Objective To probe the effect of perioperative therapeutic regime on breast reconstruction after surgery in breast cancer patients.Methods We retrospectively reviewed the clinical data of 145 consecutive breast cancer patients with 162 reconstructions.Results 127 of 145 patients got an excellent or good appearance (87.6％),and 42 cases had complications occurring in 162 operations (25.9％).After a median follow-up of 38.4 months,recurrences were found in 9 patients,3 cases died,and the disease free survival rate was 93.1％.Multivariate analysis showed that radiation therapy,without nipple-sparing and one-stage prosthesis implant were independent risk factors for negative postoperative aesthetic outcome;Delayed reconstruction and implant reconstruction were found to be protective factors for the postoperative complications.Conclusions Although the survival rate appears to be scarcely affected,different treatment modalities in reconstruction strategy bring different clinical results and outcomes.The perioperative decision-making of reconstruction strategy should be based on oncological safety,postoperative complications,aesthetic outcomes and subsequent therapies.

Background and purpose: Factor that binds to the inducer of short transcripts of human immuno-deficiency virus-1 (FBI-1) in a variety of malignant tumors showed high expression levels, which may be closely related to tumor proliferation and differentiation, angiogenesis, metastasis, but its relationship with breast cancer has not been fully elucidated. The purpose of this study was to investigate the expression of FBI-1 in breast cancer cells, and to study the effect of FBI-1 gene expression on the proliferation of breast cancer cells and its possible mechanism. Methods:Real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot analysis were applied to detect FBI-1 expression in normal human mammary epithelial cell line MCF-10A and breast cancer cell MCF-7. RNA interference method was used to down-regulate FBI-1 expression in MCF-7 cells. The cell proliferation was measured by CCK-8 kit and colony formation assay. RTFQ-PCR and Western blot were used to detect the expression of FBI-1 and NF-κBp65 in MCF-7 cells before and after the interference of FBI-1 expression. Results: The expression of FBI-1 was higher in breast cancer cells than that in normal human mammary epithelial cells (P<0.05). The effects of FBI-1 down-regulation inhibited proliferation in MCF-7 cells (P<0.05). At the same time, after inhibition of FBI-1, the NF-κBp65 mRNA and protein expression levels were significantly decreased (P<0.05). Conclusion: FBI-1 is highly expressed in breast cancer cells. Down-regulated FBI-1 expression can inhibit the proliferation of breast cancer cells,and its mechanism may be related to the inhibition of NF-κB signaling pathway.

Objective To investigate the application of statins in secondary prevention of ischemic stroke in different risk groups,and to identify the factors influencing the comphcance of statins.Me.ods Ischemic stroke patients from December 2011 to October 2012 were collected.All clinical characterisitcs and possible factors influencing the compliance of statins was recorded in 3 months.The multivariate Logistic regression analysis was used to analyze the influencing factors of the compliance of statins.Results All 368 patients were collected,and 67.9％(250/368) patients were prescribed statins for therapy during hospitalization.The application rate of statins in accordance with guidelines in high-risk,extremely high-risk Ⅱ and extremely high-risk Ⅰ patients was 28.1％ (18/64),44.1％ (30/68) and 72.3％ (136/188),respectively.Logistic regression analysis showed that the statins application during hospitalization was associated with the presence of carotid vulnerable plaques (OR =5.308,P =0.000) and diabetes history (OR =1.789,P =0.032).Routine discharge instructions had high compliance.Conclusion The compliance of statins in secondary prevention of ischemic stroke still has a large gap between clinical practice and guidelines,and routine discharge instructions on statins application increase the compliance of statins.

