Objective To analyze the clinicopathological features of bilateral primary breast cancer (BPBC) by molecular subtypes.Methods Clinical data of 145 BPBC patients were reviewed focusing on the clinicopathological features of different molecular subtype and the concordance of molecular subtype between first and second primary breast cancers.Results Of the first primary breast cancers ( FPBC),91 cases (62.8％ ) were Luminal A subtype,Luminal B subtype in 13 cases (9.0％ ),Human epidermal growth factor receptor 2 (HER-2) subtype in 14 cases (9.7％ ),triple negative breast cancer (TNBC) in 27 cases ( 18.6％ ).Of the second primary breast cancers ( SPBC ),Luminal A subtype was found in 93 (64.1％ ) cases,Luminal B subtype in 10(6.9％ ) cases,HER-2 subtype in 14(9.7％ ) cases and TNBC in 28( 19.3％ ) cases.Most TNBC patients were young ( age ≤ 50 ) with high frequency of grade Ⅲ in FPBC.Molecular subtypes do not vary with tumor size,clinical stage,lymph node status and pathological types ( P ＞ 0.05 ).Most FPBC of Luminal A and TNBC were concordant same subtypes in SPBC ( K ＞ 0.04 ),while Luminal B and HER-2 subtypes often had discordant phenotypes in SPBC ( K ＜ 0.04).BPBC were more likely to have concordant subtypes if the two tumors developed in short time interval.Conclusions The distribution and clinical leatures of each subtype in BPBC is similar to unilateral breast cancer.Patients whose FPBC are Luminal A or TNBC often have concordant phenotypes for their SPBC,a short time interval between two cancers also predicts concordance.

Objective:To research the application of flurbiprofen compound small dose fentanyl with self-control vein analgesia after laparoscopic cholecystectomy and the influence on blood coagulation function.Methods:102 cases with laparoscopic cholecystectomy who were treated in our hospital from November 2015 to November 2016 were selected and divided into the control group and the research group,with 51 cases in each group.The patients in the control group were treated with postoperative intravenous analgesia with low-dose fentanyl,while the patients in the research group were treated with postoperative intravenous analgesia with flurbiprofen ester compound low-dose fentanyl.Then the fibrinogen (Fg),activated partial prothrombin time (APTT),prothrombin time (PT),platelet count (PLT),substance P,5-hydrocarbon serotonin (5-HT),interleukin 6,8 (IL-6,IL-8) and complications between two groups were observed and compared.Results:Before treatment,there was no statistically significant difference about the Fg,APTT,PT,PLT,substance P,5-HT,IL-6 and IL-8 between two groups (P＞0.05);After treatment,the Fg,APTT,PT,PLT,substance P,5-HT,IL-6 and IL-8 increased in the two groups,while the research group was lower than that of the control group,and the differences were statistically significant (P＜0.05).The postoperative complication rate of research group was lower than that of the control group (P＜0.05).Conclusion:Flurbiprofen ester compound small dose fentanyl with self-control vein analgesia can relieve coagulation function,and inhibit the levels of inflammatory factors.

Histone deacetylases (HDACs) inhibition causes hyperacetylation of histones leading to growth arrest, differentiation and apoptosis of tumor cells, representing a new strategy in cancer therapy. Many of previously reported HDACs inhibitors are hydroxamic acid derivatives, which could chelate the zinc ion in the active site in a bidentate fashion. However, hydroxamic acids occasionally have produced problems such as poor pharmacokinetics, severe toxicity and low selectivity. Herein we describe the identification of a new series of non-hydroxamate HDACs inhibitors bearing diketo ester moieties as zinc binding group. HDACs inhibition assay and antiproliferation assays in vitro against multiple cancer cell lines were used for evaluation. These compounds displayed low antiproliferative activity against solid tumor cells, while good antiproliferative activity against human leukemic monocyte lymphoma cell line U937. Compound CPUYS707 is the best with GI50 value of 0.31 micromol x L(-1) against U937 cells, which is more potent than SAHA and MS-275. HDACs inhibition activity of these compounds is lower than that expected, further evaluation is needed.

