Objective To discuss the correlation between molecular subtypes of early stage breast cancer patients with positive sentinel lymph nodes and the metastasis of non-sentinel lymph nodes, and find out the factors predicting the metastasis of non-sentinel lymph nodes. Methods The clinical data of 124 female breast cancer patients with sentinel lymph node positive were retrospectively analyzed, and the patients were treated with axillary lymph node dissection. And the correlations were analyzed by single factor analysis and multiple factor Logistic regression analysis. Results Among the 124 patients,non-sentinel lymph node metastasis was in 45 cases (36.3%), and only sentinel lymph node positive was in 79 cases (63.7%). The single factor analysis result showed that the age≤35 years, number of sentinel lymph node positive≥2, macrometastasis of sentinel lymph node had correlation with the metastasis of non-sentinel lymph node (P<0.05 or<0.01);but the molecular type, operation method, maximum tumor diameter had no correlation with the metastasis of non-sentinel lymph node (P>0.05). The multiple factor Logistic regression analysis result showed that the number of sentinel lymph node positive and circumstance of sentinel lymph node positive lesions were the independent risk factors of the non-sentinel lymph node metastasis in patients with sentinel lymph node positive (OR = 4.589 and 2.948; P<0.01 or <0.05). Conclusions The circumstance of sentinel lymph node positive lesions and number of sentinel lymph node positive are the independent risk factors of the non-sentinel lymph node metastasis, but the molecular type is not correlated with the metastasis of non-sentinel lymph node. Predicting non-sentinel lymph node metastasis should be combined with clinical and pathological factors.

Objective To explore the effect of intravenous immunoglobulin (IVIG) on immunity and outcome for sepsis in children.Methods Eighty-four children who met the diagnosis of sepsis were included in study and divided into treatment group (36 cases) and control group (48 cases ).The patients in teatment group were administered IVIG with the dose of 1 g/kg.Peripheral venous blood samples of patients in both groups were collected before (0 h),24 h,72 h and 5 d after administration to detect the numbers of immunocyte including CD3 +,CD4 +,CD56 +,CD19 +,CD8 +cells by flow cytometry and the levels of cytokines including tumor necrosis factor (TNF)-at,interleukin (IL)-10,IL-1 7 by enzyme linked immunosorbent assay.The numbers of immunocyte and levels of cytokines and TNF-a/IL-10 were compared and the mortality at 28 days was assessed between two groups.Results The numbers of CD3 +,CD4 +,CD56 +,CD19 +cells and the levels of TNF-a,IL-17 and TNF-α/IL-10 of patients in teatment group were significantly decreased than those in control group at 24 h,72 h and 5 d afte administration ( P ＜0.05 ) and showed downtrend.However,the level of IL-10 increased significantly (P ＜ 0.05 ) and showed uptrend in treatment group.The number of CD8+ cells had no change.No difference of mortality was observed between two groups (27.7％,10/36 vs 16.6％,8/48,x2 =1.50,P =0.169,OR =1.92,95％ CI:0.671 ～5.510).Conclusion IVIG can suppress the immunity of children with sepsis and has no survival benefit.

Objective:To investigate the in vitro anti-cancer effect of Vinorelbine (NVB) combined with adriamycin (PLD) on human breast cancer MCF-7 cells and related mechanisms.Methods:The effects of NVB and PLD alone or in combination on the proliferation of breast cancer cells were detected by CCK-8 experiment. Flow cytometry was used to detect cell apoptosis and changes in reactive oxygen species (ROS) levels. Western blot experiment was carried out to detect protein expression.Results:The results of CCK-8 showed that compared with the blank control group, the inhibition rates of the vinorelbine treatment group, the adriamycin treatment group and the combined treatment group were 27.6%, 31.2% and 65.4%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.005 vs 0.001) . The results of flow cytometry showed that the proportion of apoptotic cells in each group was 3.54%, 16.95%, 15.01% and 32.24%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.006 vs 0.005) . The levels of reactive oxygen species in each group were 1, 1.03, 1.06 and 1.57, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.008 vs 0.007) . Western blot results showed that the expression of p-ERK and p-STAT3 decreased after the combination of NVB and PLD, which inhibited the ERK/STAT3 signaling pathway. Conclusions:The combination of NVB and PLD can promote the apoptosis of breast cancer cells and inhibit the proliferation of breast cancer cells with high efficiency and low toxicity. Its mechanism of action may be related to the up-regulation of ROS levels in cells, thereby inhibiting the activation of the ERK/STAT3 pathway.