Objective To investigate the efficacy and safety of trastuzumab combined with docetaxel chemotherapy in the treatment of stage Ⅲ breast cancer.Methods 150 cases of stage Ⅲ breast cancer patients from October 2013 to September 2015 in our hospital were selected and randomly divided into experimental group and control group,75 cases in each group,the control group were treated with cyclophosphamide and doxorubicin treatment,experimental group were treated with trastuzumab combined with docetaxel chemotherapy.To 21 days for a course of treatment,all patients were treated three courses.The levels of serum C reactive protein(C-reactive protein,CRP),the total effective rate and the incidence of adverse reactions in two groups before and after treatment were compared.Results After treatment,the level of serum CRP in the two groups decreased significantly,the difference was statistically significant(P<0.05),the CRP levels of serum in experimental group was significantly lower than the control group,the difference was statistically significant(P<0.05),the clinical total effective rate is higher,the difference was statistically significant(P<0.05),the incidence rate of adverse reaction was lower,the difference was statistically significant(P<0.05).Conclusion Trastuzumab combined with docetaxel chemotherapy can effectively reduce the inflammatory response in patients with stage Ⅲ breast cancer,improve clinical efficacy,and effectively reduce the adverse reactions of patients.

10.3969/j.issn.1007-3969.2013.05.007

Objective To analyze the effect and safety of budesonide combined with psychological intervention on the treatment of the children with bronchitis. Methods 60 children with capillary bronchiolitis in Enze hospital from June 2014 to May 2016 were randomLy divided into the control group and the experimental group, 30 cases in each group. The control group were received conventional treatment, such as, anti-inflammatory, antiviral, bronchodilator and oxygen inhalation. At this basis, the experimental group were given budesonide aerosol inhalation combined with psychological intervention. The clinical therapeutic effect in the two groups were compared. Results The cough stopping time, hospitalization time and the time of lung wheezing rale in the experimental group were significantly shorter than those in the control group, and the adverse reactions in the experimental group were significantly lower than those in the control group, and the difference between the 2 groups was statistically significant(P<0.05). Conclusion The children with capillary bronchiolitis patients were given budesonide inhalation combined with psychological intervention on the basis of routine therapy, which can effectively improve the clinical symptoms, improve the curative effect, low incidence of adverse reactions, shorten the treatment time, which is worthy of clinical application.

Objective To evaluate the treatment effect of balloon angioplasty and cryoplasty on iliac artery stenosis in canine model.Methods Canine models of iliac artery stenosis were established with surgical ligation and transfixion.Models were randomly divided into two groups:iliac artery stenosis treated by cryoplasty (n =8) and by balloon angioplasty (n =8).The degree of iliac artery stenosis of two model groups was assessed by digital subtraction angiography (DSA) immediately and two weeks after the angioplasties.Then all the dogs were executed for pathological observation of the target vessels.Results Sixteen canine models of iliac artery stenosis were established by surgical ligation and transfixion method with 100％ success rate.DSA showed there was (45 ± 12)％ of residual artery stenosis in the cryoplasty group immediately after surgery,while it was (39-12)％ in the balloon angioplasty group,and there was no significant difference between them(t =3.183,P ＞ 0.05).The artery stenosis of cryoplasty group was (48 ± 17) ％ after two weeks and not significantly different from that after surgery immediately (t =-1.271,P ＞ 0.05).The artery stenosis of balloon angioplasty group was (67 ± 13)％ after two weeks,and it was significantly higher compared with at after surgery immediately (t =-6.666,P ＜ 0.01).The degree of vascular stenosis in balloon angioplasty group was severer than that in cryoplasty group two weeks after angiography(P =0.041).The pathological examination showed artery intimal hyperplasia in cryoplasty group was milder than that in balloon angioplasty group and neointimal content of collagen in cryoplasty group was less than that in balloon angioplasty group.Conclusions The animal models of iliac artery stenosis were established successfully with surgical ligation and transfixion by damaging the intima and media of arterial wall.Compared with balloon angioplasty,the cryoplasty was able to inhibit proliferation of intimal and reduce collagen synthesis to prevent the iliac artery restenosis.

