Background and purpose: In recent years, more and more clinical researches on the neuroendocrine carcinoma of the breast were carried out at home and abroad. Although there are quite a lot of the retrieved documents of NEBC at home and abroad, but large-scale reports are rare, besides, the epidemiology, diagnosis, treatment and prognosis were different;more research are needed to analyze NEBC. This paper mainly discussed the NEBC clinical diagnosis, treatment and prognosis. Methods: A retrospective analysis was carried out, 25 cases of Tumor Hospital Afifliated to Xinjiang Medical University from Jan. 2004 to Jun. 2013 were pathologically diagnosed as NEBC by clinical data and the follow-up. Results:The average age of 25 NEBC patients was 58.2 years old, without clinical and imaging characteristic features, immunohistochemistry staining showed that, the estrogen receptor (ER) and progesterone receptor (PR) positive rates were 76%and 64%. No one showed HER-2 strong positive. The follow-up was 9-115 months. Besides, 1-, 2-and 5-year overall survival (OS) rates were 100%, 95%and 88%, the disease-free survival (DFS) rates were 96%, 90%and 78%. Conclusion:The age of the patients with NEBC in this study was lower than the data abroad. Age, tumor size, pathological staging may be related to the prognosis of NEBC, and postoperative comprehensive treatment options need further study.

Background and purpose:With widely use of anthracyclines,patients are easily failed to respond to anthracyclines baseal regimens chemotherapy.Docetaxel and capecitabine(xeloda)are usually considered as the most active agents in breast cancer and are often used as adjuvant chemotherapy.In this study,we evaluated the efficacy and toxicity of docetaxel and xeloda combination regimen in the treatment of patients with metastatic breast cancer and previously treated with anthracyslines.Methods:64 patients who previously failed to respond to adriamycin based chemotherapy received docetaxel and xeloda combination regimen,docetaxel 75 mg/m2 ivgtt,day 1;xeloda 1 250 mg/m2,twice daily,day 1-14.The regimen was repeated every 21 days and the clinical response was recorded after 2 cycles.The effective patients received at least four cycles.Results:In 64 patients,the overall response rate was 60.9%,with 6 patieuts CR and 33 patients PR.The most frequent treatment-related adverse events were leukopenia, fatigue,nausea,vomiting and hand-foot syndrome.The main reactions were myelosuppression,Ⅲ-Ⅳwas 45.8%. Conclusion:Good clinical efficacy were achieved in the therapy of metastatic breast cancer with docetaxel and xeloda combination regimen and toxic reactions are tolerable.

Background and purpose:Triple-negative breast cancer (TNBC) is currently the focus of breast cancer research. Researches demonstrated that the molecular biological characteristics of different ethnic groups are not the same. This study mainly probed into the expression of endothelial growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) in Han and Uygur TNBC patients, and the relationship between the expression and prognosis of patients.Methods:From Jan. 2007 to Jan. 2009, 167 patients were admitted. Among those, 121 were Han and 46 were Uygur patients. The expressions of EGFR, and VEGF were detected by PV-9000 immunohistochemical staining, and compared with lymph node metastasis and clinical staging. The results were analyzed by SPSS 18.0 statistical software.Results:Five-year disease-free survival (DFS) of two groups had no indifferent (P>0.05). EGFR and VEGF positive rate of Han patients was lower than that of Uygur patients (P<0.05). Their expressions were correlated with TNM staging and lymph node metastasis (00.05). Uygur TNBC patients might have a different prognostic factor as compared with Han patients. Further studies need to be carried out.

Objective To investigate the clinical significance of BRCA1/ 2 mutation in breast cancer patients with different malignant tumor family history. Methods We studied 98 cases of diagnosed breast cancer patients with malignant tumor family history. BRCA1/2 screening was performed by PCR-DHPLC sequencing method. All mutations were confirmed by using direct DNA sequencing. Results The prevalence of BRCA1/2 germline mutation was 20.41%.The BRCA1/2 mutation was 55.6% in patients with family breast and ovarian cancer, and was 20.0% and 17.9% in patients with family breast and in patients with ovarian cancer, respectively. In correspondence to 2 and 3 and 4 people withof the breast or ovarian cancer in family , the BRCA1/2 mutation was 16.25%、33.3%、66.67% ,respectively. Conclusion The BRCA1/2 mutation rate increased in the patients with breast and ovarian cancer family history, and the detection of BRCA1/2 mutation increased with the number of patients with cancer in a family.

