Background and Purpose:The recurrent rate of breast cancer after mastectomy was 5%~20%,high risk factors were included it could achieve 34%~40%,Chest wall recurrence was the most common.This paper explores the reason for chest wall recurrence of breast cancer after mastectomy,hoping to find an efficient way to prevent and reduce chest wall recurrence after mastectomy.Methods:For 39 patients with local recurrence on the chest wall after mastectomy clinical data was reviewed retrospectively.Results:This group of patients was 5.1% of all breast cancer patients in the same period.Most of recurrences(59.0%)occured within two years affer operation.The recurrent rate of T_1～T_4 was 1.6%、1.9%、9.7% and 37.2% respectively.Rate of chest wall recurrence in patients with negative axillary nodes and positive axillary nodes was 1.3%、7.6%,but if the amount of positive axillary nodes≥4,it was 13.4%.Conclusions:In the patients who had more positive axillary nodes,larger primary tumor and no proper adjuvant therapy,recurrence on the chest wall was seen more often.Adjuvant chemotherapy and postoperative radiotherapy are efficient ways to prevent recurrence on the chest wall.

Objective To analyze the application value of enhanced depth imaging optical coherence tomography (EDI-OCT) in measuring the lamina cribrosa thickness(LCT) in patients with branch retinal vein occlusion (BRVO).Methods The clinical data of 65 patients with unilateral BRVO treated in our hospital from September 2014 to March 2016 were selected as the observation group.The single healthy eyes of 40 healthy individuals who received physical examination in the hospital during the same period were selected as the control group.The changes of retinal nerve fiber layer (RNFL) thickness,LCT,central corneal thickness,axial length,transverse diameter of optic disc,vertical diameter of optic disc,diopter and extent of visual field defect in the two groups were determined by EDI-OCT.Results There was no significant difference in the central corneal thickness,axial length,transverse diameter of optic disc,vertical diameter of optic disc and diopter between the two groups (all P ＞ 0.05).LCT of different regions of optic disc in the observation group were lower than those in the control group (all P ＜ 0.05).The range of visual field defects in the observation group was larger than that in the control group,and the RNFL thickness was lower than that in the control group (P ＜ 0.05).LCT was positively correlated with the thickness of whole RNFL in patients with BRVO,and was negatively correlated with the visual field defects (P ＜ 0.05).Conclusion EDI-OCT is an effective means for measuring LCT.LCT of patients with glaucoma BRVO is thinner than that of normal healthy people,and LCT is positively correlated with RNFL.thickness,and negatively correlated with visual field defects.

Objective To observe the effects of the compatibility of Radix Astragali and Radix Angelicae Sinensis in different proportion on hemodynamic and balance of Th1/Th2 cells of Qi deficiency and blood stasis rat model. Methods Qi deficiency and blood stasis rats were caused by restricted diet, forced swimming and norepinephrine subcutaneous injecting, and treated by compatibility of Radix Astragali and Radix Angelicae Sinensis in different proportion of 5∶1, 3∶1, 1∶1 and 1∶2 for 21 days. The indexes of hemorheology were detected with hemorheological analyser, and the level of IFN-γand IL-4 in serum were tested by ELISA. Results Compared with model group, the compatibility of Radix Astragali and Radix Angelicae Sinensis in proportion of 1∶1, 3∶1 and 5∶1 groups reduced the low shear blood viscosity. The spleen index of model group decreased, and compatibility of Radix Astragali and Radix Angelicae Sinensis in 5∶1 proportion group increased spleen index. The level of IL-4 increased and IFN-γ decreased in the serum of model group, the compatibility of Radix Astragali and Radix Angelicae Sinensis in proportion of 3∶1 group increased the level of IFN-γ. Astragalus angelica 5∶1 group decreased the level of IL-4 and increased the level of IFN-γ. Conclusion The compatibility of Radix Astragali and Radix Angelicae Sinensis can improve hemorheology, adjust the balance of Th1/Th2 cells of Qi deficiency and blood stasis rats. The effects were better when Radix Astragali’s dosage greater than that of Radix Angelicae Sinensis, and the group of 5∶1 proportion was the best.

