Objective To explore the expression of Ki 67 in 72 cases of breast cancer and to analyze the correlation of Ki67 expression with clinicopathological factors and efficacy of neo-adjuvant chemotherapy .To as-sess the prediction value of Ki 67 in selecting neo-adjuvant chemotherapy .Methods Ki67 expression in tumor tissues of 72 cases of breast cancer was detected before and after neo-adjuvant chemotherapy .Tumor tissues are a-chieved by core needle biopsy .Results Ki67 overexpression was found in those with axillary lymph node ( ALN) metastasis, in pathological stage III and tumor diameter >2 cm(P＜0.05).Ki67 expression was not significantly associated with age(P>0.05).Objective response(OR)rate of neo-adjuvant chemotherapy was 84.2%(61/72). Patients with Ki67 over-expression were more sensitive than those with lower-expression(P>0.05).Positive ex-pression rate of Ki67 was reduced significantly by neo-adjuvant chemotherapy(P＜0.05).Positive expression rate of Ki67 was reduced significantly in pathological complete response ( PCR ) group, clinical complete remission (CCR)group and partial response(PR)group.Conclusion The expression of Ki67 may be a potential predictive biomarker for neo-adjuvant therapy response in patients of breast cancer and can provide the basis for individual therapy for breast cancer .

Objective To investigate the effect of overexpression of miRNA-4465 on invasion and metastasis of breast cancer MDA-MB-231 cells and its mechanism.Methods MiRNA-4465 minics was transfected into the MDA-MB-231 cells,and real-time PCR was used to detect the expression of miRNA-4465.Transwell assay was used to investigate the migration and invasion capability of cells after being transfected.Bioinformatics analysis were performed to predict the potential targets of miRNA-4465,and finally,luciferase reporter plasmids assay and west-ern blot was used to confirm the potential target of miRNA-4465.Results Comparing with negative control group, the expression of miRNA-4465 in miRNA-4465 minics group was increased significantly.Transwell migration assay showed that migration capability of cells in miRNA-4465 minics group was decreased(P =0.001);transwell inva-sion assay showed that invasion capability of cells in miRNA-4465 minics group was decreased(P =0.010).Lucif-erase reporter plasmids assay showed that comparing with the negative control +psiCHECK2-EZH2 3’UTR(wild type),the fluorescence activity of miRNA-4465 minics +psiCHECK2-EZH2 3’UTR(wild type)was decreased by 66%(P =0.001).Moreover,comparing with the negative control group,the expression of EZH2 protein was de-creased after transfecting miRNA-4465 minics into MDA-MB-231 cells.Conclusion MiRNA-4465 can suppress the invasion and metastasis of breast cancer MDA-MB-231 cells,which may be related to the regulation of EZH2.

Objective To evaluate the applicative value of fiberoptic ductoscopy(FDS)in abnormal nipple discharge.Methods A total of 104 patients with nipple discharge were examined by fiberoptic ductoscopy(Germany Scholly Fiberoptic Gmbh 42.0500).The results were compared with postoperative pathological diagnosis.Results All the 104 cases were successfully diagnosed with FDS.The detectable rate for intraductal mass by ductoscopy is 94 %(49/52).The sensitivity and specificity of ductoscopy for mammary duct cancer is 50%(1/2)and 91%(43/47)respectively;the negative predictive value is 98%(43/44),positive predictive value is 20%(1/5),and accuracy is 90%(44/49).Five cases of papillomatosis were diagnosed by ductoscopy,in which 3 cases were consistent with postoperative pathological findings,therefore the diagnose accordance rate is 60%;the other 2 cases were proven to be multiple papilloma.Thirty-eight cases of papilloma were detected by ductoscopy and received lobectomy of bresat;55 cases of inflammatory duct disease did not receive any operation;and 3 cases(3%,3/104)were diagnosed papilloma by re-examination with ductoscopy due to persistent nipple discharge,and were confirmed after operation.Conclusions Fiberoptic ductoscopy is the first choice for examination of nipple discharge for its accuracy in finding pathogenic cause and locating lesion,and surgery can thereby be avoided for galactophoritis and mammarv duct ectasia patients.