Objective Discussion the relationship of PALB2 and AR expression in triple negative breast cancer and its clinical pathological features. Methods The SP immunohistochemical staining was adopted to detect the expression of PALB2 and AR in 178 cases of TNBC, PALB2 divided into two groups according to the expression of different, and to analyze the clinical pathological features and prognostic impact of different AR expression status. Results 178 cases of TNBC, that PALB2 missing expression 47 cases (26.4%), AR expression of 60 cases (33.7%), between of them were negatively correlated (-1≤r<1, P<0.05), in PALB2 negative group, AR expression associated with family history, lymph node metastasis, clinical stage and recurrence and metastasis (P<0.05), and 5-year disease-free survival lower than AR negative expression, Log rank = 4.453, P = 0.035. Conclusion PALB2 negative expression while AR positive expression in TNBC have synergistic effect with disease progression, PALB 2 and AR combined detection may provide a new basis for the prognosis of TNBC interpretation, and recommending take further studies to confirm.

Obiective To investigate the association between single nucleotide polymorphisms (SNPs) of ER β gene and susceptibility of breast cancer in Uygur women in Xinjiang.Methods A case-control study was designed to explore the genotypes of Rsa Ⅰ (G/A) of ER β gene,detected by PCR-restriction fragment length polymorphism (PCR-RFLP) assay,in 112 breast cancer cases of Uygur women and 139 medical health cases of Uygur women.The association between SNPs of ER β gene and risk of breast cancer in Uygur women was analyzed by unconditional Logistic regression model.Results The frequencies of genotypes of Rsa Ⅰ (G/A) of ER β gene in cancer group and control group were 83.0 ％ and 17.0 ％,73.4 ％ and 26.6 ％,respectively.Rsa Ⅰ (G/A) locus allele frequency were 91.5 ％ and 8.5 ％,86.7 ％ and 13.3 ％,respectively.There were no statistically differences between the cancer cases and control cases (x2 =3.335,P =0.068.x2 =2.917,P =0.088).Presence of estrogen exposure history of two groups for genotypes distribution were 74.2 ％ and 25.8 ％,86.4 ％ and 13.6 ％,respectively.Any family history of cancer in the two groups for the genotypes distribution were 100 ％ and 0,72.8 ％ and 27.2 ％ respectively.There were statistically significant difference between two groups (P =0.046,P =0.001).Compared with wild-type genotype GG,the GA type with estrogen exposure and without a family history of cancer showed a lower incidence of breast cancer in Uygur women (OR =0.385,95 ％ CI 0.148-0.999.OR =0.285,95 ％ CI 0.134-0.605).Conclusions ER β gene SNP is associated with breast cancer of estrogen exposure and no family history of cancer factors.GA genotype may be a protective factor for Uygur women with breast cancer.

Objective:To compare the efficacy and safety of ultrasound-guided microwave ablation(MWA) and radiofrequency ablation (RFA) in the treatment of benign thyroid nodules.Methods:The clinical data of 119 patients (187 nodules in total) with benign thyroid nodules who were treated with ultrasond-guided MWA (56 cases) and RFA (63 cases) in Shenzhen Third People′s Hospital from January 2018 to January 2020 were retrospectively analyzed. The ablation time, ablation time per unit volume, volume reduction rate of thyroid nodules after treatment, changes in thyroid function before and after treatment, and incidence of complications were compared between the two groups.Results:The ablation time and ablation time per unit volume in the MWA group were significantly shorter than those in the RFA group (all P<0.05). At 3, 6, and 12 months after treatment, the reduction rate of nodule volume in MWA group was higher than that in RFA group, and the difference was statistically significant in the subgroup with nodule >10 ml (all P<0.05). The incidence of temporary hoarseness in RFA group [6.35%(4/63)]was lower than that in MWA group [12.5%(7/56)], with no statistically significant difference ( P>0.05). Conclusions:Microwave ablation is more effective than radiofrequency ablation in the treatment of large thyroid nodules. Radiofrequency ablation is safer than microwave ablation for thyroid nodules near the risk triangle, but further research is needed to confirm.

