0.05).(4) Significant differences between CC and CIN Ⅰ for p16,CDH1,RASSF1A and TIMP3 genes(P

Aged ; Breast Neoplasms ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy ; methods ; Metaplasia ; pathology ; Papilloma, Intraductal ; pathology ; surgery ; Sebaceous Glands ; pathology

Background:Nipple discharge cytology is a simple non-invasive method that may provide valuable information for detecting underlying malignancy.Several studies have investigated the diagnostic value of cytology in breast cancer patients with pathological nipple discharge,but the results have been highly variable.Herein we presented a systematic review and meta-analysis of published studies pertaining to the diagnostic capacity of nipple discharge cytology in patients with breast cancer.Methods:A systematic literature search was performed (Medline/PubMed,Embase,Cochrane Library databases,and Google Scholar) to identify studies that investigated the diagnostic capacity of cytology with regard to breast cancer in patients with pathologic nipple discharge.Two independent researchers identified articles that assessed the sensitivity and specificity of cytological evaluation for breast cancer detection in patients with pathologic nipple discharge published between January 2000 and October 2018.Articles were only included in the meta-analysis if they met predetermined criteria.The characteristics of each study and the data they yielded were summarized.Quality assessment of all articles included was performed using the Methodological Index for Non-randomized Studies Criteria (MINORS) and the Quality Assessment of Diagnostic Accuracy Study 2 (QUADAS-2).Heterogeneity was tested via Cochran Q test and the I2 statistic using Stata 12.0 and Meta-DiSc 1.4 software,and meta-analysis was performed.Results:A total of 286 articles were identified,of which 12 articles including a total of 1476 patients were deemed eligible for inclusion in the meta-analysis.A random-effects model assessing the capacity of nipple discharge cytology to predict breast cancer yielded pooled sensitivity 63％ (95％ confidence interval [CI]:53％-72％),specificity 95％ (95％ CI:87％-98％),positive likelihood ratio 12.35 (95 ％ CI:4.87-31.34),and negative likelihood ratio 0.39 (95 ％ CI:0.30-0.50).The diagnostic odds ratio was 31.88 (95％ CI:11.30-89.98).The area under the summary receiver operating characteristic curve was 0.79 (95％ CI:0.75-0.82).Conclusion:The current meta-analysis suggests that nipple discharge cytology is a useful diagnostic modality for detection of breast cancer in patients with pathological nipple discharge,with moderate sensitivity and high specificity.

Background Femtosecond laser in situ keratomileusis (LASIK) inevitably injury keratocytes and corneal nerve fibers.The research report about postoperative morphological changes of corneal nerve regeneration and keratocytes in femtosecond LASIK is still rare.Objective The aim of this study was to observe the kinetic changes of keratocytes and corneal nerve in corneal flap after femtosecond LASIK.Method Femtosecond laser manufacture corneal flap of LASIK surgery was performed on 60 eyes of 30 patients with refractive error using both femtosecond laser system and excimer laser treatment system.The repair of corneal wound was examined by slit lamp microscope,and the morphology of keratocytes and corneal nerve were observed with confocal microscope 1 week,1month,3 months after surgery,respectively.Results No haze or flap folds were found under the slit lamp microscope from 1 week through 3 months after operation.One week after surgery,the corneal stromal cells at the interface of the corneal flap appeared to be a mild activation status in 42 eyes (70％),but the activated cells gradually reduced with lapse of time.Three months after surgery,mild activation state still was found in 7 eyes (12％).One week after surgery,independent,short (＜50 μm),curved subbasal nerve fibers were exhibited in 7 eyes (12％),and curved filamentous nerve fibers were discovered in 48 eyes (80％) one month after surgery.The nerve fiber length of subbasal nerve was ＞200 μm in 27 eyes (45％) and classes beaded structure appeared 3 months after operation but were still different with preoperative subbasal nerve fibers.One week after the operation,filaments or discontinuous nerve fibers could been seen in 46 eyes (77％) at theinterface,and long nerve fibers or filamentous nerves were visible around the terminal or periphery of nerve fibers in 49 eyes (82％) one month after surgery,and long nerve fibers or filaments of nerve fibers were visible in 57 eyes (95％) 3 months after the surgery.Conclusions Femtosecond LASIK cause wound reaction at cellular level.Corneal nerve fibers recover with the extension of time,but there are still some morphological differences 3 months after surgery from preoperation.

