Objective To evaluate the possible causes of misdiagnosis of minimal breast carcinoma (MBC). Meth-ods The possible causes of misdiagnosis of 90 cases of MBC confirmed by pathology were retrospective analyzed. Accord-ing to the maximum diameter of the lesion, 90 cases were divided into 0.5-1.0 cm group (n=55) and≤0.5 cm group (n=35). And these two groups were subdivided into correct and misdiagnosed groups. The two-dimensional ultrasound findings were observed by using SIEMENZ S2000, GE vivid7 and GE vivid9 color Doppler ultrasound instruments, and reasons of misdiag-nosis were analyzed. Results There were 32 cases were misdiagnosed in 90 patients with MBC. There was significant differ-ence in boundary of misdiagnosis between diameter 0.5-1.0 cm group and≤0.5 cm group. There were significant differences in boundary and calcification between misdiagnosed group and correct group in diameter 0.5-1.0 cm group (P<0.05). There were also significant differences in A/T ratio and accompanying by multiple benign nodules between misdiagnosed group and correct group in diameter≤0.5 cm group (P<0.05). Conclusion The misdiagnosis in MBC is because of different lesion sizes. The misdiagnosis happens in the maximum diameter of the lesions between 0.5-1.0 cm that showed manifestation of sharp edges, no micro-calcification in sonographic features of benign. The misdiagnosis happens in maximum diameter of le-sions≤0.5 cm that manifested as the aspect A/T ratio<1 and characterized by multiple nodules.

16,95% CI 0.074-0.628 ,P<0.05) and diabetes mellitus history(RR=3.023,95% CI 0.998-9.157,P≤0.05).

Objective To investigate the effect of hyperthermia on human hepatocellular carcinoma cell line SMMC-7721 after down-regulating the expression of mTOR,and its possible mechanisms.Methods An antisense mTOR (mammalian target of rapamycin) gene eukaryotic expression vector was transfected into SMMC-7721 cells.The expression of mTOR mRNA and protein were detected using RT-PCR and Western blotting,respectively.Hyperthermia was applied after the transfection,and the vitality of cell proliferation was evaluated using CCK-8 assays and the clone formation rate was determined by colony-forming assays.The migration of SMMC-7721 cells was measured using scratch assays.Apoptosis and the cell cycle were analyzed by flow cytometry.Results The expression of mTOR mRNA and protein were significantly decreased after transfection,indicating that the antisense vector could down-regulate the mTOR gene effectively.The proliferation,clone formation and migration of SMMC-7721 cells all were decreased markedly by hyperthermia after transfection.Flow cytometry showed that the rate of apoptosis was significantly increased.The number of cells in the S phase was increased and the cell cycle was induced to arrest at the S phase.Conclusions Down-regulating the expression of mTOR can increase the thermosensitivity of SMMC-7721 cells.The mechanism involves increased apoptosis and S phase arrest.

ObjectiveTo analyze the clinicopathological characteristics and survival time of penile cancer after surgery.MethodsThe clinicopathological data of 93 cases of penile cancers patients treated from January 2002 to December 2010 were collected retrospectively.The Kaplan-Meier method was used to draw the survival function and calculate the survival rate.Log-rank test was further used to compare survival difference.ResultsThe median age of the 93 patients was 51 years ( range,23 to 82).Squamous carcinoma was most common with 87 eases (93.5％) in our group.Sixty-one patients were successfully followed up and the median follow up duration was 28 months(range,2 to 89 months).All 3 cases of verrucous carcinoma had progression free survive after surgery after follow up of 12,19,and 67 months.In the 55 patients with penile invasive squamous carcinoma,11 patients died of metastatic disease with a median survival time of 10 months ( range,2 to 24 months).Two years cumulative survival rate was 75.7％ (95％ CI 63.0％ to 88.4％ ).Six cases of 12 patients with lymph node metastasis died of penile cancer while only 5 cases of 43 patients without lymphnode metastasis died.The survival difference was significant (log rank,P =0.000).ConclusionsSquamous carcinoma is the most common type,and patients with lymphnode metastasis have poor prognosis.Verrucous carcinoma has good prognosis.

