As an important surgical approach,breast cancer conservation therapy is still controversial in breast cancer patients with BRCA1/2 mutations.Since the risk of unilateral multiple and contralateral incidences is high in the familial breast cancer patients with BRCA1/2 mutations,breast cancer conservation therapy is not recommended but mastectomy and/or immediate mamoplasty.However,if carriers have a strong desire of breast cancer conservation therapy,it is feasible if they are fully informed the risks that may exist.At that time,we should need bilateral oophorectomy,tamoxifen therapy,and more interventions for the prevention of contralateral breast incidences.

Breast Neoplasms ; classification ; pathology ; Female ; Humans ; World Health Organization

Objective To review curative effect of coronary artery bypass grafting(CABG).Methods 10 patients are off-pump CABG at normal body temperature.The rest 222 were done with CPB under general anesthesia,hypothermia.Before operation cardiopulmonary function Was adjusted.During operation the function of heart,brain and renal Was carefully protected.After operation blood slucose was controlled,inflammation was prevented and pulmonary physical therapy was given to all patients.Results 226 patients discharged recovery and free of angina pectoris completely.3 patients with CABG died of low cardiac output after operation.1 patient died of effects of protamine allergy.2 patients died of multiple organ failure.Follow-up has been done in 211 patients for 2 months to 3 years,all leading normal life and working.Conclusion Careful and standardized preoperative and pefioperative treatment is one of the factors of SUCCeSSful coronary artery bypass grafting.

The effect of nateglinide or sequential treatment with metformin on glycemic stability in newly diagnosed type 2 diabetes was investigated. Thirty-four cases of newly diagnosed type 2 diabetes received nateglinide therapy, or sequential treatment with metformin according to fasting and postprandial blood glucose, and were classified into isolated nateglinide therapy group(n=14) and sequentially treated with metformin group(n=20). Glycemic stability, reflected by mean amplitude of glycemic excursions(MAGE) and HbA1C, was determined in all patients before and after therapy for three months. HbA1C and MAGE in two groups were all improved after treatment(P＜0.05). The therapy of nateglinide alone or combined with metformin can significantly improve glycemic stability in newly diagnosed type 2 diabetes.

Objective To investigate the antitumor activity of the oncolytic adenovirus expressing lipocalin 2 gene for colorectal cancer in vivo.Methods BALB/C nude mice subcutaneously inoculated by SW620 cells and grown tumors were treated with injection of ZD-55 virus, Ad-lipocalin 2 virus and ZD55- lipocalin 2 virus respectively.The weight of implanted tumors and the tumor inhibition rate were calculated to evaluate the anti-tumor effect.Cell apoptosis was determined by TUNEL and the protein expression of VEGF and MVD were determined with immunohistochemistry.Results ZD55-lipocalin 2 inhibited the growth of transplanted tumor more significantly than ZD-55 virus and Ad-lipocalin 2 virus ( P ＜ 0.05 ).Tumor cell apoptosis was upregulated and the MVD reduced significantly in ZD55-lipocalin 2 group in contrast to the other two groups (P ＜0.05).Conclusions ZD55-lipocalin 2 induces apoptosis of colorectal tumor cells and inhibits tumor microvascular formation, slowing down the growth of transplantation tumors.

ObjectiveTo observe the effect of the combined therapy of ginkgo-dipyridimolum and mecobalamin for diabetic peripheral neuropathy (DPN).MethodsA total of 102 DPN cases were randomly divided into treatment group(n =50) and control group(n =52).The treatment group was given ginkgo-dipyridimolum and mecobalamin, and the control group was given only mecobalamin for 4 weeks.We observed the change of symptom and sign of both groups before and after treatment,and the MNCV and SNCV of median nerve,ulnar nerve and peroneal nerve were detected.ResultsIn the treatment group, the improvement of DPN symptoms (x2 = 10.090, P ＜ 0.01) and nervous conducting speed were much more obvious than that in the control group(MNCV of median nerve, ulnar nerve and peroneal nerve was(49.12 ± 3.32) m/s, (52.11 ± 3.12) m/s and(47.32 ± 3.21) m/s respectively; SNCV of median nerve,ulnar nerve and peroneal nerve was(47.13 ± 2.56) m/s, (55.12 ± 2.31) m/s, (46.78 ± 2.66) m/s respectively,all P ＜0.05).ConclusionThe combined therapy of ginkgo-dipyridimolum and mecobalamin could effectively improve the therapeutic outcome of DPN, and the treatment was safe and worthy of widespread use.

