Objective To explore the clinical and pathological characteristics of triple-negative breast cancer(TNBC) and to compare the response to neoadjuvant chemotherapy and survival in patients with TNBC and non-TNBC. Methods Five hundred and thirty-five patients were included in this retrospective study. 75 patients were TNBC and 460 were non-TNBC. The clinical and pathological characteristics, 5-year disease free survival (DFS) and overall survival (OS) were analyzed. 88 patients were treated with neoadjuvant chemotherapy in which 26 patients were TNBC, the other were non-TNBC. Their responses to neoadjuvant chemotherapy, and the relations of response and survival were analyzed. Results The patients with TNBC were younger than those with non-TNBC (35 vs 44), and most of the patients with TNBC were premenopausal at diagnosis (88.0 % vs 67.2 %, P =0.009). The frequency of invasive ductal carcinoma was higher in patients with TNBC than those with non-TNBC (92.0 % vs 80.4 %, P =0.020). Generally patients with TNBC had higher grade tumors (grade Ⅱ ) than patients with non-TNBC (56.0 % vs 17.2 %, P = 0.000). Lower rate of lymph node metastasis were observed in patients with TNBC than those with non-TNBC (33.3 % vs 53.9 %, P = 0.001). Patients with TNBC had worse 5-year DFS (66.67 %) and OS (80.0 %) than those with non-TNBC (74.78 %, 90.00 %). In this study. 88 patients were treated with neoadjuvant chemotherapy. The overall response rate(OR) of patients with TNBC was 88.46 %, including 65.38 % clinical complete response (cCR)and 23.08 % clinical partial response (cPR). It was significantly higher than patients with non-TNBC respectively (82.26 %, 37.10 %, 45.16 %) (P <0.05). Patients with TNBC had worse 5-year DFS (65.38 %)and OS (73.08 %) than those with non-TNBC (72.58 %, 80.65 %) (P <0.05). If cCR were achieved, patients with TNBC or with non-TNBC had similar 5-year DFS and 5-year OS (P>0.05). In contrast, TNBC patients with residual disease after neoadjuvant chemotherapy had worse 5-year DFS and OS compared with non-TNBC (P <0.05). Conclusion TNBC is common in young premenopausal women. Its main pathological style is nonspecial type of invasive ductal carcinoma with high grade, with low lymph node metastasis rate. Patients with TNBC are more sensitive to neoadjuvant chemotherapy than those with non-TNBC. Patients with TNBC have increased cCR rates compared with non-TNBC, and those with cCR have a good prognosis. TNBC patients in whom cCR are not achieved have significantly worse survival rates compared with that of non-TNBC patients.

Objective To expand MSCT obseration and cognition in the ponticulus of atlas,and to improve the diagnosis for it. Methods 263 cases were collected among the patients undergone the examine of MSCT angiography in intracranial and cervical and volume rendering technique(VRT)with unenhance images,and observation and analysis was focused on the posterior arch of atlas. Results 69 cases(97 sides)were detected ponticulus in this group,including unilateral in 41 cases,bilateral in 28 cases.The simple type ponticulus were 82 sides,including the ponticulus posterior (PP)were 60 sides,the ponticulus lateralis (PL)were 1 5 sides,the ponticulus borderland (PB)were 5 sides,The ponticulus middle (PM)were 2 sides.According to the shape of the ponticulus:simple root in 43 sides,opposite beaked in 21 sides,complete type in 18 sides.The ponticulus compound (PC)were 1 5 sides.Conclusion The images of MSCT VRT can showed accurately the ponticulus of atlas,and it can provide reliable imaging evidence on its diagnosis and classification,and it can be used as an unearthly method for its examination.

Objective To discuss the correlation between molecular subtypes of early stage breast cancer patients with positive sentinel lymph nodes and the metastasis of non-sentinel lymph nodes, and find out the factors predicting the metastasis of non-sentinel lymph nodes. Methods The clinical data of 124 female breast cancer patients with sentinel lymph node positive were retrospectively analyzed, and the patients were treated with axillary lymph node dissection. And the correlations were analyzed by single factor analysis and multiple factor Logistic regression analysis. Results Among the 124 patients,non-sentinel lymph node metastasis was in 45 cases (36.3%), and only sentinel lymph node positive was in 79 cases (63.7%). The single factor analysis result showed that the age≤35 years, number of sentinel lymph node positive≥2, macrometastasis of sentinel lymph node had correlation with the metastasis of non-sentinel lymph node (P<0.05 or<0.01);but the molecular type, operation method, maximum tumor diameter had no correlation with the metastasis of non-sentinel lymph node (P>0.05). The multiple factor Logistic regression analysis result showed that the number of sentinel lymph node positive and circumstance of sentinel lymph node positive lesions were the independent risk factors of the non-sentinel lymph node metastasis in patients with sentinel lymph node positive (OR = 4.589 and 2.948; P<0.01 or <0.05). Conclusions The circumstance of sentinel lymph node positive lesions and number of sentinel lymph node positive are the independent risk factors of the non-sentinel lymph node metastasis, but the molecular type is not correlated with the metastasis of non-sentinel lymph node. Predicting non-sentinel lymph node metastasis should be combined with clinical and pathological factors.