Objective To explore the empathy deficits of adolescents with different types of conduct disorder. Methods The participants included 65 adolescents ( who met the DSM-Ⅳ criteria for conduct disorder)ranging from 13 ～ 18 in age,and 195 normal adolescents ranging from 13 ～ 18 in age. All participants were assessed by revised Basic Empathy Scale. 65 patients were divided into 4 subgroups according to symptoms: destructive-nondestructive subgroups and overt-covert subgroups. Results (1) Scores of cognitive empathy were lower in patients than normal controls ( (29.86 ± 4.72) vs ( 32.09 ± 4.94), P ＜ 0. 01 ). (2) There were significant differences in the levels of cognitive empathy between patients and controls (P＜0. 01 ). Scores of cognitive empathy were lower in destructive subgroup than controls ( (29.76 ± 4.46) vs ( 32.09 ± 4.94) , P ＜ 0.01 ). (3) There were significant differences in the levels of two dimensions and total scores of empathy between patients and controls (F=3.10 ～5.36, P ＜ 0.05 ). Scores of cognitive empathy were lower in overt subgroup ( 29.22 ± 3.77 ) and covert subgroup (30.21 ± 5.17 ) than controls (32.09 ± 4.94) (P＜ 0.05, P＜0.01 );and scores of affective empathy were lower in overt subgroup than covert subgroup ( (26.13 ±5.05) vs (29.50 ±4.16), P＜0.05 ). Total scores of empathy were lower in overt subgroup (55.35 ±7.09) than covert subgroup (59.71 ±7.58) and controls (60.04 ±8.50 ) (P＜0.05). (4) Logistic regression analysis showed that cognitive empathy was a protective factor for conduct disorders( OR = 0.43 ). Conclusion The cognitive empathy level of patients is significantly lower than normal students;and boys with different types of conduct disorder possess different empathic abilities when compared with healthy controls;and cognitive empathy is a protective factor for conduct disorder.

Objective To explore the effects and mechanism of triptolide on proliferation and apoptosis of breast cancer MCF-7 cells.Methods MCF-7 cells were treated by different concentrations of triptolide.CCK-8 as-say was employed to detect the cell proliferation. The morphological changes were observed by an inverted micro-scope.The apoptosis rate was detected by flow cytometry.Expressions of Bcl-2,Bax,Survivin and Caspase-3 were measured by qRT-PCR and Western blot. Results Triptolide inhibited the proliferation of MCF-7 cells in a dose and time-dependent manner at a suitable range.Triptolide induced morphological changes and apoptosis.Triptolide also down-regulated Bcl-2 and Survivin expressions and up-regulated Bax and Caspase-3 expressions. Conclu-sions Triptolide inhibits proliferation and induces apoptosis of MCF-7 cells,and its mechanism may be related to down-regulation of Bcl-2 and Survivin expressions and up-regulation of Bax and Caspase-3 expressions.

Objective To explore the method and clinical effect of radial artery pedigreed conjoined perfora-tor flap for repairing cross-joint long-shaped skin and soft tissue defects in fingers. Methods From June, 2015 to June,2017,six patients with cross-joint long-shaped skin and soft tissue defects of the fingers were treated with radial artery pedigreed conjoined flap which axis was the artery superficial line, and carried two radial artery perforators, in order to enlarge flap cut range to repair.The size of flaps ranged from 3.0 cm ×6.0 cm to 3.5 cm ×7.5 cm.The donor site was directly sutured. After operation, all patients were followed up for 3 to 8 months. All the necessary parts are observed, such as the flaps appearances, textures, the donor sites, checked the flap sensation, activity functions of the fingers. Results Six cases of flap all survived.The wounds healed well(phase I),and all patients were followed up for 3 to 8 months, with an average of 5 months. All the flaps do not obviously bloat, the textures were soft,the colors are normal,the appearances of flaps were similar to recipient sites. The donor sites healed well only with linear scars. Conclusion Using radial artery pedigreed conjoined perforator flap to repair cross-joint long-shaped skins and soft tissue defects in fingers that it not only can enlarge the cut range but also cut conveniently, the textures are close to recipient sites.Therefore,it is an ideal repair way.

BACKGROUNDThis study was designed in an attempt to determine the influence of neoadjuvant chemotherapy on estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (Her-2), and Ki-67 expressions in patients with breast cancer.

METHODSPre- and post-neoadjuvant chemotherapy, paired-tumor specimens from 103 patients with breast cancer administrated with anthracycline or anthracycline combined taxane regimen were collected. Immunohistochemical staining for ER, PR, Her-2, and Ki-67 was performed by the DAKO EnVision method.

