The liver is one of the most common metastatic sites in patients with breast cancer. Systemic therapy is the standard treatment for breast cancer with liver metastasis, but the results are far from satisfaction. A distinctive subset of metastatic breast cancer is oligometastatic disease. Local therapy including metastasectomy, radiofrequency ablation and radiation therapy combined with systemic therapy can provide survival beneift. This review introduced the latest research results of local therapy in liver oligometastases of breast cancer.

Objective To discuss the effect of preserving ovaries on the prognosis of young early endometrial cancer patients. Methods Searched English and Chinese databases by computors, including Cochrane library, Embase, PubMed, Web of Science, China National Knowledge Internet (CNKI), data base of Wanfang, China Science and Technology Journal(CSTJ), and also relevant journals and magazines by hand. Retrieval time from January 1996 to March 2016. In accordance with the inclusion criteria, two independent investigators screened the studies and extracted the relevant data respectively. Then evaluated the quality of included studies. Finally, conducted the meta-analysis with RevMan 5.3 software from cochrane collaboration network, in which heterogeneity test of enrolled studies firstly was completed and combined analysis with effect models according to the heterogeneity secondary. In the light of the result, effect of remaining ovaries on the prognosis (5-year recurrence rate and 5-year overall survival rate) of young early endometrial cancer patients was determined. Results Ten trials were included. All of them were cohort studies, a total of 5 299 patients, in which 916 patients′ ovaries were remained. Quality assessment of all 10 studies were based on Newcastle-Ottawa Scale (NOS) scale. All of the studies enrolled were of high quality with a score of ≥7. After quality assessment,all studies illustrated the higher the quality. Meta-analysis showed that there was no statistically significant difference between who had ovarian preservation and without preservation in terms of 5-year overall survival rate [96.00%(863/899) vs 96.51%(3 736/3 871);RR=1.00,95%CI:0.99-1.02,P=0.792] and the 5-year recurrence rate [2.58%(7/271) vs 4.43%(51/1 150);RR=1.01, 95%CI:0.46-2.22, P=0.986]. Conclusion Ovarian preservation in young early stage patients of endometrial cancer could not effect the 5-year overall survival rateand the 5-year recurrence rate.

The clinical manifestation of endometrial uterine cancers is similar to other gynecological diseases like endometrial hyperplasia,polyps,uterine myoma,and adenomyosis.This similarity may result in missed diagnosis of endometrial cancer,which should be paid wide attention.In these cases,pathological examination reports malignancy of uterine specimen after simple hysterectomy.Personalized treatment,such as observation and reoperation,should be supplemented for these patients,according to the pathological characteristics of the tumor,risk factors of lymphatic and ovarian metastasis and the willingness of patient.

Objective:To investigate the expression of Leucine-rich repeat-containing G protein-coupled receptor 5(LGR5) in endometrial cancer(EC) and their relationship with clinicopathological characteristics.Methods:Immunohistochemistry were performed to measure the LGR5 expression in EC(n =90) and normal endometrium tissue(n =30).The expression of LGR5 and its relationship with clinicopathological characteristics were analyzed.Results:The expression of LGR5 was significantly higher in EC than that in normal tissue (63.3％ vs 23.3％,P＜0.001).The expression of LGR5 in ＜ 1/2 myometrium infiltration group was higher than in ≥1/2 myometrium infiltration group(72.5％ vs 33.3％,P =0.001).There was no significant difference between the expression of LGR5 in different group of age,histological type,histological differentiation,cervical stroma invasion,lymph node metastasis,FIGO stage(P ＞ 0.05).Multivariate analysis showed that LGR5 was an independent influential factor of myometrium infiltration (OR =0.163,95％ CI 0.034 ～ 0.772,P =0.022).Conclusions:LGR5 is up-regulated in EC,and is correlated to myometrium infiltration.LGR5 may play an important role in EC tumorigenesis.

