Objective To explore the clinicopathological characteristics and prognosis of invasive micropapillary carcinoma of the breast (IMPC),and the distinction between IMPC and invasive ductal carcinoma of the breast (IDC).Methods From February 2004 to November 2013,195 IMPC patients and 420 IDC patients were analyzed retrospectively.Results There were significant differences in mammilla invasion,lymph vessel invasion,orange peel sign,soft tissue encroachment,neoadjuvant chemotherapy,radical mastcctomy,lymph node metastasis,clinical stages,tumor size,lymph node staging,estrogen receptor (ER),progestin receptor (PR),human epidermal growth factor receptor 2 (HER2),molecular subtyping,ratio of radiation,ratio of endocrine therapy,disease-free survival (DFS),overall survival (OS)between the two groups,all P ＜0.05.Patients with IMPC had lower 5-year DFS and OS rates (68.2％ and 73.8％,respectively) than IDC patients (85.7％ and 88.6％,respectively),all P ＜ 0.05.In IMPC patients with positive ER/PR,HER2-negative,smaller tumor volume,less lymph node metastasis,negative nipple invasion,negative lymphatic vessel tumor thrombus,negative orange peel change had higher 5-year DFS and OS rates than those with negative ER/PR,HER2 overexpression,larger tumor volume,more lymph node metastasis,positive nipple invasion,positive lymphatic vessel tumor thrombus,positive orange peel change,all P ＜ 0.05.Besides,the patients with pathologic stage Ⅰ had higher OS than those with stage Ⅲ (P ＜ 0.05).Cox regression analysis found that orange peel change,lymph vessel invasion and HER2 were the independent risk factors for the survival time of patients with IMPC.Conclusions IMPC patients have lower DFS and OS compared with IDC.

Objective To investigate the clinicopathologic characteristics and prognosis of medullary breast carcinoma.Methods We conducted a retrospective analysis on clinical and pathologic data of 166 patients with medullary breast cancer.Results All the patients were female with a median age of 52 years old.The proportion of patients with stage Ⅰ,Ⅱ and Ⅲ disease was 16.9％,68.1％,15.0％,respectively.The Luminal,HER-2 overexpressing and triple-negative subtypes constituted 31.3％,8.4％,and 60.3％,respectively.There was significant difference in regional lymph node status of medullary breast cancer patients with different molecular types (x2 =18.248,P =0.003),but not in tumor size,TNM stage,histological grade,and expression of Ki67 (all P ＞ 0.05).Multivariate survival analysis indicated that TNM stage was an independent predictor in the prognosis of medullary breast cancer (HR =5.664,P =0.001).All the patients were followed up from 15 months to 145 months with a median follow-up time of 108 months.The 5-year survival rate was 91.5％ and the 10-year survival rate was 87.2％.Conclusions The prognosis of medullary breast cancer is favorable.Personalized treatment according to the TNM stage and histopathologic characteristics achieve a favorable prognosis.

