Objective:To investigate the clinical effect of the transverse rectus abdominismuscle (TRAM) on reconstruction of the breast.Methods:The clinical data of 23 patients receiving TRAM breast reconstruction in our department from Jan. 2018 to Dec. 2019 were retrospectively analyzed.Results:The operation time of 23 patients ranged from 240 to 360 mins, andthe average time was about 300 mins. Intraoperative bleeding was about 120 to 200 ml, with an average of 170 ml. All the flaps survived successfully, but 2 cases were complicated with local fat necrosis. The postoperative period was between 6 and 12 months. No local tumor recurrence or metastasis was found inall patients during postoperative follow-up, and the breast shape was maintained in good condition.Conclusion:TRAM can make up for the regret of breast loss caused by breast cancer in female patients. It can bring confidence in life and work to female patients, and the technology is safe and reliable, which is worthy of promotion.

OBJECTIVETo investigate the role of miR-181c in glycolysis of cancer-associated fibroblasts (CAFs) and explore the mechanism.

METHODSHuman lung CAFs and normal fibroblasts (NFs), isolated from fresh human lung adenocarcinoma tissue specimens by primary culture of tissue explants, were transfected with a miR -181c mimics, a miR-181c inhibitor, a siRNA siRNA-HK2 or the vector HK2-vector via Lipofectamine(TM) 2000. Quantitative real-time PCR was used to analyze the changes in miR-125b expression in the transfected cells; hexokinase-2 (HK2) protein expression in the cells was detected using Western blotting, and the cellular glucose uptake was assessed with 2-NBDG. Lactate production in the cells was examined and expression of HK2 mRNA was detected with dual luciferase reporter gene assay.

RESULTSNo obvious difference was found in the cell morphology between CAFs and NFs. Compared with the NFs, the CAFs showed obviously increased glucose uptake, lactate production and HK2 protein expression with decreased expressions of the miR-181 family (P<0.05). Transfection with the miR-181 inhibito- rsignificantly increased glucose uptake, lactate production and HK2 protein expression in the NFs. In CAFs, transfection with the miR-181 mimics caused significantly lowered glucose uptake, lactate production and HK2 protein expression of. Knockdown of endogenous HK2 by siRNA abolished miR-181 mimics-mediated decrease of glucose uptake and lactate production in CAFs, while transfection with miR-181 mimics suppressed HK2 overexpression-induced enhancement of glucose uptake and lactate production in NFs.

CONCLUSIONTransfection with miR-181 mimics can suppress glycolysis in CAFs by inhibiting HK2 expression.

4-Chloro-7-nitrobenzofurazan ; analogs & derivatives ; Adenocarcinoma ; pathology ; Deoxyglucose ; analogs & derivatives ; Fibroblasts ; drug effects ; Glycolysis ; Hexokinase ; antagonists & inhibitors ; Humans ; Lung Neoplasms ; pathology ; MicroRNAs ; pharmacology ; RNA, Messenger ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction ; Transfection ; Tumor Cells, Cultured

Objective To analyze the clinical manifestations of pulmonary fungal disease in patients with different pathogen infection and different immune states. Methods A retrospective analysis was carried out with the clinical data of 78 patients with pulmonary fungal disease who were treated in Fujian Provincial Hospital from June 2012 to June 2016. Results The identified pathogens included Cryptococcus (78.2％, 61/78), Aspergillus(17.9％, 14/78), Talaromyces marneffei, Mucor, and Trichosporon asahii (one each). Cryptococcus was mostly found in healthy individuals without underlying disease and Aspergillus largely infected those with underlying disease. Diabetes mellitus was the most common underlying disease. Pulmonary fungal infection was confirmed by pneumonectomy (41.0％, 32/78), CT-guided percutaneous transthoracic biopsy (43.6％, 34/78), transbronchial lung biopsy (14.1％, 11/78), or blood culture (1.3％, 1/78). Pulmonary cryptococcosis was often asymptomatic (47.5％, 29/61). Hemoptysis was only found in the patients with underlying disease. The patients with pulmonary aspergillosis showed higher prevalence of hemoptysis (57.1％, 8/14) than the patients with other pulmonary fungal diseases. Bronchoscopy usually gave negative finding in case of pulmonary cryptococcosis (77.8％, 14/18). Inflammatory exudation was the primary finding of pulmonary aspergillosis (6/10). Intraluminal necrosis and neoplasia were only found in the aspergillosis patients with underlying disease. The primary imaging findings in pulmonary cryptococcosis was nodule or mass (78.7％, 48/61). Halo sign and crescent sign were rarely found in pulmonary aspergillosis. Of the 78 patients, 45 (57.7％) patients received pharmacological therapy alone, 15 (19.2％) surgical treatment alone, and 18 (23.1％) received drugs in combination with surgery. Six patients died, 25 lost to follow-up, and 47 with stable disease. Conclusions The clinical characteristics of pulmonary fungal disease vary with the pathogen and the immune states of patients. Clinical symptoms and immune status of patients should be taken into account when making diagnosis of pulmonary fungal disease for the purpose to speculate the probable fungal pathogen and choose the most appropriate diagnostic tool.