Objective To explore the relationship between the four different molecular subtypes of locally advanced breast cancer(LABC) and the clinical effect of neoadjuvant chemotherapy containing docetaxel and anthracyclines on breast cancer. Methods The record of 68 patients with LABC who were treated with the therapeutic scheme was reviewed. Breast cancer molecules were diagnosed by core needle biopsy through IHC and were divided into four subtypes. After 3 to 5 courses of treatment, the relationship of molecular subtype and clinical effects was analyzed. Results Univariate analysis showed that absence of estrogen receptor (ER) expression and size of tumor (≤5cm) were predictive factors for clinical complete response (cCR) (P<0.05).Over expression of HER-2 and molecular subtypes were predictive for pathologic complete response (pCR) (P<0.05). pCR rate of HER2+/ER- subtype in this therapeutic scheme was, higher than that of other subtypes and pCR rate of Luminal A subtype was the lowest. Multivariate analysis showed that molecular subtypes cant be the predictive factors for this therapeutic scheme (P>0.05) and only HER-2 (P<0.05) was the independent variable in predicting pCR for this therapeutic scheme. Conclusion Molecular subtypes can not independently predict pCR for neoadjuvant chemotherapy regimen containing docetaxel and anthracyclines.

Objective To explore the feasibility of immediate breast reconstruction with subpectoral implantation of silicon gel prosthesis after nipple-areola complex (NAC) sparing modified radical mastectomy. Methods A total of 28 patients of 0,I,II stage breast cancer were implanted with silicon gel prosthesis immediately after they underwent skin-sparing modified radical mastectomy. NAC conservation depended on frozen section result. Results NAC of all the 28 patients were conserved. During 2-18 months (median15 months) follow-up, bilateral breasts were symmetrical and in good appearance with a 96.5% excellent rate. No local recurrence, distant metastasis or obvious complications occurred. Conclusions Immediate breast reconstruction with subpectoral implantation of silicon gel prosthesis after NAC sparing modified radical mastectomy is proven to be an effective and safe method with the advantage of good appearance and shorter recovery time in early-stage breast cancer.

Objective To evaluate intraoperative tracing of sentinel lymph nodes ( SLNs) by fluorescence imaging combined with carbon nanoparticles .Methods 112 breast cancer patients eligible for sentinel lymph node biopsy were randomly assigned to the combination group (56 cases)receiving indocyanine green (ICG)and carbon nanoparticles as the lymphatic mapping tracers and ICG alone group (56 cases).Intraoperative frozen sec-tion was performed , followed by conventional histopathology .Results In the combination group , subcutaneous lymphatic vessels were successfully visualized in 53 patients and the detection rate was 94.6%(53/56).The flu-orescence SLNs were successfully detected in 54 patients and the detection rate was 96.4%(54/56)in ICG alone group.In the combination group , SLNs were successfully identified in 54 patients by fluorescence and 52 patients by black dyed, and the SLNs detection rate was 100%(56/56).While in the ICG alone group, the SLNs were found in 52 patients and the detection rate was 92.9%(52/56)(χ2 =2.3, P>0.050).The average number of detected SLNs was 3.7 ±1.5 ( 205/56 ) in combination group vs 2.5 ±1.4 ( 130/52 ) in ICG alone group ( t =-3.5, P=0.001).17 metastatic SLNs were found in 10 patients in the combination group vs 12 metastatic SLNs in 9 patients in ICG alone group .Conclusion Combination of ICG and carbon nanoparticles for mapping sentinel lymph nodes in breast cancer patients can increase the number of SLNs detected and the detection rate , reducing the rate of misdiagnosis and false negative rate .

OBJECTIVETo identify the relationship between coagulation factor V (FV) gene single nucleotide polymorphisms (SNPs) and venous thromboembolism (VTE).

METHODSThe FV clotting activity (FV: C) and FV antigen (FV: Ag) in plasma of VTE group (111 patients) and normal control (110 patients) were detected using one-stage clotting assay and ELISA, respectively. Five pairs of primers of the F V polymorphisms including Asp79His, Arg306The, Arg306Gly, Arg506Gln and Ile359The/His1299 Arg were synthesized and amplified by PCR. The PCR products were digested by restriction enzyme using PCR-RFLP. The detected polymorphisms were confirmed by direct sequencing. The samples containing the polymorphisms were screened for coding regions of all F V exons with direct sequencing.

RESULTSThe plasma levels of F V: C and F V: Ag of VTE group and normal control were (106.9 +/- 28.0)%, (110.4 +/- 33.3)% and (102.4 +/- 30.9)%, (102.1 +/- 24.1)%, respectively. The plasma level of FV: Ag was significantly different between VTE group and normal control. However, there was no difference in F V: C levels. Polymorphisms for the fore mentioned 5 primer pairs were not found in either patients or normal controls. Polymorphism of His1299Arg was identified in 5 patients with VTE and 3 normal controls. And these 5 cases also combined Met1736Val polymorphism, 3 of them combined another Asp2194Gly polymorphism.

