Epithelial-mesenchymal transition cause primary carcinoma cells to acquire mesenchymal features and re-epithelialize to form a secondary mass at a metastatic site. Such plasticity has implications in the progression of breast carcinoma to metastasis, and will likely influence cancer's response to therapy. The transcriptional and epigenetic regulation that underlie the development of breast cancer and result in characteristic changes in cell behavior can be monitored using an array of marker proteins, providing the potential for emergent prognostic and therapeutic targeting.

Objective To explore the causes of secondary breast deformity after breast conservative therapy and its preventive methods.Methods 30 cases were selected from the patients with secondary breast deformity of more than 1 year after breast conservative therapy,and more than half a year after radiotherapy and chemotherapy,and no local recurrence and distant metastasis occurred.After cicatrectomy and contracture loose solution,different methods were used according to varying degrees of the secondary breast deformity to reconstruct and repair the deformity.Results Three reconstructive methods were conducted.Local mammary flaps were used in 7 patients,latissimus dorsi myocutaneous flap in 21 patients,and transverse rectus abdominal musculocutaneous flaps in 2 patients.The shape and feeling were satisfactory in 30 patients with reconstructive breasts,in which 23were excellent (76.7 ％),and 7 were good (23.3 ％).All the patients were followed-up for average 2.5 years,and they were survived without tumor recurrence.Conclusions The secondary breast deformity after breast conservative therapy could be effectively prevented,and successfully reconstructed and repaired with different procedure according to varying degrees of the secondary breast deformity.As a result,the shape and feeling of reconstructive breasts are satisfactory.

Objective To study the role Erk/Slug signal pathway in the radiosensitivity of MDAMB-231 cells.Methods MDA-MB-231 cells were transfected with NF-κBp65 siRNA,PUMA siRNA and Slug siRNA respectively or treated with U0126 for 24h,then the cells were irradiated with 4 Gy γ-ray.At different time points post-irradiation,the expressions of Erk1/2,NF-κBp65,Slug and PUMA protein were detected.The cell survival rate and apoptotic index were detected by MTT and TUNEL methods.Resluts Compared with 4 Gy irradiated group,the expression of PUMA was reduced in NF-κB p65 siRNA/4 Gy group,the expressions of Slug and Erk1/2 were obviously decreased but PUMA increased in U0126/4 Gy group,the expression of Erk1/2 had no change but the expression of PUMA increased significantly in Slug siRNA/4 Gyγ group.Meanwhile,at 48h post-irradiation,for U0126/4 Gy group and Slug siRNA/4 Gy group,cells survival rates were decreased to 19.78 ±2.71 (F=11.39,P＜0.05) and 17.41 ±4.58(F=15.31,P＜0.05),cell apoptosis rates were 28.61 ±4.70 (F=9.84,P＜0.05) and 27.55±6.41(F =10.31,P ＜ 0.05),respectively.At 24 h post-irradiation,for NF-κB p65 siRNA/4 Gy group and PUMA siRNA/4 Gy group,cell survival rates approached to 85.65 ± 9.60 (F =12.31,P ＜ 0.05) and 87.53±11.50 (F=13.68,P＜0.05),and cell apoptosis rates declined to 3.28 ±0.78 (F=10.83,P ＜ 0.05) and 3.46 ± 0.84 (F =9.92,P ＜ 0.05).Conclusions The radiosensitivity of MDA-MB-231cells was relative to the induction of NF-κB up-regulated PUMA,and the radioresistance was caused by the up-regulation of Slug induced by Erk1/2,which inhibited the expression of PUMA.

Objective:To explore an improved osteotomy of mandible ascending ramus for the surgical approach to large tumors in parapharyngeal space.Methods:According to the operation of parotid gland, masseter muscle was cut near the border of mandibular angle till subperiosteum dissection to mandibular notch, vertical osteotomy outside mandibular foramen to 1.0 cm under mandibular notch, vertical to posterior border of ascending ramus, tumor was exposed and removed, bone plate was repositioned and fixed with titanium. Results:Tumors were completely removed in this way in 3 patients without complications. Conclusion:This surgical approach is suitable for the surgical removal of parapharyngeal interstitial giantism tumor.

