Objective:This study aimed to investigate the clinical significance of hormone receptor status detection in simultane-ous axillary metastasis for hormone receptor-negative primary breast cancer patients. Methods:Using immunohistochemical methods, hormone receptor status detection in axillary lymph node metastasis was performed among breast cancer patients with simultaneous ax-illary metastasis in the First Affiliated Hospital of Chongqing Medical University. The subjects comprised patients who visited the clin-ic for follow up or those who were hospitalized from July 2012 to January 2013. Endocrine therapy was given for patients diagnosed with positive hormone receptor in their simultaneous axillary metastasis. Results:Out of 56 patients with hormone receptor-negative primary breast cancer, 14.3%gained estrogen receptor (ER), 3.6%gained progesterone receptor (PR), and 5.4%gained ER and PR in their simultaneous axillary metastasis, and then underwent endocrine therapy. The discordance rate of hormone receptor expression be-tween primary tumor and axillary metastasis was 23.3%. Conclusion:Some discordance rates of hormone receptor status between pri-mary tumor and simultaneous axillary metastasis were observed. Through hormone receptor status detection in simultaneous axillary metastasis, we may possibly distinguish patients with negative ER and PR, among whom endocrine therapy may be active.

BACKGROUND: Thoracolumbar burst fracture Dennis type B does not have significant damage in the intervertebral discs of the inferior vertebral body. To reduce fusion segment and remain normal intercalated disc, single discectomy (damaged vertebral body and supervisor vertebral body) is proposed, but because of the damage to the vertebral body, implanted screw is easy to loose following excising partial vertebral body, even cannot be fixed. However, it is still unknown whether implanted screw in the inferior vertebral body of the damaged vertebral body was stabilized using two segment discectomy with fixation.OBJECTIVE: To analyze the feasibility of single segmental spinal interbody fusion with bisegment fixation for thoracolumbar burst fracture type B.DESIGN, TIME AND SETTING: The randomized controlled in vitro study was conducted at the Laboratory of Biomechanics, Southern Medical University from June 2007 to June 2008.MATERIALS: A total of 20 fresh freezing 7-9 months pig samples (T_(13)?L_3 segment) were used, comprising 10 integral samples and 10 L_1 type B thoracolumbar burst fracture samples prepared by pre-injury and weight dropping technique.METHODS: Pig fresh thoracolumbar specimens from T_(13)?L_3 were collected to create models of type B thoracolumbar burst fracture. There were 4 groups in this study. Ten of them were selected as intact group (n=10) (fresh pig T_(13)?L_3 segment). T_1 vertebral endplate pre-injury and weight dropping technique and incremental trauma approach were used. Denis' type B burst fracture was produced, and ten of them were selected as unstable group (n=10). Firstly, unstable group was decompressed by discectomy and semivertebraectomy in upper half of the vertebral body, single level was fused with iliac and U-FRONT anterior thoracolumbar system were placed between T_(14) and L_2, as single discectomy with fixation group (n=10). Then lower disc of injury vertebra discectomy and vertebraectomy, fused with iliac U-FRONT anterior thoracolumbar system were placed between T_(14) and L_2, as two segment discectomy with fixation group (n=10). The bone graft was longer 1 mm than the bone graft region.MAIN OUTCOME MEASURES: The flexion, extension, right/left lateral bending, and right/left axial rotation range of motion (ROM) of T_(14)?L_2 were measured in each group on the spinal three-motional test machine at 10 N穖.RESULTS: The flexion, extension, right/left lateral bending, and right/left axial rotation were not stable in the unstable group.ROM was significantly increased in the unstable group compared with the intact group (P< 0.01). The primary stability was significantly elevated in the single discectomy with fixation and two segment discectomy with fixation groups. The flexion, extension, right/left lateral bending, and right/left axial rotation ROM were significantly reduced in the single discectomy with fixation and two segment discectomy with fixation groups compared with the unstable group (P < 0.05). The flexion, extension, right/left lateral bending ROM was significantly decreased in the two groups compared with the intact group, but axial rotation ROM was significantly increased (P< 0.05). Axial rotation ROM was smaller in the single discectomy with fixation group compared with the two segment discectomy with fixation group (P < 0.05).CONCLUSION: Single segmental spinal interbody fusion with bisegment fixation for thoracolumbar burst fracture type B had a good immediate stability in flexion, extension, lateral bending motion. Compared with traditional partial corpectomy L_1 between the caudal and cranial endplate of the adjacent vertebrae with bisegmental fixation, it had a better immediate stability in axial rotation.

Objective:To investigate the effect of different primary sites of colorectal cancer on early recurrence after radical resection of metastatic tumor clinical risk score (CRS).Methods:The data of colorectal cancer liver metastasis (CRLM )surgically resected between Jan 2015 and Feb 2020 were retrospectively analyzed at Li Huili Hospital and Ningbo University People's Hospital. Risk factors leading to early recurrence after CRLM resection were analyzed by univariate analysis, and the significant results were then subjected to multifactorial analysis by COX regression model. Kaplan-Meire method was used to analyze the effect of primary site on disease-free survival at 1 year after CRLM resection in different CRS subgroups.Results:A total of 209 patients were included in the study, including 143 patients with primary tumors in the left colon and 66 in the right colon. One hundred and three (49.3%) patients with recurrence within 1 year.Univariate analysis showed that primary tumor site, neoadjuvant chemotherapy, and CRS were correlated with recurrence. Multivariate analysis showed that right colon cancer, poor efficacy of neoadjuvant therapy, and high risk of CRS were independent risk factors (all P<0.05). Patients with an overall low CRS risk group and low CRS after treatment, had a higher recurrence rate (all P<0.05) within 1 year when primary tumor located right colon. Conclusion:The location of the primary tumor in the right colon is an independent risk factor for recurrence within 1 year after radical surgery in patients with CRLM.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.