Objective To study the expression of HER-3 in breast cancer patients and analyze its relationship with the clinical pathology and prognosis of breast cancer,ER,PR and HER-2.Methods Data of 139 female breast cancer patients undergoing operations at the Second Hospital of Dalian Medical University from Jan.2006 to Oct.2006 were collected.These 139 patients didn't have preoperative chemotherapy or radiation therapy,but had postoperative endocrine therapies.Immunohistochemisty was used to detect the expression of HER-3 in the 139 patients.Data like the expression of ER,PR and HER-2,histological grading,tumor size and lymph node metastasis were obtained from their medical records.The relationship between indicators and breast cancer was analyzed.Results ①The positive expression rate of HER-3,HER-2,ER,and PR was 30.2％ (42/139),42.5％ (59/139),66.9％ (93/139),and 59.7％ (83/139) respectively.(②)The statistical items had no relation with patients' age(P ＞0.05).③HER-3 expression was correlated with tumor sizes,lymph node metastasis,histological grading,5 year survival rate and HER-2 expression(P ＜ 0.05),and had no relation with ER or PR(P ＞0.05).④)The combined expression of HER-3 & HER-2 was correlated with tumor sizes,axillary lymph node metastasis,histological grading,ER and PR.(P ＜ 0.05).Conclusions HER-3 detection is of great significance for the diagnosis and prognosis of breast cancer.The combined examination of HER-3,HER-2,ER,and PR in breast cancer tissues is of clinical significance for early diagnosis/treatment,medication and prognosis of the tumor,as well as for new drug research and development.

BACKGROUND: A long-term follow-up indicates that orthotopic ileal neobladder can cause acid-base balance and nutritional metabolic disorder. Otherwise, a long mesenterium is necessary to balance the tension of bladder at pelvic cavity and urinary inosculation due to a high position of ileum. On the contrary, sigmoid neobladder is near by urinary canal, and orthotopic sigmoid neobladder as a bladder substitute after radical cystectomy has few effects on acid-base balance of electrolytes, nutritional metabolism and secretion of mucus.OBJECTIVE: To compare the clinical results of these two operations basis on long-term follow-up. DESIGN: Retrospective analysis.SETTING: Department of Urinary Surgery, the Second Affiliated Hospital of Kunming Medical College.PARTICIPANTS: 164 patients with carcinoma of bladder were selected from Department of Urinary Surgery, the Second Affiliated Hospital of Kunming Medical College form January 1995 to March 2005. Ninety-six of them, including 74 males and 22 females, with age of 43-74 years and the average age of 65 years, accepted the operation of orthotopic ileal neobladder were regarded as the ileal neobladder group, and the other 68, including 64 males and 4 females, with age of 51-72 years and the average age of 62 years, accepted the operation of orthotopic sigmoid neobladder were regarded as the sigmoid neobladder group. All patients were finally diagnosed as pathological examination, and informed consent was provided by all patients. Treatment plan was approved by the local ethical committee.METHODS: ① Orthotopic ileal neobladder: Once the bladder was removed, a segment of ileum about 40-60 cm in length was isolated. In the operative procedure, the distal part of ileum which connected to the caecum often kept, the length of which was 15-20 cm. Both distal ends of the ureters were anastomosed to the homolateral not been split end of the isolated bowel. A perforation was constructed at the bottom of the pouch which served as the outlet, this outlet was then anastomosed to the proximal portion of the remaining urethra. ② Orthotopic sigmoid neobladder: After surgically removing the bladder, a part of the sigmoid colon, the length of which was 30-40 cm was isolated. Other operations were as the same as those mentioned above. MAIN OUTCOME MEASURES: Time of operation, blood loss during the procedure, length of time confined to bed, time of indwelling catheter, the ability to maintain continence and urinate, the results of urodynamic studies, and pouch related complications after operation.RESULTS: In 164 patients, 12 (7.3%) were lost to follow-up. The mean follow-up times were 46 months in the group of orthotopic ileal neobladder and 42 months in the group of orthotopic sigmoid neobladder, respectively. Blood loss during the procedure and the ability to maintain continence and urinate were similar in the two groups (P > 0.05). Compared with sigmoid neobladder group, the ileal neobladder group spent more time on operation, keeping the bed and indwelling catheter. The max volume of ileal pouch was higher than that of sigmoid pouch, and the difference was significant in statistic analysis (t=2.56-3.08, P < 0.05-0.01). Incidence of complication of ileal pouch (16.7%, 29.2%) was higher than that of sigmoid pouch (9%, 16%). The incidence in the early phase was not significantly different, but that in the late phase was significantly different (x2=5.426, P < 0.05).CONCLUSION: Compared with orthotopic ileal neobladder, sigmoid neobladder is worthy of being preferred for its shorter operative time, faster recovery and lower rate of pouch related complications.

