Objective To systematically evaluate the risk of BRCA1 mutation in patients with triplenegative breast cancer (TNBC).Methods Articles about the association between the TNBC and BRCA1 mutation were retrieved from database,such as PubMed,CNKI,Wanfang,VIP and CBM databases.The odds ratio (OR) was used to evaluate the risk of BRCA1 mutation in TNBC compared with non-TNBC.Rev Man 5.2 software was applied to perform the Meta-analysis.Results A total of 23 articles were eligible for the Meta-analysis,including 1 104 patients with TNBC and 4 245 patients with non-TNBC.The pooled OR was 7.67 and 95％ CI(6.24,9.42),and the difference was statistically significant (Z =19.38,P ＜ 0.000 01).In the subgroup analysis about the race,the pooled OR for Asian was 6.67 and 95％ CI (4.98,8.95).The pooled OR for Caucasian was 8.83 and 95％ CI (6.61,11.80).There was statistically significant difference in the pooled OR between the Asian and the Caucasian (Z =14.74,P ＜ 0.000 01).Conclusion The patients with TNBC are 7.67 times more likely to have BRCA1 mutation compared with non-TNBC phenotype.Largesample randomized controlled trials are warranted to demonstrate the detection of BRCA1 mutation can be a conven-tional application in clinical for the patients with TNBC.

Humans ; Optical Imaging

Objective To investigate the effectiveness and feasibility of laparoscopic splenic artery ligation in the treatment of hypersplenism and thrombocytopenia in children. Methods From August 2014 to December 2014, four children with hypersplenism and three children with ITP (idiopathic thrombocytopenic purpura) were treated in our hospital.Laparoscopic splenic artery ligation was performed in all the patients.During the operation, the gastric colon ligament was cut with an ultrasonic knife, and the gastric wall was suspended to expose the pancreas and the spleen.The splenic artery was ligated at the upper edge of pancreas closing to the splenic hilum.The splenic venous branches were dissected and ligated at the splenic hilum by using the Hem-o-lok, which leaded to an area of splenic infarction more than 50%. Results The laparoscopic splenic artery ligation was successfully performed in all the patients, without conversion to open surgery.The operative time was 120-150 min ( mean, 126 min) , and the intraoperative blood loss was 10-20 ml ( mean, 15 ml) .No patient underwent blood transfusion.The length of postoperative hospital stay varied from 4 to 11 days (mean, 6.6 days).The splenic length significantly decreased postoperatively [(13.6 ±2.6) cm vs.(15.1 ±1.7) cm, t=3.199, P=0.049], and so was the splenic thickness [(3.8 ±1.0) cm vs.(4.1 ±0.8) cm, t =3.703, P=0.034].Partial splenic infarction and decreased splenic blood flow were found in the 7 patients by postoperative ultrasound.After surgery, four children suffered from fever, which were 38.8 ℃, 39.0 ℃, 38.6 ℃, and 39.2 ℃, with the duration of fever of 2, 4, 8, and 5 days, respectively.All the patients were followed-up for 6 -10 months (mean, 8.4 months).The complete blood cell count was within normal range. Conclusion The laparoscopic splenic artery ligation is an effective treatment for hypersplenism and thrombocytopenia in children.

Objective: To explore the psychological status and therapeutic efficacy of peri-operative psychological intervention among patients with oral carcinoma.Method: psychological statuses of 60 patients with oral carcinoma were investigated,and specific peri-operative psychological interventions were performed according to features and initiating factors of their psychological crisis,in order to provide references for the therapy of oral carcinoma.Result: Common psychological crises among patients with oral carcinoma such as anxiety and fear have been dramatically decreased by proper psychological investigation and peri-operative psychological intervention.Conclusion: Psychological investigation contributes to a great improvement of psychological status of patients with oral carcinoma.Therefore,in addition to routine peri-operative medical treatment,an effective psychological investigation is also crucial for patients with oral carcinoma to cure the disease and regain health.

