Objective To investigate the effect of advanced glycation end products(AGEs)on expression of vascular endothelial growth factor(VEGF)in rabbit retinal M?ller cells in vitro.Methods We successfully cultured rabbit retinal M?ller cells and made AGEs-BSA as well as its control in vitro.Study with M?ller cells were divided into AGEs-BSA group,AGEs-BSA control group and blank control group.AGEs-BSA group and AGEs-BSA control group were respectively treated with 5 different concentration series of AGEs-BSA and AGEs-BSA control and cultured for 3,6 and 9 days,while blank control group was incubated without any intervention.Then VEGF expression in M?ller cells was observed by immunocytochemistry(ICC).Results Compared with control group,VEGF expression in cultured retinal M?ller cells was significantly enhanced in AGEs-BSA group.And the effects were in the time-and concentration-dependent manners.Conclusions AGEs increases VEGF expression in rabbit retinal M?ller cells in vitro,which indicates that AGEs may promote the progression of diabetic retinopathy(DR)through the induction of VEGF expression.

OBJECTIVE:To observe the clinical efficacy of Yiru tiaojing granules on hyperprolacfinemia(HPRL)of renal deficiency and liver stagnation type.METHODS:HPRL patients were randomized to treatment group(Yiru tiaojing granules)or treatment group(Bromocriptine)for 3 months.Patients' symptoms and sex hormone were recorded.RESULTS:As compared with before treatment,serum level of prolactin(PRL)was significantly reduced(P

Objective To evaluate the prognostic significance of lymph node ratio (LNR) in axillary lymph node positive breast cancer.Methods Eight hundred and three cases axillary lymph node positive breast cancer patients without distant metastasis were systematically treated in the Obstetrics and Gynecology Hospital of Fudan University from 2006 to 2014,at least 10 lymph node removed in each case.Clinicopathological data including 5-year disease-free survival rate (5y-DFSR) and 5-year overall survival rate (5y-OSR) were described.Factors related with prognosis were analyzed by univariate analysis.Prognostic difference was compared among different LNR stage in each axillary lymph node pathological stage(pN).Prognostic significance of pN and LNR was compared by multivariate analysis.Results Mean lymph nodes removed were 15.47±4.70 lymph,and median positive lymph nodes were 4 lymph in 803 cases axillary lymph node positive breast cancer patients.Altogether 159 cases of local recurrence and distant metastasis and 99 cases of breast cancer-related death occurred during median follow-up of 61 months.Five-year DFSR was 77％ and 5y-OSR was 83％.Log-rank univariate analysis showen that pT,pN,LNR,lymphovascular invasion and ER status were related to DFS and OS.Five-year DFSR and OSR for pN1,pN2,pN3 were 89％,68％,59％ and 93％,78％,63％,respectively,whereas 5y-DFSR and 5y-OSR for LNR1,LNR2,LNR3 were 90％,69％,56％ and 94％,80％,57％,respectively.There was statistically significant difference among different LNR in pN1 and pN2 (pN1:DFS:P=0.005,0S:P=0.024;pN2:DFS:P=0.017,0S:P=0.000),but not in pN3,inspite of difference tendency (DFS:P =0.165,OS:P =0.075).In multivariate analysis,when pN or LNR were entered into the Cox regression mode respectively,both were the independent prognostic factors of DFS(P＜0.001) and OS(P＜0.001).When pN and LNR were entered into the Cox hazard regression model at the same time,LNR remained as the independent prognostic factor of DFS and OS (P ＜ 0.001),but pN lost significance (DFS:P =0.461,OS:P=0.162).Conclusion LNR is independent prognostic factor for positive axillary lymph node breast cancer.

Objective To evaluate the clinicopathological characteristics of mucinous breast carcinoma (MBC) and its prognosis.Methods 112 cases of MBC treated in Obstetrics and Gynecology Hospital of Fudan University between Jan 2005 and Dec 2014 were enrolled retrospectively together with 1 157cases of invasive ductal carcinoma (IDC) for comparison.There were 71 cases of pure MBC (PMBC) and 41cases of mixed MBC (MMBC).PMBC and MMBC were compared with each other,and were also compared with IDC respectively.Results PMBC had smaller tumor mass,higher expression rate of hormone receptors (all P＜0.05),lower rate of lymph node metastasis (7.0％ vs.40.6％,x2 =32.663,P ＜0.001) when compared with IDC.The 5 year disease free survival (DFS) and overall survival (OS) of PMBC were both better than those of IDC (DFS:94.6％ ±3.0％ vs.81.3％ ± 1.1％,x2 =7.265,P =0.007;OS:92.4％ ±5.3％ vs.88.5％ ± 1.0％,x2 =4.059,P =0.044).MMBC had relatively larger tumor mass,higher expression rate of hormone receptor,but had no difference in the rate of lymph node metastasis (48.8％ vs.40.6％,x2 =3.417,P =0.332) when compared with IDC.There was no statistically significant difference in 5 yearDFSandOSbetweenMMBCandIDC (DFS:79.1％ ±7.1％ vs.81.3％±1.1％,x2 =0.167,P=0.683;OS:84.5％ ±7.2％ vs.88.5％ ± 1.0％,x2 =0.123,P =0.726).PMBC had relatively smaller tumor mass,lower rate of lymph node metastasis,but had no difference in the expression rate of hormone receptors.The 5 year DFS and OS of MMBC were both better than those of MMBC (DFS:94.6％ ± 3.0％ vs.79.1％±7.1％,x2 =6.772,P =0.009;OS:92.4％ ±5.3％ vs.84.5％ ±7.2％,x2 =6.401,P=0.036).Lymph node status was the only statistically significant prognostic factor of MBC by COX multivariate analysis.Conclusions PMBC has better prognosis than MMBC and IDC owing to its lower rate of lymph node metastasis.MMBC has higher rate of node metastasis than PMBC,hence similar prognosis with IDC.

