Objective To study the clinical,pathological features and treatment of metastatic breast cancer with triple negative breast cancer(TNBC) and its relationship with disease free survival.Methods One hundred and fifty-eight cases of TNBC patients who were treated in the First Affiliated Hospital of Zhengzhou University and the Chinese Medicine Hospital of Changge from January 2004 to January 2009 were selected as the research objects.All patients received operation and radiotherapy,the relationship between the clinical characteristics,pathological features and treatment with 5,3 year survival rate,and the recurrence and metastasis of patient were analyzed.Results In clinical stage Ⅲ period,the 3 years survival rate was 46.51％ (20/43),5years survival rate was 37.21％ (16/43),all significantly lower than in the phase Ⅰ and Ⅱ (91.53％ (54/59) and 76.27 ％ (45/59);87.50％ (49/56) and 71.43 ％ (40/56)),and the differences were statistically significant (x2=25.306,15.787,19.348,11.592;P＜0.001).With lymph node metastasis,the 3 years survival rate was 66.00％ (33/50),5 years survival rate was 50.00％ (25/50),significantly lower than that without lymph node metastasis(83.33％ (90/108),70.37％ (76/108)),the difference was statistically significant (x2=5.954,6.150;P＜0.05).In pathological grade Ⅲ,the 3 years survival rate was 65.67％(44/67),5 years survival rate was 43.28％ (29/67),significantly lower than that of grade Ⅰ (92.86％ (26/28),85.71％ (24/28)) and grade Ⅱ (84.13％ (53/63),76.19％ (48/63)),the difference was statistically significant(x2=7.527,14.414,5.839,14.560;P＜0.05).The 3 year survival rate of radiotherapy group was significantly higher than that in non radiotherapy group,the difference was statistically significant (81.58％ (31/38) vs.57.69％ (15/26);x2=4.357,P＜0.05).Patients with metastatic sites were lung,liver,brain,bone and supraclavicular lymph nodes,the median survival time after the transfer all more than 2 years.Conclusion TNBC is a special type of breast cancer that is difficult to treat,no consensus has been reached on the clinical treatment plan.Breast conserving surgery also has certain application value,radiotherapy only can increase the 3 year survival rate.The clinical stage and pathological grade are the influence factors of prognosis.

BACKGROUND:The output of computed tomography (CT) is Digital Imaging and Communications in Medicine (DICOM), whereas the input of three-dimensional (3D) printing is an object Standard Template Library model represented by a triangular mesh. The process of data handing and forrmat conversion are keys to the combination of these two techniques. OBJECTIVE:To explore how to convert CT data into a stereoscopic 3D model efficiently. METHODS:The DICOM in Medicine format data of the patients with femoral fractures were edited and produced by Mimics. We made a 3D model by adjusting the parameters of the 3D printer slicing software, and discussed the significance of 3D model in medical field, especially orthopedics. RESULTS AND CONCLUSION:Mimics software is the bridge to connect two-dimensional CT scan images and 3D images, to create a 3D model by editing the data of DICOM which comes from the CT scanner, with a 3D printing technology. The 3D Model can help doctors for routine clinical diagnosis and treatment, to improve the communication between doctors and patients and the quality of clinical medical teaching. 3D printing also makes medicine more personalized, remote, minimally invasive, and promote the development of medicine to the direction of digital medicine.

Objective To observe the infiuence of recombinant human thyroid stimulating hormone(rhTSH)-aided 131I treatment for patients with differentiated thyroid carcinoma (DTC)and its efficacy on thyroid hormone level.Methods 20 cases with DTC admitted from Nov.2010 to Jun.2014 were divided into 2 groups.11 cases received rhTSH-aided 131I treatment (rhTSH-aided group)and the other 9 cases received 131I treatment after thyroid hormone withdrawal (THs withdrawal group).The influence of the 2 treatment methods on the serum TSH,FT3,FT4,Tg was evaluated,and the therapeutic effects were assessed according to 131I whole body scintigraphy (WBS)and Tg-negative rate.Results The serum TSH was significantly higher in rhTSH-aided group than that before treatment(t=27.70,P＜ 0.001)and in THs withdrawal group (t=7.18,P＜0.001).TSH levels of all patients were＞30 mU/L.WBS displayed that the thyroid remnant clearance rate was 72.73％(8 cases)nd 66.67％(6 cases)respectively in rhTSH-aided group and THs with-drawal group and there was no statistical difference between the 2 groups(x2=0.178,0.673).Conclusion The rhTsH treatment can help to accomplish the preparation of 131I treatment for DTC and acquire satisfactory ablation efficacy.

