Objective To assess whether survival differed among patients who had triple-negative breast cancers compared with patients who had non-triple-negative breast cancers.Methods The clinicopathologic data of 684 patients with operable breast cancer,who were treated with multimodal therapy from December 1998 to June 2007 were analyzed.Of these patients,107 cases were confirmed to have triple-negative tumor histology(triple-negative group),577 cases were confirmed to have non-triple-negative tumor histology(non-triple-negative group).The 7 years cumulative survival and disease-free survival were analyzed by Kaplan-Meier method and compared by Log-rank test.The prognosis Was analyzed by COX regression model.Results The 7 years overall survival rates for triple-negative group and non-triple-negative group were 51.4%(55/107),74.2%(428/577),respectively,there Was significant difference between the two groups(P＜0.01).However,the 7 years overall survival rates of patients with triple-negative group and those who with Her-2 positive were 51.4%(55/107)and 53.1%(43/81)respectively,there Was no significant difference between them (P＞0.05).Univariate analysis revealed that the factors affecting the disease-free survival included age,menopausal status,tumor size,lymph nodes metastasis,estrogen,progesterone,and Her-2 receptors status.Multivariate analysis showed minor size,lymph nodes metastasis,estrogen,progesterone,and Her-2 receptors status were independent prognostic factors.Conclusions This study has shown a trend towards a poorer outcome for patients with triple-negative breast cancer similarity to patients with Her-2 positive cancers.Triple-negative breast cancer is an independent predictor factor of survival.

Objective: The scavenging capacity of free radicals by enzymes-hydrolyzed wheat bran (EHWB) and its protection against DNA damage were studied in vitro. Method: EHWB, prepared by hydrolyzing de-starched wheat bran using enzymes from Aspergillus niger fermentation, was used to test its scavenging capacity of free radicals and protection against DNA damage caused by hydroxyl free radical in vitro. Results: The capacity of scavenging free radicals by EHWB was shown, and EHWB could protect DNA damage caused by hydroxyl radicals. Conclusion: EHWB has higher free radicals scavenging capacity.

Objective To construct a eukaryotic expression vector of huma n insuli n-like growth factor-1 (hIGF-1) gene,and to investigate the transfection and ex pression of pcDNA3.1(-)/hIGF-1 eukaryotic expression plasmid in myoblast cells. Methods pcDNA3.1(-)/hIGF-1 eukaryotic expression plasmid was co nstructed. Myobl ast C2C12 cells were transiently transfected with lipofectamine. RT-PCR a nd immunohistochemical methods were used to detect the expression of hIGF-1 gene . MTT test was used to detect the biological activity of the conditioned medium after the transfection. Results There were significant increas es of hIGF-1 mRN A and protein in the myoblast cells transfected with pcDNA3.1(-)/hIGF-1. The con ditioned medium after the transfection showed the biological activity which coul d stimula te the proliferation of fibroblast cells. Conclusion The pcDNA 3.1(-)/hIGF-1,a eukaryotic expression plasmid for hIGF-1 gene is constructed. High levels of hI GF-1 mRNA and protein expression can be obtained in the myoblast cells transfect ed with pcDNA3.1(-)/hIGF-1 eukaryotic expression plasmid. The expressed protein has the biological activity.

Objective　To study the MRI signs in spinal cord injury. Methods　A tatal of 90 cases of spinal cord injury examined with magnetic resonance(MR)，40 underwent a GE 0.5T superconducting system and 50 with a SIEMENS Open 0.2T. With spine surface coil, all of them were examined with axial and sagittal spin echo sequences, while 10 given extra coronal sequence. MRI findings and its correlation with prognosis of patients were analyzed. Results　Among the 90 cases of spinal cord injury, incomplete and complete transection of spinal cord was found in 14 cases (13.2%), spinal cord edema in 11 (10.4%), intraspinal cord hemorrhage in 27 (25.5%), compression and dislocation in 27(25.5%), malacia in 16(15.1%), and atrophy in 11(10.4%). Conclusion　From the morphologic and pathological changes of spinal cord MRI can not only direct the option of treatment protocols, but may also evaluate the prognosis of spinal cord injuries. Demonstrated by MRI, it suggests that.

Objectives To study the anatomic characteristic of medial patellar retinaculum and its function in patellar stability. Methods Anatomic dissection of the medial patellar retinaculum was performed on 26 knees of 13 embalmed cadaveric specimens,and its composition and conducted functional studies of the several parts were observed respectively. Results The medial patellar retinaculum comprises patellofemoral ligament, patellotibial ligament and patellomeniscal ligament. The medial patellofemoral ligament which is the thickest part in the medial patellar retinaculum contributes to the major restraints to the lateral patellar displacement.

Objective To investigate the clinical effect of interventional therapy in the treatment of acute iliofemoral venous thrombosis.Methods A total of 20 patients with acute iliofemoral venous thrombosis was treated by interventional therapy from February 2004 to April 2006.Under the guidance of ultrasonography,intravenous thrombolysis through the popliteal vein combined with iliac vein stenting was employed.The venous patency was assessed with angiography.Results The catheter-based thrombolysis through the ipsilateral popliteal vein was effective for all the patients.Balloon dilatation angioplasty combined with endovascular stenting was applied in 15 patients,while balloon dilatation angioplasty alone was utilized in other 5 patients.The implantation of a temporary cava filter was required in 10 patients.After intravenous thrombolysis through the popliteal vein,the recanalization rate was 30%～90%(mean,55%) in the iliac vein and 40%～80%(mean,65%) in the femoral vein.Postoperative hematuria was encountered in 1 patient.No symptomatic embolism of pulmonary artery was seen.Postoperatively,clinical symptoms on the effected limb significantly subsided or completely disappeared.The hospitalization expenditure was 52 000～81 000 yuan(mean,74 000 yuan).Follow-up observations for 1～24 months(mean,12 months) were carried out in the 20 patients.The patency rate was 100%(15/15) in 15 patients receiving iliac vein stenting.Out of 5 patients with balloon dilatation,the iliac vein was completely obstructed in 2 patients and was recanalized by 10%～20% in 3 patients.Conclusions Catheter-based thrombolysis through the popliteal vein combined with endovascular stenting is an effective therapeutic strategy for acute iliofemoral venous thrombosis,but it is very expensive.

