Objective:To evaluate the impact of change in the hormone receptor (HR) status on the long-term outcomes of breast cancer patients treated with neoadjuvant chemotherapy (NAC).Methods:There were 215 patients for the HR status of their lesions before and after NAC.After surgery,59 cases were confirmed to have achieved complete remission of pathology,The expression of hormo ne receptors was not consistent in 63 patients before and after neoadjuvant chemotherapy.63 patients were divided into two groups,Group A:39 patients received standard endocrine therapy for 5 years after surgery and chemotherapy;Group B:24 patients were not treated with standard endocrine therapy after surgery and chemotherapy.Conclusions:The 3-year DFS rates were 77.4％ and 54.2％ in Group A and Group B patients,respectively,There was not statistical significancebetween the two groups.The 5-year overall survival rate for Group A patients was higher than that of Group B patients(74.3％ vs 45.8％,P=0.028),The difference was statistically significant.Conclusions:This study revealed that breast cancer patients with HR altered after NAC still benefit from standard endocrine therapy.

Objectives To investigate the clinical and pathological characters , treatment of patients with Angioimmunoblastic T cell lymphoma(AITL). Methods From 1997 to 2004, 14 patients with AITL were reviewed retrospectively in our hospital. Results The most common symptoms at the presentation included general lymphadenopathy. 9 patients had fever. 3 patients had autoimmune hemolytic anemia.The histopathologic characteristics of AITL was generalized as:the damage of normal structure of lymphonodus,the proliferation of immunoblastic cell and arborescent supervascularization. All immunophenotyping were T cell type.14 patients were with ProMACE-CytaBOM regimen.The overall response rate was 57% and CR 3 cases, PR 5 cases. Median survival times was 25 months. 2-year survival was 60 %. Conclusions The most cases with AITL runs an aggressive course.The disease may progress rapidly and have unfavorable prognosis. Therefore further studies are repuired to improve the outcome.

Objective To explore the clinicopathologic features,diagnosis,treatment and prognosis of ACTH-independent subclinical Cushing syndrome caused by cortisol-secreting and hypo-androgen black adrenal cortical adenomas with lipomatous metaplasis.Methods The clinical and pathologic features of 1 patient presented with hypo-androgen and atypical signs and symptoms of Cushing syndrome were reported.The patient's 24 h UFC (235.62 μg) was higher than normal range,his plasma ACTH concentrations (＜1.1 pmol/L,was lower than normal range and his serum cortisol concentrations lacked diurnal rhythm.There was absence of serum cortisol suppression in overnight dexamethasone suppression tests.Serum levels of androgens (1.2 nmol/L) were lower than normal range.24 h urine catecholamine was normal,NE was 160.5 nmol/24 h (5-591 nmol/24 h),E was 23.1 nmol/24 h (0-82 nmol/24 h),DA was 1496nmol/24 h (424-2612 nmol/24 h).Aldosterone lying and standing test:ALD1 138-415 pmol/L,AT-Ⅱ1 64.54 ng/L,PRA1 0.80 μg · L-1 · h-1 Abdomen CT showed right adrenal mass (3.1 cm).131Ⅰ-MIBG scanning was normal.Adrenocortical carcinoma was considered as a possible diagnosis based on cortisol hypersecretion,hypo-androgen and the imaging characteristics.This patient accepted laparoscopic adrenal adenoma resection.Results The adrenal tumor size was 3.5 cm.Immunohistochemical (IHC) staining showed Melan-A,CgA,α-inhibin and Syn positive and Ki-67 ＜ 1％.Histopathologic results showed black adrenal cortical adenomas with myelolipomatous change.After surgery,patient's serum androgen was normal,and the signs and symptoms of Cushing syndrome and oligo-androgen disappeared.There was recurrence after 1.5 years follow-up.Conclusions Although most patients with corticotropin-independent Cushing syndrome associated with abnormal androgen proved to have adrenocortical carcinoma,the clinician should be aware of the possibility of benign,black adrenal adenoma.

Basic knowledge of forensic science is theoretical and abstract,therefore,confir-matory experiment teaching is often adopted in the experiment teaching. International education has become an important topic in medical colleges and universities. Forensic medicine is a compulsory subject for medical international students. This article discussed the exploration and practice in teach-ing forensic medicine for international students at Wenzhou Medical University,which included faculty constructing and training,encouraging whole English teaching by young teachers,applying heuristic interactive teaching and case teaching,establishing strict attendance and appraisal system and con-ducting comprehensive evaluation on medical teaching quality and teaching management.

