ObjectiveTo study the clinicopathological features of endometrial cancer patients diagnosed during or after tamoxifen (TAM)treatment for breast cancer and to evaluate the relevance between the clinicopathological features and the cessation time of TAM treatment. Methods42 TAM-related endometrial cancers patients in the Affiliated Hospital of Medical Collage of Qingdao University were divided into 2 groups according to the cessation time of TAM.Group B were 20 past TAM users who were diagnosed as endometrial cancer 12 or more months since the cessation of TAM.Group A included the rest 22 patients.The clinicopathological features of the 2 groups were analyzed retrospectively.ResultsThe age of patients was ranging from 32 to 85 years when they were diagnosed endometrial cancer.There was no significant difference in terms of the age at which breast cancer was diagnosed, BMI, HRT, single dose of TAM, duration and cumulative dose between the 2 groups.However, the difference of the age at which endometrial cancer was diagnosed, menopausal status, the interval between diagnostic date of the 2 cancers, histological types, pathological stage, myometrial invasion, and cervical invasion had statistical significance between the 2 groups ( P ＜ 0.05 ). Conclusion Compared with group A, group B have a higher pathological stage and more invasive histological features, which may be because group B include more elderly and postmenopausal patients.

Objective:In order to compare the effect of ascending medial open-wedge high tibial osteotomy and descending medial open-wedge high tibial osteotomy on patellar height.Methods:Our group analyzed 77 patients of medical cases which were closely associated with medial open-wedge high tibial osteotomy for the treatment of knee varus deformity and medial compartment osteoarthritis from May 2011 to December 2018 and 77 cases were effectively followed up, including 36 males and 41 females with an average age of 59.4±10.5. By the way, there are 51 cases of ascending osteotomy and 26 cases of descending osteotomy. During these treatment, we adopted some scientific methods full-length standing anteroposterior radiograph,Miniaci method, Insall-Salvati index (ISI), Caton-Deschamps index (CDI) and Blackburne-Peel Index (BPI) to measure the corresponding parameters and changes in patellar height (PH) at different stages.Results:77 patients were enrolled, the mean follow-up time was 20.6 months (range, 12-60 months), ascending and descending high tibial osteotomy (HTO) show the average degree of varus correction (10.43°±2.67° and 11.16°± 2.80°) respectively. And at the same time, in these cases of ascending HTO, PH decreased by 8.1% (CDI method), 2 cases of low PH (the patellar height decreased by 10%, which is the low patellar) were measured (ISI method), 7 cases of low PH occurred (CDI and BPI). Instead, PH decreased by 4.5% (CDI method) in descending HTO,the difference was significant ( t=2.101, P=0.040). 22 cases of ascending HTO with varus correction less than 10 degrees, the PH decreased by 6.9%. By the way, the ISI method did not detect the occurrence of low PH, but we found one by CDI and BPI. The 29 cases with varus correction of more than 10 degrees in ascending HTO, and PH decreased by 10.4%. There were 2 low PH (ISI method), and 6 low PH (CDI and BPI), the difference was significant ( t=2.310, P=0.028). Conclusion:In ascending HTO, the low PH is closely related to the degree of varus correction. Conversely, The descending HTO did not influence PH.

Objective:To investigate the expression of TIP30 and its relationship with clinico-pathological characteristics in patients with extrahepatic cholangiocarcinoma (ECC).Methods:The expression of TIP30 in 78 cases of ECC tissues and 78 cases of para-cancerous tissues were detected by immunohistochemistry.Results:The positive expression rate of TIP30 was 43.59％ and 75.64％ in ECC tissues and para-cancerous tissues,respectively.Differences were statistically significant (P＜ 0.05).The expression levels of TIP30 were not correlated with age,gender,degree of differentiation and tumor size(P＞0.05),but correlated with lymph node metastasis,distant metastasis and TNM staging(P＜ 0.05).The median overall survival of 78 ECC cases was 14.8 months,and it of TIP30 positive expression cases was 20.3 months,statistically higher than 11.5 months in TIP30 negative expression cases(P＜ 0.01).Conclusion:The downregulation of TIP30 is closely correlated with the development,metastasis and prognosis of ECC.TIP30 may be used as a molecular marker to identify and predict the progression,metastasis and prognosis of ECC.

Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years. In these patients, first time operations were ascending aorta replacement procedure in 3 patients, ascending aorta combined with partial aortic arch replacement in 4 patients, aortic root replacement (Bentall) associated with Marfan syndrome in 3 patients, aortic valve combined with ascending aorta replacement (Wheat) in 1 patient, ascending aorta combined with Sun′s procedure in 1 patient, Wheat combined with Sun′s procedure in 1 patient, Bentall combined with Sun′s procedure in 1 patient. The interval between two operations averaged 0.3 to 10.0 years with a mean of (4.8±3.1) years. The reasons for reoperations included part anastomotic split, aortic valve insufficiency, false aneurysm formation, enlargement of remant aortal and false cavity. The selection of reoperation included anastomotic repair, aortic valve replacement, total arch replacement and Sun′s procedure. Results: Of the 14 patients, the cardiopulmonary bypass times were 107 to 409 minutes with a mean of (204±51) minutes, cross clamp times were 60 to 212 minutes with a mean of (108±35) minutes, selective cerebral perfusion times were 16 to 38 minutes with a mean of (21±11) minutes. All patients survived from the operation, one patient died from severe pulmonary infection 50 days after operation. Three patients had postoperative complications, including acute renal failure of 2 patients and pulmonary infection of 1 patient, and these patients were recovered after treatment. Thirteen patients were finally recovered from hospital. The patients were followed up for 16 to 45 months, and no aortic rupture, paraplegia and death were observed in the follow-up. Conclusions Patients for residual aortic dissection after initial operations on Stanford type A aortic dissection should be attached great importance and always need emergency surgery, but the technique is demanding and risk is great for surgeons and patients, which need enough specification and accurate on aortic operation. More importantly, the Sun′s procedure also should be performed on the treatment of residual aortic dissection or distal arch expansion, and obtains the short- and long-term results in the future.