RESULTSAmong the 103 cases, five patients (4.9%) had a complete response (CR), 82 (79.6%) partial response (PR), 15 (14.6%) stable disease (SD), and one (0.9%) progressive disease (PD), yielding an overall response rate (CR + PR) of 84.5%. Nine patients achieved pathological CR. There was a significant decrease in the average index of Ki-67 postneoadjuvant chemotherapy, compared with that before chemotherapy (24.1% vs. 39.7%, P < 0.001). After neoadjuvant chemotherapy, the changes of Ki-67 in different subtypes of breast cancer were different (P < 0.001), and these changes correlated with response to neoadjuvant chemotherapy (P < 0.001). No significant changes in immunohistochemical expression were observed for ER, PR and Her-2.

CONCLUSIONSNeoadjuvant chemotherapy apparently reduced Ki-67 index in primary breast carcinomas, but profiles for ER, PR and Her-2 were not significantly different before and after neoadjuvant chemotherapy. The change of Ki-67 correlated with molecular subtypes and response to neoadjuvant chemotherapy, suggesting that Ki-67 index was a surrogate marker to predict the treatment response of neoadjuvant chemotherapy.

Adult ; Aged ; Anthracyclines ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; therapy ; Bridged-Ring Compounds ; therapeutic use ; Female ; Humans ; Immunohistochemistry ; In Vitro Techniques ; Ki-67 Antigen ; metabolism ; Middle Aged ; Neoadjuvant Therapy ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Taxoids ; therapeutic use ; Young Adult

Objective: To explore the feasibility of 7, 12-dimethylbenz[a] anthracene (DMBA) induced tree shrew breast cancer model, and compare the effects of two administration modes by gavage and mammary gland injection. Methods: A total of 40 tree shrews were randomly divided into two groups (20 animals per group): DMBA gavage group and mammary gland injection group. DMBA was dissolved in edible vegetable oil. For gavage group, tree shrews were administered with DMBA solutions (15 mg/kg) by gavage once a day. For mammary gland injection group, DMBA solution (10 mg/kg) was injected into the mammary fat pad of tree shrews, and the injection was performed for a total of 3 times. From the first administration of DMBA, medroxyprogesterone acetate (MPA, 100 mg/kg) was intramuscularly injected into the muscles of the lateral thighs of tree shrews at the same time, for a total of 5 times. The tumorigenesis and survival of tree shrews were monitored. The tumor histological morphology was observed by HE staining. The expression of estrogen receptor (ER), progesterone receptor (PR), cytokeratin5/6 (CK5/6) and human epidermal factor receptor-2 (HER-2) was detected by immunohistochemical staining. Results: In the gavage group, there were 10 deaths, and 4 tree shrews developed mammary tumors with 20.0% (4/20) tumor formation rate. The success rate of mammary cancer modeling was 10.0% (2/20), and the tumor formation time was 197.3±15.1 days. In the mammary gland injection group, there were 8 tree shrews died, and 9 tree shrews formed tumors with 45.0% (9/20) tumor formation rate. The success rate of mammary cancer modeling was 40.0% (8/20), and the tumor formation time was 71.8±19.0 days. There was no significant difference in mortality and tumor formation rate (P>0.05) between the two groups (all P>0.05). However, in the mammary gland injection group, the success rate of mammary cancer modeling was significantly higher than that in the gavage group (P<0.05), whereas the tumor formation time was markedly shorter than that in the gavage group (P<0.01). The pathological types in the gavage group included ductal hyperplasia, intraductal papilloma and ductal carcinoma in situ, while those in the breast injection group included intraductal papilloma and ductal carcinoma in situ. In both groups, immunohistochemical staining showed the negative expression of HER-2 but positive expression of ER, PR and CK5/6 with varying degrees. Conclusion Both the DMBA gavage and mammary gland injection can successfully establish the tree shrew breast cancer model, and the modeling effect of mammary gland injection is better than gavage.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.