OBJECTIVETo investigate if immunological factors associated with rheumatoid arthritis (RA) affect the result of human immunodeficiency virus (HIV) screening by electrochemiluminescence immunoassay (ECLIA) and enzyme-linked immunosorbent assay (ELISA).

METHODS100 RA cases were enrolled from January 2012 to February 2013 into this study. HIV screening was conducted with ECLIA detecting both HIV-1 p24 antigen, HIV-1 and HIV-2 antibodies, with ELISA and colloidal gold method detecting HIV-1 and HIV-2 antibodies. The samples producing positive results were submitted to the Center for Disease Control for confirmation using Western blotting method. The antibody titers of rheumatoid factors (RF) including RF-IgG, RF-IgM, RF-IgA, and CCP-IgG were analyzed by ELISA.

RESULTSThe HIV positive-rate determined by ECLIA was significantly higher than that by ELISA and colloidal gold method (P<0.01). The false-positive rate of HIV screening was associated with antibody titers of RF-IgG, RF-IgM, RF-IgA, and CCP-IgG in RA (P<0.01).

CONCLUSIONSImmunological factors, including RF and anti-CCP antibody, may influence the screening of HIV by ECLIA, producing false-positive result.

Adult ; Aged ; Arthritis, Rheumatoid ; physiopathology ; Enzyme-Linked Immunosorbent Assay ; False Positive Reactions ; HIV Antibodies ; blood ; HIV Antigens ; blood ; HIV Infections ; diagnosis ; Humans ; Middle Aged ; Rheumatoid Factor ; physiology

To evaluate the efficacy and safety of Chinese patent medicines in the treatment of ankylosing spondylitis(AS) by frequency network Meta-analysis. Randomized controlled trials(RCTs)of Chinese patent medicines for AS were retrieved from CNKI, Wanfang, VIP, CBM, PubMed, EMbase and Cochrane Library databases from the time of database establishment to January 2021. The quality of the included RCTs was evaluated according to the Cochrane bias risk standard, and the data was analyzed by RevMan 5.3 and Stata/MP 15.1. A total of 12 kinds of Chinese patent medicines in 55 RCTs were included. According to Meta-analysis, in term of the effectiveness, the top three optimal medication regimens were Biqi Capsules, Yishen Juanbi Pills and Yaobitong Capsules combined with western medicine. The top three interventions to reduce the erythrocyte sedimentation rate(ESR)were Yishen Juanbi Pills, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. The top three interventions to reduce the C-reactive protein(CRP)were Biqi Capsules, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. In terms of the safety, top three optimal medication regimens were Total Glucosides of Paeony Capsules, Yishen Juanbi Pills, and Wangbi Tablets combined with western medicine. This network Meta-analysis suggests that Chinese patent medicines combined with conventional western medicine can effectively improve the joint pain symptoms of AS patients and reduce the acute inflammatory indicators, with high safety. However, the literature included in this study is generally of low methodological quality, and the conclusion needs to be verified by high-quality research.
Capsules ; China ; Drugs, Chinese Herbal/adverse effects* ; Humans ; Network Meta-Analysis ; Nonprescription Drugs/therapeutic use* ; Spondylitis, Ankylosing/drug therapy*

OBJECTIVETo study the objective diagnostic mechanisms on Chinese medical (CM) syndrome patterns of rheumatoid arthritis (RA), and to research different titers of rheumatoid factor (RF)/citrullinated protein antibody (CCP) in CM syndrome patterns of RA.

METHODSTotally 230 early RA patients were assigned to five CM syndrome pattern groups, i.e., the dampness-heat blockage group (50 cases), the cold-dampness blockage group (50 cases), the Shen-qi deficiency-cold group (50 cases), the Gan-Shen yin deficiency group (40 cases), and the blood stasis blockage group (40 cases). Another 100 healthy subjects were recruited as the healthy control group. RF-IGM, RF-IGA, RF-IGG, and anti-CCP antibody were detected and compared.

