Objective To investigate the surgical treatment of occult breast cancer.Methods The clinical data of 11 cases of occult breast cancer were analyzed retrospectively.Results In 11 female cases aged between 44and 70 years old,2 cases were accompanied with supraclavicular node metastasis.Axillary node enlargement was presented as the first sign,which was located in left side in 4 cases and right side in 7 cases.3 cases underwent axillary lymph lode desection,2 cases accepted axillary node excision and other 2 cases with supraclavicular node enlargement only underwent excisional biopsy.All patients received radiochemotherapy and endocrine therapy.All cases were followed-up from 8 months to 9 years and 6 months,during which 3 cases died,with the 5 years survival rate of 54.5%(6/11).Conclusion Combined treatment is suitable to occult breast cancer.Modified radical mastectomy or breast conserving surgery should be conducted,but axillary lymph node desection may be conducted when the diagnosis is established.

Objective To explore the value of fiberoptic ductoseopy in diagnosis and treatment of nipple discharge diseases.Methods From March 2007 to March 2008,91 patients with nipple discharge were admitted in our hospital.These patients were diagnosed and treated using flberoptic ductoscope FVY-780,and their documents were retrospectively analyzed.Results All the 91 cases were successfully diagnosed and treated with fiberoptic ductoscopy.54 cases(59.3%) were diagnosed as protrusion lesions,19 of whom experinced multiple protrusion,and 5 cases(5.5%) of early breast carcinoma were confirmed by postoperative pathology.37 patients(40.7%) diagnosed as non-protrusion lesions were treated by irrigation therapy,some of whom improved or cured.Conclusions Fiberoptic ductoseopy is the first choice of examination for nipple discharge,and it has important clinical values in choosing procedures for it can show precisely the cause and lesion site.Surgery can thereby be avoided for non-protrusion lesions.Locating the site of lesions in mammary ducts guided by fiberoptic duetoscopy may make operations more accurate and minimally invasive.

Objective To investigate the factors of hospitalization expense in patients with type 2 diabetes mellitus undergoing non-emergency surgery.Methods A retrospective study included diabetic (109 cases) and control (162 cases) groups.Hospitalization expense and other observation indices were compared between two groups and subgroups.The factors that contribute to hospitalization expense were analyzed with multifactor regression analysis model.Results The median hospitalization expense was 12 014.74 yuan in the diabetic group,1.24 times than that in the control group (P =0.001).Diabetic group has higher American Society of Anesthesiologists (ASA) classification,longer wound healing time,higher postoperative infection rate,and longer hospital stay (P ＜ 0.01).Multifactor analysis revealed that the significant factors that influence the hospitalization expense were ASA classification (β =0.442,P =0.000),postoperative fasting plasma glucose (β =0.204,P =0.020),and postoperative infection (β =0.204,P =0.019).No significant difference was found in postoperative infection rate and hospitalization expense between two groups,when patients had received minimally invasive surgeries (P ＞ 0.05).Conclusions Type 2 diabetes patients have higher hospitalization expense;ASA classification,postoperative fasting plasma glucose,and postoperative infection are the main influence factors.Giving priority to minimally invasive surgeries and enhancing perioperative glucose control can help to reduce hospitalization expense in patients with type 2 diabetes mellitus.

Objective To investigate the value of ultrasound-guided Mammotome minimal invasive system in the treatment of breast fibroadenoma.MethodsFrom January 2007 to October 2008,266 benign breast lesions of 183 cases were treated by ultrasound-guided Mammotome minimal invasive system.The diameter of the masses ranged from 4 to 25 mm(≤ 10 mm in 73 cases,10-20 mm in 148,and ≥ 20 mm in 45).ResultsThe 266 lesions in the 183 patients were excised completely by using the Mammotome system.The excision was performed for a mean of 15 times in each case(ranged from 5 to 44 times) with an average operation time of 26 minutes(10 to 60 minutes).No complication was found after the surgery except slight subcutaneous ecchymosis in 2 cases.The length of the incisional scar,which was not apparent,ranged from 2.5 to 4 mm.The 183 cases were followed up by ultrasonography for 2 to 22 months(mean,12 months),during which their BI-RADS scales ranged from Ⅰ to Ⅱ,no local recurrence was found.ConclusionsUltrasound-guided Mammotome minimally invasive system is feasible for total resection of breast fibroadenoma with appropriate sizes.The technique leads to fewer complications and good cosmetic results.Further studies on the system are necessary for the treatment of multiple breast fibroadenomas.