Objective To investigate the risk factors of portal vein thrombosis (PVT) in patients with liver cirrhosis.Methods From January 2009 to December 2011,the data of 294 hospitalized patients diagnosed as liver cirrhosis were retrospectively analyzed.PVT was diagnosed according to multislices spiral computed tomography or color doppler ultrasonography.Fifty-five patients with liver cirrhosis and PVT were in PVT group,239 patients with liver cirrhosis however no PVT were in non-PVT group.Age,gender,etiology of cirrhosis,Child-Pugh grading and score,blood routine examination,blood chemistries,blood coagulation function,D-dimer,main portal vein (MPV) internal diameter,portal vein velocity (PVV) and thickness of spleen were recorded and analyzed.The measurement data were analyzed by t test.Unconditional Logistic regression model was performed to screen corresponding risk factors.Area under curve (AUC) was calculated according to receiver operator characteristic (ROC) curve to evaluate the diagnostic value of each index.Results The results of white blood cell,hemoglobin,total bilirubin,creatinine,serum natrium,prothrombin time,activated partial prothrombin time,fibrinogen and international normalized ratio of PVT group were similar with those of non-PVT group and there were no statistically significant differences (all P＞ 0.05).Compared with those of non-PVT group,the differences in platelet count,albumin level,the level of D-dimer,MPV internal diameter,PVV,spleen thickness,and Child Pugh score of PVT group were statistically significant ((82.55 ± 23.04) × 109/L vs (99.66±20.23)×109/L(t=-0.308,P=0.022),(30.53±2.32) g/L vs (33.36±3.62) g/L(t=-2.117,P=0.036),(1.00±0.22) mg/L vs (0.77±0.15) mg/L(t=7.557,P=0.003),(15.11± 1.32) mmvs (13.40±1.43) mm(t=8.013,P=0.014),(13.51±1.51) cm/s vs (15.16±1.60) cm/s (t=-6.979,P=0.036),(59.35±5.45) mm vs (54.64±5.92) mm(t=1.9555,P=0.043),(11.73± 2.01) scores vs (8.18 ± 3.05) scores (t =6.225,P =0.006)).The results of unconditional Logistic regression model analysis indicated that D-dimer,Child-Pugh score,MPV and PVV were independent risk factors of PVT in patients with liver cirrhosis (OR=13.420,10.237,8.534,0.151; P=0.001,0.014,0.019,0.025).ROC curve analysis indicated that the AUC of D-dimer,Child-Pugh score,MPV and PVV was 0.868,0.823,0.810 and 0.756,respectively.The predicate value was D-dimer＞ Child-Pugh score＞ MPV＞ PVV.Conclusion D-dimmer,Child-Pugh score,MPV and PVV are independent risk factors of PVT in paitients with liver cirrhosis.

Objective: To realize cycle management early warning function of measuring instruments. Methods: The software will visit the existing access log files of measuring instruments for the next test date. They are compared with the system date. Software will alarm when measurement instruments test cycle is about to expire. Results: By setting the parameters, the software can easily access the measuring equipment log files. It can effectively implement early warning function. Conclusion:Visual Basic6.0 achieved the development of this software conveniently, took up less system resources, powerful, effectively preventing the verification of measuring instruments and missed period expired to happen.

Objective To investigate the efficacy and safety of laparoscopic repair in children with congenital esophageal hiatal hernia. Methods From September 2001 to December 2008,seven children with congenital esophageal hiatal hernia,including 4 boys and 3 girls,were treated by laparoscopic repair and Nissen's fundoplication in our hospital. One of them received laparoscopic pyloroplasty in the meanwhile because of delayed gastric emptying (confirmed by preoperative gastrointestinal angiography); one child underwent laparoscopic high ligation due to right oblique inguinal hernia; spleneolus was found in one patient,no further treatment was carried out. Results The procedures were completed in all of the patients without conversion to open surgery. The mean operation time was 94.2 min (75-150 min) in this series,and the average blood loss was 5 ml (2-10 ml). No patient received blood transfusion after the surgery. The children began to intake milk or regular diet in 24-48 hours after the operation. They were discharged from hospital in a mean of 4.5 days (ranged from 3 to 7 days). Then,the children were followed up for 6 to 20 months (mean,12.6 months). One of the patients suffered from vomiting on the 10th day after the operation,1 patient showed recurrence in 1 year postoperation and then was cured by a second operation. The other five patients were healthy during the follow-up. Conclusions Laparoscopic repair of congenital esophageal hiatal hernia is a safe,effective,and minimally invasive procedure. It is feasible for patients complicated with other diseases. The indications for the surgery must be strictly selected.

