Purpose: To analyze the clinical and pathological factors in post-operative breast cancer patients with bone metastasis, and, identify risk factors predicting the skeletal metastasis. Methods: We evaluated data from 3 796 patients who were surgically treated from January 1981 to December 2000. Those patients were divided into groups according to different first events. Then we assessed data of 116 cases of bone metastasis as first event, and comparing with visceral metastasis and lymph node or soft tissue metastasis cases. Results: In our group there were 116 cases with bone metastasis as first event, about 3. 1%; bone metastasis correlated with young age, large tumor, clinical palpable axillary nodes, pathological positive nodes, stage II/HI disease and non-specific invasvie breast carcinoma. Multivariate logistic regression found that large tumor, clinical palpable axillary nodes related with bone metastasis in pre-operative data. In post-operative data, large tumor, pathological positive nodes and non-specific invasive breast carcinoma correlated with bone metastasis. Hormone receptor status and HER2 expression did not predict the bone metastasis. All cases received standard local and adjuvant systemic treatment. Among patients who had as their first event a local recurrence or a recurrence in soft tissue or lymph node or local and systemic metastasis, there were more specific invasive carcinomas than those in bone metastasis group. Occurrence of bone metastasis and visceral metastasis had similar time distribution, however, local recurrence and/or node, soft tissue metastasis occurred earlier than skeletal metastasis. Conclusions: Pre-operative bone scintigraphy was indicated in those with young age, T2/T3 tumor, and clinical palpable nodes. Breast cancer patients at high risk for bone metastasis were T2/T3 tumor, non-specific invasive breast carcinoma and with 4 or more involved axillary lymph nodes. It might be important to study the effect of bisphosphonates in the adjuvant settings.

OBJECTIVE To retrospectively analyze the results of the composition and drug resistance of urinary pathogens isolated from geriatric inpatients from 2003 to 2005.METHODS The identification and antibacterial drug sensitivity test of urinary pathogens was carried out by VITEK AMS-60.RESULTS Urinary tract infections of geriatric inpatients were still mostly caused by Gram-negative bacilli(72.9%),others as Gram-positive cocci(14.3%) and fungi(12.8%).The majority of Gram-negative bacilli was Escherichia coli(46.6%) and the majority of fungi was Candida albicans(7.9%),as for Grampositive cocci,were Enterococcus faecalis(5.3%) and coagulase negative Staphylococcus(4.9%).Drug resistance rate of common antibiotic against the majority of urinary pathogens showed an ascending trend.CONCLUSIONS E.coli is still the primary urinary pathogen among geriatric inpatients,but the isolation of fungi and multi-drug-resistant bacteria is on the rise.

OBJECTIVETo investigate the correlation between enhanced computed tomography (CT) findings and pathological results of rare parotid gland tumors, and improve diagnosis accuracy.

METHODSThe enhanced CT manifestations of 22 cases with pathologically documented rare parotid gland tumors, which included 6 cases of basal cell tumor, 5 cases of myoepithelioma, 4 cases of vascular invasion, 3 cases of lymphatic cyst, 3 cases of lipoma, and 1 case of chondrosarcoma, were retrospectively analyzed. The location, size, shape, density, and relationship with surrounding structure were evaluated on CT images.

RESULTSThe enhanced CT showed that basal cell tumors occurred in the superficial lobe of the parotid gland, with clear boundary, within the cystic lesion. The lesions were moderate to obviously enhanced, which may be accompanied by enlarged lymph nodes. Myoepithelial tumors were located in the superficial lobe of the parotid gland, with a small cystic prone and microcalcification within a few cases. The lesions were moderate to obviously enhanced. Hemangiomas of soft tissue mass prominent in the parotid gland surface were mild to significantly enhanced. Larger lesions may occupy the entire parotid gland, with uneven density and visible vein stone. The CT density values of the lymphatic cyst were usually higher. Chondrosarcoma mainly manifested cystic mass at the calcification edge. Lipoma with fat density mass exhibited clear boundary without enhancement. Fiber separation could be observed in the lesion.

CONCLUSIONCT can reflect the pathological features of rare parotid gland tumors by demonstrating their corresponding imaging features. Enhanced CT is the most effective means of imaging to identify the nature of rare tumor of the parotid gland lesions.

Objective:To investigate effects of tumor specific TCR gene Vα12.2-Vβ7.1 modification on recognition of tumor antigen and activation of anti-tumor reactivity of T cells.Methods: T cells were transduced using recombinant Ad 5F35-TRAV-TRBV adenovirus ,and multiplicity of infection was optimized.Specific lysis of T cells was evaluated by calcein release assay.The frequency of apoptotic cells in target cells was detected by Annexin V /PI double-labeled FACS.The expression of FasL on T cells was analyzed by FACS.The secretion of cytokine IFN-γand IL-2 of T cells was determined by ELISA assays.Results: The highest tranduce efficiency was obtained at MOI 100 by recombinant Ad5F35-TRAV-TRBV adenovirus.The frequency of TCRVα12+Vβ7+cells reached above 25%3 days after transduction.TCR gene modification enhanced the ability of T cells to lyse HLA-A2+AFP+target cells(P<0.001), the ability of T cells to induce HepG-2 apoptosis(P<0.001),and expression of FasL on T cells(P<0.001).TCR gene modification also enhanced T cells to secret IFN-γafter coculture with antigen positive tumor cells ( P<0.001 ).Conclusion: Specific TCR gene modification by recombinant adeno virus effectively promotes T cells to recognize antigen positive tumor cell and exert anti -tumor reac-tivity.

