Objective To elucidate the differences between invasive micropapillary carcinoma (IMPC) and invasive ductal carcinoma(IDC),and explore the clinicopathological and immunohistochemistry characteristics of invasive micropapillary carcinoma of the breast.Methods Invasive micropapillary carcinoma was identified in 51 patients by retrospective review of database from October 2004 to November 2007.Data were compared with 102 patients identified as invasive ductal carcinoma available in this hospital during the same period.Results Significant differences were observed in mammilla invasion,lymphatic vessel invasion,positivity of lymph node,lymph node metastatic level,extranodal extension,estrogen receptor,progestin receptor,triple negative between the two groups; while there was no significant differences between the two groups as to amenorrhea status,lesion laterality,number of metastatic lymph nodes,human epidermal growth factor receptor-2,local recurrence and distant organ metastasis.The median follow-up time of the invasive micropapillary carcinoma group were 46 months ( 16 - 75 months),and the 3-year overall survival and disease free survival was 90.2％ and 84.3％,respectively.Conclusions Invasive micropapillary carcinoma is a unique subtype of breast cancer which manifests an aggressive behavior tending to involve lymph node and extranodal soft tissues.Invasive micropapillary carcinoma of the breast had high expression of hormonal receptors,and triple negative breast cancer is less common in this type of breast cancer.

OBJECTIVETo compare the efficacy of internal fixation (including PFNA and PFN) versus hip replacement (including FHR or THA) in the treatment of trochanteric fractures in adults.

METHODSReports of studies using randomized controlled trials (RCT) to compare internal fixationg with hip replacement in the management of intertrochanteric fractures were retrieved (up to January 1, 2013) from the Cochrane Library, PUBMED Data, CNKI (China National Knowledge infrastructure), Elsevier, the Chinese Biomedical Database, Wanfang Data, and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software RevMan 5.0 was used for data-analysis.

RESULTSSeven articles were included in the meta-analysis. The results showed that,compared internal fixation with hip replacement,there were statistical significance in the duration of surgery time [WMD = -2.66, 95% CI (-5.25,-0.06), P = 0.05], intra-operative blood loss [WMD = -24.20, 95% CI (-30.38, -18.02), P < 0.000 01], hospital stays time [WMD = -4.72, 95% CI (-5.18, -4.25), P < 0.000 01], bearing load time [WMD = -29.54, 95% CI (-30.77, -28.31), P < 0.000 01], total complications rate [WMD = 0.15, 95% CI (0.11, 0.22), P < 0.000 01], the good rate of Harris scores [WMD = 1.09, 95% CI (0.54,1.32), P < 0.05]. However, there were no statistical significance in the rate of deep venous thrombosis [WMD = 1.09, 95% CI (0.47, 2.55), P > 0.05]. CON- CLUSION: Hip replacement (containing FHR or THA) for the treatment of intertrochanteric fractures is superior to internal fixa- tion in regards to the duration of surgery time, the mean duration of hosipital stays, mean post-operative down time, intra-opera- tive blood loss, the rate of post-operative good Harris scores. But there is not enough evidence to show any difference between hip replacement (containing THA or FHR) and internal fixation in regards to the rate of deep venous thrombosis. However, internal fixation for the treatment of intertrochanteric fractures is superior to hip replacement (containing FHR or THA) in regards to total complications rate.

Arthroplasty, Replacement, Hip ; methods ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans

OBJECTIVETo study the clinical characteristics and the treatment of periorbital injuries.

METHODS61 cases were treated, including 30 cases orbitozygomatic fracture, 6 cases of frontal-orbital fracture, 8 cases of naso-ethmoid-orbital fracture, 7 cases of blow -out fracture and 10 cases of complicated fracture. The patients were diagnosed after physical examination and other examination, like CT. Through bicoronal or local mini incision at the end of eyebrow, combined with subciliary incision and local wound approach, the fractured sites were exposed completely. Then the fractured fragments were repositioned and fixed rigidly. The orbital wall was reconstructed with titanium net and Medpor.

