OBJECTIVETo investigate the psychological impact of mastectomy on women with breast cancer.

METHODSQuestionnaires were answered by 90 patients after mastectomy for breast cancer. The data were collected and analyzed regarding the age, occupation, education, income and living place of the patients. Their psychological changes were compared and evaluated statistically using chi-square analysis.

RESULTSMastectomy caused psychological impact on half of the patients, which included fear of cancer, feeling of body incompleteness, inconvenience in working and social communication, less sexual act and low spirit. 79 percent of the patients considered breast reconstruction unnecessary. 54 percent did not know that the breast could be reconstructed. The patient feelings differed with the age, occupation, income and living place.

CONCLUSIONMastectomy hurts patient psychological health.

Age Factors ; Body Image ; Breast Neoplasms ; psychology ; surgery ; Chi-Square Distribution ; Fear ; Female ; Humans ; Mammaplasty ; psychology ; Mastectomy ; psychology ; Socioeconomic Factors ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVEAt present, although appropriate radiotherapy and combined treatments are widely used for the patients with primary nasopharyngeal carcinoma (NPC), local or regional recurrence rates are still high. According to clinical performance, pathology, and diagnostic imaging of the patients with the first recurrence of NPC, this study analyzed the clinical features of recurrent NPC to provide a reference for tracking the rules of recurrence after the treatment of patients with NPC.

METHODSClinical data of 337 patients diagnosed with recurrent NPC for the first time were collected. The diagnoses were based on pathology and/or imaging and the patients were treated at the Sun Yat-sen University Cancer Center between January 1999 and December 2004. Data used for statistical analysis included clinical performance during the patient visit, the extension of the invasion as shown on imaging, pathologic features, Epstein-Barr virus (EBV) serology, restaging, etc.

RESULTSPatients were staged according to the system developed by the International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC) in 2002. Patients with diseases at stages I/II accounted for 25.2%, while those with stage III/IV accounted for 74.8%. The median interval of relapse was 25 months. Patients had local recurrence (69.4%), regional recurrence (4.5%), or both (26.1%). Epistaxis and headache were the most common symptoms. Abduct dysfunction and facial numbness induced by cranial nerve damage were the most common signs. The probability of invasion of structures adjacent to the nasopharynx, such as the oropharynx, the prestyloid space, and the carotid sheath area, was low in patients with recurrent NPC. By contrast, the probability of invasion of structures far from the nasopharynx, such as the base of the skull, the paranasal sinuses, cranial nerves, the cavernous sinus, the brain, the pterygopalatine fossa, the infratemporal fossa, the orbital apex, and the soft palate, was higher in recurrent NPC.

CONCLUSIONSThe most common interval of relapse is about 2 years. The relapsed disease is usually more widespread and located deeper. Most recurrent NPC is advanced disease.

Adult ; Aged ; Antigens, Viral ; blood ; Bone Neoplasms ; secondary ; Capsid Proteins ; blood ; Female ; Humans ; Immunoglobulin A ; blood ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; pathology ; virology ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; pathology ; Neoplasm Staging ; Retrospective Studies ; Young Adult

Objective: To gradually implement electronic signature in medical records included outpatient prescription, examination report, test report, hospitalization record and others so as to realize paperless archiving for electronic medical record(EMR) of hospital. Methods: The national law of electronic signature was used as the legal basis and the electronic signature technique was used as the technological foundation to establish electronic signature mechanism about signature, encryption and authentication. The dean who was responsible for informatization of hospital was appointed group leader, and section chief of each relevantly functional department, director of clinical department and head nurse were members of the group. Through perfect the leading group for informatization to ensure electronic signature was effectively implemented. Results: Through adhered to some principles included top-level design, gradual implementation and from easiness to difficulty, the electronic signatures about out-patient prescription, examination reports, test reports, documents of medical record and the paperless archiving for hospitalization record were realized after technique development of many years. Conclusion: The implementation of electronic signature can ensure the legality and authenticity of EMR, and the traceability of modified behavior. And it has realized paperless management for medical archives and has strengthened internal sharing of medical information in hospital.