Objective To evaluate the safety and effectiveness of robotic surgery in surgical staging of endometrial cancer. Methods Searched English and Chinese databases, including Cochrane library, PubMed, Embase, Web of Science, China National Knowledge Internet, data base of Wanfang, China Science and Technology Journal(CSTJ), and relevant journals and magazines by hand from Jan. 2000 to Oct. 2016.(1)In accordance with the inclusion criteria,two independent investigators screened databases and extracted the relevant data respectively, then evaluated the quality of including studies in Newcastle-Ottawa Scale(NOS).(2)Meta-analysis was performed with RevMan 5.3 software. Heterogeneity inspection was done for each study and different effect model included the random effect model and fixed effect model was chose according to the results of the inspection. At last, the related parameters of the robotic surgery and laparoscopic surgery was analysed. Results (1) Thirteen articles were ultimately included. All of them were written in English and included a total of 1554 patients, included 739 cases of robotic surgery and 815 cases of laparoscopic surgery. Thirteen articles were all cohort study, four of them were prospective cohort study, while others were retrospective cohort study. After quality assessment, all studies had more than 5 stars and illustrated the higher quality.(2)Meta-analysis results showed:compared with laparoscopic surgery in surgical staging of endometrial cancer, robotic surgery had less estimated blood loss [standard deviation (SD)=-72.31 ml,95%CI:-107.29 to-37.33,P<0.01], less time for hospital stay (SD=-0.29 days,95%CI:-0.46 to-0.13,P=0.001), less need for blood transfusion [risk ratio (RR)=0.57,95%CI:0.33 to 0.97,P=0.040], and conversion to open surgery (RR=0.41,95%CI: 0.26 to 0.65,P=0.000),less intraoperative complications (RR=0.43,95%CI: 0.24 to 0.76,P=0.004) in surgical staging of endometrial cancer. There was no statistically significant difference in aspects of operative time (SD=10.26 minutes, 95%CI:-13.62 to 34.13,P=0.400), postoperative complications (RR=0.87, 95%CI: 0.67 to 1.12,P=0.280), the total number of lymph nodes removed (SD=-0.04,95%CI:-3.99 to 3.91,P=0.980), the number of pelvic lymph node dissection (SD=0.48,95%CI:-1.76 to 2.71,P=0.680) and the number of para-aortic lymph node dissection (SD=0.46,95%CI:-1.42 to 2.34,P=0.630). Conclusions Compared the robotic surgery with laparoscopic surgery in surgical staging of endometrial cancer, robotic surgery has less estimated blood loss, less need for blood transfusion and conversion to open surgery,less intraoperative complications and other advantages. While its cost is so expensive that restrict clinical application.

Objective To understand the influence of HBsAg+ pregnant woman on the persistence of hepatitis B surface antibody(HBsAb)of neonates in three years after the first"0,1,6"immunization,and the influences of regular examination every half-year and revaceination in time on maintaining the immune effect. Methods Twenty neonates born from HBsAg-mothers and 24 from HBsAg+ mothers were followed up for 3 years.And children whose HBsAb's titer faded or disappeared(unstable)received recombinate yeast-derived hepatitis B gene vaccine.The proportion of children with unstable HBsAb and the positive rate of HBsAb on 7 month-old and 3 year-old were compared. Results The unstable rate of HBsAb in HBsAg- and HBsAg+ groups were 20.0%(4/20)and 79.2%(19/24),respectively(P<0.05).The rate of revaccination in these two groups were significantly different.The positive rate of HBsAb in 7 month-old children of HBsAg-mothers was 100.0%(20/20)and 62.5%(15/24)in those of the HBsAg+ group(P<0.05).No statistically difference was detected between the two groups when followed up at 3 years of age[85.0%(17/20)vs 91.7%(22/24),P>0.05]. Conclusions HBsAg+ mothers would reduce the stability of HBsAb in their neonates within three years after the first"0,1,6"immunization,but the immune effect of vaccination against hepatitis B can be maintained through regular examination every half or one year and revaccination.