Effects of Cu2+,Zn2+and Mn2+ on responses to ACh were studied with toad rec-tus abdominis. Cu2+, Zn2+and Mn2+concentra-tion- dependently shifted the concentration-response curves for ACh to the right unparallelly and reduced the maximal response considerably. The pAh values of Cu2+ , Zn2+ and Mn2+ were 3.69, 2.95 and 2. 62, respectively. The inhibitory potent of Cu2+ and Zn2+ seemed to be 11.7 times and 2. 1 times respectively more thanthat of Mn2+. It was suggested that Cu2+, Zn2+ and Mn2+postsynaptically interfere with the action of ACh. However, Zn2+in lower concentration shifted the bottom section of the curve for ACh to the left and top, and shifted the top section of the curve to the right, suggesting that Mn2+in lower concentration be possessed of partial agonistic property.

Objective To assess the prognostic value of progesterone receptor (PR) in Luminal B HER2(-) lymph-node-negative breast cancer.Methods The clinical data of 196 Luminal B HER2 (-) lymph-node-negative breast cancer patients were collected in this study.The correlation between PR and clinicopathological factors and its influence on prognosis was analyzed.Results Among 196 patients with Luminal B HER2 (-) lymph-node-negative breast cancer,14.8％(29/196)were PR-negative and 85.2％(167/196)were PR-positive (HR=3.25,95.0％ CI:0.73-1.45,P=0.123).PR negativity indicated postmenopausal status (P=0.029) and high tumor grade (P=0.001).Mter a median follow-up of 60 months,9.7％(19/196) of the patients had relapses and 4.1％(8/196) died of breast cancer.The 5-year disease-free survival(DFS) was 75.9％ in PR-negative group and 92.8％ in PR-positive group (Log-rank P=0.001).The 5-year overall survival (OS) was 89.7％ in PR-negative group and 97.0％ in PR-positive group (Log-rank P=0.023).In multivariate analysis,PR negativity was significantly associated with a poor 5-year DFS (HR=2.85,95.0％ CI:1.05-7.72,P=0.039)but not with 5-year OS (HR=1.78,95.0％ CI:0.34-9.35,P=0.495).Conclusion In this study,PR is a prognostic factor for relapse in Luminal B HER (-) lymph-node-negative breast cancer.

Objective To explore the auricular application pressure added dietary intervention of perimeno-pausal syndrome (PS)the influence of women's sex hormone levels.Methods Research subjects were randomly divided into two groups.The observation group was given auricular application pressure to add dietary intervention, control group was given dietary intervention alone.Before and after six months of follow -up,sex hormone levels in the blood were monitored.Results After the intervention,the estrogen level of the observation group was (272.93 ± 15.71)pmol/L,progesterone was (3.14 ±0.47)nmol/L,which of the control group was (186.32 ±12.80)pmol/L, (2.86 ±0.34)nmol/L;After the intervention,the follicular thorn hormone content of the two groups were decreased, which of the observation group was (12.88 ±1.50)U /L,which of the control group was (21.35 ±4.70)U /L;The perimenopausal symptoms were reduced,Kuppermun score in the observation group were (9.36 ±1.41 )points, (10.43 ±1.63)points,the difference between the two groups were statistically significant (t =40.15,4.52,3.82, 4.65,all P <0.01)for the control group.Conclusion Auricular application press fit dietary intervention for patients with perimenopausal syndrome sex hormone regulation of metabolic disorders has obvious effect,can significantly improve the patients'symptoms of the menopausal transition,it is worthy of further research on intervention measures.

