The axillary reverse mapping (ARM) is a new minimally invasive technique, which has been developed to map and preserve arm lymphatic drainage during axillary lymph node dissection (ALND)and/or sentinel lymph node (SLN) biopsy, thereby minimizing arm lymphedema.

Objective To investigate the feasibility of laparoscopic extirpation for mammary multiple fibroadenoma. Methods A total of 12 patients with multiple fibroadenoma that were diagnosed by ultrasonography and fine needle aspiration were enrolled in this study. Through an axillary small incision, the air was inflated into the retromammary space, which had been obtusely separated to build a surgical space. Then, 58 fibroadenomas were resected under a laparoscope. Frozen-section examination was carried out during the operation. Results All the masses of the 12 patients were laparoscopically extirpated successfully, without operative complications. The operation time was 40-150 minutes with a mean of 80 minutes. One month after the operation, the shape of the breast looked well and the sensation of the nipple remained normal. During a 1- to 36-month follow-up (mean 18.5 months), none of the patients had scars on the breast or tumor recurrence. All of them were satisfied with the cosmetic results. Conclusion Laparoscopic extirpation of mammary multiple fibroadenoma through the retromammary space is safe and feasible.

Objective To investigate the feasibility and complications of the transcranial approach for resection of tumors that involve the anterior skull base, orbit and paranasal sinuses. Methods Nine cases of tumors involving the anterior skull base, orbit and paranasal sinuses, which were resected by transcranial approach alone in our hospital from July 2000 to April 2001, were retrospectively analyzed. All patients had the lesion of the anterior skull base and orbit, and 5 cases had additional paranasal sinuses involvement. Results The tumors in all patients were removed completely. Complications occurred in three cases, including one case of cerebrospinal fluid leaking and two cases of blepharoptosis. One died of tumor recurrence one year after operation. Eight were tumor-free survival during the follow-up period of 20～29 months. Conclusion The transcranial approach can completely remove the tumors widely invading the anterior skull base, orbit and paranasal sinuses. Separation of the periosteum of the orbital roof can cause blepharoptosis, which leads to failure of cosmetics. Extending approach must be avoided if it is possible. The reconstruction of the skull base with pedicle pericranial flap may be the key factor to reduce complications.

Objective To explore effects of paclitaxel on proliferation and migration of breast cancer Michigan Cancer Foundation-7 (MCF-7) cells via mammalian target of rapamycin (mTOR) signaling pathway.Methods The cases were randomly divided into four groups,including control group,paclitaxel low-dose group (0.25 μmol/L),paclitaxel medium-dose group (0.5 μmol/L),and paclitaxel high-dose group (1 μmol/L).The viability of MCF-7 cells was measured with methyl thiazolyl tetrazolium (MTT) assay.MCF-7 cell cycle was examined with flow cytometry.MCF-7 cell migration was tested with transwell migration assay.The levels of mTOR signalling pathway-related protein were assayed with Western blot.Results Compared to the control group,MCF-7 cell viability was significantly decreased in paclitaxel low,medium and high-dose groups (P ＜ 0.05),and the inhibitory rate was highest at 48 h (P ＜ 0.05).MCF-7 cell migration was significantly inhibited in paclitaxel low,medium and high-dose groups [(98 ± 9.78) vs (86.21 ± 6.58),(53.41 ± 3.16) and (42.00 ± 4.69),P ＜ 0.05].Moreover,compared to the control group,the number of MCF-7 cells at G1 phase was significantly increased in paclitaxel low,medium and high-dose groups [(52.14±6.13)％ vs (67.93 ±8.16)％,(72.32 ±3.67)％ and (78.53 ± 6.28)％,P ＜ 0.01],the number of MCF-7 cells at G2 phase was significantly reduced in paclitaxel low,medium and high-dose group [(13.68 ± 0.85) ％ vs (8.57 ± 1.03) ％,(5.30 ± 0.89) ％ and (3.46 ± 0.78) ％,P ＜0.01].The phosphorylations of 4E binding protein (4EBP1) and mTOR proteins as well as the expressions of cell-cycle protein D1 (Cyclin D1) and matrix metalloproteinase-9 (MMP-9) were significantly inhibited in paclitaxel low,medium and high-dose groups (P ＜ 0.01).Conclusions These results suggested paclitaxel could inhibit proliferation and migration in breast cancer MCF-7 cells,which might be related to mTOR signal pathway.