Objective:To evaluate the clinical efficacy of endoscope assisted supraclavicular thyroidectomy and lymph node dissection through the sternocleidomastoid muscular approach (ELDS) .Methods:Clinical data of 40 patients undergoing ELDS and 40 patients who had open surgery (open group) by same team admitted to Ningbo Medical Center Lihuili Hospital from Jan. 2021 to Jan. 2022 were retrospectively analyzed. The intraoperative and postoperative outcomes and follow-up were observed situation. The intraoperative situation, the number of lymph nodes dissected, postoperative outcomes and scar healing satisfaction were observed. SPSS 20.0 software was employed to carry out statistical analysis, the measurement date were compared with t-test, and the counting date were analyzed by χ2 test. Results:There was no significant differences in the two groups with respect to the number of lymph nodes dissected (ELDS group: 30.5±9.8, open group: 29.9±9.0) . The surgical injury in ELDS group were significantly smaller than those in open group, and the operation time was significantly higher in open group (ELDS group: 95.2±12.0min, open group: 82.3±13.9min, P<0.05) . In postoperative follow-up, there were significant differences between the two groups in swallowing impairment, anterior cervical pressure and scar satisfaction (ELDS group: 4.45±1.82, open group: 6.03±1.47, P<0.05) , and the lateral approach group was superior to open group, but there were no significant differences in parathyroidism or recurrent laryngeal nerve injury ( P>0.05) . Conclusions:ELDS has the advantages of good cosmetic effect, less postoperative anterior cervical discomfort, less postoperative complications, and good lymph node dissection effect. The operation is safe and feasible, and has obvious advantages over traditional operation.

Objective:To investigate the feasibility and clinical significance of near-infrared fluorescence positive imaging combined with intraoperative rapid parathyroid hormone (PTH) determination in identification and function protection of the parathyroid gland during thyroidectomy.Methods:According to the inclusion and exclusion criteria, patients in the Affiliated Lihuili Hospital of Ningbo University, who needed bilateral thyroidecto-my and central lymph node dissection due to suspected bilateral thyroid cancer from Mar. 2020 to Oct. 2020 were selected for a prospective clinical study. They were randomly divided into the study group (near-infrared fluorescence positive imaging combined with intraoperative rapid PTH determination) and the control group (intraoperative experience identification) . The number of parathyroid glands found during operation, PTH before and after the operation, blood calcium, blood phosphorus, the presence of parathyroid tissues in routine pathological section examinations, and postoperative symptoms were collected. SPSS 25.0 statistical software was used for analysis, the measurement data were expressed by mean±standard deviation ( ± s) , t test was used for comparison between groups, and χ2 test was used for counting date. Results:In the study group of 33 cases, 135 suspicious parathyroid glands were exhibited during operation, with an average of (4.09±0.52) ; Hand and foot numbness occurred in 1 case (3.03%) ; On the 1st after the operation, PTH was (23.68±9.48) ng/L. In the control group of 31 cases, 109 parathyroid glands were identified by naked eyes, with an average of (3.52±0.63) ; Hand and foot numbness occurred in 6 cases (19.35%) ; On the 1st after the operation, PTH was (17.93±11.58) ng/L. The differences were statistically significant ( P<0.05) . But no statistical significance was found in operation duration (79.45±30.18) min, postoperative hospitalization days (5.85±2.27) days, PTH (27.10±9.80, 33.08±10.21) ng/L, blood calcium (2.11±0.10,2.25±0.09) mmol/L, and blood phosphorus (1.20±0.20,1.15±0.12) mmol/L on the 3rd day and the 6th month after the operation. Conclusion:Near-infrared fluorescence positive imaging combined with intraoperative rapid PTH determination can improve the recognition rate of the parathyroid gland and reduce postoperative complications, which is a safe, effective and rapid method for intraoperative parathyroid gland recognition.

Objective To investigate the effect and prognosis of breast conserving surgery on triple-negative breast cancer patients ≤35 years old. Methods 60 cases of ≤35-year-old triple negative breast cancer from July 2011 to July 2016 in our hospital were selected as the observation group. Other 60 triple-negative breast cancer patients who underwent modified radical mastectomy from July 2011 to July 2016 at the same period were selected as control group. The surgical observation index, complications, local recurrence, distant metastasis and 1-year survival rate between the two groups were compared. Results The operation time of the observation group was significantly shorter than that of the control group, and the difference was significant(P＜0. 05). The intraoperative blood loss in the observation group was significantly less than that of the control group. There was significant difference between the two groups (P＜0. 05). The incidence of postoperative complications in the observation group was significantly less than that in the control group. There was significant difference between the two groups (6. 67％ vs 20. 00％, P＜0. 05). Among them, there were 2 cases of subcutaneous effusion, 2 cases of flap ischemia in the observation group. And there were 3 cases of subcutaneous effusion, 3 cases of ischemic skin flap and 6 cases of upper limb swelling in the affected side in the control group. The follow-up of 1 year showed that the local recurrence rate and distant metastasis rate in the observation group was significantly lower than that in the control group. There was significant difference between the two groups (P＜0. 05). However, there was no significant difference in one-year survival rate between the two groups (98. 33％ vs 83. 33％, P＞0. 05). One case died in the observation group and died of brain metastases at 11 months after operation. Two patients in the control group died of liver metastases at 6 months and 12 months after operation. Conclusion Breast-conserving surgery for triple-negative breast cancer patients ≤35 years has definite effect, which can significantly reduce postoperative recurrence and distant metastasis and improve the success rate of operation.