Gaschromatography-tandemmassspectrometrywasadoptedtoidentifythehydroxylatedmetabolites of polychlorinated biphenyls and analyze the target compounds in fishery products. After the silylation derivatizaiton at 60 ℃ for 40 min, the MS spectrum of derivatives was obtained by GC/MS/MS under fullscan mode, and the fragment ions with the highest relative abundance were identified as m/z 399, 399, 399, 399, 399, 448 and 469, respectively which were defined as the precursor ion for product ion scan. The MS/MS spectrum was obtained under multiple reaction mode ( MRM ) by GC/MS/MS. And the product ions corresponded with the precursor ions were m/z 364, 364, 364, 364, 364, 433 and 434, respectively. The target compounds can be identified accurately by GC/MS/MS. In the present study, we took seven hydroxylated polychlorinated biphenyls as target compounds including 3-OH-PCB101 , 4-OH-PCB106 , 4-OH-PCB112 , 4'-OH-PCB101 , 3-OH-PCB118 , 3-OH-PCB138 and 3-OH-PCB180 . According to the identification method stated as above, the MS and MS/MS spectra of seven compounds were obtained. The compounds can be qualified and quantified by the identification method. The limits of detection ranged from 0. 02 to 0. 14 μg/L, and the limits of quantification ranged from 0. 09 to 0. 48 μg/L. The method has been applied to identify the hydroxylated polychlorinated biphenyls in fishery products.

Objective To evaluate the clnical value of percutaneous nephrolithotomy combined with flexible cystoscope in the treatment of complicated renal calculi.Methods Data of 53 cases of complex renal calculi treated with single channel percutaneous nephrolithotomy combined with flexible cystoscope from July 2011 to September 2013 were analyzed retrospectively.There were 31 males and 22 females.Their age ranged from 26 to 74 years with a mean age of 49 years.Thirty-two cases were located on the left side,19 cases right,2 cases bilateral,21 cases of staghorn calculi and 32 cases of multiple stones.All the stones were filled in 2 or more calyces,with 7 cases in upper ureteral stones at the same time and 2 cases in solitary kidney.The longest diameter of stones was between 2.5 cm to 4.6 cm,with an average of 3.7 cm.There were 39 cases with hydronephrosis and the separation of the collection system was 2.0-5.1 cm with an average of 3.8cm.The period which patients suffered from stones was from 1 month to 6 years.Fourteen cases underwent ESWL and 6 cases underwent open operation before percutaneous nephrolithotomy.All patients underwent single channel percutaneous nephrolithotomy under the guidance of color Doppler ultrasound,and the channel of puncture was expanded to 24 F.Results Fifty-three cases (55 sides) were performed successfully in one-stage sugery and the operation time was between 85 to 170 min,with an average of 119 min.Thestone clearance rate was 89％ (49/55) and postoperative hemoglobin decreased 3.9-9.2 g/L with an average of 6.1 g/L.The hospitalization time was 8 to 12 days with an average of 9.2 days.Two cases had hemorrhage of about 500 ml after surgery and the renal hemorrhage stopped after clamping of renal fistula without blood transfusion.Two patients suffered from fever on surgery day and 1 patient on one day after surgery,and the body temperature returned to normal level after anti-infection treatment for 2 or 3 days.No renal perforation,fluid pneumothorax or damaged surrounding organs occurred.6 patients had residual stones,among which 2 were treated by two-stage operation and 4 were treated with extracorporeal shock wave lithotripsy.Conclusion Percutaneous nephrolithotomy combined with flexible cystoscope has little trauma and high stone clearance rate in the treatment of complex renal calculi with high clinical value.

Objective To discuss the effect of selenoprotein P (SeP) on occurring and developing of colorectal cancer and its clinical significance by detecting the expression of SeP in adjacent mucosa of colorectal cancer, and in the cancer, metastatic lymph node and metastasis hepatic tissues.Methods Tissue microarray was constructed, the expression of SeP in adjacent mucosa of colorectal cancer, and in the cancer, metastatic lymph node and metastasis hepatic tissues were detected by means of immunohistochemistry.Results The positive rate of SeP were 48.4%,69.5%,66.7% and 61.5% in adjacent mucosa, tumor cell, lymph node metastasis and hepatic metastasis. The expression of adjacent mucosa was significantly lower than that in other three sites(?2=16.53,P

Objective To elucidate the diagnosis and treatment of the bladder mixed tumor.Methods 16 cases treated from Jun 1990 to Aug 2004 were reviewed.The clinical manifestations,diagnosis,treatment and prognosis were discussed.Correlative literature was reviewed at the same time.Results 16 cases of the bladder mixed tumor accounted for 6.9% of 223 bladder tumor patients in the same period,of which 7 of 16 were transitional squamous cell carcinoma,4 transitional adenocarcinoma,3 transitional squamous adenocarcinoma and 2 squamous adenocarcinoma mixed tumor.Most of the patients had irritable bladder symptoms and hematurine.Partial cystectomy was undergone for 3 of 16 cases,total cystectomy for 10 and radical total cystectomy for 3.The main treatment was partial or total cystectomy.The overall survival rates at 1,3 and 5 years post operation were 81.3%,56.3% and 12.5% respectively.Conclusion There were higher malignancy and worse prognosis in bladder mixed tumor.Early diagnosis and therapy might prolong survival.Radical total cystectomy seems to be the best method of treatment.

