The surgery of the breast cancer has dramatically changed,sentinel lymph node(SLN) is one of the aspects.SLN biopsy can precisely predict the status of axillary basin.If the SLN is negative,the patients can spare the unnecessary axillary lymph node dissection(ALND) and reduce the morbidity of the surgery.One of the most important issues with sentinel node biopsy is the intraoperative pathological evaluation of the sentinel nodes.Accurate intraoperative pathological examination of sentinel nodes would enable the selection of candidates for ALND during the initial operation,eliminating the need for second surgery.This article will review the two techniques(touch imprint cytology and frozen section) employed for intraoperative examination of SLN and compare these two methods.And evaluate the role of touch imprint cytology and existing problems in introperative diagnosis of the sentinel lymph nodes and raise the probably ways to improve the sensitivity of touch imprint cytology initially.

As a result of accuracy of staging and decreased patient morbidity,sentinel lymph node biopsy for breast cancer was quickly accepted into clinical practice.Many controversies remain in the methods and indications of sentinel lymph node biopsy.In this article,we attempt to highlight the clinical studies regarding the biopsy techniques,pathologic evaluation,indication for lymphatic mapping and eliminating axillary lymph dissection by sentinel lymph node biopsy.It is demonstrated that radioisotope and blue dye techniques are complementary.Preoperative lymphoscintigraphy is most useful for detecting an internal mammary SLN,but the practicability of internal mammary SLN biopsy is still in the investigative stage.As for intraoperative diagnosis of sentinel lymph node,imprint cytology is a quick,economic and tissue-preserving method,but not very effective in the identification of micrometastasis;axillary lymph node dissection is preferable for patients with micrometastasis.Sentinel lymph node biopsy is indicated for ductal carcinoma in situ,with prophylactic mastectomy,breast cancer patients with previous reduction mammoplasty and breast implants.Currently,NSABP B32,Z0010 and Z0011,large,prospective randomized trials are in progress to evaluate unresolved issues of SLN biopsy.Although data from these trials is not available,SLN biopsy has been widely adopted in the clinic.Consistency of technique as well as case selection has attained great significance.

“Big Data” gradually enters the field of Laboratory Medicine , there are some cases for clinical application of “Big Data”, such as quality control , reference interval , nutritional status and epidemiological investigation.There are also many challenges , such as experimental design , data accessect.Big Data mining needs more wisdom , more efforts.

Breast cancer is the most common malignant tumor in women. For early stage breast cancer patients, surgical treatment is still the foundation of local treatment. With background from precision medicine, this article reviews recent hot issues in surgical treat-ment for early stage breast cancer patients. We summarized strategies in surgical treatment, selection of resection range, manage-ment of local lymph nodes, timing of breast reconstruction, and the application of minimally invasive surgery.

Pancreatic cancer is a commonly malignant gastrointestinal tumor with an obviously increasing incidence all over the world.Those patients without specific symptoms at early stage had mostly lost the opportunity of surgical therapy when pancreatic cancer was detected at advanced stage,and their prognosis is poor.Therefore,it is rather crucial to improve the early diagnosis of pancreatic cancer.Tumor marker is a considerable tool for early tumor detection and screening.It will help to improve the diagnostic rate of early pancreatic cancer and promote the prognosis of pancreatic cancer if we could find out tumor markers and screen one or a group of pancreatic cancer tumor markers.

Breast calciifcation plays an important role in breast cancer in various areas, such as early-stage diagnosis, recurrence monitoring and prognosis prediction. However, the mechanism of breast calciifcations remains elusive. One proposed mechanism is based on an imbalance between the enhancers and inhibitors of physiological mineralization. Traditionally, the classiifcation of breast calciifcation is based on the assessment of morphology and distribution. These radiology features are closely related to pathology and biological behavior of tumor. However, chemical composition of calciifcations can provide us with more information about tumor status. Calciifcations could be divided into two categories according to chemical composition. Type I (calcium oxalate) is found in benign breast disease, while typeⅡ (hydroxyapatite) is found in proliferative lesions, mostly to be associated with malignancy. Moreover, carbonate concentrations in typeⅡ calciifcations is related to pathology grades. Despite emerging imaging technologies such as digital breast tomosynthesis, they are unable to yield any information on chemical composition of breast calciifcations and thus cannot provide a deifnitive marker for classifying benign and malignant lesions. Recent researches show that using Raman spectroscopy, the chemical information of calcification could be obtained non-invasively and might provide us with a better mode for calciifcation diagnosis in the future.

Breast cancer is the most common malignant tumor in women. Surgical treatment is one of the important treatment methods. Breast reconstruction following mastectomy can improve patients' quality of life with acceptable oncological safety. Autologous tissue breast reconstruction has become an important way owing to its spe-cific advantages. The ideal tissue for autologous breast reconstruction is free abdominal flap. This review presented the clinical application, timing of operation and complications of breast reconstruction with free abdominal flap.

Child ; Humans ; Neurology ; Pediatrics

Objective: To evaluate effects of atrioventricular nodal ablation, pacemaker and pharmaco logic agents on ventricular rate control. Methods:Three patients with chronic sustained atrial fibrillation ( AF) were treated by atrioventricular nodal ablation. Fast-slow junctional cardiac rhythm in this course meant the ablation was successful. Unless the ablation was able to get Ⅱ? Ⅱ type or Ⅲ? AVB, R-R intervals ≥3 s, ventricular rate≤40 bpm, it would be canceled. Otherwise implantation of a permanent pacemaker was performed. Results:One patients having complete atrioventricular block and a ventricular rate of 38 -40 bpm had implantation of a permanent pacemaker. Two patients having no atrioventricular block, prolongation of R-R intervals and ventricular rate of 90 - 120 bpm were given antiarrhythmic drugs. Conclusion: Patients with chronic sustained AF can be treaded with atrioventricular nodal ablation, pacemaker and pharmacologic agents effectively.

Purpose: To analyze the clinical and pathological factors in post-operative breast cancer patients with bone metastasis, and, identify risk factors predicting the skeletal metastasis. Methods: We evaluated data from 3 796 patients who were surgically treated from January 1981 to December 2000. Those patients were divided into groups according to different first events. Then we assessed data of 116 cases of bone metastasis as first event, and comparing with visceral metastasis and lymph node or soft tissue metastasis cases. Results: In our group there were 116 cases with bone metastasis as first event, about 3. 1%; bone metastasis correlated with young age, large tumor, clinical palpable axillary nodes, pathological positive nodes, stage II/HI disease and non-specific invasvie breast carcinoma. Multivariate logistic regression found that large tumor, clinical palpable axillary nodes related with bone metastasis in pre-operative data. In post-operative data, large tumor, pathological positive nodes and non-specific invasive breast carcinoma correlated with bone metastasis. Hormone receptor status and HER2 expression did not predict the bone metastasis. All cases received standard local and adjuvant systemic treatment. Among patients who had as their first event a local recurrence or a recurrence in soft tissue or lymph node or local and systemic metastasis, there were more specific invasive carcinomas than those in bone metastasis group. Occurrence of bone metastasis and visceral metastasis had similar time distribution, however, local recurrence and/or node, soft tissue metastasis occurred earlier than skeletal metastasis. Conclusions: Pre-operative bone scintigraphy was indicated in those with young age, T2/T3 tumor, and clinical palpable nodes. Breast cancer patients at high risk for bone metastasis were T2/T3 tumor, non-specific invasive breast carcinoma and with 4 or more involved axillary lymph nodes. It might be important to study the effect of bisphosphonates in the adjuvant settings.