Objective:To observe the effect of local excision under ultrasonography with immediate mammoplasty in granulomatous lobular mastitis.Methods:Fifty-three patients with granulomatous lobular mastitis admitted from Jan 2017 to Jul 2020 were retrospectively analyzed. Combined with sonographic findings and clinical manifestations, patients were divided into four types: type Ⅰ, single mass; Type Ⅱ, single mass located in one quadrant with one or no skin lesion; Type Ⅲ, multi-quadrant involved with one or no skin lesion; Type Ⅳ, multiple abscesses with multiple lesions in the skin. Twenty-five patients underwent wide local excision (control group); Twenty-eight patients underwent local excision under ultrasonography with immediate mammoplasty (experiment group). Patients with erythema nodosum or in type Ⅳ were given antibiotics and corticosteroid therapy preoperatively for 1 week and postoperatively for 5 days. The others went straight to surgery.Results:All patients were followed up for 1 year. In the experiment group, 28 patients had primary wound healing, and 3 patients had poor wound healing after operation (all were of type Ⅳ). The control group had 6 cases of recurrence(were of type Ⅲ and type Ⅳ). There was significant difference of the recurrence rate between the two groups (0 vs. 24%, χ 2=6.033, P=0.014), and the aesthetic effect of local excision under ultrasonography with immediate mammoplasty was better than that of wide local excision(93% vs. 68%, χ 2=5.330, P=0.020). Conclusion:The recurrence rate of local excision under ultrasonography with immediate mammoplasty is low, and with a satisfactory cosmetic effect.

Objective To Screen serum protein markers related to CRF and establish a diagnosis model,exploring and discussing its significance in serodiagnosis by comparing differences of serum protein spectrum expression between patients with chronic renal failure (CRF) and control group.Methods The trial included 62 CRF patients and 28 control ones.Serum samples were tested by surface enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS).The data were analyzed to screen serum proteomic biomarkers.By bioinformatics analysis,decision classification tree models were to be established and tested.Results A total of 19 effective protein peaks were significantly different between CRF and normal control (P＜0.001) at m/z range of 1 500 to 30 000,among which 18 showed low expression and 1 showed high expression in CRF.CRF and normal control were obviously different in the clustering;By bioinformatics analysis,a CRF-normal controls of the diagnostic decision tree model was developed,which was 87.8% in with prediction accuracy rate of 87.8% sensitivity of 87.1% and a specificity of 89.3%.Condusion Diagnostic decision tree model provides a more accurate prediction and solid experimental evidence for early clinical diagnosis.

Objective:To examine the effect of“lesion removal plus whole breast exploration and washing plus micro-plastic surgery”in granulomatous lobular mastitis.Methods:A single-center prospective randomized controlled study method was used to enroll patients diagnosed with granulomatous lobular mastitis for whom surgical procedures were projected from March 2017 to September 2019 at Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University. The sample size is determined by the superiority test. Based on the literatures and the previous work, the two groups require 97 cases. Fifty-two patients underwent“lesion removal+whole breast exploration and washing plus micro-plastic surgery”(observation group). Forty-five cases underwent“empirical breast lesion resection plus fascia tissue flap plasty plus nipple and areola correction”(control group). The primary study endpoint is the recurrence rate, and the secondary study endpoints include surgical complications, incision healing time, and postoperative patient satisfaction. Independent sample t test, Wilcoxon rank-sum test, χ2 test and Fisher exact test were used for comparison between groups. Results:All procedures were completed successful, with no severe complications. All patients were followed up for (15.2±1.9) months (range: 12 to 24 months). There were no significant differences in incidence of postoperative complications (7.7% (4/52) vs. 6.7%(3/45), P=1), drainage time ((8.6±0.6) days vs. (8.4±0.8) days, t=1.921, P=0.053) and hospital stay ((7.7±0.6) days vs. (7.6±0.5) days, t=1.633, P=0.102) between the two groups. The recurrence rate of the observation group was lower significantly than that of the control group (3.8% (2/52) vs. 24.4%(11/45), χ2=8.819, P=0.003). The observation group had better cosmetic effects ( Z=-2.657, P=0.008) and patient satisfaction than control group ( Z=-5.730, P=0.000). Conclusion:The “lesion removal plus whole breast exploration and flushing plus micro-plastic surgery” has a good therapeutic effect and cosmetic value for patients with refractory granulomatous lobular mastitis.

Objective:To examine the effect of“lesion removal plus whole breast exploration and washing plus micro-plastic surgery”in granulomatous lobular mastitis.Methods:A single-center prospective randomized controlled study method was used to enroll patients diagnosed with granulomatous lobular mastitis for whom surgical procedures were projected from March 2017 to September 2019 at Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University. The sample size is determined by the superiority test. Based on the literatures and the previous work, the two groups require 97 cases. Fifty-two patients underwent“lesion removal+whole breast exploration and washing plus micro-plastic surgery”(observation group). Forty-five cases underwent“empirical breast lesion resection plus fascia tissue flap plasty plus nipple and areola correction”(control group). The primary study endpoint is the recurrence rate, and the secondary study endpoints include surgical complications, incision healing time, and postoperative patient satisfaction. Independent sample t test, Wilcoxon rank-sum test, χ2 test and Fisher exact test were used for comparison between groups. Results:All procedures were completed successful, with no severe complications. All patients were followed up for (15.2±1.9) months (range: 12 to 24 months). There were no significant differences in incidence of postoperative complications (7.7% (4/52) vs. 6.7%(3/45), P=1), drainage time ((8.6±0.6) days vs. (8.4±0.8) days, t=1.921, P=0.053) and hospital stay ((7.7±0.6) days vs. (7.6±0.5) days, t=1.633, P=0.102) between the two groups. The recurrence rate of the observation group was lower significantly than that of the control group (3.8% (2/52) vs. 24.4%(11/45), χ2=8.819, P=0.003). The observation group had better cosmetic effects ( Z=-2.657, P=0.008) and patient satisfaction than control group ( Z=-5.730, P=0.000). Conclusion:The “lesion removal plus whole breast exploration and flushing plus micro-plastic surgery” has a good therapeutic effect and cosmetic value for patients with refractory granulomatous lobular mastitis.