OBJECTIVE: To explore the clinical characteristics, diagnosis method and treatment of petrous apex cholesteatoma. METHOD: A retrospective analysis was taken with respects to the clinical characteristics, diagnosis and surgical management of 38 patients who underwent surgery for petrous apex cholesteatoma in our department. RESULT: (1)31 patients had unilateral hearing loss and facial paralysis of different degree, 27 patients were firstly characterized with hearing loss, and followed by facial paralysis. 6 cases had facial paralysis as the main performance. (2)17 patients had syndrome of tinnitus, and 15 patients had syndrome of vertigo and 4 cases of severe pain of ear. (3)All patients had petrous bone destroy with high resolution CT scan, while MRI suggests the presence of pathological changes in petrous apex. (4)All patients were taken surgeries to remove the lesion, and translabyrinth approach was chosen for 23 patients, middle cranial fossa approach is 12, while 3 case has choose endoscopic approach. 8 cases were operated with facial nerve decompression. 7 cases was taken end to end anastomosis. 3 cases of great auricular nerve transplantation. There is no recurrence in follow-up of 1 years to 2 years. CONCLUSION The clinical manifestations of petrous apex cholesteatoma lack specificity, and high resolution CT and MRI has important value in the diagnosis of petrous apex cholesteatoma. The strategy of surgical operation should be taken according to the classification, location of petrous apex cholesteatoma as well as hearing level and facial nerve function with patients.
Cholesteatoma ; pathology ; surgery ; Cranial Fossa, Middle ; Decompression, Surgical ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Hearing Loss, Unilateral ; Humans ; Magnetic Resonance Imaging ; Petrous Bone ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVE: To construct and obtain ideal protein delivery vectors by researching the delivery efficiency and cytotoxicity to Hela cells using mPEG-PLGA-BSA-FITC-NPs. METHOD: The mPEG-PLGA nanoparticle was obtained through surface modification of PLGA with PEG, and deliver BSA-FITC into Hela cells in vitro. The positive cells were counted by Laser scanning confocal microscopy and the survival rate of Hela cells was calculated by MTT assay at different time points. RESULT: mPEG-PLGA-BSA-FITC-NPs shows the classic nanometer size, and the encapsulation efficiency reached 51. 2%. At the same time, the nanoparticles possess characteristics of slow release. By optimizing the delivery conditions, the highest efficiency of mPEG-PLGA-BSA-FITC-NPs was above 65.2%, and the cellular viability was about 85.7%. CONCLUSION mPEG-PLGA-BSA-FITC-NPs nanoparticles can successfully carry the target protein into cells as safe and effective as novel delivery materials of protein in vitro, and has shown slow release characteristics. The mPEG-PLGA-BSA-FITC-NPs provide ideal delivery vector for future application in clinical treatment of disease using nano-materials.
Drug Carriers ; Fluorescein-5-isothiocyanate ; analogs & derivatives ; HeLa Cells ; Humans ; Nanoparticles ; Particle Size ; Polyesters ; Polyethylene Glycols ; Serum Albumin, Bovine

OBJECTIVETo investigate a new surgical method to treat unilateral limb lymphedem after radical mastectomy.

METHODS10 cases of upper limb lymphedema after radical mastectomy were treated using flap transfer (the lateral thoracic skin flap or latissimus dorsi musculocutaneous flap combined with liposuction).

RESULTSAfter the treatment, the upper limb perimeter reduced in varied degrees. Nuclear lymphatic radiography showed notable changes in lymphatic circulation. The effective results were steady during the follow-up of 3-18 months.

CONCLUSIONFlap transplantation combined with liposuction is a useful treatment for limb lymphedema from radical mastectomy.

Breast Neoplasms ; surgery ; Female ; Humans ; Lipectomy ; Lymphedema ; etiology ; surgery ; Mastectomy, Radical ; adverse effects ; Postoperative Complications ; surgery ; Surgical Flaps

Objective:To investigate the association between indoleamine 2,3-dioxygenase(IDO)expression in tumor tissue,its periph-eral blood activity, and the efficacy of neoadjuvant chemotherapyin patients with breast cancer. Methods: Immunohistochemistry (IHC)and high-performance liquid chromatography(HPLC)were used to measure IDO protein expression in tumor tissue,and kynuren-ine(Kyn),tryptophan(Trp),and IDO activity(Kyn/Trp)in peripheral blood before neoadjuvant chemotherapy in 53 patients with breast cancer from Tianjin Medical University Cancer Institute and Hospital between September 2015 and December 2016.The correlations between the expression and activity of IDO and the efficacy of chemotherapy were analyzed.Results:In tumor tissue,IDO expression-before neoadjuvant chemotherapy was related to clinical tumor stages(P=0.006),node stages(P=0.020),clinical stages(P=0.045),and estrogen receptor(ER)status(P=0.014).High IDO activity before neoadjuvant chemotherapy in peripheral blood was associated with high IDO expression in tumor tissue(P=0.004),and was also correlated with clinical tumor stages(P=0.019)and node stages(P=0.047). Univariate analysis showed that the clinical efficacy of neoadjuvant chemotherapy was associated with pre-chemotherapeutic clinical tumor stages(P=0.049),ER status(P=0.025),and molecular subtype(P=0.014),while pathologic complete response(pCR)was related to pre-chemotherapeutic clinical tumor stages(P=0.014).Importantly,the clinical efficacy of neoadjuvant chemotherapy and pCR were both related to IDO expression and activity before chemotherapy(all P<0.05).Multivariate analysis showed that pre-chemotherapeu-tic IDO activity in peripheral blood was the only independent factor that affected pCR(P=0.032).Conclusions:Tumor tissue IDO expres-sion and peripheral blood IDO activity before chemotherapy were associated with chemotherapy efficacy,and could provide promising information for the clinical prediction of chemotherapy sensitivity.

