Breast cancer susceptibility gene 1 (BRCA1) is a tumor suppressor gene, whose encoded proteins play an important role in cell-cycle regulation, DNA damage repair, induction of apoptosis in damaged cells and the maintenance of genomic stability. Some foreign studies reported the down-regulation of BRCA1 expression in initial treatment leukaemia, and this result may have clinical implications for surveillance of therapy and prognosis .In this review, the construction features, biological characteristics of BRCA1 and the expression of BRCA1 in lenkaemia and lymphoma were covered.

Objective To investigate the expression and significance of breast cancer suscepterbility gene 1 (BRCA1) in leukemia.Methods Fluorescent quantitative reverse transcription-polymerase PCR was used to investigate the expression of BRCA1 in 18 patients with ALL-L2 (13 denovo ALL patients,5 relapsed ALL patients),20 patients with CML-CP and 15 normal controls.Results The mRNA expression of BRCA1 in denovo patients with ALL was lower than that in normal control,with statistical significance (P ＜ 0.05).The mRNA level of BRCA1 in ALL patients in CR was higher compared with before to cure, with statistical significance (P ＜ 0.05),but lower than that in normal control,without statistical significance(P ＞ 0.05).The mRNA expression of BRCA1 in patients with relapsed ALL was lower than that in normal control with statistical significance (P ＜ 0.05), and lower than that in denovo patients with ALL, without statistical significance (P ＞ 0.05).The mRNA level of BRCA1 showed no difference in CML-CP patients compared with normal control (P ＞ 0.05). Conclusion The different expression of BRCA1 in leukemia indicates that he has closely relationship with the prognosis of leukemia and guides the clinical diagnosis and treatment.

Objective:To evaluate the optimization strategy of labor analgesia in obese parturients using dural puncture epidural (DPE) combined with programmed intermittent epidural bolus (PIEB).Methods:Eighty American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ obese primiparae, who were at full term with a singleton fetus in vertex presentation, aged 20-40 yr, with body mass index of 30-40 kg/m 2, at 37-42 week gestation, with cervical dilation of 2-5 cm, and with visual analogue scale score ≥50 mm, were divided into 2 groups ( n=40 each) using a random number table method: DPE plus PIEB group (DPEP group) and DPE plus continuous epidural infusion group (DPEC group). All parturients received DPE labor analgesia, and parturients received PIEB (DPEP group) and continuous epidural infusion (DPEC group) to maintain analgesia during labor. In DPEP group, the patient-controlled epidural analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval and background infusion at 2 ml/12 min after an initial dose of 8 ml. In DPEC group, the patient-controlled epidural analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval and background infusion at 10 ml/h after an initial dose of 8 ml. The analgesia solution contained 0.1% ropivacaine plus 0.3 μg/ml sufentanil. The time to achieve adequate analgesia, consumption of ropivacaine per unit time, height of sensory block at the thoracic vertebral level, modified Bromage score, effective pressing times of patient-controlled analgesia, the number of rescue analgesia, Apgar score, delivery mode, occurrence of adverse reactions and maternal satisfaction with labor analgesia were recorded. Results:Compared with DPEC group, the time to achieve adequate analgesia was significantly shortened, the consumption of ropivacaine per unit time was decreased, and the number of rescue analgesia and effective pressing times of patient-controlled analgesia were decreased in DPEP group ( P<0.05). There were no significant differences in the height of sensory block at the thoracic vertebral level, modified Bromage score, Apgar score, delivery mode, incidence of adverse reactions and maternal satisfaction with labor analgesia between the two groups ( P>0.05). Conclusions:DPE combined with PIEB offers faster onset and better effect and achieves a greater local anesthetics-sparing effect when used for labor analgesia in obese parturients.

Objective:To investigate the clinical features of IgD multiple myeloma (MM) and the effect and prognosis of daratumumab-based combination therapy.Methods:The clinicopathological data of a IgD MM patient with disease progression and extramedullary infiltration treated with daratumumab in the Affiliated Hospital of Qingdao University in December 2019 were retrospectively analyzed.Results:The 74-year-old woman was diagnosed as IgD MM by bone marrow aspiration and immunofixation electrophoresis. The patient was given VD (bortezomib, dexamethasone), RD (lenalidomide, dexamethasone) and ID (ixazomib, dexamethasone) regimens. In June 2020, the patient developed multiple subcutaneous nodules, and she was assessed as progressive disease with extensive extramedullary infiltration. After treated with daratumumab-PAD (liposomal doxorubicin, bortezomib, dexamethasone) regimen, the patient's subcutaneous nodules were significantly reduced and partially disappeared, and the general condition was significantly improved. But the patient was in a cachexia state and finally died of the irregular treatment and disease progression.Conclusions:IgD MM has a low incidence and a short survival period, and there is no uniform standard treatment. The early application of daratumumab combined with proteasome inhibitors, immunomodulators, cytotoxic drugs and hematopoietic stem cell transplantation may improve the overall survival of patients.