Objective To compare the mRNA expressions of interleukin (IL)-17 and IL-23 in peripheral blood of patients with psoriasis vulgaris versus healthy individuals,assess the relationship of these parameters with psoriasis area and severity index (PASI) score,and to investigate the therapeutic mechanisms of total glucosides of peony (TGP) for psoriasis vulgaris.Methods Fifty patients with psoriasis vulgaris and 40 healthy individuals were enrolled in this study.Of these patients,42 were treated with TGP of 600-900 mg twice a day for 8 weeks.Blood samples were obtained from all the healthy individuals,50 patients before treatment,42 patients after 4-week treatment,and 23 patients after 8-week treatment.Real-time fluorescence-based quantitative reverse transcription PCR (RT-PCR) was used to determine the mRNA expression levels of IL-17 and IL-23 in the blood samples.The severity of psoriasis was evaluated using PASI score before and after the treatment.Statistical analysis was done by t test,rank sum test,and Pearson correlation analysis using the SPSS16.0 software.Results The IL-17 and IL-23 mRNA expression levels (given in △Ct value) in the patients before treatment were significantly higher than those in the healthy controls (IL-17,-5.32 ± 0.80 vs.2.79 ± 0.76,t =47.71,P ＜ 0.05; IL-23,-5.43 ± 0.68 vs.-3.77 ± 0.86,t =10.38,P ＜ 0.05),and positively correlated with the PASI score (r =0.61,0.52 respectively,both P ＜ 0.05).A significant decrease was observed in the mRNA expression levels of IL-17 and IL-23 as well as PASI score in the 42 patients after 4-week treatment with TGP compared with those before treatment(IL-17,-2.24 ± 0.61 vs.-5.30 ± 0.78,t =20.40,P ＜ 0.05; IL-23,-1.97 ± 0.74 vs.-5.44 ± 0.68,t =21.69,P ＜ 0.05; PASI,5.8 ± 2.7 vs.9.4 ± 4.2,t =4.68,P ＜ 0.05),and in the 23 patients after 8-week treatment compared with those after 4-wek treatment(IL-17,-1.51 ± 0.78 vs.-2.21 ± 0.59,t =3.50,P ＜ 0.05; IL-23,-1.27 ± 0.81 vs.-1.89 ± 0.72,t =2.70,P＜ 0.05; PASI,3.8 ± 1.8 vs.7.3 ± 2.5,t =5.47,P＜ 0.05).Conclusions It seems that both IL-17 and IL-23 are involved in the pathogenesis of psoriasis vulgaris,and TGP treatment can reduce the mRNA expression levels of IL-17 and IL-23 as well as PASI score in patients with psoriasis vulgaris.

Aim To investigate the effects of diallyl di-sulfide( DADS) on G2/M arrest in Chk1/MGC803 and Chk2/MGC803 cells so as to establish stable human gastric cancer MGC803 cells with overexpression of Chk1/2 gene. Methods The colony formation, flow cytometry, RT-PCR and Western blot were used to de-tect the proliferation, cell cycle, and expression of Chk1/2 mRNA and protein, p-Chk1/2, CDC25C and cyclinB1, respectively. Results The colony formation showed that the colony forming efficiency in Chk1/MGC803 and Chk2/MGC803 cells treated by 30 mg· L-1 DADS was lower than in control group and vector group ( P <0. 05 ) . Flow cytometry demonstrated that 41. 3%, 57. 4%, 68. 9% and 42. 9% of G2/M cells in Chk1/MGC803 were increased than in MGC803 and Chk2/MGC803 , respectively after treated by DADS in 12,24, 36 and 48 h(P <0. 05). At the same time, RT-PCR disclosed that expression of Chk1 and Chk2 mRNA had no marked change. Western blot showed that total proteins of Chk1 and Chk2 and p-Chk2 had invisible change, but expression of p-Chk1 was up-reg-ulated, and CDC25C and cyclinB1 were down-regula-ted time-dependently in Chk1/MGC803 cells ( P <0. 05 ) . Conclusion DADS arrests MGC803 cells at G2/M by increasing p-Chk1 expression to cause down-regulation of CDC25C and cyclinB1 simultaneously.

