Objective To discuss how to determine the operative margin in breast-conserving surgery in patient with early-stage breast cancer. Methods The breast-conserving surgery was performed on 111 patients with early-stage breast cancer who met the indication of breast-conserving. The operative incision was performed on normal breast tissue 1cm from the tumour edge and then the frozen sections of the surgical margin tissue were done to confirm that tumour was completely excised. The individualized therapy was performed according to pathologic examination and clinical stage. All patients were followed up regularly. Results 111 patients with early stage breast cancer received breast-conserving surgery and all had good curative effect except one patient had a local recurrence during the follow-up. Conclusions Operative incision on normal breast tissue 1cm from the tumour edge and frozen section of the surgical margin tissue are two crucial procedures to ensure the success of breast-conserving surgery and increase the life quality of patient with breast cancer.

ObjectiveTo study the scope of excison in breast-conserving surgery for breast carcinoma.MethodsClinical data of 275 breast cancer patients undergoing breast-conserving surgery in t he First Affiliated Hospital of Nanjing Medical University,the Affiliated Zhenjiang Hospital of Jiangsu University and Changzhou Traditional ChineseMedicine Hospital were retrospectively analyzed.The operation procedure and postoperative adjuvant therapy were carried out with the same protocol.Local and general conditions of patients were followed up regularly.Results271 out of 275 patients got follow-up.The follow-up rate was 98.5％.The follow-up time ranged from 1 month to 117 months,median follow-up time was 34 months.Six patients died of distant metastasis,2 with local recurrence.The 1-year,3-year,and 5-year overall survival rates were 99.5％,98.1％,and 95.7％,respectively.ConclusionsIt is safe to excise 1 cm normal breast tissue with clear margin confirmed by frozen section,followed by postoperative adjuvant therapy,endocrine therapy,and radiotherapy,this improves the life quality of patients with breast cancer.It is safe and effective to determine whether the disease is multicentric or multifocal by mammogram plus clinical breast examination.

Objective:To summarize the etiology, laboratory examinations and clinical features of rhabdomyolysis(RM)in children.Methods:The clinical data of children with RM admitted to the pediatric general ward at Third Hospital of Peking University from January 1st, 2010 to March 31st, 2021 were collected.The clinical characteristics, etiology distribution, laboratory examinations, treatments and prognosis of the children were analyzed.Results:A total of 24 children were included with 16 males and 8 females.The age ranged from 4 to 15 years old, with median age was 13years old.The etiology was exertional diseases in 14 cases(58.3%), non-exertional diseases in ten cases (41.7%, 7 cases of infection and 3 cases of other causes). The average age of exertional RM was(13.50±1.83)years, and that of non-exertional RM was(8.60±3.72)years.There was significant difference( t=3.848, P=0.002). The main clinical symptoms were muscle soreness, abnormal urine color and muscle weakness.Serum creatine kinase(CK)and serum myoglobin were significantly increased.The proportion of CK value moderate to severe increased of exercise RM children was significantly higher than that of non-exertional RM children( P=0.009). All children were treated with hydration and alkalization.Except for one case who died of critical primary disease, the other 23 children had good treatment response, and no rhabdomyolysis was found during the follow-up. Conclusion:The main causes of rhabdomyolysis in children are exercise and infection.Exertional RM is common in elder children.The increasing of CK level caused by exertional RM is more obvious.Active hydration and alkalization measures could avoid the occurrence of acute kidney injury.Most children with RM have good prognosis.

The incidence of nonsynostotic plagiocephaly in infants is increasing year by year. This article reviews the etiology, types, early assessment, monitoring and diagnosis, and nursing intervention of nonsynostotic plagiocephaly, aiming to further improve the awareness and attention of medical staff and caregivers of infants to nonsynostotic plagiocephaly and achieve early identification and intervention, so as to improve the adverse outcomes of nonsynostotic plagiocephaly.