RESULTSThe titers of RF-IGM, RF-IGA, RF-IGG, and anti-CCP antibody were higher in all groups than in the healthy control groups (P < 0.01). As for the 5 groups, RF-IGM, RF-IGA,RF-IGG, and anti-CCP antibody were higher in the RA active stage than in the nonactive stage. They were higher in the dampness-heat blockage group in the RA active stage than in the Shen-qi deficiency-cold group, the Gan-shen yin deficiency group, and the blood stasis blockage group.

CONCLUSIONTiters of RF-IGM, RF-IGA, RF-IGG, and anti-CCP antibody could be taken as judging indicators for differentiating objective lab indices of CM syndromes and assessing the active stage of RA.

Adult ; Aged ; Arthritis, Rheumatoid ; blood ; diagnosis ; immunology ; Autoantibodies ; blood ; Case-Control Studies ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Peptides, Cyclic ; immunology ; Rheumatoid Factor ; immunology

OBJECTIVETo evaluate clinical effect of the new ProTaper Nickel-titanium rotary instruments in preparation of curved root canals.

METHODS68 teeth with curved root canals were instrumented by ProTaper rotary instruments using crown-down technique, and by K files using step-back technique for control. All teeth were obturated with lateral condensation method. The efficiency of preparation and obturation was analyzed with radiographs before, during and after operation.

RESULTSNo transportation, apical blockage and ledge were found in test. The technique could keep the curvature and flow of curved canals. There were two ledge and more apical transportation (P < 0.01) in control than in test. The operative time was shorter and post treatment pain seldom occurred in ProTaper group.

CONCLUSIONThe ProTaper NiTi rotary instruments can prepare curved root canals effectively and safely. It is an efficient instrumentation method for curved canals and can be used widely.

Dental Instruments ; Humans ; Nickel ; Root Canal Preparation ; instrumentation ; Titanium

OBJECTIVEThis research aimed to study and assess clinical application of the using of three Nickel-titanium (NiTi) rotary instruments, namely ProFile, ProTaper and Hero 642, in preparation of curved root canals.

METHODS80 teeth with curved root canals were instrumented by ProFile, ProTaper or Hero 642 rotary instruments using crown-down technique in test groups and by stainless steel K files in control group. All teeth were obturated with lateral condensation method. The efficiency of preparation and obturation was analyzed with radiographs before, during and after operation.

RESULTSThree NiTi rotary instruments could keep the curvature and flow of curved canals very well, and the continuously tapered root canal shape was achieved. There were no transportation, apical blockage, and ledge in all test groups. The operative time was shorter for ProTaper than that of ProFile and Hero 642. Endodontic flare-up seldom occurred in test groups. Two rotary instruments fractured in canals.

CONCLUSIONWith the NiTi rotary instruments, ProFile, ProTaper and Hero 642, curved root canals can be prepared effectively and quickly. Meanwhile, the problem of instrument separation should be prevented.

Dental Alloys ; Dental Pulp Cavity ; Humans ; Molar ; Nickel ; Root Canal Preparation ; Root Canal Therapy ; Stainless Steel ; Titanium

OBJECTIVESTo investigate the carious dissolution mechanism of enamel apatite nano-crystals at lattice fringe level and the possible correlation between the carious dissolution and the appearance of central dark line (CDL) in enamel crystals.

METHODSThe body of the lesion in incipient enamel caries was observed by high resolution transmission electron microscopy (HRTEM, JOEL-2010 operating at 200 kv), combined with selected-area argon-ion-beam thinning technique.

RESULTSIn the body of the lesion, the preferential core dissolution was found in most of enamel nano-crystals, whereas the peripheral dissolution of individual crystal could be occasionally observed. The initial carious dissolution of individual enamel apatite crystal occurred as a number of small electron-lucent spots along the central dark line with blurry, bent or disconnected lattice fringes. These small electron-lucent spots fused with each other to form large electron-lucent areas. Finally the central perforation was frequently seen in the crystals. The CDL always appeared in the same place with central perforation in carious crystals, which could be seen to extend along the CDL.

CONCLUSIONSThe initial carious dissolution is directly related to the lattice defects in the enamel nano-crystals. The preferential core dissolution can be partly ascribed to the CDL, which is presumed to be particularly susceptible area to caries.

Dental Caries ; metabolism ; Dental Enamel Solubility ; Humans ; Microscopy, Electron, Scanning