Objective To investigate the apoptosis induction effects and the possible mechanism of YM155 on triple negative breast cancer MDA-MB-231cells.Methods MDA-MB-231 cells were treated with dif-ferent concentrations of YM 155, and the survival rate of the cells was determined by CCK-8 assay and the half maximal inhibitory concentration ( IC50 ) value of YM155 was calculated .The apoptosis rate was examined by An-nexin V-FITC/PI double staining.mRNA expression of survivin and bcl-2 in MDA-MB-231cells was detected by RT-PCR.The protein expression of survivin , bcl-2, caspase-3, and PARP were detected by Western blot .Re-sults YM155 significantly inhibited the growth of MDA-MB-231 cells in a dose-and-time-dependenct way .IC50 was(1.749 ±0.265) ng/ml and(0.823 ±0.125) ng/ml respectively at 24 and 48 hours.The apoptosis rate of cells treated with 0.5 ng/ml, 1.0 ng/ml, and 1.5 ng/ml YM155 was (10.93 ±0.94)%,(31.10 ±1.51)%, and(46.83 ±2.92)%respectively, which had significant difference compared to that of the control group (6.4 ± 1.2)%(P<0.01).YM155 could significantly decrease mRNA and protein expression of surviving , besides, it reduced bcl-2 expression and increased caspase-3 and PARP protein expression .Conclusions YM155 can ef-fectively induce the apoptosis of MDA-MB-231 cells by downregulating survivin and activating caspase pathway . Bcl-2 might play a role in the apoptosis .

Objective To evaluate ultrasound combined with thri-operators and the blood-oxygen functional image (TOBOFI) technology in diagnosis of breast cancer in young women. Methods 221 breast tumor patients under 45 years old were selected to analyze their TOBOFI and ultrasonographic characteristics respectively. Based on pathological result, the two diagnostic methods were compared to determine the accurate rate. Results Of all the 221 patients, 82 (37.1%) were malignant and 139 benign. The sensitivity of TOBOFI and ultrasonography was 90.24% and 83.57% respectively, while the accurate rate of the two was 89.14% and 84 62% respectively. Accurate rate was improved to 93.90 % (77/82) if the two were combined. Conclusion TOBOFI has unique clinical value in diagnosing breast cancer in young women, especially in combination with ultrasound.

Objective:To assess whether familial occurrence has an influence on the morphological characteristics of patients with nonsyndromic cleft lip and/or palate (NsCL/P).Methods:A case-control analysis was performed on the morphological characteristics of familial group and sporadic group,using medical records of 1967 patients with NsCL/P treated in the Affiliated Stomatological Hospital of Nanchang University from 2002 to 2014.Results:164 (8.34％) cases presented a positive history of cleft in their families.The cleft types,the positive familial rate of cleft lip only (CLO),cleft lip and alveolar ridge(CLA),cleft lip and palate (CLP) and cleft palate only (CPO) were 8.11％,8.54％,6.19％ and 9.65％ respectively.A positive family history of NsCL/P was associated with 0.66 times risk of CPO (P =0.036,OR =0.66,95％ CI 0.44-0.98) compared to those of CLO,CLA and CLP.In familial group of CLP,the lateral incidence of male patients was different from that of female patients (P ＜ 0.001).There was no significant difference between familial group and sporadic group on birth weights,parental child-bearing age and clinical manifestations of patients.Conclusion:Familial occurrence might have an influence on cleft type,laterality and gender of the patients with NSCL/P.

OBJECTIVEThis study described the clinical, surgical, and radiographic findings of simple bone cysts.

METHODSA retrospective study was conducted for patients diagnosed with simple bone cysts in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Nanchang University from March 2005 to March 2015. Clinical, radio-graphic, surgical, and follow-up data were gathered. Results were statistically analyzed by central tendency and dispersionusing SPSS 20.0 software.

RESULTSEleven cases of simple bone cysts were collected, including three male and eight female patients. Ten cases (90.9%) were asymptomatic and one case developed symptoms of swelling. All of the cases had no history of trauma in the affected area, and all were solitary; ten cases (90.9%) were unilocular, and one (9.1%) was multilocular.The shape of each lesion could be assigned to four categories: cone (3 cases), round (2 cases), oval (4 cases), and irregular (2 cases). The treatment in 10 cases consisted of surgery to explore the cavity and curettage of the bone walls. During surgery,the bone cavity in seven cases (70%) was vacant, whereas serous fluid was found in two cases (20%) and serous-bloody fluid in one case (10%). Of the ten cases, three cases exhibited complete bone healing and seven cases showed new bone formation.