Objective To investigate the incidence and bacterial etiology of stent associated respiratory tract infec-tion (SARTI) caused by two types of airway stents.Methods Silicone and coated metal airway stent were placed into patients with central airway stenosis caused by varied pathologies. The incidence of stent related respiratory tract infection,bacteria etiology of SARTI and improved dyspnea score were compared between two groups receiving different airway stent.Results 1)Totally 171 patients received airway stents, and among them, 39 patients (22.81%) developed SARTI.2)The incidence of SARTI in metal stent group and silicone stent group was 29.21% (26/89) vs.15.85% (13/82),P<0.05;3)Bacterial spectrum of SARTI was different in metal and silicone stent groups:staphylococcus aureus was 38.46% vs. 69.23%,respectively;candida albicans was 23.08% vs. 0%,re-spectively;Singular proteus was 7.26% vs.0%,respectively;4)The narrowed lumen was improved from 74.27%± 7.13% to 17.64%±6.22%in the metal stent group,while the data was improved from 74.94%±9.18% to 12.68%± 8.32% in the silicone stent group (P<0.01). Accordingly, the dyspnea symptomscore was improvedfrom 2.85 ± 0.89 to 0.85±0.68 in metal stent group,and from 2.88±0.91 to 0±0.61 in the silicone stent group (P<0.05). Conclusions Compared with metal airway stents,silicone stents have a lower incidence of SARTI,which mightbe due to the projections in the silicon stent surface and wider expanded in the bronchial stenosis.

Objective To explore the risk factors on the death and complications of orthopedics patients after operation .Methods Nine hundred and thirty-five hospitalized patients in the department of orthopedics were retrospectively analyzed and the occurrence of death and complications after operation were statistics .The risk factors on causing serious outcome were analyzed by the multivariate logistic regression analysis , and the preventive nursing measures were taken according to the risk factors .Results The cases of postoperative complication were 82 cases (82/935,8.77%), and the cases of death were 32 cases (32/935,3.42%).The multivariate logistic regression analysis showed that preoperative renal insufficiency , chronic respiratory diseases , heart failure, atrial fibrillation, myocardial ischemia and cerebrovascular diseases were the independent risk factors on leading to the death and complications of orthopedics patients after surgery (P<0.05).Conclusions Six factors including preoperative renal insufficiency , chronic respiratory diseases, heart failure, atrial fibrillation, myocardial ischemia and cerebrovascular diseases are the independent risk factors on the death and complications of orthopedics patients after operation , and the nurses should give the positive prevention and intervention according to the risk factors .

OBJECTIVETo explore whether transplantation of autologous bone marrow stem cells might augment angiogenesis and collateral vessel formation in a canine model of hindlimb ischemia.

METHODSCD34(+) stem cells were centrifugation through Ficoll and an immune magnetic cell sorting system from bone marrow (20 ml) of canine (n = 5) and induced into endothelial cells with VEGF in vitro, and expression of von Willebrand factor. Bilateral hindlimb ischemia was surgically induced in canines and Dil fluorescence labeled autologous stem cells were transplanted into the ischemic tissues.

RESULTSFour weeks after transplantation, fluorescence microscopy revealed that transplanted cells were incorporated into the capillary network among preserved skeletal myocytes. The stem cells transplanted group had more angiographically detectable collateral vessels, a higher capillary density (12.0 +/- 2.8 vs. 5.0 +/- 1.6 per field; t = 4.17 P < 0.05) and a higher ABI (0.58 +/- 0.14 vs. 0.32 +/- 0.11; t = 2.95, P < 0.05).

CONCLUSIONSDirect local transplantation of autologous bone marrow CD34(+) stem cells seems to be a useful strategy for therapeutic neovascularization in ischemic tissues in adults, consistent with "therapeutic vasculogenesis."

Animals ; Antigens, CD34 ; analysis ; Cell Differentiation ; Disease Models, Animal ; Dogs ; Endothelial Cells ; cytology ; Female ; Hematopoietic Stem Cell Transplantation ; methods ; Hematopoietic Stem Cells ; chemistry ; cytology ; physiology ; Hindlimb ; blood supply ; Ischemia ; therapy ; Male ; Neovascularization, Physiologic

Child ; China ; epidemiology ; Humans ; Monitoring, Immunologic ; statistics & numerical data ; Vaccination ; statistics & numerical data