Objective To explore the clinical efficacy of trastuzumab combined with vinorelbine therapy in the treatment of advanced breast cancer with human epithelial growth factor receptor-2 (HER-2) positive.Methods From April 2010 to April 2013,91 advanced breast cancer patients who failed in the paclitaxel therapy received trastuzumab plus vinorelbine (45 cases,vinorelbine group) or capecitabine (46 cases,capecitabine group).The treatment efficacy,toxic effects and 3-year survival rate in two groups were compared.Results The clinical benefit rate in two groups had no significant difference (P ＞ 0.05),but objective response rates in vinorelbine group was higher than that in capecitabine group:44.44％(20/45) vs.23.91％(11/46),and there was significant difference (P =0.039).The toxic effects in two groups had no significant difference (P ＞ 0.05).The 3-year survival rate in two groups had no significant difference (P =0.252).Conclusions In the treatment of HER-2 positive advanced breast cancer,trastuzumab plus vinorelbine or capecitabine shows no significant differences in adverse reaction or in 3-year survival rate.However,trastuzumab plus vinorelbine shows better objective response rate compared with trastuzumab plus capecitabine.

Objective: To evaluate the application effect of the platform switching implants in maxillary anterior region, to explore the effect of platform switching technology on the surrounding tissues. Methods: 55 patients with 60 single maxillary anterior implants were divided into two groups: platform-switching implants group (Ankylos), 25 patients with 28 implants; butt-joint implants group (Nobel Replace), 30 patients with 32 implants. The patients received follow-up care more than 1 and 2 year after the final setting of the prosthesis, at which time periapical radiographs were taken. The marginal bone level around the implant and Pink Esthetic Score (PES) were measured for comparison. Results : The average marginal bone changes of platform-switching implants after 1 year and 2 year were (-0.41 ± 0.36) mm and (-0.55 ± 0.33) mm respectively; and the ones of butt-joint implants were (-1.77 ± 0.54) mm and (-1.82 ± 0.61) mm. The average PES of platform- switched implants after 1 year and 2 year were 10.43 ± 1.37 and 10.32 ± 1.21 respectively; the ones of butt-joint implants were 9.21 ± 0.97 and 9.16 ± 0.95. There were significantly differences of marginal bone changes and PES between both groups (P < 0.05). Conclusion Platform switching implant in the maxillary aesthetics area is more effective in preserving the surrounding bone tissue and aesthetic effect.

OBJECTIVETo assess the feasibility and outcome of orthotopic liver transplantation (OLT) with no veno-venous bypass (VVB) in adult patients.

METHODSBetween 1999 and June 2001, 43 adult patients were subjected to orthotopic liver transplantations with veno-venous bypass (28), or no veno-venous bypass (15).

RESULTSThere was no significant difference in mean serum creatinine on day 3 and gas discharge time in patients with veno-venous bypass or not. With no veno-venous bypass, the average operative time was 5.6 +/- 1.4 h, median amount of blood loss during operation was 4 200 +/- 850 ml, median amount of blood transfused intraoperatively was 4 800 +/- 920 ml, and median intensive care unit stay was 6.3 days. All these were lower or shorter than those of the patients with veno-venous bypass.

CONCLUSIONSOrthotopic liver transplantation with no veno-venous bypass is safe and can be performed in the majority of adult patients. Liver transplantation with no veno-venous bypass is associated with shorter total operating time, lower blood product usage, and shorter intensive care unit stay compared with standard technique of OLT with routine use of VVB.

Adult ; Creatinine ; blood ; Feasibility Studies ; Female ; Hepatic Veins ; surgery ; Humans ; Liver Diseases ; blood ; surgery ; therapy ; Liver Transplantation ; methods ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Vascular Surgical Procedures

Objective:To investigate the relationship between 21-gene recurrence risk score (21-Gene RS) and the prognosis and clinicopathological features of hormone receptor (HR) positive, HER2-negative early breast cancer patients who did not receive neoadjuvant therapy.Methods:A total of 469 patients with HR positive and HER2-negative early breast cancer who received surgical treatment in the First Affiliated Hospital, Zhejiang University School of Medicine from January 2014 to October 2017 were selected. Their clinicopathological data were retrospectively analyzed. Tumor tissue samples were collected from patients, and the expression of 21-gene was detected by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR). The 21-Gene RS was calculated according to the Trial Assigning Individualized Options for Treatment (TAILORx) RS grouping and National Surgical Adjuvant Breast and Bowel Project B-20 (NSABP B-20) RS grouping principles. Patients were divided into low (21-Gene RS<11 or 21-Gene RS<18), intermediate (11≤21-Gene RS<26 or 18≤21-Gene RS<31) and high (21-Gene RS≥26 or 21-Gene RS≥31) risk groups, and the clinicopathological features and prognostic differences of patients in different risk groups were compared. Statistical data were compared by chi-square test. Survival analysis was performed using Kaplan-Meier curve analysis and the differences between groups were compared using Log-rank test. Multivariate analysis was conducted by COX regression analysis.Results:Based on TAILORx RS grouping, the proportions of low-risk, intermediate-risk and high-risk groups among the 469 patients were 18.8% (88/469), 48.2% (226/469) and 33.0% (155/469), respectively. Based on NSABP B-20 RS grouping, the proportion of low-risk, intermediate-risk and high-risk groups were 43.1% (202/469), 37.5% (176/469) and 19.4% (91/469), respectively. The association of 21-Gene RS with histological grading, luminal typing, Ki-67 expression, and chemotherapy and treatment modalities were statistically significant ( P<0.05) regardless of TAILORx RS grouping or NSABP B-20 RS grouping. Kaplan-Meier survival curve suggested poor prognosis in high-risk group ( P<0.05, Log-rank test). Multivariate COX regression analysis showed that surgical method and 21-Gene RS were risk factors affecting the prognosis of patients. Conclusions:21-Gene RS is significantly associated with the prognosis of patients with HR-positive, HER2-negative, early-stage breast cancer not receiving neoadjuvant therapy, as well as with their clinicopathological characteristics such as patients′ histologic grade, luminal typing, Ki-67 expression, and whether or not they are treated with chemotherapy or other treatment modalities.The 21-Gene RS threshold of 11 and 26 or 18 and 31 can be used to grade the prognosis in Chinese patients with early-stage breast cancer. More researches are needed to guide the selection of postoperative adjuvant therapy for patients with HR-positive and HER2-negative early-stage breast cancer.