OBJECTIVETo study the role of cerebrovascular hemodynamic indexes (CVHI) changing in stroke and to provide reference for stroke prevention and risk factor study.

METHODSFrom 2003 to 2004, participants aged 40 years and above in two communities in Fengxian district were recruited by cluster sampling. Risk factors of stroke and CVHI were investigated and checked during baseline investigation. A total of 10 565 individuals completed the survey and met the inclusion criterion. After baseline investigation, the cohort was followed up for stroke occurrence. Relative risk (RR) of CVHI and common risk factors were estimated by cohort study design.

RESULTSAge of the cohort was (56.2 ± 11.4) years. 4444 (42.1%) were males and 6121 (57.9%) were females. Total follow-up duration was 67 885.7 person-years. A total of 195 stroke cases occurred and incidence density of stroke was 287.2 per 100 000 person-years. Stroke incidence in exposure groups of hypertension, heart disease and alcohol drinking was 3.47% (108/3118), 2.96% (21/710) and 2.50% (47/1882), respectively. The incidence in corresponding non-exposure group was 1.17% (87/7448), 1.77% (174/9855) and 1.70% (148/8683) respectively. There was significant difference between 2 groups (χ(2) value was 62.72, 4.56 and 4.94, respectively, P < 0.05). Stroke incidence in CVHI score < 25, 25 - 49, 50 - 74 and ≥ 75 groups was 9.12% (59/647), 5.68% (44/775), 2.52% (39/1545) and 0.72% (53/7403)(χ(2)trend = 273.57, P < 0.05), respectively. Incidence of stroke in 40 - 49, 50 - 59, 60 - 69, ≥ 70 years age group was 0.22% (8/3565), 1.28% (43/3357), 2.71% (50/1848) and 5.88% (94/1600) (χ(2)trend = 181.48, P < 0.05), respectively. Multiple Cox regression analysis indicated that RR (95%CI) value of hypertension and cigarette smoking was 1.40(1.02 - 1.92) and 1.59(1.19 - 2.12), respectively when comparing with non-exposure group. RR (95%CI) value in CVHI score < 25, 25 - 49 and 50 - 74 points group were 6.15 (4.08 - 9.26), 4.55 (2.98 - 6.96) and 2.68 (1.75 - 4.09), respectively when comparing with the score ≥ 75 points group. RR (95%CI) value in age 50 - 59, 60 - 69 and ≥ 70 years group was 4.61 (2.16 - 9.82), 7.81 (3.67 - 16.60) and 13.49(6.44 - 28.24), respectively when comparing with below 40 years group.

CONCLUSIONCVHI score is the strong independent predictive factor and hypertension, cigarette smoking and age are the independent risk factors of stroke.

Aged ; Brain ; physiopathology ; Cohort Studies ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Risk Factors ; Stroke ; epidemiology ; etiology ; physiopathology

OBJECTIVEDermabrasion has been of great value in plastic surgery. Dermabrasion was developed for a specific indication; however, within a very short time, the concept of dermabrasion found wide applicability. This study was to investigate the application of dermabrasion in the treatment of acne scars.

METHODSFrom Feb. 1996 to May 2004, a total of 110 patients with acne scar were treated with dermabrasion.

RESULTSPostoperatively, the curative results were achieved in 45 cases; good results in 40 cases and effective results in 25 cases. The study revealed that the patients at 18-46 years of age have good results.

CONCLUSIONSDermabrasion is a good and safe technique to treat the scar of acne.

Acne Vulgaris ; complications ; surgery ; Adolescent ; Adult ; Cicatrix ; etiology ; surgery ; Dermabrasion ; methods ; Face ; surgery ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To optimize ambi-extracting and inclusion process of volatile oil from Chuanxiong Rhizoma and Angelicae Sinensis Radix. Methods With yield ratio of volatile oil and ferulic acid content in water extract as evaluation indexes, single factor experiments were used to study the extraction process. With the inclusion rate of volatile oil and yield of inclusion as evaluation indexes, saturated aqueous solution was used to L9(34) orthogonal experiments to reach optimum inclusion process. Results The optimum extraction process of Chuanxiong Rhizoma and Angelicae Sinensis Radix was extracted for 8 hours with 8 folds the amount of water, and without soaking. The validation experiments of extraction of volatile oil and ferulic acid content in water extract were 1.23 mL and 0.387 9 mg/g. The optimum conditions of inclusion process were as follows: volatile oil (mL): β-CD (g) was 1:8;inclusion temperature was 40 ℃; inclusion time was 3 hours. The validation experiments of inclusion rate of volatile oil and yield of inclusion were 74.89% and 72.81%. Conclusion Optimum ambi-extracting and inclusion process of volatile oil from Chuanxiong Rhizoma and Angelicae Sinensis Radix are feasible and stable, witch can provide certain supporting data for preparation production.