ObjectiveTo investigate the clinical characteristics and prognostic factors in intrahepatic cholangiocarcinoma (ICC) patients with positive alpha-fetoprotein (AFP).MethodsClinical data of 57 patients with ICC in the Third Afifliated Hospital of Sun Yat-sen University from September 2004 to December 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. There were 34 males and 23 females with an average age of (52±13) years old. According to serum AFP test result after admission in hospital, the patients were divided into AFP positive group (n=16) and AFP negative group (n=41). The difference of clinicopathological factors between two groups such as age, gender, hepatitis B surface antigen (HBsAg), liver cirrhosis, biliary lesions, preoperative carbohydrate antigen 19-9 (CA19-9), surgical procedure, metastastic lymph nodes, histological differentiation degree were compared byt-test , Chi-square test or Fisher's exact probability test. The patients were followed up and the survival of two groups was recorded. Prognostic factors analysis was conducted by Log-rank test and Cox proportional hazards regression model.ResultsMale patients accounted for 94% (15/16) in AFP positive group, which was signiifcantly higher than that in AFP negative group [46%(19/41)] (χ2=10.747,P<0.05). Patients complicated with liver cirrhosis accounted for 88% (14/16) , which was significantly higher than that in AFP negative group [37% (15/41)] (χ2=11.937,P<0.05). No patients were complicated with biliary lesions in AFP positive group but in AFP negative group, 12 cases were complicated with biliary lesions, where signiifcant difference was observed between two groups (P<0.05). Surgical procedure was the independent risk factor for patients in AFP positive group. Patients undergoing radical resection had better prognosis (RR=26.813,P<0.05).ConclusionsICC patients with positive AFP are mostly complicated with liver cirrhosis but a low incidence of biliary lesions. Surgical procedure is the independent risk factor for the prognosis. Radical resection is an effective way to improve the prognosis of ICC patients with positive AFP.

Objective To investigate the impact of exogenous of triiodothyronine (T3) on the liver hyperplasia of mouse. Methods Forty-ifve healthy speciifc pathogen free (SPF) C57BL/6 mice were divided into group A, B and control group using random number table method with 15 mice in each group. Mice in group A, B were respectively injected with 2 ml exogenous T3 solutions 10, 5μg/kg intraperitoneally. Mice in control group were injected with 2 ml normal saline. Three mice of each group were put to death respectively on day 0, 7, 14, 21, 42 after treatment. The total liver weight of the mice was measured after death. The proliferation of liver cells was detected by immunohistochemistry. The experimental data were compared using t test or analysis of variance. Results Compared with control group, the liver weight of mice in group A increased signiifcantly on day 7, 14, 21, 42 after treatment (t=3.298, 6.760, 7.119, 6.128;P<0.05) , and the liver weight of mice in group B increased signiifcantly on day 14, 21, 42 after treatment (t=4.188, 4.570, 2.978;P<0.05). The increased liver weight in group A was signiifcantly more than that in group B on day 7, 14, 21, 42 after treatment (t=4.935, 4.303, 4.033, 4.480;P<0.05). The liver weight in group A, B rose to the top on day 21 after treatment (F=21.480, 11.244;P<0.05). Compared with control group, the liver cell count in group A increased signiifcantly on day 0, 7, 14, 21, 42 after treatment (t=28.383, 23.842, 40.194, 31.059, 15.841;P<0.05), and the same with group B (t=9.097, 7.680, 20.597, 42.192, 14.415;P<0.05). The increased liver cell count in group A was signiifcantly more than that in group B (t=8.016, 4.872, 10.719, 9.514, 7.831;P<0.05). The liver cell count rose to the top in group A on day 14 after treatment (F=169.190, P<0.05) and rose to the top in group B on day 21 after treatment (F=90.460, P<0.05). Extensive proliferation of liver cells was observed both in group A and B after treatment. Conclusions Exogenous T3 can effectively promotes the liver hyperplasia of mouse, and the hyperplasia becomes more signiifcant as the T3 concentration rises.

ObjectiveTo investigate the influencing factors of portal vein thrombosis (PVT) after splenectomy in patients with portal hypertension.MethodsClinical data of 67 patients with liver cirrhosis and portal hypertension undergoing splenectomy + endoscopicvariceal ligation in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University between March 2012 and April 2015 were retrospectively studied. Among the 67 patients, 47 were males and 20 were females with the average age of (47±8) years old. Thirty-five patients underwent laparoscopic splenectomy and 32 patients underwent open splenectomy. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the PVT group and the non-PVT group according to whether PVT developed after surgery. The influencing factors of PVT in two groups were compared. The comparison of the influencing factors of PVT was conducted usingt test or chi-square test.ResultsEleven cases developed PVT after splenectomy with the incidenceof 16% (11/67) including 6 cases of laparoscopic splenectomy and 5 of open splenectomy. The incidence of PVT was associated with Plt and the concentration of D-dimer in blood circulation. Blood Plt of the PVT group was (739±39) ×109/L, which was significantly higher than (318±51)×109/L of the non-PVT group (t=14.678,P<0.05). The concentration of D-dimer of the PVT group was (7.4±1.1) mg/L, which was significantly higher than (4.0±0.9) mg/L of the non-PVT group (t=5.458, P<0.05). The incidence of PVT was not associated with surgical procedure (χ2=0.028,P>0.05).Conclusion The incidence of PVT after splenectomy is associated with Plt and the concentration of D-dimer and is not associated with surgical procedure.