RESULTSThe wounds healed primarily. Good cosmetic and functional results achieved in most of the patients. 4 cases underwent second-stage ophthalmectomy. 2 patients had diplopia after operation, but improved gradually. 3 cases of blepharoptosis needed further treatment.

CONCLUSIONSEarly diagnosis and treatment is very important for periorbital injuries. Fracture reposition and orbital wall reconstruction should he performed at early period.

Adolescent ; Adult ; Aged ; Child ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Orbital Fractures ; surgery ; Skull Fractures ; surgery ; Young Adult

Adult ; Carcinoma ; virology ; Cervical Intraepithelial Neoplasia ; virology ; Female ; Human papillomavirus 16 ; isolation & purification ; Human papillomavirus 18 ; isolation & purification ; Humans ; In Situ Hybridization ; Middle Aged ; Papillomavirus Infections ; Uterine Cervical Neoplasms ; virology

Objective To analyze the clinical performance of free prostate-specific antigen (fPSA)detection by ECLIA method,and evaluate whether ECLIA is suitable for clinical use.Methods 341samples were collected and tested prostate-specific antibodies with CMIA and ECLIA methods.These samples contain:97 samples with abnormal high PSA value tested by CMIA method,and 244 normal PSA samples.Use CMIA as the reference method,and detect fPSA,tPSA levels,and the ratio of fPSA/tPSA.Analyze the testing results with statistical methods.Results Compared with CMIA,correlation coefficent of ECLIA fPSA detection is 0.99; correlation coefficent of f/tPSA ratio detection is 0.96; the sensitivity,specificity of ECLIA f/tPSA ratio detection are 85.71％,92.6％ respectively,the agreement rate with ECLIA is 87.4％.No cross reaction with bilirubin,lipohemia,hemolysis,RF,CEA,AFP,CA125,CA153,CA199 were found in the tests.Conclusion The ECLIA method for free prostate-specific antigen detection showed good clinical performance; and is suitable for clinical use.

Objective To investigate the morphological features of colorectal sessile serrated adenoma/polyp (SSA/P) by white light endoscopy (WLE) and narrow band imaging (NBI). Methods A retrospective analysis was made on the morphological characteristics of SSA/P from January 2014 to March 2017, and compared with HP. Results There were 50 cases of SSA/P from 41 patients and 50 cases of HP from 43 patients. SSA/P located in the right colon was more than HP, but the difference was no statistical significance (16 cases vs 14 cases,P > 0.05). SSA/P have 11 cases of Type Is, 21 cases of Type IIa, 16 cases of Type IIb, 2 cases of Type LST, HP have 17 cases of Type Is, 25 cases of Type IIa, 8 cases of Type IIb, there was no significant difference (P > 0.05); SSA/P has more mucus than HP (37 cases vs 11 cases, P < 0.05). In NBI: The proportion of SSA/P with a red mucus cap, indistinctive borders, irregular shape, black dots inside the crypts, Cloud-like surface, Type II-O pit pattern and varicose microvascular vessels were higher than that of HP (P < 0.05). In the differential prediction of SSA/P and HP: Black dots inside the crypts (OR^ : 14.2; 95%CI: 5.8 ~ 34.7) with higher sensitivity, the sensitivity, specificity and accuracy respectively were 80.0%, 78.0%, 79.0%; Type II-O pit pattern (OR^ : 56.0; 95%CI: 17.7 ~ 177.6) with higher specificity, the sensitivity, specificity and accuracy respectively were: 70.0%, 96.0%, 83.0%; Red mucus cap (OR^ : 9.3; 95%CI: 3.8 ~ 22.8) with high specificity, the sensitivity, specificity and accuracy respectively were 64.0%, 80.0%, 74.0%; Cloud-like surface (OR^ : 16.9; 95%CI: 5.7 ~ 50.7) with high specificity and low sensitivity, the sensitivity, specificity and accuracy respectively were: 52.0%, 94.0%, 73.0%. Combining the black dots inside the crypts and Type II-O pit pattern with other endoscopic features of SSA/P could improve the sensitivity and the accuracy in diagnosis prediction. Conclusion The study has confirmed that SSA/P has unique endoscopic features compared with HP in NBI mode. Observing the morphological characteristics of SSA/P with NBI could achieve the purpose of identifying SSA/P and HP. The black dots inside the crypts and Type II-O pit pattern respectively have higher sensitivity and specificity in diagnosis prediction of SSA/P, so we recommend to combine the two indicators with others endoscopic features of SSA/P to identify SSA/P and HP to achieve the purpose of screening SSA/P in colonoscope examination.