Objective: To explore the association of hypertriglyceridemic waist phenotype ( HTGW ) with impaired fasting glucose ( IFG ) and diabetes, so as to provide reference for the early prevention and control of diabetes. Methods: The survey was conducted among 35 to 75-year-old residents in 8 project sites in Jiangsu Province from 2015 to 2019. The information about demography and lifestyle was collected by the general information questionnaire and the primary screening questionnaire from the National Center for Cardiovascular Diseases; waist circumference, height, weight, triglyceride, high-density lipoprotein cholesterol, total cholesterol and fasting plasma glucose were measured. The multinomial logistic regression model was employed to analyze the association of HTGW with IFG and diabetes. Results: A total of 118 383 subjects were included, among whom 21 851 cases of HTGW, 27 245 cases of IFG and 22 899 cases of diabetes were identified, with the prevalence of 18.46%, 23.01% and 19.34%. The multinomial logistic regression analysis showed HTGW was statistically associated with IFG ( OR=1.414, 95%CI: 1.343-1.489 ) and diabetes ( OR=2.216, 95%CI: 2.098-2.341 ). Conclusion HTGW is associated with IFG and diabetes, which make it possible to be an indicator for screening and assessment of glucose abnormality in middle-aged and elderly population.

OBJECTIVETo study the effect of Qianyang Recipe (QYR) on the Gan-yang hyperactivity syndrome (GYHS), the blood pressure, and correlated vascular regulatory factors of hypertension rat.

METHODSThirty SD rats were randomly divided into the normal control group, the model group, and the QYR group, ten in each. Hypertension rat model of GYHS was prepared using Aconiti Praeparata Decoction plus ephedrine plus salt water. Rats in the QYR group orally took QYR physic liquor, while distilled water was given to rats in the normal control group and the model group. They were medicated for 28 successive days. The facial temperature, the grip strength, and the systolic pressure were determined once every 7 days. Rats' irritable degree and feather color were observed and recorded once every 14 days. After the last administration the plasma renin (PR), angiotensin II (Ang II), aldosterone (ALD), atrial natriuretic peptide (ANP), calcitonin gene-related peptide (cGRP) were determined.

RESULTSCompared with the model group of the same phase, the facial temperature of rats in the QYR group significantly decreased on the 14th, 21th and 28th day after administration. The systolic pressure obviously decreased on the 21st day after administration. On the 28th day after administration symptoms such as irritability, dry hair were improved, and the Ang II level decreased. There was significant difference in all these changes (P<0.05, P<0.01).

CONCLUSIONSQYR could relieve GYHS rats' symptoms such as facial hotness, irritability, dry hair, and so on, and decrease the systolic pressure. Decreased Ang II level might be one of its mechanisms.

Aldosterone ; blood ; Angiotensin II ; blood ; Animals ; Atrial Natriuretic Factor ; blood ; Calcitonin Gene-Related Peptide ; blood ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Hypertension ; blood ; diagnosis ; Male ; Medicine, Chinese Traditional ; Rats ; Rats, Sprague-Dawley ; Renin ; blood

OBJECTIVETo summarize the experience of diagnosis and treatment of occult breast cancer in 44 cases.

METHODSClinicopathological data of 44 cases of occult breast cancer initially presenting axillary mass alone treated in our department during Jan 1997 to Dec 2008 were retrospectively analyzed.