Objective To compare the prophylactic efficacy of combination of ganciclovir and acy- clovir or acyclovir alone against cytomegalovirus pneumonia in renal transplant recipients.Methods A to- tal of 217 renal transplant recipient(124 men and 93 women;mean age,32 years;age range,16-72 years) were divided into 3 groups randomly.In 51 cases,acyclovir was taken orally at a dose of 400 mg,3/d,from the third d to 3 months after transplantation.In 74 cases,ganciclovir was administered at a dose of 250 mg/d intravenously from the 21st d to 27th d to replace Acyclovir.In 92 cases,no prophylaxis against eytomegalov- irus pneumonia was performed.All patients were followed 3 months after transplantation.Comparison of the incidence rates of cytomegalovirus pneumonia among the 3 groups was performed using Fisher's exact test. Results Cytomegalovirus pneumonia developed in 20 cases in the 3 groups,including 4 cases(5.4%) in combined use group,2 cases(3.9%)in acyclovir alone group,and 14 cases(15.2%)in control group. Significant difference existed between the 2 experimental and control groups(P＜0.05).However,no signifi- cant difference existed between the 2 experimental groups(P＞0.05).Of the 20 cases,17(85.0%)were cured,and 3 died of respiratory failure.Conclusions Ganciclovir and acyclovir have prophylactic effect a- gainst cytomegalovirus pneumonia in renal transplant recipients.These 2 medications are inexpensive,and the patients have good compliance.

OBJECTIVETo investigate the effects of astragalus on tubulointerstitial lesions in rats with IgA nephropathy (IgAN) and to explore the possible mechanism.

METHODSTwenty-eight Sprague-Dawley rats were randomly assigned to three groups. The rat model of IgA nephropathy was induced by intragastric administration of bovine serum albumin and injections of LPS and CC14. Six weeks later, the rats with IgAN were randomly treated with oral astragalus (3 g/kg/d, for 6 weeks) or normal saline. Normal control rats which were not subjected to IgAN were treated with normal saline. The number of urinary erythrocytes and urinary protein and B-D-N-Acetyl glucosaminidase (NAG) contents were determined by Pan-automatic biochemistry analyzing meter. Expression of monocyte chemotactic protein-1 (MCP-1) and nuclear factor-kappa B (NF-kappaB) in tubulointerstitial tissues were analyzed by immunohistochemistry. A semiquantitative score was used to evaluate the degree of renal pathologic lesions.

RESULTSThe number of urinary erythrocytes (74.02+/-16.58 / microL vs 383.23+/-4.94 /microL) and urinary protein (13.88+/-4.94 vs 59.82+/-14.73 mg/L) and NAG contents (2.84+/-0.31 vs 5.24+/-0.80 U/L) in the astragalus-treated IgAN rats decreased remarkably compared with those in the IgAN rats without astragalus treatment (P<0.01). Expression of the NF-kappaB and MCP-1 in the renal tissues in the IgAN rats without astragalus treatment was significantly higher than that in the astragalus-treated IgAN rats and normal control rats (P<0.01). There were significant differences in the scores of renal pathologic lesions between the IgAN rats with or without astragalus treatment (6.03+/-0.46 vs 10.57+/-1.23; P<0.01).

CONCLUSIONSAstragalus can decrease the number of urinary erythrocytes and urinary protein and NAG contents, and relieves tubulointerstitial lesions, possibly through the down-regulation of NF-kappaB and MCP-1 expression in rats with IgAN.

Animals ; Astragalus Plant ; Chemokine CCL2 ; analysis ; Glomerulonephritis, IGA ; drug therapy ; metabolism ; pathology ; Immunohistochemistry ; Kidney Tubules ; pathology ; Rats ; Rats, Sprague-Dawley ; Transcription Factor RelA ; analysis

OBJECTIVETo compare the therapy efficiency of immediate implanting breast reconstruction after skin sparing mastectomy and modified radical mastectomy in breast cancer.

METHODSThis study retrospectively analyzed 530 female patients with early breast cancer operated in the department of General Surgery, Beijing Chaoyang Hospital, from Jan. 2004 to Dec. 2008, including 91 patients operated with skin sparing mastectomy and immediate implanting breast reconstruction and 439 patients with modified radical mastectomy. The follow up ended in Mar. 2010. By comparing complications, local recurrence, distant metastases and mortality rates between the two groups, the research was done to evaluate the therapy efficiency.

RESULTSIn the group of immediate implanting reconstruction, 84 patients completed follow up with the median follow-up time of 35 months (14 - 72 months) while the local recurring rate was 2.4%, distant metastasis rate was 8.3% and mortality rate was 6.0%. In the group of modified radical mastectomy, 398 patients completed follow up with the median follow-up time of 36 months (12 - 74 months) while the local recurring rate was 3.3%, distant metastasis rate was 9.5% and mortality rate was 6.5%. Therefore there was no obvious statistic difference between the two groups in local recurring rate, distant metastasis rate and mortality rate (P > 0.05). Evaluation of aesthetic results was done in the 84 patients after immediate implanting reconstruction for 12 months which was 93% as good or excellent by surgeons while 87% by patients. Surgeons and patients were both satisfied with the breast appearance.

CONCLUSIONFor patients with early stage breast cancer, combining standard postoperative therapy, skin sparing mastectomy and immediate implanting reconstruction could achieve the same effect as the traditional modified radical mastectomy, while reconstruction would bring about better appearance and higher quality of life.