Objective To explore the value of laparoscopic partial nephrectomy for children with duplex kidney.Methods Between June 2006 and February 2009,we performed laparoscopic partial nephrectomy on totally 21 children with duplex kidney.Three or four trocars were used for the operation.Through transabdominal approach the peri-renal tissues were freed and the vessels supplying the duplicated kidney were ligated.Afterwards,we resected the duplicated kidney,as well as the ureter,and a subperitoneal drainage tube was indwelt.Results The operation was completed in all of the 21 cases without conversion to open surgery.The mean operation time for laparoscopy was 190 min(range,130 to 210 min).The intraoperative blood loss ranged from 5 to 10 ml.No patient received blood transfusion.Liquid diet was given in 8 to 10 hours after the operation.In this series,the postoperative hospital stay ranged from 5 to 7 days with a mean of 6.2 days.Follow-up was available for 3 to 28 months in the cases(mean,20.2 months).During the period,the clinical symptoms disappeared and B ultrasonography showed no abnormalities.Conclusions Providing larger operation space and better exposed surgical field,laparoscopic partial nephrectomy for children with duplex kidney is feasible and safe with quicker recovery.

Objective To investigate whether the laparoscopic portoenterostomy is superior to open surgery in the treatment of biliary atresia.Methods A total of 26 children with type Ⅲ biliary atresia underwent laparoscopic portoenterostomy from August 2003 to September 2005(Laparoscopic Group).The operation was performed under 4-port laparoscopy.The hepatic portal was fully exposed and mobilized and the gallbladder was removed.The cut end of the duct was widened by incising along the anterior wall of the hepatic duct following the excision of the narrow segment.By using intraoperative bile duct endoscopy,the optimal level of resection of the common hepatic duct was determined without endangering the orifices of the hepatic ducts or leaving any redundant duct.The Roux-en-Y jejunal loop was fashioned extracorporeally by exteriorizing the jejunum for 40 cm in length distally through the umbilical incision and passed up retrocolically followed by an end-to-side hepaticojejunostomy.They were compared with other group of 34 children,with the same age range and diagnosis,who underwent open portoenterostomy(Open Group) in the same period,in respect of the operative time,the blood loss,the liver functions,complications,the length of hospital stay,the hospitalization expenditure,and the short-term outcomes. Results As compared with the Open Group,the Laparoscopic Group presented a less blood loss(15.4?5.0 ml vs 33.8?19.4 ml;t=-4.709,P=0.000) and a higher hospitalization expenditure(19 153.9?619.5 yuan vs 15 116.7?898.4 yuan;(t=19.607),P=0.000).There were no significant differences between the two groups in the operative time and the length of hospital stay.The serum levels of total bilirubin,direct bilirubin,ALT,and AST were deceased more significantly in the Laparoscopic Group than in the Open Group.Complications happened in 1 case in the Laparoscopic Group(incisional hernia) and in 4 cases in the Open Group(1 case of acute hepatic failure,1 case of incision rupture,and 2 cases of wound infection),the incidence of complications being not significant(?~2=0.395,P=0.530).Follow-up observations at 4 postoperative month found the jaundice had subsided in 13 cases in the Laparoscopic Group(50%) and in 18 cases in the Open Group(53%). Conclusions Laparoscopic portoenterostomy is a minimally invasive,safe,and effective procedure for the treatment of pediatric biliary atresia.

Objective The study evaluated the efficiency and safety of a short-acting full-dose fibfinolytic regimen to promote early infarct-related artery (IRA) patency during the inherent delay experienced by infarction patients referred for angioplasty as the principal recanalization modality. Method Accepted aspirin and heparin, 75 patients were treated by an intravenous bolus of 20 mg recombined tissue-type plasminogen activator (rt-PA), then followed by 80 mg over 30 minutes. Patients were to undergo angiography as soon as possible following study drug. If the IRA was occlude (TIMI flow grade 0 or 1),or was open but with ≥50% stenosis, immediate early PTCA at the same time. The end point included patency rates on catheterzation laboratory (cath Lab) arrival, technical results when PTCA was performed, complication rates, clinical adverse events rates and left ventricular (LV) function by treatment assignment in two weeks. Results Patency on Cath lab arrival was 88% with combination treatment group (26% Thrombolysis in myocardia infarction trial TIMI-2, 66%TIMI-3), and 36%with primary PTCA group (20%TIMI-2, 16%TIMI-3), (P