Purpose: The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear. Methods: Data was collected from patients who had poor responses to NAC and underwent modified radical surgery from January 2013 to December 2018. The interval from completion of NAC to surgery was divided into two groups: a longer (greater than four weeks) or shorter (four weeks or less) interval. The associations of these interval groups with overall survival (OS) and recurrence-free survival (RFS) were evaluated by multivariable Cox models adjusting for the existing prognostic factors. Propensity score matching (PSM) was used to minimize election bias. Results: A total of 1,229 patients (mean age, 47.2 ± 8.9 years; median follow-up duration, 32.67 [6.57–52.63] months) were included. The 5-year OS rates were 73.2% and 60.8% in the shorter (n = 171) and longer interval group (n = 1,058), respectively, while the 3-year RFS rates were 80.8% and 71.7%, respectively. In multivariate Cox analysis, the longer interval was associated with an increased risk of mortality (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.01–2.02; p = 0.046) and recurrence (HR, 1.50; 95% CI, 1.12–1.99; p = 0.006).There was an interaction between the molecular subtype and the surgery interval for OS (pinteraction = 0.014) and RFS (pinteraction = 0.027). After PSM, no significant difference in OS (p = 0.180) and RFS (p = 0.069) was observed between the two groups. Conclusion Among LABC patients with a poor response, those with a longer interval between NAC and surgery had worse OS and RFS. The results indicate that these patients should receive modified radical surgery timely, which may in turn improve their prognosis.

Purpose: The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear. Methods: Data was collected from patients who had poor responses to NAC and underwent modified radical surgery from January 2013 to December 2018. The interval from completion of NAC to surgery was divided into two groups: a longer (greater than four weeks) or shorter (four weeks or less) interval. The associations of these interval groups with overall survival (OS) and recurrence-free survival (RFS) were evaluated by multivariable Cox models adjusting for the existing prognostic factors. Propensity score matching (PSM) was used to minimize election bias. Results: A total of 1,229 patients (mean age, 47.2 ± 8.9 years; median follow-up duration, 32.67 [6.57–52.63] months) were included. The 5-year OS rates were 73.2% and 60.8% in the shorter (n = 171) and longer interval group (n = 1,058), respectively, while the 3-year RFS rates were 80.8% and 71.7%, respectively. In multivariate Cox analysis, the longer interval was associated with an increased risk of mortality (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.01–2.02; p = 0.046) and recurrence (HR, 1.50; 95% CI, 1.12–1.99; p = 0.006).There was an interaction between the molecular subtype and the surgery interval for OS (pinteraction = 0.014) and RFS (pinteraction = 0.027). After PSM, no significant difference in OS (p = 0.180) and RFS (p = 0.069) was observed between the two groups. Conclusion Among LABC patients with a poor response, those with a longer interval between NAC and surgery had worse OS and RFS. The results indicate that these patients should receive modified radical surgery timely, which may in turn improve their prognosis.

Purpose: The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear. Methods: Data was collected from patients who had poor responses to NAC and underwent modified radical surgery from January 2013 to December 2018. The interval from completion of NAC to surgery was divided into two groups: a longer (greater than four weeks) or shorter (four weeks or less) interval. The associations of these interval groups with overall survival (OS) and recurrence-free survival (RFS) were evaluated by multivariable Cox models adjusting for the existing prognostic factors. Propensity score matching (PSM) was used to minimize election bias. Results: A total of 1,229 patients (mean age, 47.2 ± 8.9 years; median follow-up duration, 32.67 [6.57–52.63] months) were included. The 5-year OS rates were 73.2% and 60.8% in the shorter (n = 171) and longer interval group (n = 1,058), respectively, while the 3-year RFS rates were 80.8% and 71.7%, respectively. In multivariate Cox analysis, the longer interval was associated with an increased risk of mortality (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.01–2.02; p = 0.046) and recurrence (HR, 1.50; 95% CI, 1.12–1.99; p = 0.006).There was an interaction between the molecular subtype and the surgery interval for OS (pinteraction = 0.014) and RFS (pinteraction = 0.027). After PSM, no significant difference in OS (p = 0.180) and RFS (p = 0.069) was observed between the two groups. Conclusion Among LABC patients with a poor response, those with a longer interval between NAC and surgery had worse OS and RFS. The results indicate that these patients should receive modified radical surgery timely, which may in turn improve their prognosis.