Objective To explore the application effects of clinical nursing pathway on recovery of upper-extremity functions during different stages after surgery of breast tumor. Methods A total of 120 patients who received the surgery of breast tumor in our hospital from January 2012 to December 2013 were selected as research subjects. They were randomly assigned to a research group and a regular group according to the method of random number table, with 60 in each. The regular group was given clinical regular nursing for the recovery of upper-extremity functions after the surgery, and the research group was given clinical nursing pathway for the recovery of upper-extremity functions after the surgery. Nursing effects were observed between the two groups. Results Arms bending forward and arms bending inward as well as abduction and rotation in the research group were significantly better than those in the regular group, and the differences were statistically significant (P<0.05). Satisfaction rate on clinical nursing in the research group was 93.3%, higher than that of 75.0%in the regular group(P<0.05). Life quality score in the research group was(56.1±5.9), significantly higher than that of(43.8±6.3)in the regular group, and the difference was statistically significant(P<0.05). Conclusion Clinical nursing pathway is feasible clinically for the recovery of upper-extremity functions during different stages after the surgery of breast tumor. It promotes the recovery of upper-extremity functions, as well as en-hances satisfaction rate on clinical nursing and life quality, which is worthy of clinical application.

Objective To determine the clinicopathological risk factors and reliable biochemical predictors of the development of hypoparathyroidism after total thyroidectomy plus central compartment node dissection in papillary thyroid carcinoma (PTC).Methods A study was performed on 93 patients who underwent a total thyroidectomy with central compartment node dissection due to PTC.The rate of hypoparathyroidism was calculated.We evaluated the correlations between hypoparathyroidism and clinicopathological factors by chi-square test and logistic regression model for multivariate analysis.The prediction value of PTH and serum calcium level was assessed by a 2×2 contingency table and ROC curve analysis.Results Postoperative hypoparathyroidism was found in 46 patients (49.5％) and 2 with permanent hypoparathyroidism.Univariate analysis showed that tumor size (P=0.034),perithyroidal extension (P=0.003),bilateral cancer(P=0.045)and bilateral central neck dissection (P=0.028)were risk factors for postoperative hypoparathyroidism in patients with PTC.Multivariate analysis showed that perithyroidal extension (P=0.003) and bilateral central neck dissection(P=0.044)were independent risk factors for postoperative hypoparathyroidism in patients with PTC.ROC curve analysis showed that PTH level in the first after operation played significant roles in predicting hypoparathyroidism(AUC 0.875).Conclusions Hypoparathyroidism is the most common complication after total/near-total thyroidectomy.Perithyroidal extension and bilateral central neck dissection are the important risk factors of hypoparathyroidism.The level of PTH is a reliable and early predictive indicator of postoperative hypoparathyroidism.

Objective To study the effects of CTLA4-Ig on mu rine allergic contact dermatitis.Methods Mice were exposed to DNFB to induce allergic contact dermatitis and were i njected with CTLA4-Ig.Ear swelling was measured 24h after antigen challenge.Splenocytes from treated mice were assayed for their ability to prolif erate in response to DNFB or FITC stimulation in vitro.Results Profound inhibition of contact hypersensitivity response(CHS )was shown by 69.7%in mice treated with CTLA4-Ig compared with mice treate d with PBS control.CT-LA4-Ig-treated mice displayed DNFB-specific tolerance,but exhibited a vigorous immune response to FITC when re-sensitizing 14days after the fir st challenge.Adoptive transfer of l ymphocytes from CTLA4-Ig-treated mice could induce inhibition of CHS in recipien t mice.Conclusions CTLA4-Ig can inhibit CHS by blocking B7/CD28co-stimulatory pathway,which provides a new way to suppress typeⅣallergic reaction.[