Objective To analyze the clinical effect of anterior cervical decompression with double-way connection intervertebral fusion device (ROI-C) implantation for type Ⅱ or type Ⅱ a Hangman fracture.Methods A retrospective study was made on 14 patients with type Ⅱ or type Ⅱ a Hangman fracture treated with anterior cervical ROI-C implantation between February 2011 and March 2014.The patients (11 males and 3 females) were aged between 22 and 46 years (mean,26.4 years).Nine patients sustained traffic injury,4 fall injury and 1 crash injury.Nine patients were classified as type Ⅱ and 5 type Ⅱ a according to the Levine-Edwards classification.All were completed cervical anteroposterior and lateral X-ray,CT scan,three-dimensional CT reconstruction and MRI examination after adnission.American Spinal Injury Association (ASIA) grade E was noted in all before operation.Clinical posttraumatic neck score,visual analogue scale (VAS) as well as angle deformity and displacement of the axis were recorded before operation and at the latest follow-up.Results All patients were operated successfully.Mean operation time was 61 min(range,45-116 min).There were no injuries of superior laryngeal nerve,hypoglossal nerve,throat wall and vessel during operation.Laryngeal edema,dysphagia,paralysis of tongue,hematoma and wound infection were not observed after operation.Mean period of follow-up was 24.2 months (range,4-32 months).All segments and fracture sites showed solid fusion after 3 months.No cages became subsided or displaced,no discs collapsed,and no malunion occurred at the latest follow-up.Data of preoperation and latest follow-up differed significantly with respect to clinical posttraumatic neck score[(53.1 ±7.2) points vs.(91.1 ±5.0)points],VAS[3.38(2.43,4.33)points vs.0.58(0,1.29) points],axis displacement[(4.0 ± 1.5) mm vs.(1.3 ± 1.2) mm],and angle deformityoftheaxis[(9.2±4.7)° vs.(2.1 ±1.9)°] (P＜O.05 or O.01).Conclusion Anterior cervical surgery with ROI-C implantation for type Ⅱ or type Ⅱa Hangman fracture provides good fusion rate and satisfactory clinical effect.

BACKGROUND:Major abdominal vascular injury is a seldom serious complication during lumbar discectomy. Once occurring, it wil cause critical condition, and incorrect rescue and operation wil lead to patient’s death or functional disorder of the limbs. ＜br> OBJECTIVE:To explore the cause, diagnosis, prevention and treatment action for major abdominal vascular injury caused by lumbar discectomy. ＜br> METHODS:One case of common iliac artery injury caused by lumbar discectomy was reviewed in the aspects of diagnosis, prevention and treatment action. ＜br> RESULTS AND CONCLUSION:The case suffered from common iliac artery injury caused by lumbar discectomy of right L 4-5 vertebrae, and achieved successful rescue by timely diagnosis, surgical intervention and artificial blood vessel transplantation. Injury of the vessels is relevant with many factors, including surgical operation, anatomy, pathology, etc. Unexplained intervertebral hemorrhage accompanied with sudden drop of blood pressure during surgery hints the possible occurrence of major vascular injury. Accurate diagnosis and instant surgical intervention is the key to rescue the patient’s life.

Objective To establish a novel PCR method that can differentiate the two biotype of Mycoplasma urealytium rapidly based on the disparities of parC gene sequences for clinical routine examination.Methods Design two pairs of specific primers and probes for the targeted gene according to the differences of the parC gene sequences from 14 standard serotypes.The specificity of this amplification was verified by detecting two Mycoplasma urealyticum standard strains including serovar1 and serovar4,50 clinical isolated strains ( 12 are Uu strains and 38 are Up strains) and 7 common bacterias from vagina.Collected 70 swab specimens from patients of Sexually Transmit Department with urogenital inflammation symptom and 71 swab specimens from the gynecology health examination population.All those specimens were detected by culture and our method respectively.The sensitivity of this method was evaluated by comparing with the culture.Differences of the infection rate and distribution of biotypes between different populations were analyzed using statistical software.Results Standard strains of Mycoplasma urealyticum and clinical isolates can be typed into two species by the PCR method without nonspecific amplification.The sensitivity of PCR method is much higher than that of culture ( P＜0.05).The infection rates of Uu,Up and the mixing were 8.57％,61.40％,24.30％ respectively for the patients with vaginitis.However,it was 8.80％,67.60％,8.45％ respectively for the gynecology health examination population.There is a significant difference of the total infection rate between the two population(P＜0.05).It showed no significant difference with the distribution of the two types of simple infection in the two groups ( P＞0.05).But the rate of mixing infection is much higher in the patients with vaginitis ( P＜0.05 ).Conclusion The pathology of Mycoplasma urealyticum may be related to the mixed infection of different biotypes.