ObjectiveTo investigate the application value of laparoscopic splenectomy combined with endoscopic variceal ligation in cirrhosis and portal hypertension.MethodsSixty-three patients with cirrhosis and portal hypertension undergoing laparoscopic splenectomy combined with endoscopic variceal ligation in Lingnan Hospital, the Third Afifliated Hospital of Sun Yat-sen University between September 2011 and September 2014 were included in the prospective study. The patients were randomized into the laparoscopy group and the laparotomy group according to different surgical procedures. Among the 28 patients in the laparoscopy group, 25 were males and 3 were females with the age ranging from 40 to 69 years old and the median of 55 years old. Among the 35 patients in the laparotomy group, 32 were males and 3 were females with the age ranging from 43 to 69 years old and the median of 53 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients of two groups underwent endoscopic variceal ligation during the splenectomy. The duration of operation, intraoperative blood loss, length of hospital stay, treatment costs and incidence of postoperative complications of two groups were observed. The comparison of the observed indexes of two groups was conducted usingt test and the rate comparison was conducted using Fisher's exact test.ResultsAll the patients completed the surgery successfully. The duration of operation and the intraoperative blood loss were (113±8) min and (204±52) ml for the laparoscopy group, and were (106±6) min and (226±63) ml for the laparotomy group where no significant difference was observed (t=1.97,-0.75;P>0.05). The length of hospital stay and treatment costs of laparoscopy group were (6.0±1.2) and (35 000±3 000) RMB, which were signiifcantly lower than (11.2±2.7) and (45 000±1 000) RMB of laparotomy group (t=-4.87,-6.81;P<0.05). Eight patients in the laparoscopy group developed complications, among them, 7 were with portal venous thrombosis and 1 was with recurrent hemorrhage. Seventeen patients in the laparotomy group developed complications, among them, 10 were with portal venous thrombosis and 7 were with fat liquefaction of incisions. The incidence of fat liquefaction of incisions in laparoscopy group was signiifcantly lower than that of the laparotomy group (P=0.035).ConclusionLaparoscopic splenectomy combined with endoscopic variceal ligation can achieve the similar curative effect with laparotomy and has the advantages of small operational wound, quick recovery, less complications, as well as shorter length of hospital stay and lower total treatment costs.

OBJECTIVE: To investigate the effectiveness of sequential plate internal fixation in the correction of Madelung deformity after ulnar osteotomy and shortening. METHODS: The clinical data of 13 patients with Madelung deformity admitted between September 2015 and July 2021 were retrospectively analyzed. There were 5 males and 8 females with an average age of 18.3 years ranging from 17 to 23 years. The disease duration ranged from 12 to 24 months, with an average of 17 months. Three cases had a clear history of trauma. All patients had external radial deviation deformity and limited movement of the ulnar deviation, and the ulnar impact pain was significant during ulnar deviation movement; 9 patients had limited wrist joint supination movement, and the supination movement was normal. In the first stage, ulnar osteotomy and shortening combined with external fixator were used to correct wrist deformity in 13 patients. After operation, bone transfer was performed 6 times per day, with adjustments made every 4 hours, which was 1 mm per day. After the osteotomy was in place, the ulnar plate internal fixation was performed to reconstruct the ulnar stability in the second stage. The Cooney wrist joint score was used to assess the pain, function, range of motion, flexion and extension range of motion, and grip strength of the wrist joint before operation and before the removal of internal fixator. The subjective feeling and appearance satisfaction of patients were recorded. RESULTS: After the second-stage operation, all the 13 patients were followed up 10-22 months, with an average of 15 months. The deformity of wrist joint disappeared after operation, and the flexion, extension, and ulnar deviation were basically normal. There was no complication such as ulnar impingement sign, nonunion or infection. Wrist function, pain, and range of motion were significantly improved after operation, except for 1 patient who had no significant improvement in rotation and pain. The ulnar internal fixator was removed at 10-18 months after the second-stage operation. The scores of pain, function, range of motion, flexion and extension range of motion, and grip strength in the Cooney wrist score before removal of internal fixator significantly improved when compared with those before operation ( P<0.05). Subjective and appearance satisfaction of patients were excellent in 9 cases, good in 3 cases, and fair in 1 case. CONCLUSION Ulnar osteotomy and shortening with sequential plate internal fixation for correction of Madelung deformity, with mild postoperative pain, can effectively avoid bone nonunion, improve wrist joint function, and have significant effectiveness.
Male ; Female ; Humans ; Adolescent ; Retrospective Studies ; Ulna/surgery* ; Osteochondrodysplasias ; Radius Fractures/surgery* ; Wrist Joint/surgery* ; Osteotomy ; Range of Motion, Articular ; Treatment Outcome