Purpose: The interval between neoadjuvant chemotherapy (NAC) and surgery for locally advanced breast cancer (LABC) remains controversial. At the same time, the prognostic effect of delayed surgery in patients with poor responses is currently unclear. Methods: Data was collected from patients who had poor responses to NAC and underwent modified radical surgery from January 2013 to December 2018. The interval from completion of NAC to surgery was divided into two groups: a longer (greater than four weeks) or shorter (four weeks or less) interval. The associations of these interval groups with overall survival (OS) and recurrence-free survival (RFS) were evaluated by multivariable Cox models adjusting for the existing prognostic factors. Propensity score matching (PSM) was used to minimize election bias. Results: A total of 1,229 patients (mean age, 47.2 ± 8.9 years; median follow-up duration, 32.67 [6.57–52.63] months) were included. The 5-year OS rates were 73.2% and 60.8% in the shorter (n = 171) and longer interval group (n = 1,058), respectively, while the 3-year RFS rates were 80.8% and 71.7%, respectively. In multivariate Cox analysis, the longer interval was associated with an increased risk of mortality (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.01–2.02; p = 0.046) and recurrence (HR, 1.50; 95% CI, 1.12–1.99; p = 0.006).There was an interaction between the molecular subtype and the surgery interval for OS (pinteraction = 0.014) and RFS (pinteraction = 0.027). After PSM, no significant difference in OS (p = 0.180) and RFS (p = 0.069) was observed between the two groups. Conclusion Among LABC patients with a poor response, those with a longer interval between NAC and surgery had worse OS and RFS. The results indicate that these patients should receive modified radical surgery timely, which may in turn improve their prognosis.

Objective:To explore the application effect of pelvic floor outpatient intervention during pregnancy on vaginal delivery of full-term primiparous women.Methods:Single birth primipara who were willing to establish a card and have a desire to give birth naturally in the First People's Hospital of Longquanyi District from January 2021 to December 2021 were divided into odd and even number groups according to the order of filing:the odd group received routine obstetric outpatient management and pelvic floor outpatient intervention(Kegel exercise joint perineum massage)in 200 cases(research group),and even number group received routine obstetric outpatient management in 200 cases(control group).The incidence of vaginitis,cesarean section rate,vaginal delivery rate,obstetric laceration,vaginal midwifery rate,perineal incision,delivery outcome and the length of perineal body and reproductive hiatus before and 42 days after delivery,vaginal width andother vaginal delivery complications(urina-ry retention and puerperal hemorrhoids)were compared between the two groups.Results:87 cases were includ-ed in the final study group,while 104 cases were included in the control group.The perineal incision rate,perineal integrity rate,vaginal midwifery rate,l degree and Ⅱ degree perineal laceration rate,postpartum hemorrhage in the study group were better than those in the control group(P＜0.05).The length of reproductive hiatus 42 days after delivery in the study group was shorter compared with that in the control group(P＜0.05).There were no signifi-cant differences in the incidence of vaginitis,cesarean section rate,time of the second stage of labor,vaginal wall laceration rate,Apgar score of newborns neonatal birth trauma rate,urinary retention,puerperal hemorrhoids,post-partum vaginal width and perineal body length between the two groups(P＞0.05).Conclusions:Pelvic floor outpa-tient intervention during pregnancy can reduce the harm caused by vaginal delivery in full-term primiparas to a cer-tain extent,and does not increase the incidence of neonatal delivery complications,it is worthy of clinical promotion.

Objective:To explore the application effect of pelvic floor outpatient intervention during pregnancy on vaginal delivery of full-term primiparous women.Methods:Single birth primipara who were willing to establish a card and have a desire to give birth naturally in the First People's Hospital of Longquanyi District from January 2021 to December 2021 were divided into odd and even number groups according to the order of filing:the odd group received routine obstetric outpatient management and pelvic floor outpatient intervention(Kegel exercise joint perineum massage)in 200 cases(research group),and even number group received routine obstetric outpatient management in 200 cases(control group).The incidence of vaginitis,cesarean section rate,vaginal delivery rate,obstetric laceration,vaginal midwifery rate,perineal incision,delivery outcome and the length of perineal body and reproductive hiatus before and 42 days after delivery,vaginal width andother vaginal delivery complications(urina-ry retention and puerperal hemorrhoids)were compared between the two groups.Results:87 cases were includ-ed in the final study group,while 104 cases were included in the control group.The perineal incision rate,perineal integrity rate,vaginal midwifery rate,l degree and Ⅱ degree perineal laceration rate,postpartum hemorrhage in the study group were better than those in the control group(P＜0.05).The length of reproductive hiatus 42 days after delivery in the study group was shorter compared with that in the control group(P＜0.05).There were no signifi-cant differences in the incidence of vaginitis,cesarean section rate,time of the second stage of labor,vaginal wall laceration rate,Apgar score of newborns neonatal birth trauma rate,urinary retention,puerperal hemorrhoids,post-partum vaginal width and perineal body length between the two groups(P＞0.05).Conclusions:Pelvic floor outpa-tient intervention during pregnancy can reduce the harm caused by vaginal delivery in full-term primiparas to a cer-tain extent,and does not increase the incidence of neonatal delivery complications,it is worthy of clinical promotion.