Male breast cancer is rare,it mainly caused by the interaction of the genetic factors,hormone levels,way of life,and the environment.Its clinical manifestations are indolent tumors.The diagnosis method includes clinical medical examination and imaging examination,and pathology examination.The treatment is in reference to the female breast cancer treatment model,including surgery,chemoradiotherapy and endocrine therapy.Tumor size and axillary lymph nodes involvement are independent predictors of overall survival.

OBJECTIVE: To evaluate the features and application of tissue engineered biomaterials in repairing femur defects, and to search an optimal femur substitution.METHODS: Papers published between January 1993 and October 2009 were searched using computer with key words of "tissue engineering, femur defect, mesenchymal stem cells, cytokines and materials" both in English and Chinese. Documents addressing biomaterials and tissue engineered bone in repairing femur defects were included. Repetitive research or Meta analysis was excluded. After that, 21 literatures were selected to discuss the features and application of tissue engineered biomaterials in repairing femur defects.RESULTS: Stem cells technology is obtaining seed cells from myeloid tissues, amplifying in vitro, combining with scaffold material, and in vitro constructing tissue engineered bones. The cultured cells could maintain osteoblast biological characteristics and fully fused with bone tissues at recipient sites, simultaneously, avoid immunological rejection. The combination of materials or modify the material surface could promote cells adhere to materials and increase the cellular biological activity. When transfecting seed cells to bone defect areas using certain carriers, the transplanted calls could form new bones and secret bone growth factor, induce determined osteogenic precursor cells differentiated into inducible ostegenic precursor cells, thereby, fasten the bone healing. The composite materials prepared by three-dimensional virtual surgical simulation and computer numerical control exhibited advantages of composite materials and histological anatomy conjunction, which had perfect appearance.CONCLUSION: Currently, there is no material can fully meet the requirement of bone tissue engineering. Thus, promoting adhesion between cells and materials, increasing cellular biological activity, and maintaining biological functions by combing materials or modifying material surface are the research focuses.

Objective To research the impact of axillary limph node group dissection oriented by senti-nel lymph nodes instead of axillary dissection on upper limb lymph edema and disease -free survival ( DFS ).Methods We designed a randomized controlled research , which included 205 cases of operatable breast cancer (AJCC 7th:stage I or stage IIa)from Jan.2011 to Jan.2013.Those cases were separated into 2 groups randomly ( random number method ):group A underwent mastectomy ( or lumpectomy ) and axillary group lymphadenectomy oriented by sentinel lymph node biopsy ( SLNB) ( if positive continued for ALND ) while group B underwent mastec-tomy(or lumpectomy)and axillary lymph node dissection(ALND).All patients underwent SLNB by blue dye method and received adjuvant therapy after surgery according to National Comprehensive Cancer Network ( NCCN) guideline and Chinese anti-cancer association guideline .Results There were 101 cases in group A and 104 ca-ses in group B , but 1 case in group A was excluded for false negative of SLN.The midium follow-up was 30 months.There were no significant differences of average age , tumor size, grade, estrogen receptor (ER),proges-terone receptor ( PR) and human epidermal growth factor receptor 2 ( HER2 ) expression between the 2 groups. Group A had a lower frequency of lymph edema than group B (4.0%vs 17.3%,χ2 =9.384,P=0.002), and al-so a milder degree ( mild 2%vs 11.5%,middle 2%vs 3.8%,severe 0%vs 1.9%).There were no significant differences of upper limb sensory disorder (14.0%vs 16.3%,χ2 =0.218,P=0.641), neither of DFS(Log-Rank analysis:3-year average DFS 32.89 months vs 33.72 months,χ2 =0.186,P=0.667;Cox risk model analysis:HR=1.395,P=0.495)between the 2 groups.Conclusion Axillary group lymphadenectomy oriented by SLNB can reduce the happening of lymph edema from ALND and has a comparative effect on DFS as ALND .

Objective To investigate effect of anthracyclines of VEGF-C, VEGFR-3, ER and E-cadherin in serum of patients with breast cancer.Methods 43 patients with breast cancer were selected and randomly divided into experimental group and control group, 40 cases in each group.According to the experimental program based on the treatment, serum VEGF-C, VEGFR-3 levels and breast tissue ER and E-cadherin were detected after the end of the treatment.Results Compared with the control group, VEGF-C, VEGFR-3 levels of the experiment group were lower( P<0.05),ER level was lower(P<0.05) and E-cadherin level was higher(P<0.05).Conclusion the ER, VEGFR-3 and VEGF-C levels in breast cancer patients can significantly decrease the E-cadherin level, and it has a guiding significance for clinical.