CONCLUSIONThe higher plasma level of F V: Ag contribute to venous thromboembolism. There is no relationship between polymorphisms of Asp79His, Arg306The, Arg306Gly, Arg506Gln, Ile359The and venous thromboembolism in Chinese studied. Polymorphism His1299Arg is higher in VTE group than in normal control, but has no statistical difference. Polymorphisms of His1299Arg, Met1736Val and Asp2194Gly are linked disequilibrium in Chinese Han population.

Factor V ; genetics ; Female ; Gene Frequency ; Humans ; Linkage Disequilibrium ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Venous Thromboembolism ; genetics

To study the effect of donor TNF-alpha gene polymorphism on severe acute and extensive chronic graft versus host disease (GVHD), TNF-alpha gene polymorphism was analyzed by denaturing high performance liquid chromatography (DHPLC) and DNA sequencing in twenty-one patients with III/IV degree acute GVHD and twenty-seven patients with extensive chronic GVHD. The results showed that the frequency of TNF-alpha-308 (G/A) significantly increased in patients with III/IV degree acute GVHD compared to 0/I degree aGVHD patients (8/21 vs 1/28) (P < 0.01) and the frequency of TNF-alpha-308 (G/A) is significantly higher in patients with extensive chronic GVHD than in patients without chronic GVHD (7/23 vs 1/17) (P < 0.05). However, the frequency of TNF-alpha-238 (G/A) does not significantly changed in patients with III/IV degree acute GVHD and extensive chronic GVHD. In conclusion, the TNF-alpha-308 (G/A) is likely to contribute to high risk for III/IV degree acute GVHD and extensive chronic GVHD.
Base Sequence ; Blood Donors ; Chromatography, High Pressure Liquid ; methods ; DNA ; chemistry ; genetics ; DNA Mutational Analysis ; Female ; Gene Frequency ; Genotype ; Graft vs Host Disease ; etiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Point Mutation ; Polymorphism, Genetic ; Tumor Necrosis Factor-alpha ; genetics

OBJECTIVETo observe the osteoblasts transfected with green fluorescent protein (GFP)by adenovirus vector expressed in vitro and traced it in vivo in order to research the feasibility of GFP as a tracer of seeding cells for tissue engineering.

METHODSCFP were transfected into the osteoblasts which derived from adult human bone marrow stromal cell (hBMSc) by adenovirus vector after being packed in 293A cells. The nontransfected hBMSc was used as the control group. The osteoblasts in each group were observed under an inverted phase contrast microscope and fluorescence microscope. The expressive efficiency of GFP was examined by flow cytometry,and alkaline phosphatase (ALP) activities and osteocalcin (OCN) synthesis. After eight days of the transfection,the osteoblasts were implanted into the muscle of nude mouse thigh while the non-transfected osteoblasts were also implanted as a control. Four and eight weeks after the operation, the nude rats were killed and the continuous tissue sections were examined using fluorescence microscopy after adjacent sections were performed by immunohistochemistry or routine HE staining.

RESULTSThe green fluorescence was shown the transfected osteoblasts which derived from bone marrow. The rate of positive expression was over 75%. After eight days of the transfection, the marker proteins of the surface of the osteoblasts showed extremely efficient expression of CD29 and CD44, but the CD34 expressed negative. Either ALP or OCN of the osteoblasts was no significant difference between the two groups (P > 0.05) four and eight days after the transfection. The GFP were obviously expressed in nude mouse both at four and eight weeks, meanwhile it did not harm on the morphology and function of the transfected osteoblasts whose immunohistochemistry examination showed positive reaction.

CONCLUSIONSGFP could be transfected osteoblasts effectively in vitro and traced in vivo in nude mouse. It may be an optimal tracer for living cells on tissue engineering research.

Adult ; Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cells, Cultured ; Green Fluorescent Proteins ; genetics ; Humans ; Immunohistochemistry ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Osteoblasts ; cytology ; Tissue Engineering ; methods ; Transfection

AIMTo investigate the role of TNF-alpha in vascular endothelial cells injury mediated by freezing/thaw ing PMN.

METHODSFreezing/thawing cell model was founded using rat PMN isolated by dextran sedimentation technique and VEC cultured in vitro. The injury level of VEC was indicated by measuring activity of LDH in medium. The number of frozen/thawed PMN adhering to VEC was counted with Phagocytizing reactive dyes the degree of frozen/thawed PMN and VEC adhesion. Expression of LFA-1 on the surface of frozen/thawed PMN was analyzed with flow cytometry.

RESULTSTNF-alpha could obviously upregulate expression of LFA-1 on surfaced of frozen/thawed PMN. Upregulation of LFA-1 expression promoted adhesion of frozen/thawed PMN and normal VEC,and aggravated VEC injury. Monoclonal antibody against LFA-1 could partly block adhesion of frozen/thawed PMN and normal VEC,and attenuate VEC injury.

CONCLUSIONTNF-alpha can promote expression of LFA-1 on surface of frozen/thawed PMN adhering of frozen/thawed PMN to normal VEC and VEC injury increase, monoclonal antibody against LFA-1 could partly block PMN-VEC adhesion and attenuate VEC injury.