Objective:To investigate the clinical effect and demonstrate the techniques of single position laparoscopic nephroureterectomy.Methods:The clinical data of 84 upper urinary tract urothelial carcinoma patients admitted to the Cancer Hospital Chinese Academy of Medical Sciences from September 2018 to July 2022 were retrospectively analyzed, including 39 males and 45 females, with a median age of (64.9±9.3)years and mean BMI of(24.7±3.4)kg/m 2. The tumor was located on the left side in 47 cases and the right side in 37 cases. All 84 patients received single position laparoscopic nephroureterectomy. According to different treatment methods, they were divided into two groups, including 67 cases undergoing nephrectomy first, and then bladder cuff excision was performed along ureter(traditional group), 17 cases undergoing bladder cuff excision before clamping the ureter below the tumor, and then nephrectomy was performed along the ureter to the head side (modified group). There was no statistically significant in the comparison of age [(65.5±9.4)years vs.(62.7±8.9)years], BMI[(24.9±3.5)kg/m 2vs.(23.9±3.3)kg/m 2], left/right side tumor of(38/29 cases vs. 9/8 cases), tumor location (in renal pelvis or calyx or upper/middle/lower ureter being 46/9/12 cases vs. 13/2/2 cases)and tumor stage(T 1-2/T 3-4: 54/13 cases vs. 15/2 cases) between traditional group and modified group ( P>0.05). The operation time, estimate blood loss, postoperative intestinal function recovery time and postoperative drainage time were recorded and compared. Results:All 84 cases were successfully completed without conversion to open surgery. The mean operation time was (160.4±50.1)min, the mean estimated blood loss was(59.4±24.4)ml, the median postoperative intestinal function recovery time was 1(1, 2)d and the mean postoperative drainage time was (4.8±1.9)d(No drainage tube was placed in 4 patients). No Clavien Dindo >grade 3 complications occured. There was no significant difference in the comparison of operation time [(159.2±52.9)min vs. (164.7±38.1)min], estimate blood loss [(60.5±26.2)ml vs. (55.0±17.5)ml], postoperative intestinal function recovery time [1(1-2)d vs. 2(1-2)d] and drainage removal time [(4.8±1.8)d vs. (5.2±2.0)d] between traditional group and modified group ( P>0.05). The postoperative pathology of 84 cases was urothelial carcinoma, and the pathological results of the resection margin were negative. The median follow-up of 84 upper tract urothelial carcinoma patients was 13(3, 28)months. Five patients were lost to follow-up. In traditional group, 5 patients had bladder tumor recurrence, and 5 patients had distant metastasis. In modified group, no bladder tumor recurrence occurred and 1 patient had distant metastasis. Conclusions:Laparoscopic nephroureterectomy in single position is a safe and effective minimally invasive technique for the treatment of upper urinary tract urothelial carcinoma. Treatment of the bladder cuff excision firstly is more in line with the principle of tumor-free and increase surgical space.