Objective To evaluate the effect of technical improvement of radical retropubic prostatectomy(RRP) for patients and reduction of complications.Methods 22 patients with clinically prostate cancer(mean age 67 years,stage B 19 cases,stage C 3 cases) underwent radical retropubic prostatectomy.During operation the dorsal vein complex,puboprostatic ligament,puborectalis sling,the neurovascular bundle,external urethral sphincter,reconstruction of the bladder neck were carefully managed.Results All the patients recovered uneventful except 2 deaths,and they survived and were followed up for a mean time of 16 months(range 1～4 years).The mean operative time was 140 minutes(range 90～220minutes) and the mean blood loss was 600mL(range 250～1500mL).16 cases received blood transfusion for 300～1200mL and no ureteral or rectal injury occurred.The urinary catheters were removed 2～3 weeks after operation.2 cases had stress incontinence 3 months later,1 case encountered urethral stricture and became well after urethral dilation,15 cases had satisfactory erectile function after operation and 3 patients had biochemical failure and endured continually chemotherapy during follow-up.Conclusions Accurate maneuver is handled according to correct anatomy can protect the apex of prostate and its surrounding tissue and reconstructing the bladder neck is helpful to reduce complications and achieve better outcome.

Objective To investigate the clinical features of multiple primary malignancies ( MPM) in patients with kidney malignancy .Methods The clinical data of 111 patients suffered from MPM associated with kidney malignant tumor in Yantai Yuhuangding Hospital and Affiliated Yantai Hospital of Binzhou Medical College from April 1984 to December 2014 were retrospectively analyzed .Results Among the 111 cases,there were 100 cases with two primary malignancies ,9 with three cancers and 2 cases with four or five cancers.Synchronous MPM were 37 cases,and metachronous 74 cases.The interval between the first and the second primary malignancy was between 0 and 348 months,with average of 46 months and median of 16 months.One hundred and seventy-two cases were treated by operation , and 64 cases by conservative therapy.The proportion of operation from the first to the fifth cancers were 89.2%(99/111),59.5%(66/111),54.5%(6/11),50.0%(1/2),0%(0/1),respectively,with the trend of declining.Finally 95 cases (85.6%) were followed up ,with 53 cases survived and 42 cases died.From the diagnostic date of the first primary cancer,overall survival in 1 year,3 years,5 years,10 years were 97.2%,77.2%,67.8%,48.4%, respectively.Median survival time was 120 months.From the diagnostic date of the last primary cancer , overall survival in 1 year,3 years,5 years were 81.4%,53.4%,48.2%,respectively.Median survival was only 48 months.Univariate analysis showed that the cumulative survival rate was higher in patients with operation than conservative therapy ( P =0.000 ) , in metachronous group than synchronous group ( P =0.009).COX proportional hazard model showed metachronous MPM (OR=3.870,95%CI 1.702-8.801,P=0.001),aggressive operation of the first primary cancer (OR=0.107,95%CI 0.018-0.647,P=0.015) and the second cancer (OR=0.313,95%CI 0.131 -0.750, P=0.009) were independent prognostic factors. Conclusions The main treatment of MPM associated with kidney malignancy is aggressive operation, radiotherapy, chemotherapy and biological therapy are adjuvant .Early detection and early operation for MPM are beneficial for increasing the survival of the patients .

Objective To evaluate the expression and clinical significance of Periostin (POSTN) in craniopharyngi?oma. Methods Forty-two patients with pathologically diagnosed adamantinomatous craniopharyngioma involving the floor of 3rd ventricle were retrospectively analyzed. The correlation between expression of POSTN and outcome was studied. Results POSTN was expressed in stroma of craniopharyngioma tissues. The expression of POSTN was not associated with the postoperative recurrence (Z=-0.236,P=0.813) while was associated with the degree of the adhesion between tumor and floor of 3rd ventricle (r=0.685, P<0.001), postoperative Hypothalamic Status Scale (r=0.569, P<0.001) and Body Mass Index (r=0.594, P<0.001). Conclusions POSTN may predict the degree of the adhesion between craniopharyngioma and 3rd ventricle floor. The high expression of POSTN may indicate the worse hypothalamus function.

31 patients with cysticercosis of cerebral ventricles verified by operation or pathological investigation were reported. All patients were between 7 and 64 years of age and 14 were females. All had a single cyst. Since 29 patients (94%) were without a history of intestinal taeniasis, it was proposed that most patients of cysticercosis of cerebral ventricles were caused by hetero-infection and the entrance of Cysticercus into brain ventricle was through choroid plexus along the cerebro-spinal fluid. This is probably the reason why it occurs mostly in the 4th ventricle. The clinical manifestation of cysticercosis of cerebral ventricles were paroxysmal headache and vomiting caused by increased intracranial pressure. Ventricu-lography and CT scanning have considerable diagnostic value. Removal of Cysticercus by surgical operation is successful (Figs. 1 - 8).