BACKGROUND:In the treatment of tibial plateau fractures, because of the variety of fracture, the complexity of anatomical changes, X-ray films or three-dimensional CT scan limited by two-dimensional plane, increases the difficulty in preoperative plan and surgical treatment. The application of three-dimensional (3D) printing technology has attracted attention in the department of orthopedics. OBJECTIVE:To explore the auxiliary role of 3D printing technique in preoperative plan and treatment for tibial plateau fractures. METHODS:Thirty patients with tibial plateau comminuted fractures were enroled in this study and divided into two groups: experimental and control groups, with 15 patients in each group. In the experimental group, patients underwent 3D CT scan, which was stored in DICOM format, and processed by Mimics software. Data were converted into STL format, entered 3D printer, and a 1:1 entity size of the fracture model was made, in accordance with repair plan of 3D fracture model. Operation time and intraoperative blood loss were compared between the two groups. At 12 months after treatment, their outcomes were assessed using Rasmussen evaluation criteria. RESULTS AND CONCLUSION: The 3D printing fracture models of 1:1 ratio identified fracture type and made a repair program before surgery in the experimental group. Operation time and intraoperative blood loss were significantly less in the experimental group than in the control group (P < 0.05). After surgery, patients were folowed up for 12 to 18 months. The healing time was 3-5 months, averagely 4.3 months. At 12 months after treatment, the Rasmussen evaluation criteria results showed that the excelent and good rate was significantly higher in the experimental group than in the control group (P < 0.05). These results suggest that the fracture model of 3D can help to make the operation plan. The treatment of tibial plateau fractures is more precise, personalized and visual.

Objective To analyze the clinical data, including clinical features, treatment, and prognosis,in patients with different kinds of pituitary adenomas. Methods In this retrospective study, 746 cases were included. The characteristics of general epidemiology, clinical symptoms, pathology, imaging, treatment, and prognosis were analyzed. Results Clinical features were different among various pituitary adenomas. Symptoms caused by mass effect and hormone abnormality were expresssed in varying degrees. Serum prolactin>121.28 μg/L can differentiate the prolactin adenoma from the other huge tumor causing hyperprolactinemia due to the mass effect. There is significant relationship between the size and the various types of pituitary adenomas ( P<0.01 ),also between the size and the invasive capability ( P<0.01 ). Conclusions The pituitary adenomas may have their specific epidemiological, clinical, pathological, and imaging features, due to the distinct biological behavior. It is necessary to do the diagnosis, treatment, and prognosis evaluation individually.

BACKGROUND:Polyhydroxybutyrate-co-volerate (PHBV) is a noticeable tissue engineering material of polyhydroxyalkanoates family. It has the properties of low immune rejection response and good biocompatibility, and its degradation products are non-toxic.
OBJECTIVE:To investigate the biocompatibility of PHBV membrane material and human bone marrow mesenchymal stem cel s in vitro.
METHODS:Human bone marrow mesenchymal stem cel s at passage 3 were seeded upon PHBV membrane as experimental group and upon conventional culture plates as control group. Then we calculated the adherent cel number of two groups at 1, 2 and 4 hours and got the cel adherent rate. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide assay was used at days 2, 4, 6, 8 to observe the cel proliferation of two groups. Fluorimetric method with the fluorescent dye Hoechst 33258 was used to detect the DNA content of cel s at days 3, 6, 9 and 12 in both groups. After cel s were seeded upon PHBV membrane for 5 days, the cel growth upon the material was examined under a scanning electron microscope.
RESULTS AND CONCLUSION:When the cel s were cultured for 1 hour, the adherent rate in the experimental group was lower than that in the control group;but there were no significant differences between two groups at the other two periods. No difference was found in the cel proliferation and the DNA content between the two groups. Human bone marrow mesenchymal stem cel s seeded upon PHBV membrane for 5 days grew wel with spindle morphology and the intercel ular connections were tight and more extracel ular matrices were observed by scanning electron microscopy. Taken together, PHBV membrane material shows a good biocompatibility with human bone marrow mesenchymal stem cel s.