Objective:To explore the effect of enhanced recovery after surgery (ERAS) protocols in patients undergoing laparoscopic radical cystectomy (LRC) and intracorporeal urinary diversion (ICUD).Methods:A total of 83 patients who received LRC+ ICUD in Beijing Chaoyang Hospital from March 2014 to September 2020, were divided into 2 groups based on different perioperative management, including 29 ERAS cases and 54 conventional recovery after surgery (CRAS) cases. The ERAS group included 26 males and 3 females , with an average age of (62.07 ± 9.26) years. There were 26 patients with ASA class Ⅰ-Ⅱ, 3 patients with ASA class Ⅲ, 4 patients received neoadjuvant chemotherapy, and 7 patients had a history of abdominal surgery in ERAS group. The CRAS group included 44 males and 10 females , with an average age of (61.59 ± 10.16) years. There were 50 patients with ASA class Ⅰ-Ⅱ, 4 patients with ASA class Ⅲ, 9 patients received neoadjuvant chemotherapy, and 10 patients had a history of abdominal surgery in CRAS group. There were no statistically significant differences in the baseline characteristics between the two groups. The patients in both groups underwent LRC+ ICUD procedures. The perioperative results and complications between the two groups were compared.Results:In the ERAS group, there were 20 patients who underwent Bricker ileal conduit surgery and 9 patients who underwent Studer orthotopic ileal neobladder surgery. Pathological staging included 3, 3, 7, 7, 5 and 4 cases in stage T a, T is, T 1, T 2, T 3 and T 4a, respectively. There were 23, 2, 3 and 1 patient with pathological stage N 0, N 1, N 2 and N 3, respectively. Pathological diagnosis included 3 cases of low-grade urothelial carcinoma, 24 cases of high-grade urothelial carcinoma, and 2 cases of other histological subtypes. In the CRAS group, there were 31 patients who underwent Bricker ileal conduit surgery and 23 patients who underwent Studer orthotopic ileal neobladder surgery. Pathological staging included 5, 3, 12, 9, 15 and 10 patients in stage T a, T is, T 1, T 2, T 3 and T 4a, respectively. There were 35, 6, 7 and 6 patients with pathological stage N 0, N 1, N 2, and N 3, respectively. Pathological diagnoses included 6 cases of low-grade urothelial carcinoma, 45 cases of high-grade urothelial carcinoma, and 3 cases of other histological subtypes. There were no statistically significant differences ( P>0.05) in surgical methods, pathological staging, or pathological types between the ERAS and CRAS groups. ERAS group presented less albumin loss [(25.73±8.63)% vs. (32.63±9.05)%, P=0.001], shorter hospital stay [9(7, 13)d vs. 12(9, 16)d, P=0.006], less 30-day overall complications [55.2% (16/29) vs. 83.3% (45/54), P=0.009]. In multivariable analysis, maximum albumin loss≥20% was independently associated with 30-day minor complications ( P=0.049), and maximum albumin loss ≥25% was independently associated with hospital of stay≥10 days ( P=0.038), respectively. Conclusions:For patients who received LRC+ ICUD, ERAS was associated with reduced perioperative albumin loss, shorter length of stay, less 30-day complications, accelerated recovery time, improved clinical outcome and less albumin injection.

【Objective】 To investigate the effects of diabetes and/or obesity on the incidence of acute kidney injury (AKI) and long-term renal function recovery in patients undergoing laparoscopic partial nephrectomy. 【Methods】 A retrospective analysis was performed on 221 patients who underwent laparoscopic partial nephrectomy in Beijing Chaoyang Hospital during Jan.2018 and Dec.2019. Baseline data, incidence of AKI, and renal function recovery after 12 months were analyzed in the diabetic, non-diabetic, diabetic + obese and diabetic + non-obese groups, with estimated glomerular filtration rate (eGFR) reaching 90% of the preoperative level as the standard. Risk factors of AKI were analyzed with univariate and multivariate regression analyses. 【Results】 Compared with the non-diabetic group, the diabetic group had lower preoperative eGFR [ (79.1±12.1)mL/ (min·1.73 m² )vs. (85.3±10.7)mL/ (min·1.73 m² ), P=0.01] , higher incidence of AKI (14.0% vs. 11.8%), and lower proportion of patients whose renal function recovered to at least 90% of the preoperative level (73.1% vs.83.5%). Patients with diabetes and obesity were more likely to develop AKI (31.3% vs.3.7%, P=0.039), and diabetic patients without obesity had better renal function recovery (81.3% vs. 60.0%). Multivariate analysis showed gender and operation time were the independent risk factors of AKI. 【Conclusion】 There were no significant differences between diabetic and non-diabetic patients in the incidence of postoperative AKI, or rate of renal function recovery 12 months after surgery. The incidence of AKI significantly increased in diabetic patients with obesity, and the renal function recovery rate decreased one year after surgery. Gender and operation time were the independent risk factors of AKI.