RESULTSThe 44 patients with occult breast cancer accounted for 0.42% of all breast cancer patients admitted to our hospital and institute in the same period. The surgery included radical mastectomy in 16 cases, modified radical mastectomy in 19 cases, axillary clearance in 1 case, and simple axillary node excision in 8 cases. Follow-up, ranging from 12-132 months, was available in 38 cases. Among 32 cases who underwent mastectomy or axillary clearance, 2 cases died of distant metastases and 3 cases were still alive with local recurrence at the time of analysis. In two out of six cases who refused further surgical treatment received mastectomy 16 months and 41 months after the primary diagnosis of occult breast cancer, respectively. Others were alive without evidence of recurrence or metastases at the time of analysis.

CONCLUSIONSOccult breast cancer should be taken into consideration in cases presenting with axillary metastasis of unknown primary origin. The treatment of occult breast cancer should include modified radical mastectomy/radical mastectomy or breast conserving surgery combined with breast irradiation.

Adenocarcinoma ; diagnosis ; therapy ; Adult ; Aged ; Axilla ; Breast Neoplasms ; diagnosis ; therapy ; Carcinoma, Ductal, Breast ; diagnosis ; therapy ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Mastectomy, Radical ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy, Adjuvant ; Retrospective Studies

Objective To discuss the value of digital tomosynthesis for detection of pulmonary nodules. Methods Thirty patients suspected of having pulmonary nodules underwent chest radiography, digital tomosynthesis and CT examination. Above image data were transferred to postprocessing work station and were reviewed by 2 radiologists with 3 years of chest-radiology diagnosis experience in a double-blind method. The number, location and size of nodules were recorded. Then, 2 radiologists reviewed the all images once more, and discuss in consensus. The sensitivities of chest radiography and digital tomosynthesis for detection of pulmonary nodules were respectively calculated according to the CT results. Chi-square test was used for radiography, digital tomosynthesis and CT examination. Results Of 30 patients, 21 were detected having pulmonary nodules by X-ray radiography and 9 were negative, the total number of 40 nodules was detected, while 89 nodules in 26 patients were detected by digital tomosynthesis, and only 4 patients were negative. CT demonstrated 102 nodules in 27 patients, and 3 patients were negative. Taking CT as "gold standard", the sensitivities of X-ray radiography and digital tomosynthesis were 27.4%(28/102)and 87.2%(89/102), X~2=4.35, P<0.05, respectively. Conclusion Digital tomosynthesis has a high sensitivity for detection of pulmonary nodules compared with X-ray radiography, and could be an excellent and necessary supplementary technique of X-ray radiography.

Objective To develop a convenient, rapid and specific method using real-time fluorescent quantitative polymerase chain reaction (FQ-PCR) for detection of facioscapulohumeral muscular dystrophy(FSHD). Methods Genomic DNA was extracted and digested by restricted endonuclease EcoR Ⅰ , followed by agarose electrophoresis. The DNA (< 38 kb) was retrieved from agarose electrophoretic gels. The primers and probe were designed in D4ZA gene in chromosome 4. One hundred and fifteen subjects were examined by FQ-PCR using the retrieved DNA (<38 kb) as a template and the result was analyzed by fluorescent curve comparing with positive control. Results The results by FQ-PCR showed that 13 cases were positive in 16 FSHD cases whose EcoR Ⅰ fragment sizes were known, 75 cases were negative in 78 cases of normal controls, 15 cases were positive in 16 FSHD cases diagnosed clinically whose EcoR Ⅰ fragment sizes were unknown, and 3 cases were positive in 5 cases of relatives of FSHD patients. Consistency was checked using Kappa index between the 2 gene diagnostic tests for FSHD (FQ-PCR test and the traditional Southern blotting test), and between the 2 diagnostic criterions (gene diagnosis by FQ-PCR and clinical diagnosis). The results were statistically significant (κ = 0. 765, P = 0. 002 ; κ = 0. 844, P = 0. 000). Conclusions A new genetic diagnostic method of FSHD by FQ-PCR was developed, which was more simplified and reliable compared to the time-consuming, radioactive Southern blotting. It could also detect the D4Z4 arrays in cases having deletion of p13E-11 as well as the interchromosomal exchange between 4q35 and 10q26. The new method of FQ-PCR for FSHD may be extended to utilize clinically in future.