± 8.2) years].In terms of the distribution of injured vertebrae,there were three cases of T10,seven T11,nine T12,six L1,and five L2.The operation time,visual analogue scale (VAS) before operation,1 day after operation and at the last follow up,Japanese Orthopedic Association (JOA) score,anterior compression ratio of injured vertebrae,and cement leakage rate were compared between the two groups.Results All the operations were completed successfully.The patients were followed up for 14-26 months [(18.7 ± 3.4)months] in Group A and for 12-28 months [(20.0 ± 5.4) months] in Group B.The operation time was (28.0 ± 3.4) min in Group A and (30.9 ±5.3) min in Group B (P ＜ 0.05).Both the VAS 1 d after operation of Group A [(2.3 ± 1.0) points] and Group B [(2.0 ± 0.8) points] and the VAS at the last follow up of Group A [(0.7 ± 0.7) points] and Group B [(0.8 ± 0.7) points] were significantly lower than those before operation (P ＜ 0.05),but there was no significant difference between thetwo groups (P ＞ 0.05).Both the JOA at day 1 after operation of Group A [(21.3 ± 2.2) points] and Group B [(20.7 ± 2.1) points] and the JOA at the last follow up of Group A [(24.7 ± 2.3) points] and Group B [(24.1 ± 2.0) points] were significantly higher than those before operation (P ＜ 0.05),but there was no significant difference between the two groups (P ＞ 0.05).The anterior compression ratio of injured vertebrae 1 d after operation of Group A (59.4 ± 7.9) ％ and Group B (59.1 ± 6.8) ％ and that at the last follow up of Group A (59.1 ± 7.8) ％ and Group B (58.7 ± 5.4) ％ were significantly improved than those before operation (P ＜ 0.05),but there was no significant difference between the two groups (P ＞ 0.05).There were three cases of bone cement leakage in Group A (11％) and 11 cases of bone cement leakage in Group B (37％) after PVP,and the difference was statistically significant (P ＜ 0.05).Conclusion Compared with conventional PVP,3D printingassisted PVP has lower leakage rate,shorter operation time,and better clinical effect in treating severe OVCF in the elderly.

Objective:To establish a senescence model of rat intervertebral disc nucleus pulposus cells .Methods :The nucleus pulposus cells ,which were extracted from rat intervertebral discs and cultured in complete medium ,were set as control group . The senescence model of nucleus pulposus cells in vitro (senescence model group) was established by additional culture for two hours on the basis of control group ,to which tert‐butyl hydroperoxide(t‐BHP) was added with a final concentration of 100μmol/L .The expression levels of senescence associated indexes ,such as caveolin‐1 and beta‐galactosidase (SA‐β‐gal) ,in two groups were assessed by Western blotting ,while the cell viability in two groups was detected by Cell Counting Kit‐8(CCK‐8) proliferation assay .Results :After two hours of t‐BHP function ,the expression levels of caveolin‐1and SA‐β‐gal in senescence model group were significantly higher than those in control group ,while the nucleus pulposus cells proliferation was slower and the cell viability was much lower .Conclusions :The senescence model of nucleus pulposus cells in vitro can be established successfully with the induction of t‐BHP ,and caveolin‐1 induces the senescence of nucleus pulposus cells during the process .