Objective To investigate the effects of internal and external biliary drainage on liver regeneration of the obstructive jaundice rats after partial hepatectomy.Methods The rat models of obstructive jaundice with 70％ liver resection were successfully constructed.All the 120 rats were randomly divided into the control group:rats received middle and left hepatic lobectomy; internal drainage group:a drainage tube was placed between the dilated bile duct and the duodenum; external drainage group:a drainage tube was placed in the dilated bile duct.There were 40 rats in each group.Rats in the internal and external drainage groups received middle and left hepatic lobectomy at postoperative day 7.The blood and hepatic tissues were collected at postoperative day 0,1,2,4,12,24,48,72 hours after operation,and the rate of liver regeneration and mitotic index were determined.The expression of proliferating cell nuclear antigen (PCNA) and signal transducer and activator of transcription 3 (STAT3) in the hepatic tissues were detected by immunohistochemistry,and the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected by ELISA,and the mRNA expressions of TNF-α and IL-6 were detected by RT-PCR.All data were analyzed using the one way analysis of variance or SNK test.Results Within 72 hours after partial hepatectomy,the rate of liver regeneration of the internal drainage group was 94.86％± 12.72％,which was significant higher than 62.39％±8.01％ of the external drainage group and 45.77％ ± 5.41％ of the control group (F =33.62,P ＜ 0.05).The mitotoic index and PCNA levels of the 3 groups had obvious increase at postoperative hour 12,and the mitotoic index and PCNA levels of the external drainage group reached peak at postoperative hour 24,which were 24.47％ ± 4.01％ and 88.1％ ± 9.2％,respectively,the mitotoic index and PCNA levels of the control group and the external drainage group reached peak at postoperative hour 48,which were 15.80％ ± 1.08％,58.3％ ± 5.8％ and 18.40％ ± 1.12％,70.2％ ± 6.9％,respectively.The mitotoic index and PCNA levels of the internal drainage group were significantly higher than those of the control group and the external drainage group (P ＜ 0.05).The expression of STAT3 expression of the internal drainage group reached peak at postoperative hour 4,which was 42.6％ ± 3.6％ ;the expression of STAT3 expression of the control group and the external drainage group reached peak at postoperative hour 12,which were 22.9％ ± 2.0％ and 29.2％± 3.7％.The peak level of STAT3 of the internal drainage group was significantly higher than those of the control group and the external drainage group (P ＜0.05).The levels of TNF-α and IL-6 of the internal drainage group reached peak at postoperative hour 12,which were (227 ±23)U/L and (256 ± 32)U/L; the levels of TNF-α and IL-6 of the control group and the external drainage group reached peak at postoperative hour 24,which were (309 ± 41) U/L and (388 ± 40) U/L,(287 ± 30)U/L and (346± 33)U/L,respectively.The levels of TNF-α and IL-6 of the internal drainage group at postoperative hour 0,1,2,4,12,24,48,72 were significantly lower than those of the control group and the external drainage group (P ＜ 0.05).The expressions of TNF-α mRNA of the control group,internal drainage group and external drainage group reached peak at postoperative hour 4,which were 0.92 ±0.14,0.39 ±0.05,0.80 ±0.15,respectively.The expressions of IL-6 mRNA reached peak at postoperative hour 12,which were 0.79 ± 0.07,0.38 ± 0.06,0.63 ±0.10,respectively.The expressions of TNF-α mRNA and IL-6 mRNA of the internal drainage group at postoperative hour 0,1,2,4,12,24,48,72 were significantly lower than those of the control group and the external drainage group (P ＜ 0.05).Conclusions Both internal and external drainage can improve liver regeneration of obstructive jaundice rats following partial hepatectomy,while the effect of internal drainage is superior.Internal biliary drainage has influence on the expression of STAT3 by decreasing the levels of TNF-α and IL-6,and help to improve liver regeneration of obstructive jaundice rats following partial hepatectomy.

BACKGROUNDTo investigate the efficacy of hyperfractionated radiotherapy (HRT) for non small cell lung cancer (NSCLC).

METHODSFifty patients with stage I-III NSCLC were treated in our department from Oct. 1995 to Jan. 2000. All patients had the pathological diagnosis. The patients were divided into two groups according to their entrance sequence: 25 patients were treated by HRT as the treatment group given the tumor doses (DT) 68.9-74.6 Gy/6-6.5 weeks, mean DT 70.3 Gy/6-6.5 weeks; 25 patients were irradiated by conventional fractionation (CF) as the control group given DT 64.2-70.4 Gy/6-7 weeks, mean DT 68.6 Gy/6-7 weeks. No patients received chemotherapy or immunotherapy before this treatment.

RESULTSThe effective rate after the radiotherapy was 80% (20/25) in the HRT group and 48% (12/25) in the CF group (Chi-square=5.56,P < 0.05 ). The 1-, 2-, 3-year survival rate of the HRT group was 68% (17/25), 60% (15/25) and 36% (9/25) respectively. The 1-, 2-, 3-year survival rate of the CF group was 52% (13/25), 32% (8/25) and 20% (5/25) respectively. The 2-year survival rate was significantly different between two groups (Chi-square=3.95,P < 0.05 ). The 1-, 2-, 3-year local progression free-rate of the HRT group was 72% (18/25), 60% (15/25) and 44% (11/25) respectively. The 1 , 2 , 3 year local progression free rate of the CF group was 64% (16/25), 48% (12/25) and 32% (8/25) respectively.

CONCLUSIONSAccording to the direct calculation, the efficacy of HRT for NSCLC is higher than that of CF. It is necessary to follow up the long term survival for the patients treated with HRT.