0.05). The upper extremity function in group C was better than that in group H (P

Objective To discuss the diagnosis and management of tracheomalacia complicating large goiter. Methods Clinical data of 36 patients with large goiter complicated by tracheomalacia at Xijing Hospital between 1992 and 2004 were retrospectively reviewed. Preoperative Valsalva-Mueller test were performed in all patients before undergoing subtotal thyroidectomy with tracheal suspension, and two patients were treated by subtotal thyroidectomy with tracheal suspension and tracheostomy. Results Valsalva-Mueller test was positive in all patients. The compressed tracheal cartilage disappeared in 2 cases, became thin and soft in other 34 cases. Thirty-four patients who underwent subtotal thyroidectomy with tracheal suspension recovered and 2 patients were resued by tracheal suspension with tracheostomy. There was no mortality. Postoperative 34 cases were followed-up from 6 months to 13 years. Thirty-two cases had no postoperative respiratory obstruction, 2 patients died of unrelated diseases. Conclusions The diagnosis of tracheomalacia from large goiter is based on Valsalva-Mueller test and operative detection. Subtotal thyroidectomy with tracheal suspension is the treatment of choice for tracheomalacia complicating large goiter.

Triple-negative breast cancer(TNBC)is characterized by tumor heterogeneity and diverse tumor microenvironment(TME),which make its research and treatment more difficult.Chemotherapy is an important TNBC treatment;however,predicting post-treatment effic-acy and chemoresistance remain urgent clinical challenges,with changes in the TME being a major cause.Understanding the facilitating role of the TME is crucial to resolve the challenges.In this study,we assessed the findings of multi-omics studies to explore the research progress on the correlation between the TME and clinical efficacy and chemotherapy resistance of TNBC.We hope to provide a possible direction to improve clinical efficacy and overcome chemotherapy resistance in TNBC.