OBJECTIVETo compare the hemostatic effect between absorbable hemostatic fluid gelatin (HFG) and absorbable gelatin sponge(GS) during operation of unilateral open-door cervical expansive laminoplasty.

METHODSThe clinical data of 83 patients underwent unilateral open-door cervical expansive laminoplasty from February 2014 to May 2016 were retrospectively analyzed. According to the used hemostatic materials, patients were divided into two groups. In HFG group, there were 30 males and 11 females, ranging in age from 29 to 81 years, with an average of(55.6±11.6)years; 14 cases were simple cervical spinal stenosis, 9 were cervical spinal stenosis and ossification of posterior longitudinal ligament, and 18 were cervical spinal stenosis complicated with multiple cervical disc herniation. And in GS group, there were 32 males and 10 females, ranging in age from 36 to 78 years, with an average of (55.4±11.1) years; 12 cases were simple cervical spinal stenosis, 10 were cervical spinal stenosis complicated with ossification of posterior longitudinal ligament, and 20 were cervical spinal stenosis complicated with multiple cervical disc herniation. There was no significant difference in the age, gender, and disease categories of patients between two groups (>0.05). The operative time, intraoperative bleeding, postoperative drainage, and postoperative complications were compared between two groups.

RESULTSThe average operative time, intraoperative bleeding, and postoperative drainage in HFG group were(137.2±30.0) min, (156.1±74.6) ml, and (212.1±67.6) ml, respectively; and in GS group were (154.8±33.5) min, (242.9±120.7) ml, and(303.3±115.5) ml, respectively. There were significantly differences in above items between two groups(<0.05). No acute heamatoma or related complications was found postoperatively.

CONCLUSIONSCompared with GS, HFG can obviously decrease operative time, intraoperative bleeding, and postoperative drainage. It is a safe and effective hemostatic material for the operation of unilateral open-door cervical expansive laminoplasty.

OBJECTIVETo screen and identify the immunogenic membrane antigens in human pancreatic cancer for early diagnosis.

METHODSMembrane protein was extracted from pancreatic cancer cell lines and separated by using 2-DE. One of the two parallel 2-DE gels went for staining while the other underwent immunoblot. Serum IgG, which was purified from clinically collected sera of pancreatic cancer patients, was used as the primary antibodies for the immunoblot. Positive dots of immunoblot were identified by MALDI-TOF mass spectrometry and PMF matching, and then evaluated by bio-informatics methods. The candidate membrane antigens were further validated respectively in cell lines and tissues by RT-PCR and immunohistochemistry.

RESULTSThe immunoblot of mixed membrane protein with serum IgG from cancer patients showed eight positive dots. These dots were identified with MALDI and PMF as: VDAC-1, VDAC-2, CHCHD3, SLP-2 and TOM40. RT-PCR showed that these membrane antigens were expressed in several pancreatic cancer cell lines. Immunohistochemistry showed prominent SLP-2 over expression in cancer tissue.

CONCLUSIONSVDAC-1, VDAC-2, CHCHD3, SLP-2, and TOM40 are the new candidate immunogenic membrane antigens of pancreatic cancer. These membrane antigens can be subsequently tested in high dangerous population for early diagnosis of pancreatic cancer.