Objective To evaluate the effect and clinical value of open surgery combined ultrasound-guided Mammotome in the treatment of multiple breast lumps. Methods Four hundred and forty-four patients in our hospital from Jan. 2006 to Jun. 2008 were divided into 3 groups, who underwent classical open surgery, ultrasound-guided Mammotome operation, or combined therapy respectively and followed by post-operation visits reguarly. The operation effects were compared between the 3 groups. Results Compared with the classical open surgery, combined therapy had no difference in time of procedure and procedural bleeding, but had lower incidence of local skin, better incision condition and higher satisfaction of patients. Compared with ultrasound-guided Mammotome operation, combined therapy took less time in procedure, and in the same time had less procedural bleeding, lower post-operation complication and higher patients satisfaction. Conclusions Combined therapy has high complete removal rate, low post-operation complication as well as cosmetic effect. It has special advantages over the other two kinds of surgery, so it has wide clinical application.

Objective To summarize and explore the clinical value of Mammotome technology in the diagnosis and treatment of breast neoplasms. Methods Nine hundred and eighty-seven breast neoplasms of 710patients were biopsied and excised with the aid of ultrasound-guided Mammotome system. The malignant neoplasms,according to the histological report,were radically removed during the operation without delay. All patients enrolled into the study were followed up closely on the complcations and satisfaction degree. Results All the operations except one were successful and got the sufficient specimen to perform the pathological examination,the biopsy achievement rate was 99. 8% . Both the sensitivity and specificity of the diagnosis were 100% in 16 breast tumors. Complete resection rate was 99%. The incision length was about 3 mm,showing good cosmetic outcome. Complcations were mild,mainly composed of haematoma and ecchymosis. The patients' general satisfactory rate was 93%. Conclusions This technique can help achieve biopsy of breast neplasm and excision of benign lesions at the same time with cosmetic result Further attention should be paid to reduce the lesion residue and hemorrhagic complications.

Objective To evaluate the effect of ultrasound-guided vacuum-assisted minimal invasive resection(Mammotome procedure)of breast lumps through the retromammary space. Methods Seven hundred and eighty-seven patients in Obstetrics and Gynecology Hospital Affiliated to Fudan University from Jan. 2011 to May 2012 were underwent ultrasound-guided Mammotome operation through the retromammary space (retromammary space group,385 cases),or adjacent the lumps,and followed by post-operation visits regularly (Mammotome operation adjacent the lumps group,402 cases). The operation effects were compared between the two groups. Results All cases were followed up for 12 months. The period of Mmmotome operation through the retromam mary space and the rate of resection were(48 ± 6)min and(52 ± 4)min,99. 48%(383 / 385), 99. 25%(399 / 402),perspectively,in group of Mammotome operation through the retromammary space and Mammotome operation adjacent lumpsand. There was no significant difference between the two groups( P> 0. 05). The amount of procedural bleeding,the incidence of ecchymosis,local hematoma and the number of incision in group of Mammotome operation through the retromammary space were(8 ± 3)ml,2. 34%(9 / 385), 0. 52%(2 / 385),(1. 3 ± 0. 6)respectively,which were significantly lower than those in Mammotome operation adjacent the lumps group((14 ± 6)ml,8. 71%(35 / 402),2. 74%(11 / 402),(2. 4 ± 0. 3)respectively). There were statistical difference between two groups( P = 0. 003,P < 0. 001,P = 0. 001,P = 0. 006). The rate of satisfaction in group of Mammotome operation through the retro-mammary space was 98. 70%(380 / 385),which is significantly higher than in group of Mammotome operation adjacent the lumps(89. 30%(359 / 402),P< 0. 01). Conclusion The therapy approach of ultrasound-guided Mammotome operation through the retromammary space has lower hemorrhagic complication,as well as the better effect with special advantages. Therefore it has prospective clinical application.

As a new strategy for the application of sacubitril/valsartan (LCZ696) in patients with CKD, much evidence showed that it improved the prognosis of patients with CKD. This review summarizes the efficacy and safety of sacubitril/valsartan in physiology, pathology, pharmacology and clinical application by searching Wanfang, CNKI, PubMed and other databases for related articles on the application of sacubitril/valsartan in CKD patients. Although LBQ657, the active product of sacubitril, has a high drug accumulation in patients with moderate, severe renal injury, and ESRD, it is not cleared in hemodialysis, and has very little eliminated in peritoneal dialysis, which does not affect its safety. Compared with angiotensin converting enzyme inhibitor and angiotensin receptor blocker drugs, LCZ696 could increase the blood pressure control rate, improve cardiac function, slow down the decline of glomerular filtration rate, and significantly improve cardiovascular outcomes without more adverse events. Sacubitril/valsartan can be used in all levels of CKD patients complicated with hypertension and/or heart failure, with reliable safety and tolerance.