Objective To discuss the surgical therapy of primary leiomyosarcoma of the inferior vena cava(PIVCLS).Methods Retrospective analysis of was made 5 patients of PIVCLS from Oct 2009 to May 2011 hospitalized in Department of Vascular Surgery,Provincial Hospital Affiliated to Shandong University.All patients underwent surgical resection,combined with reconstruction of bilateral renal vein and distal inferior vena cava using artificial vascular graft.Results Surgical resection was performed successfully in all patients.The mean operation time was 166.6 min,with mean blood loss 1 560 mL.Leiomyosarcoma intruding the inferior vena cava and right renal vein were observed in all patients during operation.The mean size was 12 cm × 10 cm× 8 cm.The diagnosis of PIVCLS in 5 patients was confirmed by postoperative pathologic examination.All patients did not present lower extremity swelling after surgery and discharged from hospital with normal blood (BUN) and (CREA).All patients were administrated with oral warfarin therapy after discharge.No clinical relapse and pulmonary embolism was observed during the follow-up (range 3 months to 12 months).The ultrasound revealed the patency of artificial vascular grafts in all patients.Conclusions Surgical resection combined with reconstruction of bilateral renal vein and distal inferior vena cava using artificial vascular graft is an effective and feasible treatment of PIVCLS.Leiomyosarcoma is completely eliminated and important abdominal viscera are protected well during the procedure because of minimal impact on hemodynamics.The incidence of postoperative pulmonary embolism also decreases obviously.

Objective To discuss the operational technique and clinical effect of metallic stent placement in treating malignant gastroduodenal obstruction.Methods Metallic stent placement under fluoroscopic monitoring and endoscopic direct vision was performed in 47 patients with malignant gastroduodenal obstruction.A total of 54 metallic stents was used.Results The procedure was successfully completed in all 47 patients.During the follow-up period,all the patients could take liquid or ordinary diet and were markedly relived of vomiting.The living quality was much improved and no serious complications occurred.Conclusion Under fluoroscopic monitoring and endoscopic direct vision,stent placement is a safe,effective,technically-simple and time-saving procedure for the treatment of malignant gastroduodenal obstruction with less sufferings to the patient.Therefore,it is definitely worth popularizing this technique in clinical practice.

Objective:To evaluate the quality of the current foreign clinical practice guidelines (CPG) on obstetric venous thromboembolism (VTE), providing reference for standardizing the prevention and treatment of domestic VTE clinical practice.Methods:The GPGs for the management of obstetric VTE published abroad from inception to July 2020 were electronically searched. Two researchers independently evaluated the quality of the included guidelines in accordance with the internationally recognized guideline evaluation tool, AGREE Ⅱ.Results:A total of 12 guidelines, 2 recommendations and 1 consensus for obstetric VTE were included, covering 3 continents and 9 countries, and the published time span was 2009-2020. The standardized scores of the six domain (scope & purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability and editorial independence) included in the guidelines were: 99.44%, 62.78%, 70.35%, 95.74%, 68.80% and 76.94% respectively, and the scores in each domain were ≥ 50.00%, indicating that the included CPGs were of good quality. Except for the domain scope & purpose, the ranges of the other five domains were ≥ 50.00%, suggesting that the quality of the CPGs differed significantly. Among the 15 included CPGs, 4 CPGs were level A (recommended), 11 CPGs were level B (recommended after being revised), and there was no CPG in level C (not recommended). The difference in the recommended content of obstetric VTE management mainly focused on the risk assessment, drug type, dosage and period.Conclusions:The overall quality of the CPGs for obstetric VTE management is high, while the quality of the CPGs varies greatly. In addition, there are differences in the recommended content of obstetric VTE management. More high-quality researches are required to provide evidence-based support for the improvement of the CPGs.

Objective To explore the value of 31P magnetic resonance spectroscopy(31P MRS)for differential diagnosis of bone malignancy and inflammation.Methods Radiography.MRI and 31P MRs were performed on 20 bone malignancy patients,22 bone and soft-tissue inflarnmation patients and 32 healthy voluntecrs.The spectra were analyzed by measuring the areas under the peaks of various metabolites,and by calculating the pH from the Pi shift relative to PCr.The data were analyzed by one-way analysis of vailance (ANOVA).Results Analysis of the 31P MRS data suggested differences among the bone malignancy,the inflammation and the healthy group.The mean of PME/β-ATP ratio(1.24±0.37)in malignancy group increased significantly(P＜0.01).The mean of PDE/β-ATP(2.21.±0.37),Pi/β-ATP(1.46±0.43)in inflammation group was higher than that of the other two groups(P＜0.05),but the ratio of PME/β-ATP (0.19±0.10)wag not increasing.The LEP/T31P(0.10±0.02),PCr/T31P(0.45±0.03)and ATP/T31P (0.45±0.03)ratios in control group were significantly difierent from the two others(P＜0.01).The mean of intracellular pH in malignancy group was 7.45±0.16,higher than that in control group(7.05±0.06),and in inflaruination group(7.20±0.13)(P＜0.01).Conclusions The significant increase of PME and intraeellular pH is of great value in diagnosis of bone malignancy.Combined conventional radiography and MRI.31PMRs would be a simple,no-.invasive and effective diagnostic method.