BACKGROUND:Currently, there is no effective treatment for keloids that often recur. Its pathogenesis is stil entirely unclear, and fibroblast proliferation and apoptosis have become a research hotspot.
OBJECTIVE:To investigate the expression of Livin, Smac and Caspase-3 in keloids and to analyze their relationship so as to preliminarily explore the significance of Livin, Smac and Caspase-3 in the pathogenesis of keloids.
METHODS:RT-PCR and immunohistochemical methods were used to detect the mRNA and protein expressions of Livin, Smac and Caspase-3 in keloids (n=20) and normal skin tissues (n=20).
RESULTS AND CONCLUSION:Compared with the normal skin tissue, the mRNA and protein positive expressions of Livin were significantly higher in keloids (P < 0.05), while the mRNA and protein positive expressions of Smac and Caspase-3 were lower in keloids (P < 0.05). There was a negative association between Livin and Smac, Caspase-3 protein expression in keloids. These findings indicate that the high mRNA expression of Livin may cause the imbalance between proliferation and apoptosis of fibroblasts by inhibiting the mRNA expression of Smac and Caspase-3, and eventualy lead to the formation of keloid.

Objective To explore the belongingness,name and clinical significance of a sort of osteal structure variation (OSV) posterior,outboard and superior to the ditch of vertebral artery of atlas.Methods 23 cases of OSV were collected among 426 patients underwent MSCT intracranial and cervical angiography with volume rendering technique (VRT)to notice the pier point,shape and direction of protuberance,and the relation and influence to the vertebral artery.Results The incidence of OSV was 5.40%(23/426) in which 31 sides were detected,and 1 5 cases in unilateral and 8 cases in bilateral.Simple type was showed at 1 9 sides,compound type at 12 sides with other ponticulus.According to the shape of the ponticulus,simple root was seen at 1 7 sides(13 inferior root and 4 lat-erial root),opposite beaked at 5 sides,complete type at 9 sides.OSV was located at posterior,outbord and superior to the ditch of vertebral artery of atlas and closed to the vertebral artery.The vertebral artery was influenced by OSV as following:in simple OSV vertebral artery stenosis was seen at 4 sides in which unite convulsion was showed at one side;in compound OSV vertebral artery ste-nosis was seen at 5 sides,in which unite convulsion was showed at 2 sides.Conclusion OSV is similar to ponticulus posticus(PP)and ponticulus lateralis(PL),and has similarly importance clinical significance,and should belong to the ponticulus of atlas,and to be named as ponticulus borderland(PB).

Objective:To investigate the in vitro anti-cancer effect of Vinorelbine (NVB) combined with adriamycin (PLD) on human breast cancer MCF-7 cells and related mechanisms.Methods:The effects of NVB and PLD alone or in combination on the proliferation of breast cancer cells were detected by CCK-8 experiment. Flow cytometry was used to detect cell apoptosis and changes in reactive oxygen species (ROS) levels. Western blot experiment was carried out to detect protein expression.Results:The results of CCK-8 showed that compared with the blank control group, the inhibition rates of the vinorelbine treatment group, the adriamycin treatment group and the combined treatment group were 27.6%, 31.2% and 65.4%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.005 vs 0.001) . The results of flow cytometry showed that the proportion of apoptotic cells in each group was 3.54%, 16.95%, 15.01% and 32.24%, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.006 vs 0.005) . The levels of reactive oxygen species in each group were 1, 1.03, 1.06 and 1.57, compared with the NVB group and PLD group, the difference between the combined treatment group was statistically significant ( P=0.008 vs 0.007) . Western blot results showed that the expression of p-ERK and p-STAT3 decreased after the combination of NVB and PLD, which inhibited the ERK/STAT3 signaling pathway. Conclusions:The combination of NVB and PLD can promote the apoptosis of breast cancer cells and inhibit the proliferation of breast cancer cells with high efficiency and low toxicity. Its mechanism of action may be related to the up-regulation of ROS levels in cells, thereby inhibiting the activation of the ERK/STAT3 pathway.