Objective To study the rules of lochia rubra and draw normal pattern chart of post-partum lochia prospectively. Methods Samples were collected from parturients who had given birth in our hospital from July to December in 2002 consecutively including 191 women with cesarean section (CS) ,and 187 with spontaneous delivery. The amount of blood loss was measured and recorded everyday from 24 hours postpartumly to the day that lochia rubra was over by checking the special sanitary pads with squares on. All subjects were followed up on the 42nd day after delivery and the charts collected. Results The mean duration of lochia rubra in spontaneous delivery and CS group were (33. 9?12. 0) days and (39. 6?13. 1) days, respectively; and the 95% CI were 10-57 days and 14 -65 days, respectively (P = 0. 006). More recurrent lochia cases were seen in the CS group than that in spontaneous delivery group (103 vs 28, 66. 5% vs 19. 9%). Conclusions The duration of lochia rubra of CS group is longer than that of spontaneous delivery group. The 95% CI of the duration of lochia rubra is: 10- 57 days in spontaneous delivery group while 14- 65 days in CS group. Lochia rubra will recurred several times during puerperium, especially in CS group.

Sentinel lymph node biopsy has been the standard axillary intervention for breast cancer patients with clinical negative axillary lymph nodes.Complete axillary dissection could be omitted for patients with negative sentinel lymph nodes.While, the optimal axillary intervention for patients with 1-2 positive sentinel lymph nodes remained controversial.This review introduced the latest research results of the axillary management for early stage breast cancer patients with 1-2 positive sentinel lymph nodes.

Objective To investigate the change of serum nitric oxide ( NO ) in premature rupture of membrane (PROM) and its clinical significance, so as to assess the role of NO in the mechanism of PROM . Method The serum NO in 40 advanced stage pregnant women,28 premature delivery PROM,40 unknown reason term pregnancy PROM ,40 term pregnancy ,40 term labor were detected and compared. Results The serum NO was higher in unknown reason term pregnancy PROM [(95.364±3.562) (u)ol/L] than that in term pregnancy [(75.020±3.416)(u)ol/L] and term labor [(31.457±3.859)(u)ol/L](P<0.01). The serum NO was higher in premature delivery PROM [(101.256±3.124)(u)ol/L] than that in advanced stage pregnant women [(80.363±5.112)(u)ol/L] (P<0.0l),but similar with unknown reason term pregnancy PROM (P = 0.086). Conclusions The serum NO in PROM of term pregnancy significantly is higher than that of advanced stage and term labor women,indicates PROM relating to the increase of NO level. Because the increase of NO links to infection,it suggests that PROM relate closely to the amniotic infection.

Objective To explore the clinical characteristics,causes,diagnosis and treatment of pelvic mass in adolescents caused by gynecologic diseases. Methods One hundred and twenty-six adolescents with gynecologic diseases presented as pelvic mass were retrospectively reviewed. Results The average age of all patients was 17. 6 years,ranging from 10. 0 to 19. 0 years. Ectopic pregnancy was found in 38 patients(30. 2%) ,the average age of the patients was 18.6 ±0.5 years, ranging from 17.0 to 19.0 years. Ovarian neoplasm was found in 35 patients (27. 8%) ,the average age of the patients was 17. 1 ± 2. 1 years, ranging from 10. 0 to 19. 0 years. Twenty cases (57. l%)had germ cell tumor, eighteen with mature teratomas, one with endodermal sinus tumor and one with immature teratoma. Thirteen cases(37. 2%)had epithelial ovarian tumors;eight with serous cystadenomas,three with mucinous cystadenoma, one with mucinous cystadenoma complicated with serous cystadenoma and one with borderline mucinous cystadenoma. Two cases had simple cyst of the ovary (5. 7%) . Congenital abnormality of reproductive tract was found in 14 patients (11. 1%), the average age was 14. 7 ±2. 2 years, ranging from 13.0 to 19. 0 years. Seven had imperforate hymens, two had rudimentary horn of uterus,four had atresia of vagina,one had atresia of vagina complicated with rudimentary horn of uterus,and one had oblique septum of vagina. Corpus luteum rupture was found in 11 patients (8. 7%) , the average age was 18. 1 ± 1. 9 years, ranging from 13. 0 to 19. 0 years. 116 patients underwent operative treatment and 10 patients underwent conservative therapy. Conclusions According to the stage of adolescents, main causes of pelvic mass in adolescents are different Main causes of pelvic mass in early adolescents are tumorous disease. Congenital abnormalities of reproductive tract are usually in middle adolescents. The gonads develop closely mature in late adolescent period; main causes of pelvic mass are ectopic pregnancy, ovarian neoplasm and physiologic ovarian cyst Surgery is the main therapy of pelvic mass in adolescents.