Objective To discuss the feasibility and reproducibility of left ventricular volume and function of patients with left atrial remodeling and left ventricular remodeling by 3-dimensional echocardiography HeartModel (3D-HM).Methods Three-dimensional images of 156 subjects were collected under HMACQ imaging mode.They were assigned into three groups:① control group (group A,n =70);② group of left ventricular remodeling after,acute myocardial infarction (group B,n =17);③group of hypertension left atrial remodeling (group C,n =69).3D-HM method was used for quantifying left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left atrial end-systolic volume (LAESV) and left ventricular ejection fraction (LVEF),and the results were compared with conventional 3D-manual results.The reproducibility of the 3D-HM method within one group and among different groups was evaluated.Results There was a significant difference in all the parameters measured with the 3D-HM method in different groups(P ＜0.05).LVEDV,LVESV,and LAESV in group B were higher than those in group A and group C(P ＜0.05),and LVEF was lower than that in group A and group C(P ＜0.05),LAESV of group C was higher than that of group A(P ＜0.05).The difference in the measurements of LVEDV and LVESV between the two methods was greatest in group B compared with group C and group A(P ＜0.05).In group C,the measured value difference of LAESV between two methods was greater than that of group A (P =0.03).There was closer correlation among LVEDV,LVESV,LAESV and LVEF measured values of 3D-HM method as well as measured values of the 3D-manual method (r =0.94,0.97,0.91 and 0.90).The data post-processing time of 3D-HM was significantly shorter than that of 3D-manual (P ＜0.05).The inter-observer and intra-observer difference of measured values of 3D-HM method had no statistical significance (P ＞0.05).Conclusions 3D-HM is a fast and feasible technique with high reproducibility for quantifying the left ventricular volume and function in patients with left atrial remodeling and left ventricular remodeling.

Objective To dynamically monitor the changes of peripheral blood lymphocyte subsets of renal transplant recipients and investigate the relationship between lymphocyte subsets with infection and rejection.Methods The clinical data of allogenic kidney transplantation recipients and living relative donors in the Department of Kidney Transplantation of the First Affiliated Hospital of Zhengzhou University were prospectively collected from June 2015 to December 2016.The data of lymphocyte subsets and other related indexes were obtained from renal transplant recipients and relatives of the same period.Results Sixty-four cases of living-relative donors and 351 cases of renal transplant recipients were enrolled in this study,and the recipients were divided into 3 groups:infection group (67 cases),acute rejection group (46 cases),and stable group (238 cases),according to the diagnostic criteria.There was significant difference in the concentration distribution of lymphocytes between the stable group and the control group (P<0.05).The stable frequency distribution range of the stable group was as follows (cells/μL):Lym (1 000-1 500),T (<1 500),CD4+ (<1 000),CD8+ (<1 000),B (<300),NK (100-300),CD4+/CD8+ (0.5-1.0).The number of Lym,T,CD4+,CD8+,NK and B cells in the preoperative patients was less than that in the healthy population (P<0.05);The number of Lym,T,CD4+, CD8+,B and NK cells was gradually decreased in the postoperative infection group,which was less than that in the stable group (P<0.05).After treatment the indicators gradually restored to the level in the stable group level;the number of T,CD4+,CD8+,B cells was highly correlated with infection.The number of T and CD4+ cells,and CD4+/CD8+ ratio were significantly increased in acute rejection group as compared with the stable group,and gradually decreased after the rejection was reversed.The number of T,CD4+,CD8+ cells was highly correlated with rejection.Lymphocyte subsets had a predictive effect on infection and rejection of recipients,and CD4+ cell count and CD4+/CD8+ ratio were independent risk factors.Conclusion The monitoring of lymphocyte subsets has an important clinical value in the evaluation of immune status and individual treatment of renal recipients.

Objective To observe the therapeutic efficacy of ozone injection in treating lumbar disc herniation. Methods One hundred and four patients with CT or MRI proved lumbar disc herniation, including 144 diseased lumbar discs, were enrolled in this study. The main complains were severe pain or numbness in the low back and lower limbs. Under the X-ray guidance, a 21 G needle was punctured into the disc, followed by an injection of 4-40 ml ozone (50 ug/ml) and 40 mg prednisolone acetate into intradiscal and paravertebral space. Results All patients were followed up for 3 to 84 months with an average time of 38 months. The last follow-up check was carried out in March of 2009. The total effective rate was 77.1%, with no occurrence of any serious complications. Conclusion The percutaneous injection of medical ozone into disc and paravertebral space is an effective and safe method for the treatment of lumbar disc herniation.

Objective To investigate the status of living relative kidney transplantation, and the clinical effects and social significances of kidney transplantation between spouses. Methods We retrospectively collected the clinical data of the department of kidney transplant of the First Affiliated Hospital of Zhengzhou University, from January 2011 to December 2013. The spouse group as group 1, the age and sex of doners were taken into account,the siblings with the similar age of the same period were enrolled in group 2. Then the postoperative recoveries of the two groups were compared. Considering the current social status, particularly the shortage of donor kidneys, the clinical, social and family significances of kidney transplantation between spouses were analyzed. Results Twelve cases of spouses in group 1, 8 cases of siblings in group 2 , the differences of donor and recipient age of the two groups were 0.33 ± 0.98 years and 2.29 ± 7.23 years, respectively. The human major histocompatibility complex antigens (HLA) was less than three in group 1, and was greater than or equal to three in group 2. The changes of serum creatinine and urea nitrogen were analyzed. No significant differences of serum creatinine and downward trend of blood urea nitrogen were observed between two groups (P = 0.84, P = 0.79). Conclusion The kidney transplantation between spouses has good clinical efficacy and great social significance, improving the status of the shortage of donor kidney and contributing to family harmony. The renal transplantation between spouses has obvious advantages and need further promotion.