Objective To observe the clinical efficacy and safety of edaravone and dexborneol concentrated solution for injection in the treatment of patients with ischemic stroke.Methods Patients with acute ischemic stroke were divided into two groups,the control group was given conventional treatment,the treatment group was given edaravone and dexborneol concentrated solution for injection 15 mL on the basis of conventional treatment.The clinical efficacy of the two groups was compared.The National Institutes of Health stroke scale(NHISS)score was used to evaluate the neurological function of the patients,the modified RanKin scale(mRS)was used to evaluate the ability of daily living of the patients,and the adverse drug reactions during the treatment was observed.Results There were 63 cases in the control group and 75 cases in the treatment group.After treatment,the total effective rates of the treatment group and the control group were 85.33％(64 cases/75 cases)and 65.07％(41 cases/63 cases),and the difference was statistically significant(P＜0.05).After treatment,the differences of NHISS score before and after treatment in the treatment group and the control group were(2.11±1.01)and(0.99±0.68)points;the differences of mRS score were(0.96±0.57)and(0.63±0.41)points,and the differences were statistically significant(P＜0.01,P＜0.05).The adverse drug reactions in the two groups were nausea and vomiting,abnormal liver and kidney function.The total incidences of adverse drug reactions in the treatment group and control group were 2.67％and 6.35％,and the difference was not statistically significant(P＞0.05).Conclusion Edaravone and dexborneol concentrated solution for injection can improve the therapeutic effect of acute ischemic stroke without increasing the incidence of adverse drug reactions.

This study was aimed to investigate the mechanism of histone deacetylase (HDAC) inhibitor, valproic acid (VPA), reversing transcription inhibition of AML1-ETO fusion protein in Kasumi-1 cell line. The mRNA expressions of AML1-ETO, AML1 and cyclin D2 were detected by semi-quantitation RT-PCR after treating kasumi-1 cells with VPA at different doses/and different time points. The results indicated that the mRNA expression of AML1-ETO showed no obvious change, when kasumi-1 cells were treated with VPA. Compared with control group, the expression level of AML1 mRNA significantly increased in a dose-dependent manner. Compared with control group, the expression level of cyclin D2 mRNA significantly decreased when kasumi-1 cells had been treated with 3 mmol/L VPA as well as kasumi-1 cells were treated with different concentrations of VPA for 3 days. In conclusion, VPA could remove transcription inhibition of AML1-ETO fusion protein, increase transcription of AML1 and down-regulate mRNA expression of AML1 target gene cyclin D2 through HDAC inhibiting activity.
Acetylation ; drug effects ; Cell Line, Tumor ; Core Binding Factor Alpha 2 Subunit ; drug effects ; genetics ; Cyclin D2 ; genetics ; Gene Expression Regulation, Leukemic ; Histone Deacetylase Inhibitors ; pharmacology ; Histones ; drug effects ; Humans ; Oncogene Proteins, Fusion ; drug effects ; genetics ; RUNX1 Translocation Partner 1 Protein ; Valproic Acid ; pharmacology

BACKGROUNDMany studies have indicated that hyperpolarizing cardioplegia is responsible for myocardial preservation and researchers have suggested that the adenosine triphosphate-sensitive potassium channels (K(ATP)) were the end effectors of cardio-protection. But whether mitochondrial K(ATP) plays an important role in hyperpolarizing cardioplegia is not apparent. The present study investigated the effect of hyperpolarizing cardioplegia containing pinacidil (a nonselective K(ATP) opener) on ischemia/reperfusion injury in rat hearts, especially the role of mitochondrial K(ATP) in pinacidil hyperpolarizing cardioplegia.

