0.05).The sera levels of sCD40L in CHD were significantly and positively correlated with Jenkins score(r=0.524,P

Objective:To investigate the clinicopathological characteristics and prognosis of invasive micropapillary carcinoma (IMPC) of the breast. Methods:Data of 65 IMPC cases obtained from the Fourth Hospital of Hebei Medical University between Janu-ary 2009 and December 2011 were retrospectively analyzed. The expression of epithelial membrane antigen (EMA) was evaluated us-ing immunohistochemistry (IHC) to detect the micropapillary component in the tumor. The patients were divided into 4 groups based on the percentage of micropapillary component:≤10%, 11%-30%, 31%-50%, and>50%. Expressions of estrogen receptor (ER), pro-gesterone receptor (PR), and HER-2 were analyzed by IHC. Kaplan-Meier method, Log rank test, and multivariate Cox proportional hazard model were used to determine the factors affecting post-treatment survival. Results:Of the 65 cases, 12 were simple IMPC, 46 were IMPC with invasive ductal carcinoma, and 7 were other invasive carcinoma cases. The≤10%, 11%-30%, 31%-50%, and>50%micropapillary component groups comprised 7.69%(5/65), 44.62%(29/65), 26.15%(17/65), and 21.54%(14/65) of the total cases, re-spectively. Statistically significant differences were found in the four groups (P<0.01). IHC results showed that the positive rates of ER, PR, and HER-2 in the IMPC tissues were 76.92%(50/65), 67.69%(44/65), and 24.62%(16/65), respectively. Statistical differences ex-isted among the groups (P<0.05). Kaplan-Meier method indicated that positive rate of lymph node metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 significantly affect survival time of IMPC cases (P<0.05). Conclusion:Positive rate of nodal metastasis, the proportion of IMPC, vascular invasion, and the expression of ER, PR, and HER-2 are correlated with the prognosis of IMPC.

Objective To explore a method to prepare a model of renal ischemia-reperfusion injury, with mild injury to animals, simple and easy to operate and stable effectiveness. Methods Healthy SD male rats were randomly divided into normal group (group C), sham-operated group (group S) and experimental group (IR group). Rats in the experimental group received a median incision in the middle of the back skin. Through the muscle fascia of each side on the back into the bilateral retroperitoneal space, the bilateral renal pedicles were separated, and closed for 50 min with a mini artery clamp without injury, and then the blood perfusion of the bilateral renal pedicles was resumed by releasing the mini artery clamp. Except that the rats of sham operation group were not blocked the renal pedicle, the rest of the operating steps were consistent with the experimental group. The normal group rats were not treated except for anesthesia. To observe the condition of the rats, serum creatinine (SCr), blood urea nitrogen (BUN) and pathologyical changes in the kidney tissues at 24 h after operating. Results Skin incision was 2. 24 ± 0. 27 cm in the group IR, the right incision of lumbar dorsal fascia and muscle was 1. 36 ± 0. 21 cm, and the left incision was 1. 36 ± 0. 24 cm. The operation time was 3. 30 ± 0. 37 min from incising skin to clamping the bilateral kidney pedicles. The successful rate of model preparation reached 95% in the IR group. Compared with the groups C and S, the levels of SCr and BUN were remarkably increased in the IR group (P ＜0. 01), and renal tubular necrosis scores were also significantly increased (P＜ 0. 05). Conclusions The rat model of renal ischemia-reperfusion injury is established by clamping bilateral renal pedicles via dorsal retroperitoneal incision. This surgical procedure is stable and simple, with a high success rate and small incision, less bleeding, and minimal animal injury.

Objective:To investigate the mRNA and protein expressions of steroid sulfatase (STS) in breast cancer tissues and normal breast tissues, and analyze its relationship with clinicopathologic characteristics. Methods:The mRNA and protein expressions of STS, in 40 cases of breast cancer tissues and corresponding paracancerous normal breast tissues, were examined by reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemistry. The correlation of STS expression level with clinicopathologic characteristics was analyzed. Results:STS protein was mainly expressed in the cytoplasm of breast carcinoma cells and epithelial cells in normal breast glands, but not in the stroma. It could be detected in the nucleus of carcinoma cells in 3 cases of breast cancer tissues, which was pathologically classified as invasive ductal carcinoma, invasive lobular carcinoma, and invasive micropapillary carcinoma. STS was not observed in interstitial tissues of breast glands. STS protein expression had positive correlation with its mRNA expressing level. The positivity of STS was 70.0% in breast cancer tissues, significantly higher than that of normal breast tissues (42.5%). The difference was significant (P =0.013). Stratified analysis showed that the positive rates of STS protein were significantly higher in premenopausal patients, the patients with lymph node metastasis, and those with advanced breast carcinoma than those in the matched normal breast tissues (P<0.05). Conclusion:Breast cancer tissues highly expressed STS protein to stimulate local estrogen production, thereby enhancing the progression and migration of breast cancer cells. In addition, as the tumor growth, locally biosynthesized estrogens may play more and more important roles.