Adult ; Breast Implantation ; Breast Neoplasms ; surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; methods ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective To investigate the effect on adhesion and motion capbilities of adenoid cystic carcinoma(ACC) , by detecting the expression of nerve growth factor (NGF) , E-cadherin (E-cad) and S100A4 and the clinical significance in ACC tissues and analyzing the relationships between them with perineural invasion(PNI). Methods The expression of NGF, E-cad and S100A4 in ACC was detected with the way of immunohistochemistry SP, and then analyzing the expression level of them in different pathological types and histological regions in statistical ways on the basis of their relation with clinical and pathological parameters. Results The expression of NGF and S100A4 in PNI group [ 88% (23/26) and 77% (20/26) ] , was higher than that in NPNI group (8/16 and 7/16, P <0.05), and a positive correlation between them was identified in PNI group(r =0. 316,P <0.05). However the E-cad expression was lower in PNI group[31%(8/26) ,P<0. 05]. On the other hand it suggested a negative correlation with NGF (r = 0.385, P<0.05) as well as that with S100A4(r = -0.612,P =0.000). The expression level of NGF in fasciculus[ 83% (25/30)] has significant deviation compared with it in distant tumor tissues [ 47% (14/30), P<0. 05]. Conclusions In the PNI process of ACC, NGF plays important parts but not the only factor. It can increase the expression and activity of S100A4 but decrease E-cad expression through binding with its receptor. Thus, adhesion abilities of tumor cells was weakened and motional abilities was strengthen.

OBJECTIVESystematic reviews of diagnostic value of the nuclear matrix protein 22 (NMP22) and urine cytology for bladder cancer.

METHODSDevelopment of inclusion criteria, exclusion criteria and search strategy to retrieve relevant literature. Screening the literature according to inclusion criteria and exclusion criteria. Quality evaluation of the screening and data extraction, using MetaDiSc 1.4 software for Meta analysis.

RESULTSIn total, 266 relevant studies were searched, excluded 256 studies, and then 10 studies were included, with 4895 patients involved. The pooled sensitivity and specificity of NMP22 to detect bladder cancer were 0.76 (95%CI: 0.74 - 0.77), 0.80 (95%CI: 0.79 - 0.82), respectively. The pooled sensitivity and specificity of urine cytology were 0.36 (95%CI: 0.34 - 0.38), 0.94 (95%CI: 0.93 - 0.95), respectively. The area under curve (AUC) for NMP22 and urine cytology were 0.8533 and 0.8628, and Q(*) index were 0.7863 and 0.7934, respectively.

CONCLUSIONSFor the diagnosis of bladder cancer, the sensitivity of NMP22 was higher than urine cytology, but the specificity was lower than urine cytology. Overall diagnostic performance of NMP22 was medium, it was no significant difference with urine cytology. It can't replace urine cytology now.

Cytological Techniques ; Humans ; Nuclear Proteins ; analysis ; Sensitivity and Specificity ; Urinalysis ; Urinary Bladder Neoplasms ; diagnosis

OBJECTIVETo investigate the feasibility of using adipose tissue derived stem cells (ASCs) to promote neovascularization and survival rate of free fat transplantation.

METHODSASCs were isolated from aspirates from human liposuction and cultured in vitro. The cells were incubated in adipogenic, osteogenic, and chondrogenic medium for 2-4 weeks to induce adipogenesis, osteogenesis and chondrogenesis, respectively. ASCs were labelled by DiI. ASCs (A group), Insulin (B group), Medium (C group) were respectively mixed with free fat graft from aspirates. The mixtures were injected subcutaneously at the three random points on the back of eighteen 4- 6-week-old nude mice. Transplanted fat tissue was harvested after 6 months. The grafts were assessed by morphological observation, HE staining and immunohistochemistry.

RESULTSASCs can be easily harvested from liposuction aspirates and differentiate into adipogenic, osteogenic, chondrogenic lineages. The wet weight of transplanted fat tissue in ASCs group was (165.97 +/- 5.51) mg, significantly higher than that in the insulin group (93.42 +/- 5.12) mg and control group (67.64 +/- 5.09) mg (P = 0.000). The rate of fibrosis and steatonecrosis in ASCs group was( 152.2 +/- 9.8)/10HF, significantly lower than that in the Insulin group (743.9 +/- 20.4)/10HF and control group (892.2 +/- 16.5)/10HF (P = 0.000). DiI labelled ASCs were found between adipocytes and in the connective tissue in free transplanted fat tissue, and some of these cells were immunopositive for antihuman CD31 and FITC, suggesting differentiation into vascular endothelial cells.

CONCLUSIONSASCs can differentiate into vascular endothelial cells and contribute to angiogenesis in free transplanted fat tissue. ASCs can increase the survival rate and decrease the rate of fibrosis and steatonecrosis of free transplanted fat tissue. These findings suggest that ASCs-assisted transplantation may be an ideal cell therapy.

Adipocytes ; cytology ; Adipose Tissue ; cytology ; transplantation ; Adult ; Animals ; Cell Differentiation ; Cells, Cultured ; Feasibility Studies ; Female ; Graft Survival ; Humans ; Mice ; Mice, Nude ; Neovascularization, Physiologic ; Stem Cells ; cytology ; Tissue Scaffolds