METHODSSprague-Dawley rat hearts were Langendorff-perfused for 20 minutes with Krebs-Henseleit buffer at 37°C before equilibration. Cardiac arrest was then induced in different treatments: there was no arrest and ischemia in the normal group, the control group were arrested by clamping the aorta, depolarizing caidioplegia (St. Thomas solution containing 16 mmol/L KCl) and hyperpolarizing cardioplegia groups used St. Thomas solution containing 0.05 mmol/L pinacidil and 5 mmol/L KCl to induce cardiac arrest in group hyperkalemic and group pinacidil, in group hyperkalemic + 5-hydroxydecanote (5HD) and Pinacidil + 5HD, 5HD (0.1 mmol/L) was added to the above two solutions to block mitochondria K(ATP) channels. Global ischemia was then administrated for 40 minutes at 37°C, followed by 30 minutes of reperfusion. At the end of equilibration and reperfusion, hemodynamics, ultrastructure, and mitochondrial function were measured.

RESULTSIn the control group, ischemia/reperfusion decreased the left ventricular developed pressure, heart rate, coronary flow, mitochondrial membrane potential, impaired mitochondrial respiratory function, increased reactive oxygen species and left ventricular end diastolic pressure. Damage to myocardial ultrastructure was also evident. Both depolarized arrest and especially hyperpolarized cardioplegia significantly reduced these lesions. 5HD partially blocked the beneficial effects of pinacidil cardioplegia but showing no effects on hyperkalemic arrest.

CONCLUSIONSPinacidil cardioplegia provides better cardioprotection with preservation of hemodynamics, ultrastructure, and mitochondrial function than traditional cardioplegia. The mitochondria K(ATP) channels may play an important role in the protection mechanism.

Animals ; Hemodynamics ; drug effects ; Membrane Potential, Mitochondrial ; drug effects ; Microscopy, Electron, Transmission ; Myocardial Reperfusion Injury ; drug therapy ; metabolism ; Myocardium ; metabolism ; ultrastructure ; Pinacidil ; therapeutic use ; Potassium Channels ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism

OBJECTIVETo assess the early efficacy of metallic modular radial head prostheses in patients with Mason III and IV unreconstructable radial head fractures.

METHODSThe medical records of 16 patients (9 males, 7 females) with a mean age of 43 years old (31 to 57) with Mason III/IV unreconstructable radial head fractures requiring metallic modular radial head replacement between January 2009 and March 2012, were reviewed retrospectively. The functional results were assessed by range-of-movement, Mayo elbow performance score (MEPS). All patients underwent radiographic evaluation for radial head height and radiolucent lines.

RESULTSFourteen patients were evaluated with follow-up for 12 to 33 months with an average of 23 months. Range of movement parameters was significantly lower in the affected elbow than in the unaffected side (P < 0.01). MEPS results were excellent in 9 cases, good in 2 cases, fair in 2 cases, and poor in 1 case. According to Grewal grading, there were 4 cases of periprosthetic lucencies of the radius and 1 case had significant clinical signs of loosening.

CONCLUSIONRadial head replacement with the metallic modular prostheses yields satisfactory results regarding range of motion and function of the elbow joint in short term. The evolution of this prostheses needs to be evaluated with further studies to assess mid-term and long-term follow-up results.

Adult ; Arthroplasty, Replacement, Elbow ; methods ; Female ; Fracture Fixation ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius ; surgery ; Radius Fractures ; physiopathology ; surgery ; Retrospective Studies