Objective: To investigate the significance of extranodal extension of axillary lymph nodes (ALN-ENE) metastases in post-operative primary invasive breast carcinoma of non-specific type. Methods: Six hundred and thirty-eight invasive breast cancer cases confirmed by postoperative pathological examination were collected from January 2006 to December 2008. The relationship of lymph node metastases and ALN-ENE with other lymph node parameters and patient outcome was analyzed. Results: Among 638 cases, 263 (41.2%) showed axillary lymph node metastases. ALN-ENE was present in 91 cases (36.4%). The rate of ALN-ENE increased with pT stage and tumor size. Five-year recurrence-free survival rate (RFS) and 5-year overall survival rate (OS) was 86.6% and 91.2% respectively for ALN-ENE positive group, and both were lower than ALN-ENE negative group (P<0.01). One hundred and forty-nine patients with 1 to 3 positive lymph nodes had a 5-year RFS of 91.9%, and 5-year OS of 92.3%, less than ALN-ENE negative group (P<0.01). Univariate analysis showed ALN-ENE positively correlated with lymph node metastasis. Multivariate analysis suggested that ENE was associated with increased recurrence risk and shortened recurrence-free and overall survival, especially in patients with 1 to 3 positive lymph nodes; and it was an independent prognostic factor (P<0.01). Conclusions The number of lymph nodes metastases is an important predictor of survival in breast cancer patients. ALN-ENE is an independent risk indicator for recurrence and overall survival. For patients with 1 to 3 metastatic axillary lymph nodes, ALN-ENE could alter the patient′s clinical pathologic staging, and therefore it is an independent prognostic factor.

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (＜ 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3％ vs.42.7％,P ＜ 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9％ vs.61.7％,P ＜0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4％ vs.4.2％,P ＜ 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.

OBJECTIVETo summarize the disposal methods and the reasons of complications in operation of totally implantable central venous port (TICVP).

METHODSA total of 2 007 patients were enrolled in this observational, single-center study between December 2008 and March 2013. TICVP implantation was performed with one small skin incision and subcutaneous puncture of subclavian or jugular vein. Patient's profiles, indications of port system, early and delayed complications, and disposal methods were evaluated. There were 38 male and 1 969 female patients, aged from 21 to 85 years, with a mean of 47.6 years.

RESULTSThe mean duration of the TICVP system was (242 ± 12) days, ranging from 9 to 1 243 days. The achievement rate of puncture in the right jugular vein (99.76%) was the highest. Sonographic approach using the internal jugular vein were better than the external landmark-guided technique (99.80% vs. 96.34%, χ² = 29.905, P = 0.000). The rate of immediate complication was 0.80%, which included pneumothorax, hemothorax, lymphatic fistula and thrombosis. Early complications rate was 0.10%, which included pocket hematoma, catheter migration, venous thrombosis, port pocket infection, fibrin sheath formation. Late complications rate was 7.87%, which included catheter fracture, pinch-off syndrome, catheter-related bloodstream infection, fibrin sheath formation, catheter migration, extravasation, port inversion and port reveal. The rate of removal due to complications was 1.34% (27/2 007), and the early complication was higher (χ² = 8.053, P = 0.011).

CONCLUSIONSThe low incidence of complications suggests that TICVP is safe and reliable for long term intermittent venous access. The results support the use of TICVP in the oncology patients and patients requiring long-term intravenous therapy.

Adult ; Aged ; Aged, 80 and over ; Catheterization, Peripheral ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Prostheses and Implants ; Retrospective Studies ; Young Adult

Objective: To summarize the status of immediate breast reconstruction (IBR) after mastectomy in Beijing City, Tianjin City and Hebei Province. Methods: A retrospective analysis was made on the data of 382 cases with breast cancer who were treated and followed up successfully with immediate breast reconstruction after mastectomy from January 2012 to December 2016 in Beijing City, Tianjin City and Hebei Province. Clinic data of the followed-up 382 cases (all female, age (38.5±4.2) years (range: 24 to 70 years)), including general information, tumor information, sugery methods, and treatments after surgery were collected. The survival status, metastasis,complications and prognosis were followed up. Cosmetic effcet was evalated by Harris method, and life quality by Functional Assessment of Cancer Therapy-Breast scale (FACT-B). χ² test was used to compare the difference between year 2012 and year 2013 to 2016. Bonferroni method was used to correct the inspection level, which was 0.05/10=0.005. The trend of IBR rate (ratio of IBR to modified radical mastectomy) from 2013 to 2016 was analyzed by trend χ² test. Results: There was 46 cases in stage 0, 152 cases in stage Ⅰ, 165 cases in stage Ⅱ, 19 cases in stage Ⅲ. Twenty-five cases was treated by neoadjuvant chemotherapy, 231 by chemotherapy and 35 by radiotherapy. The proportion of implant reconstruction was 48.7% (186/382), more than expanded of 21.5% (82/382), with latissimus dorsi of 12.0% (46/382), TRAM of 8.9% (34/382), DIEP of 2.1% (8/382), and latissimus plus implant of 6.8% (26/382). According to the Harris standard, the excellent and good rate of the cosmetic effect of the reconstructed breast was 93.7%. The score of FACT-B was 108.20±16.9 (range: 67 to 144) 1 year postoperatively. Compared with 2012, the IBR rate was significant increased, till 2015, the IBR rate was 153/10 000 cases (χ²=47.028, P=0.000). Conclusions There is a significant increase on IBR rate in Beijing City, Tianjin City and Hebei province by year. Most of cases received IBR is stage Ⅰ to Ⅱ. Implant reconstruction is the main reconstructive method. Postoperative cosmetic effects and quality of life are both meet patients′ demon.