Objective To investigate expression of TPS, VEGF of beast cancer patients and relationship with clinical pathological.Methods 68 cases of breast cancer were selected as experiment group, 36 cases with breast fibroma were selected as control group.TPS and VEGF were detected by elisa of patients before and after treatment.Serum TPS and VEGF levels and TNM staging were compared after operation.Results TPS and VEGF of the experiment group were higher than control group(P<0.05).TPS and VEGF of experiment group after operation were higher than before operation.TPS and VEGF increased with the grade of tumor, but there was no significance between grade Ⅰ and 0.The expression of VEGF in tumor diameter≤2 cm group was significantly lower than >2 cm group(P<0.05).TPS and VEGF of axillary lymph node metastasis group and axillary lymph node metastasis had significant difference(P<0.05).The concentration of TPS was significantly higher than that of estrogen and progesteronepositive group in estrogen receptor negative, progesterone receptor negative (P<0.05).Conclusion TPS, VEGF levels in the serum of breast cancer patients showed high expression, the expression of TPS, VEGF levels related to axillary lymph node metastasis, estrogen receptor, progesterone receptor.

Objective To evaluate the effect of CT guided permanent 125I seeds implant brachytherapy on early non-small cell lung cancer (NSCLC) that is not suitable for operation.Methods 18 patients with early stage of NSCLC (stage Ⅰ and Ⅱ) were treated with CT guided permanent seeds 125I implantation from December 2002 to December 2006.The prescribed dose (PD)was 110 Gy,the median activity of 125I seed source was 0.7 mCi.The chest CT detection was performed at 1,2,6 months and 1 year after treatment.The tumor size and the clinical effect were compared before and after treatment.Results The minimum PD in target tumor was (107.7±5.3)Gy,D90 was (113±3.7) Gy,and D9o was more than mPD.The chest CT showed that complete relief (CR) was achieved in 7 patients (38.9％),partial relief (PR) was in 9 patients (50％),stable disease (SD) was in 2 patients (11.1％),no progress disease (PD) was found.The effective rate (CR rate + PR rate) was 92.9％ (16 cases),and local control rate was 88.9％ (16 cases) within one year.During the follow-up to December 2011,the 1,3 and 5 years cumulatively survival rate was 94.4 ％ (17 cases),72.2％ (13 cases),66.7％ (12 cases),56.8％ (10 cases) respectively.Median survival time was 58 months.Conclusions CT-guided permanent 125I seeds implant brachtherapy is effective in the treatment of early non-small cell lung cancer that is not suitable for operation.

Objective:To evaluate the curative effect of computed tomography (CT)-guided percutaneous implantation of 125I radioactive seeds on inoperable early-stage non-small cell lung cancer (NSCLC). Methods:From January 2003 to December 2012, we selected 48 patients who had pathologically confirmed early-stage NSCLC (stageⅠ, 18 cases;stageⅡ, 30 cases with N0). We treated the nidus by CT-guided percutaneous implantation of 125I radioactive seeds. Six months after implantation, the chest CT-scan was reviewed, and the effect of the treatment was evaluated according to the international standards. Final follow-up was performed in December 2013. Results:All operations were successfully completed. The target tumor matched peripheral doses (MPDs) were 215.8±14.3 Gy (D100), 106.8±11.6 Gy (D90), and 148.6± 17.3 Gy (D90>MPD). Six months after implantation, chest CT was reviewed, and treatment effects were evaluated. The percentages of stage I patients achieving complete relief (CR), partial relief (PR), stable disease (SD), and progressive disease (PD) were 27.8%(5 cases), 72.2%(13 cases), 0%, and 0%, respectively. Among stageⅡpatients, CR, PR, SD, and PD percentages were 0%(3 cases), 73.3%(22 cases), 13.3%(4 cases), and 3.3%(1 case), respectively. The effective rate was 89.6%. The 1-year local control rate was 85%. Until December 2013, the 1-, 2-, and 5-year cumulative survival rates up to the end of the interval were 95.8%(46/48), 81.3%(39/48), and 56.3%(27/48), respectively. Conclusion:CT-guided percutaneous implantation of 125I radioactive seeds is an effective micro-invasive method for treating inoperable early-stage NSCLC.