Objective To evaluate the value of breast duct endoscopy and breast localization needle for the diagnosis and microinvasive treatment of intraductal lesions. Methods A total of 103 patients with nipple discharge without breast lumps were examined by breast duct endoscopy in our hospital. Of them, 63 cases of intraductal lesions were localized with breast localization needle and received arc incision of the areola of the breast and excision of the localized breast duct with 1-cm adjacent tissues, which were sent for intraoperative frozen. After the frozen pathological examination, the operation was ended for the patients with intraductal papilloma; simple mastectomy was performed on those with duct papillomatosis; and simple mastectomy combined with DIEP reconstruction was carried out for the patients with intraductal carcinoma. Results Frozen and postoperative pathological examinations showed single intraductal papilloma in 59 of the patients (59/63, 93.6%), duct papillomatosis in 2 (2/63, 3.2%) , and intraductal carcinoma in 2 (2/63, 3.2%). The 59 patients with single intraductal papilloma were reexamined in 3 months after the operation, none of them had nipple discharge or other symptoms. Conclusions Resection of intraductal lesions under the guidance of breast localization needle is less traumatic with good cosmetic outcomes. By using the method, high rates of complete resection and accuracy of pathological examination can be achieved.

Objective To summarize the clinical experience in rigid ureteroscopy for the treatment of acute obstructive renal failure. Methods From June 2005 to April 2008,totally 127 patients with acute obstructive renal failure were treated by rigid ureteroscopy in the emergency of our hospital. Using EWSL or Holmium laser,the calculi were broken into pieces smaller than 2 mm in diameter. Larger pieces were removed with clamps. Double-J stent was indwelled after the operation. Results In this series,2 patients were converted to open surgery because of failure to insert the ureteroscope owning to ureteral stenosis. In the rest of the cases,the ureteroscopy was succeeded in 151 of the 178 sides (84.8%); and the obstruction was released with double-J stent indwelling in 169 sides. The mean operation time was 34 min (16-57 min). During the operation,2 cases developed ureteral perforation and 3 had hypovolemic shock. In 17 cases (18 sides),the calculi moved back into the renal pelvis,and thus received a second EWSL. Totally 65 cases (51.2%,65/127) developed gross hematuria,and were cured spontaneously in 1 to 3 days. Conclusions Rigid ureteroscopy can be the first choice for acute obstructive renal failure,for the procedure is safe and minimally invasive,leading to quick recovery. It is applicable to bilateral ureteral obstruction.

Objective To evaluate the efficacy of tonsils and adenoid ablation by plasma-mediated temperature-controlled radiofrequency for obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Methods From August 2005 to May 2007,43 cases with OSAHS received tonsillectomy and adenoid radical resection with Evac70 tool bit using a plasma-mediated temperature-controlled system. The clinical data of the patients were reviewed. Results The mean operation time was 16 minutes,ranged from 10 to 20 minutes. During the operation,the patients had a mean of 3 ml hemorrhage (1 to 10 ml). Compared with the preoperative examination,the patients showed significantly lowered AHI [(14.6?4.6) times/h vs (4.2?2.7) times/h,t=8.563,P=0.000] and OAI [(6.9?3.5) times/h vs (3.3?1.4) times/h,t=5.443,P=0.000] and increased minimum blood oxygen saturation [(85.7?4.4)% vs (99.7?0.2)%,t=-6.687,P=0.000]. Conclusions The ablation of the tonsil and adenoid using plasma-mediated temperature-controlled radiofrequency is effective and safe for children with OSAHS.

Objectives To approach the effect of the disturbance of lipid metabolism, fatty infiltration in oropharyngeal tissues on the patient with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods 19 obese patients of OSAHS, 15 nonobese patients of OSAHS and 9 healthy people (as control) were selected. Among the three groups, The related clinical index and size and the weight of uvula were measured. The fatty weight of uvula was analyzed by biochemical methods. The uvular tissue sections were evaluated by light microscope (LM) and transmission electron microscope (TEM). Results 1 Both the obese and nonobese groups, the TC, TC/HDL, size and weight and the adipose tissue in uvula were obviously different compared with control group( P