Objective:To explore any effect of electroacupuncture (EA) at the Baihui (DU20) and Dazhui (GV14) acupoints on the learning and memory of rats modeling cerebral palsy (CP), and on the miR-126 regulated VEGF/Notch1 pathway.Methods:Fifty-four male Sprague-Dawley rats 7 days old with an average weight of (20±5g) were randomly divided into a sham operation group, a model group, and an electroacupuncture group, each of 18. All except the sham operation group had a model of CP induced using left common carotid artery ligation combined with hypoxia. Twenty-four hours after successful modelling, the EA group received 14 sessions of electroacupuncture at the DU20 and GV14 acupoints, once every other day. On the 29th day, learning and memory ability were evaluated using a Morris Water Maze. The expression of vascular endothelial growth factors (VEGF and VEGFR-2) was detected using immunohistochemical staining. The levels of notch1 and hes1 protein were quantified using western blotting, and the expression of miR-126 RNA was quantified using reverse transcription polymerase chain reactions (RT-qPCRs).Results:Compared with the sham group, there was a significant decrease in the average learning and memory, and the level of miR126 in the model group, but a significant increase in the expression of VEGF and VEGFR-2 and the levels of notch1 and hes1. Significant improvement was observed in all of the measurements of the EA group compared with the model group.Conclusions:Electroacupuncture at the DU20 and GV14 acupoints can improve the ability of learning and memory of rats modeling CP. The mechanism may be related to regulation of the VEGF/notch1 pathway by miR-126 and its promotion of angiogenesis.

OBJECTIVETo investigate the possibility and short-term effect of high dose chemotherapy with peripheral blood stem cell support in the preoperative therapy of breast cancer, and-its influence on the following operation and would healing.

METHODSThree patients with T(3)N(1)M(0) (III(a)), T(4)N(1)M(0) (III(b)), T(4)N(1)M(1) (IV) of breast cancer were diagnosed histopathologically. After receiving HDC/APBSCT, the 3 patients were operated on. HDC/APBSCT process included 2 cycles of FEC induction chemotherapy; PBSC mobilization, APBSC collection and cryopreservation and PBSC infusion; and high-dose chemotherapy, APBSC infusion and supportive therapy. The therapy consisted of CTX2.5 g/m(2), VP-16 600 mg/m(2), and cerboplatin 600 mg/m(2) delivered on day 1, APBSC infusion 48 h later, rhG-CSF (150 microg, BID) was administered 4 h after infusion of APBSC until WBC was higher than 10 x 10(9)/L. During HDC/APBSCT, the patients were protected in the air laminar flow room with supportive therapy of antibiotics, anti-virus and anti-fungus drugs. They left the air laminar flow room after their WBC was greater than 2 x 10(9)/L. Case 1 was treated by radical mastectomy, Case 2 by improved radical mastectomy, Case 3 by improved radical mastectomy and transplantation of skin for the large area.

RESULTSRapid recovery of bone marrow function was observed in all 3 patients. Operation was performed 4 weeks after HDC/PBSCT in Cases 1, 2 and 33 days in Case 3. No influence was seen on operative procedure and would healing, especially in Case 3 with a large area of skin transplantation. Two patients with stage III(a) and III(b) have been alive since the treatment for 30 months and the other with stage IV died of brain metastasis 16 months later.

CONCLUSIONSHDC/APBSCT as a preoperative therapy for breast cancer has no influence on the coming surgery and would healing, even on skin transplantation for a large area. It has a practical response in stage III(a) and III(b), but it is still controversial in stage IV. This method as a salvage therapy for patients with breast cancer of intemuediate or stage.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; therapy ; Combined Modality Therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Mastectomy, Radical ; Middle Aged ; Neoplasm Staging ; Preoperative Care ; Salvage Therapy

Anemia, Aplastic ; drug therapy ; immunology ; Animals ; Antilymphocyte Serum ; immunology ; therapeutic use ; Calcineurin Inhibitors ; immunology ; therapeutic use ; Humans ; Immunoglobulins ; immunology ; therapeutic use ; Lymphocytes ; drug effects ; immunology ; Swine