Objective To investigate the feasibility of low dose dual phase contrast-enhanced chest CT with iterative mod el reconstruction (IMR) technique.Methods Totally 130 patients with suspected pulmonary occupying lesions underwent dual phase contrast-enhanced chest CT,who were randomly assigned into 2 groups (group A and group B,each n=65).Patients in group A were scanned with 100 kV,DoseRight technique with dose right index 10,and images were reconstructed with the hybrid iterative reconstruction (iDose4).While patients in group B were scanned with 80 kV,DoseRight technique with dose right index 8,and images were reconstructed with iterative model reconstruction (IMR).The objective image quality,subjective image scores and the excellence rate of vascular visualization were compared in both pulmonary artery (PA) and bronchial artery (BA) phases.The radiation dose was also calculated.Results The effective dose was (3.30 ±0.89)mSv in group A and (1.27 ±0.19)mSv in group B.Compared to group A,the effective dose reduced 61.52％ in group B (P＜0.001).Lower image noise and greater CNR were obtained in group B compared to group A in both PA and BA phases (all P＜0.001).No significant difference was found in subjective image scores of lung and mediastinal setting and the excellence rate of vascular visualization in both groups (all P＞0.05).Conclusion Using IMR,dual phase contrast-enhanced chest CT allows for a radiation dose reduction up to 61.52％,meanwhile,ensures the image quality and meets the diagnostic requirements.

Objective To observe the pulmonary protective effect of large and small doses of mucosolvan in elderly patients with lung cancer undergoing radioactive seed implantation.Methods 93 patients with non-small cell lung cancer undergoing radioactive seed implantation guided by CT were selected and randomly divided into 3 groups:the high-dose group,the low-dose group and control group (n-31,each).All patients received the mucosolvan treatment with routine immunization and nutrition support after implantation.Patients was given mucosolvan 990 mg/d and 300 mg/d by continuous intravenous pumping in high-dose and small-dose groups respectively.Patients in the control group was given saline.The incidence of pneumothorax and plasma levels of C reactive protein (CRP),tumor necrosis factor alpha (TNF alpha),neutrophils (ANC) were compared between the three groups at 1 d,3 d and 5 d after implantation.Results There was no statistically significant difference in plasm levels of CRP,TNF alpha and ANC between the three groups at 1 d and 3 d after implantation (all P＞0.05).Plasma levels of CRP,TNF alpha and ANC were lower in highdose group than in low-dose group and control group at 5 d after implantation (F=3.596,3.555,3.406,respectively,all P＜0.05).The incidence of pneumothorax was lower in high dose group than in control group (x2 =4.31,P ＜ 0.05).Conclusions Perioperative application of high-dose mucosolvan can relieve lung inflammatory reaction rapidly and reduce the incidence of pneumothorax in elderly lung cancer patients undergoing radioactive seed implantation.

OBJECTIVE: To investigate feasibility and effectiveness of pedicle screw bi-cortical fixation in lumbar spondylolisthesis or destabilization of aged people. METHODS: The statistical significance of the distance between the anterior edge of vertebral body and the anterior major blood vessels at the level of pediculus arcus vertebrae by CT scan at random were measured and analyzed. 82 cases of lumbar spondylolisthesis or destabilization, aged 65 years (range 51 to 75 years), including 35 males and 47 females, were treated pedicle screw bi-cortical fixation, with the anterior edge of the vertebral body penetrated by one screw thread. The function was evaluated by Macnab backleg pain scale standards. RESULTS: There was significant difference in the distance of the anterior edge and the major vessels between the old and the young (P< 0.05). All the 82 cases were operated successfully, and the mean time was 145 minutes and the mean amount of bleeding was 530 mL. The 43 cases including 15 males and 28 females were followed up for 18 months (range 3 to 53 months). There was one case of rupture of the spinal dura mater with no sequela after the suture. There were 3 cases of transient paralysis and pain of lower limbs, which were alleviated after 2 months' treatment. No complications of nerve root or vessel injuries were found. All incisions healed well at the primary stage. The lumbocrural pain of all 43 cases was alleviated to a certain content. There were 31 cases of excellent, 10 of good, and 2 of fair; the excellent and good rate was 97%. CONCLUSION: It is feasible and safe to treat the lumbar spondylolisthesis or destabilization in the old with the pedicle screw bi-cortical fixation.