Animals ; Cell Adhesion ; Cells, Cultured ; Endothelial Cells ; drug effects ; Endothelium, Vascular ; cytology ; Freezing ; Lymphocyte Function-Associated Antigen-1 ; metabolism ; Neutrophils ; cytology ; metabolism ; Rats ; Tumor Necrosis Factor-alpha ; pharmacology

Objective To study the prevalence of smoking and its influential factors among pupils in Shandong.Methods A multi-stage stratified-cluster random sampling method was used in the survey.6050 students from 3 different cities of Shandong province were selected as the study population.A self-administered anonymous questionnaire was designed and the survey was conducted by trained investigators.Results The rate of attempting smoking among pupils under study in Shandong province was 6.0％ while the current smoking rate was 1.2％.The average age of children who initiated smoking cigarette was 7.8 ± 2.1 with 80.5％ of them due to curiosity.34.7％ of them got the cigarettes from their families.In terms of the motivation of buying cigarettes,74.3％ of them claimed that the access to purchase was easy.Data from multivariate unconditional logistic regression analysis showed that the smoking behavior of pupils was influenced by their familial or surrounding environments.Conclusion Tobacco control programs on pupils should be strengthened with more powerful control measures including health education.

Objective To compare the clinical effect between percutaneous nephrolithotomy (PCNL) and retroperitoneal laparoscopic pyelolithotomy (RLP) in the treatment of renal pelvis calculus,so as to provide evidence for the treatment of renal pelvis calculus.Methods A total of 108 patients with renal pelvis calculus were selected from January 2012 to December 2016 in Zhumadian Central Hospital.The patients were divided into PCNL group (n =59) and RLP group (n =49) according to the therapeutic method.The operation time,intraoperative blood loss,intraoperative blood transfusion rate,operative success rate,stone clearance rate,postoperative hemoglobin reduction,postoperative analgesia time,postoperative hospitalization time and the incidence of complications were compared between the two groups.Results The success rate of operation in PC-NL group and RLP group was 94.9％ (56/59) and 100.0％ (49/49) respectively,there was no significant difference in the success rate of operation between the two groups (x2 =1.026,P ＞ 0.05).The stone clearance rate in PCNL group and RLP group was 94.9％ (56/59) and 98.0％ (48/49) respectively,there was no significant difference in the stone clearance rate between the two groups (x2 =0.140,P ＞ 0.05).The intraoperative blood transfusion rate in PCNL group and RLP group was 5.1％ (3/59) and 2.0％ (1/49) respectively,there was no significant difference in the intraoperative blood transfusion rate between the two groups (x2 =0.105,P ＞ 0.05).There was no significant difference in operation time and postoperative analgesia time between the two groups (P ＞ 0.05).Compared with the PCNL group,the blood loss and postoperative hemoglobin reduction were less,and the postoperative hospitalization time was shorter in the RLP group (P ＜ 0.05).The incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage in PCNL group was 3.4％ (2/59),8.5％ (5/59)and 6.8％ (4/59) respectively;the incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage in RLP group was 8.2％ (4/49),4.1％ (2/49) and 4.1％ (2/49) respectively;there was no significant difference in the incidence of postoperative urinary leakage,urinary tract infection and secondary hemorrhage between the two groups (x2 =2.975,1.064,1.811;P ＞ 0.05).Conclusion The clinical effect of PCNL and RLP in the treatment of renal pelvis calculus is fairly,and their safety is high.However,RLP has the advantages of less intraoperative bleeding,quick postoperative recovery and short hospitalization time.

Objective To analyze the pathogenic epidemiological characteristics of acute lower respiratory tract infection(ALRTI) in children in Gansu Province from 2012 to 2015. Methods The surveillance data of 458 children infected with ALRTI in 10 sentinel hospitals in Gansu province from 2012 to 2015 were collected, and infection status and epidemiological characteristics of each virus and bacteria were analyzed by descriptive study methods. Results The male to female ratio of the 458 children with ALRTI was 1.81:1, and the positive detection rate of the virus was 33.62%（95% CI：29.28%-37.97%), among which the positive detection rate of respiratory syncytial virus was the highest (12.23%).The positive detection rate of bacteria was 24.84%（95% CI：20.04%-29.65%),among which the positive detection rate of streptococcus pneumoniae was the highest (18.47%).There was significant no difference in the positive detection rate of virus and bacteria between children of different genders (P>0.05).There was significant no difference in the positive detection rate of virus among children of different age groups ( 2=5.980,P=0.050), but the positive detection rate of bacteria was different ( 2=12.078,P=0.002).Positive detection rates of virus infection and bacterial infection were different in distinct seasons (all P<0.05). By using logistics regression analysis, season, age and sentinel hospital were the influencing factors of ALRTI virus infection in children (all P<0.05), and sentinel hospital and years were the influencing factors of ALRTI bacterial infection in children (all P<0.05). Conclusion Respiratory syncytial virus, influenza virus and parainfluenza were the main causes of ALRTI virus infection in children aged 0-14 years in Gansu province, and the main bacterial infections were streptococcus pneumoniae and haemophilus influenzae, the number of virus infection was more than that of bacterial infection. Viral and bacterial infection had the same peak incidence.