Biomarkers, Tumor ; analysis ; Cell Line, Tumor ; Early Diagnosis ; Female ; Humans ; Immunoblotting ; Immunoelectrophoresis, Two-Dimensional ; Immunoglobulin G ; blood ; immunology ; Immunohistochemistry ; Male ; Mass Screening ; methods ; Membrane Proteins ; analysis ; genetics ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; immunology ; metabolism ; Proteomics ; methods ; Reverse Transcriptase Polymerase Chain Reaction ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

BACKGROUNDThe potential application of retinoic acid receptor activators, such as all trans-retinoic acid (ATRA), for treating various cancers have been studied both pre-clinically and clinically. Whether ATRA has an anticancer effect on human esophageal squamous cancer cell (ESCC) is still unknown. We have explored the anticancer effect of ATRA in ESCC, and in this study, the effects of ATRA on levels and patterns of expression of the vascular endothelial growth factor (VEGF) signal transduction pathway in transplantable tumor growth of the human ESCC cell line, EC9706, in nude mice.

METHODSThe animal model of the ESCC xenograft was made by subcutaneous implantation of tumor cells into nude mice. Reverse transcription-polymerase chain reaction (RT-PCR), Western blotting and immunohistochemical assays were used to detect the expression of the VEGF signal transduction pathway in ESCC xenograft tissues.

RESULTSCompared to the control group, the tumor inhibition rates in the low dose ATRA, high dose ATRA, and 5-FU groups were 83.21%, 88.32%, 91.02%, respectively. The protein and mRNA levels of VEGF were down-regulated after being treated with ATRA and 5-FU compared to the control group (P < 0.05). The study also revealed that ATRA specifically down-regulated VEGF and the component of the VEGF signal transduction pathway of CD31, CD34, and CD105 (component of the TGF-β receptor) in ESCC xenograft tissues (P < 0.05).

CONCLUSIONSATRA can significantly inhibit tumor growth and has anticancer effects on transplantable tumor growth of human ESCC cell line EC9706 in nude mice. These findings indicate that ATRA specifically down regulated VEGF and the components of VEGF signal transduction, which may be an important mechanism responsible for the neoangiogenesis inhibition of ESCC cells.

Animals ; Blotting, Western ; Carcinoma, Squamous Cell ; drug therapy ; metabolism ; Cell Line, Tumor ; Esophageal Neoplasms ; drug therapy ; metabolism ; Humans ; Immunohistochemistry ; Mice ; Mice, Nude ; Neovascularization, Pathologic ; drug therapy ; metabolism ; Real-Time Polymerase Chain Reaction ; Tretinoin ; therapeutic use ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays

Although many studies have investigated intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC), sample sizes in the reported studies are usually small and different in outcomes in different T and N subgroups are seldom analyzed. Herein, we evaluated the outcomes of NPC patients treated with IMRT and further explored treatment strategy to improve such outcome. We collected clinical data of 865 NPC patients treated with IMRT alone or in combination with chemotherapy, and classified all cases into the following prognostic categories according to different TNM stages: early stage group (T1-2N0-1M0), advanced local disease group (T3-4N0-1M0), advanced nodal disease group (T1-2N2-3M0), and advanced locoregional disease group (T3-4N2-3M0). The 5-year overall survival (OS), local relapse-free survival (LRFS), and distant metastases-free survival (DMFS) were 83.0%, 90.4%, and 84.0%, respectively. The early disease group had the lowest treatment failure rate, with a 5-year OS of 95.6%. The advanced local disease group and advanced nodal disease group had similar failure pattern and treatment outcomes as well as similar hazard ratios for death (4.230 and 4.625, respectively). The advanced locoregional disease group had the highest incidence of relapse and death, with a 5-year DMFS and OS of 62.3% and 62.2%, respectively, and a hazard ratio for death of 10.402. Comparing with IMRT alone, IMRT in combination with chemotherapy provided no significant benefit to locoregionally advanced NPC. Our results suggest that the decision of treatment strategy for NPC patients should consider combinations of T and N stages, and that IMRT alone for early stage NPC patients can produce satisfactory results. However, for advanced local, nodal, and locoregional disease groups, a combination of chemotherapy and radiotherapy is recommended.
Adolescent ; Adult ; Aged ; Carcinoma ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; radiotherapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Radiotherapy Dosage ; Radiotherapy, Intensity-Modulated ; Survival Rate ; Young Adult