BACKGROUND:Titanium and titanium aloy are used mostly in artificial joints, fracture fixation, and oral transplantation, while there are complex cases of insufficient bone mass in these areas. The deepened research of stem cels offers a solution for bone injury to promote new bone formation. The biocompatibility of titanium and stem cels and optimization of titanium surface modification have aroused people's attention. OBJECTIVE:To investigate whether the biocompatibility of titanium and human adipose-derived mesenchymal stem cels can be improved by type I colagen modification of titanium sheets. METHODS:The experiment was divided into two groups. Modification group: titanium sheet was modified with type I colagen; control group: titanium sheet was not modified with type I colagen. Human adipose-derived mesenchymal stem cels at passage 6 were implanted into titanium sheet in two groups. Then we calculated the number of adherent cels in two groups at 1, 2 and 4 hours after implantation, and compared the celladhesion rate. MTT assay was used to observe the proliferation of cels on titanium sheet at 2, 4, 6 and 8 days after implantation. DNA and protein content of cels were detected at 3, 6, 9 days after implantation. The growth of human adipose-derived mesenchymal stem cels seeded upon the titanium sheets was observed under scanning electron microscope at 6 days. RESULTS AND CONCLUSION:When the cels were cultured for 1 hour and 2 hours, the number of adherent cels in the modification group was higher than in the control group (P < 0.05). The absorbance of cels in two groups was increased as the culture time, as detected by MTT assay. The modification group had a significantly higher absorbance value than the control group at 4, 6, 8 days (P < 0.05). DNA and protein contents of the cels in the modification group were higher than that in control group at 6 and 9 days (P < 0.05). At 6 days, the number of adherent cels and secretion of adherent stromal cellmatrix in the modification group were significantly better than that in control group, observed by scanning electron microscopy. Type I colagen modified titanium sheets have good surface activity and biocompatibility, and can promote the proliferation of human adipose-derived mesenchymal stem cels.

BACKGROUND:Autologous tissue-engineered bone marrow mesenchymal stem cel s (BMSCs) transplantation is one of the most common methods of treating early osteonecrosis of femoral head, but now there is stil no any special-purpose grafter available in the market. Such surgical transplantation is a laborious, time-consuming and tedious process, which goes against its clinical promotion. OBJECTIVE:To develop a supporting, efficient, special-purpose grafter, to solve the difficulty in stem cel s transplantation during core decompression of femoral head. METHODS:CAD software was used to perform solid modeling for this special-purpose grafter and print them by three-dimensional (3D) fast printing technology. The performance of this special-purpose grafter was tested by femoral head core decompression combined with BMSCs transplantation. It was compared with traditional surgical instrument in terms of duration of operation, intraoperative blood loss, visual analogue scale (VAS) of stem cel/biological fiber col agen complex omission amount and doctor’s satisfaction score. RESULTS AND CONCLUSION:(1) A kind of special-purpose grafter was developed by 3D printing technology rapidly. (2) Compared with the control group, duration of operation, intraoperative blood loss, VAS scores and doctor’s satisfaction scores were significantly improved in the trial group (P<0.05). (3) CAD software combined with 3D printing technology is a highly efficient means for front-line clinicians to perform independent development. The research and development of this special-purpose grafter provides a perfect solution to the laborious, time-consuming and tedious process of cel/biological col agen fiber transplantation.