CONCLUSIONSimple bone cysts of the jaws are usually asymptomatic and appear incidentally on routine radiographies. The prevalence is higher in the mandible and young people. The patient usually has no history of trauma, and the bone cavity of lesion is mostly vacant. Curettage of the bone walls of the lesion is suggested for simple bone cysts. Systemic clinical and radiologic follow-up are necessary to ensure successful treatment.

Bone Cysts ; Dental Caries ; Female ; Hospitals ; Humans ; Jaw Cysts ; diagnosis ; pathology ; Male ; Mandible ; Mandibular Diseases ; Radiology ; Retrospective Studies ; Software

Objective To observe the influence of oleanolic acid on the ethology of 9-month-old mice,the completeness of synapsis structure and the expression of cAMP-response element binding protein (CREB) in cortex and hippocampus.Methods Thirty 9-month-old healthy male SMAP8 mice were randomly divided into model group,oleanolic acid group and aricept group,and with 10 rats in each group,while 10 healthy male mice of the same age and species as normal group.Oleanolic acid group and aricept group were given intragastric administration with corresponding drugs,while the normal group and model group were given the same amount of physiological saline.4 weeks later,the ethology changes were observed by Morris water maze and morphology changes of hippocampus neurons were viewed by electron microscope and the expression of CREB was detected by Western Blot.Results (1)Morris water maze results suggested that compared with the normal group,the latency time in the model group mice was longer,which were ((83.33±4.96) s,(75.13±6.01) s,(71.75±7.77) s,(63.40± 8.93) s,(60.97±8.38) s),while compared with the model group,the latency time in the oleanolic acid group and the aricept group was remarkably shorter (P＜ 0.05),which were (75.97± 4.49) s,(64.98± 4.93) s,(64.16± 6.23) s,(53.47±5.99) s,(47.91±7.64) s and (71.30±7.65) s,(63.32±7.57) s,(59.82±4.69) s,(52.28±5.90) s,(46.22±7.27) s respectively.In the spatial probe trial,compared with tbe normal group,the crossing times of the model was less,while compared with the model one,the crossing times of the oleanolic acid group and the aricept group was more(P＜0.05).(2)Compared with the normal group,the number of synapses in the model group was smaller,in which the synaptic cleft was mixed with the front of synapses severely swollen,uninform synaptic vesicles and few clear outlines of mitochondrias.While the oleanolic acid group and the aricept group had clear synapses outlines with the front of synapses slightly swollen,intensive and uniform synaptic vesicles and clear mitochondrias with their cristae not easy to be seen.(3) The Western Blot showed that compared with the normal group,there was a decline in the CREB expression both in the cortex and hippocampus in the model group,while compared with the model group,there was a rise in the oleanolic acid group as well as the aricept group(P＜0.05).Conclusion Oleanolic acid can improve the learning and memorizing of model rats,which is possibly related to the increased expression of CREB protein to protect the synapses structure of model mice.

Objective To evaluate thri-operators and the blood-oxygen functional image technology in di-agnosing breast cancer. Methods One hundred and forty-six patients were admitted to hospital for operation due to one hundred and fifty-three suspicious lesions detected in their breasts. These lesions were detected by physical examination, thri-operators and the blood-oxygen functional image, mammography uhrasonography. The sensitivity and specificity of each diagnostic method were obtained and the radiolagie-pathologic correlation was meanwhile calculated. Results Sixty one(41.8%)breast lesions were diagnosed as malignancy. The sensitivity, specificity, accuracy,positive prognostic value and negative prognostic value of ultras onography were 80. 33% ,89. 41%,85.61% ,84.48% and 86.36%. Such data of mammography were 57.89% ,80. 36% ,69.03% ,75.00% and 65. 22%. And those of thri-operators and the blood-oxygen functional image technology were 91.80% ,83.53%, 86.99% ,80.00% and 94.67%. Conclusions Thri-operators and the blood-oxygen functional image technology is superior to uhrasonography and mammography in diagnosing breast lesions with its sensitivity accuracy and neg-ative prognostic value, while specificity and positive prognostic value were between them, have greater value in screeninging and the diagnosing breast cancer.