Objective To evaluate gene associated with retinoid-interferon-induced mortality-19 (GRIM-19) expression levels and the correlation with its target gene product signal transducers and activator of transcription 3 (STAT3)in human breast cancer tissues and normal gland tissues,and to analyze their roles in the tumorigenesis of breast cancer.Methods The expression of GRIM-19 and STAT3 protein and mRNA in 40 cases of breast cancer tissues and 40 cases of normal gland tissues was detected by immunohistochemistry and Western blot.The correlation of the expression of GRIM-19 and STAT3 to various clinicopathologic characteristics of breast cancer were analyzed statistically.The mRNA expression and gene mutation of GRIM-19 in breast cancer cell line MCF-7 and 25 specimens of breast cancer and normal gland tissue were detected by reverse transcription-polymerase chain reaction(RT-PCR)and sequencing.Results The protein and mRNA expression of GRIM-19 was obviously lower in breast cancer than in normal gland tissues (P ＜ 0.05) while the protein and mRNA expression of STAT3 was obviously higher in breast cancer than in normal gland tissues(P ＜0.05).The expression of GRIM-19 and STAT3 was negatively correlated with each other(x2 =8.25,P ＜0.01).Breast cancer samples exhibited low level of GRIM-19 and moderate to high level of STAT3 expression.In contrast,the normal gland tissue was characterized by high level of GRIP-19 and low level of STAT3 expression.The protein expression of GRIM-19 was correlated with the histological grading and clinical stage of breast cancer(P ＜ 0.05).STAT3 was not correlated with clinicopathologic characteristics of breast cancer (P ＞ 0.05).No mutation of GRIM-19 gene was detected in breast cancer tissues,normal gland tissues or MCF-7 breastcancer cells.Conclusions The low expression of GRIM-19 and the high expression of STAT3 co-exist in breast cancer.Downregulation of GRIM-19 was closely correlated with increased histological grade,clinical stage and STAT3 in breast cancer.The potential role of GRIM-19 in breast cancer development may be through these correlations.

Objective To determine the quality of life of patients treated with one of three different types of surgery for breast cancer.Methods This was a cross-sectional study using a questionnaire survey completed by Chinese patients without active disease after at least 2 years of follow-up after breast cancer surgery.Results This study totally included 139 breast cancer patients:44 ( 31.6%) had undergone modified radical mastectomy with reconstruction, 41(29.5%)had a quadrantectomy with axillary lymph node dissection, and 54(38.9%)had a modified radical mastectomy without reconstruction.The EORTC QLQ-C30 and EORTC QLQ-BR23 question-naires were used;their reliability was>0.82.Global health status(94.30 ±12.04, P=0.028)and role functio-ning(85.16 ±17.23, P=0.138)were highest in the quadrantectomy group.Pain score was highest in the modi-fied radical mastectomy with reconstruction group(26.13 ±30.15, P =0.042).The breast symptom score (22.56 ±22.30, P=0.009)and body image perception(85.56 ±19.72, P=0.025)were highest in the conser-vative treatment group.The overall health of patients given modified radical mastectomy without reconstruction was lower(72.61 ±20.89, P=0.014) in women older than 50 years compared with younger women.Conclu-sions The quadrantectomy with axillary lymph node dissection procedure had better acceptance, but the overall health status did not differ between groups.Overall health status is lower in women older than 50 years receiving a modified radical mastectomy without reconstruction.

Objective To investigate the expression of the ER,CyclinD1 in breast tissue of pubertal mammary hypertrophy and explore the possible etiology of pubertal mammary hypertrophy.Methods The expression of ER,CyclinD1 was detected by Western-blot in 15 cases of pubertal mammary hypertrophy,15 normal breast tissue and 10 cases of micromastia.Results There was significant difference of the expression of ER,CyclinD1 within breast tissue between pubertal mammary hypertrophy and micromastia(P＜0.01).There was significant difference of the expression of ER,CyclinD1 within breast tissue in pubertal mammary hypertrophy and in normal breast tissue(P＜0.01).There was no difference between the expression of ER,CyclinD1 within breast tissue in micromastia and in normal breast tissue(P＞0.05).Conclusions The expression of ER,CyclinD1 in pubertal mammary hypertrophy are significantly higher than in micromastia and normal breast tissue.The pubertal mammary hypertrophy may be related to the expression status of ER,CyclinD1 within breast tissue.