Background and purpose: BRCA1 and BRCA2 mutation carriers have a high lifetime risk of developing breast and ovarian cancer. Through genetic counseling, mutation carriers can take the appropriate measures to reduce such cancer risk. At present, almost all related studies were conducted in Caucasian, while, the studies in Chinese population were rare. This study aimed to investigate the risk of breast cancer in BRCA1 and BRCA2 mutation carriers in Chinese Han population. Methods:Twenty unrelated families with BRCA1 or BRCA2 mutations were re-viewed. Kaplan-Meier analyses were used to estimate the cumulative risks of unilateral breast cancer and contralateral breast cancer for female BRCA1 and BRCA2 mutation carriers. Results:Breast cancer risk to 70 years (penetrance) was 67.2%(sx 0.100) for BRCA1 and 76.8%(sx 0.079) for BRCA2, respectively. Different from BRCA1 mutation carriers, the cumulative incidence of breast cancer in BRCA2 mutation carriers remained increasing after 70 years, reaching 93.1%at age 80. The 10-and 20-year risk for contralateral breast cancer was 19.4%(sx 0.089) and 50.3%(sx 0.155) for BRCA1/2 mutation carriers. Conclusion:BRCA1 and BRCA2 mutation carriers in Chinese Han population have a high risk of developing breast cancer. Thus, it has great clinical signiifcance to test mutations in BRCA1/2 genes in Chinese high-risk population.

Objectiv e:To investigate the effect of different culture conditions on the differentiation of Treg and Th17 to lay a foundation for exploring the methods to reverse the immune tolerance induced by tumor microenvironment.Methods:The IL-6 gene was cloned and stablely transferred into the tumor cell line expressing TGF-β.The conditioned mediums ( CM) were prepared by collecting the culture supernatants of tumor cell lines with or without IL-6 expression and used in the in vitro culture of peripheral blood mononuclear cells ( PBMC ) .The changes of Treg and Th17 in PBMC treated with different CM were detected with flow cytometry ( FCM) .Results:The expression of TGF-βin BEL-7402 was higher than that in HepG2.Thus the BEL-7402 was selected for preparation of cell line stablely transfected with IL -6 gene.ELISA detection confirmed the effective expression of IL -6 by the identified cell lines.It was showed that the Treg increased in PBMC treated with culture supernatants of tumor cells .However,the presence of IL-6 reversed the increase of Treg and promoted the differentiation of Th 17.Conclusion: The culture supernatants of tumor cells increases the proportion of Treg.However,the presence of IL-6 in this CM can reverse the increase of Treg and raise the proportion of Th 17.

Objective To discuss the design of pedicled thoracodorsal artery perforator flap (TDAP flap),and to evaluate the aesthetic results and donor-site complications for immediate partial breast reconstruction (IPBR) after breast conserving surgery (BCS) for breast cancer patients.Method Clinical data of 13 breast cancer cases treated with BCS + IPBR using TDAP flap from November 2004 to November 2010 were retrospectively analyzed.Perforators were identified with Doppler preoperatively in all patients.Results All perforators originated within a median distance of 8.0 cm ( range,7.5 to 9.5 cm) from axillary plica at the posterior line of axilla.Median area of the flaps was 6.0 × 8.0 cm ( range,5.0 × 7.0 cm to 8.0 × 10.0 cm).One flap was muscle-sparing,while a small muscle strip was left embedding the perforators in other twelve flaps to increase the reliability of the vascular pedicle.Postoperatively patients were followedup from 4 to 71 months.Median follow-up time was 41 months.Flap necrosis and seroma in the donor-site were not found in all patients.Aesthetic results were graded as excellent or good in 9 patients,fair in 3,and poor in one.Conclusions TDAP flap is a good choice for IPBR after BCS for breast cancer patients whether lesions in outer quadrants or inner quadrants,especially for those patients with excisional biopsy.Preoperative mini-Doppler is helpful for determining the precise location of the main perforators,and decreasing the risk of vessels injury.

AIM:To explore the role of survivin-2B in the process of tumor cell apoptosis .METHODS:The survivin-2B gene was cloned into pcDNA3.1 vector and the recombinant plasmid pcDNA3.1-survivin-2B was obtained.Hu-man breast cancer MCF7 cells were transfected with pcDNA3.1 and pcDNA3.1-survivin-2B using Lipofectamine 2000.The cell cycle was determined by propidium iodide staining , and the apoptosis was detected by annexin V/7-AAD staining 48 h after transfection.Meanwhile, tatal RNA was extrated and multiplex polymerase chain reaction based on GenomeLab GeXP Genetic Analysis System was performed to detect the expression of 21 tumor-related genes .RESULTS: Flow cytometry analysis indicated that over-expression of survivin-2B promoted the apoptosis and cell cycle arrest of MCF 7 cells.Compared with control group , totally 10 differential expressed genes were related to the over-expressed survivin-2B, among which 2 were up-regulated and 8 were down-regulated. The expression of aldehyde dehydrogenase 4 family member A1 (ALDH4A1) was 48%down-regulated, and the expression of protein regulator of cytokinesis 1 (PRC1) was 1.08 folds up-regulated.CONCLUSION:Survivin-2B induces the expression changes of some tumor-related genes, which results in the apoptosis and G 2/M arrest of MCF7 cells.

OBJECTIVE: To investigate the imaging manifestations of 16-slice enhanced CT of parotid adenolymphoma in the parotid gland and the corresponding pathology,in order to improve the understanding of the CT imaging manifestations of parotid adenolymphoma in the parotid gland. METHOD: The enhanced CT characteristics of 34 cases of parotid adenolymphoma in the parotid gland confirmed by histological pathology were retrospectively analyzed. RESULT: There were totally 86 lesions in 34 cases, of which 12 cases with lesions in bilateral sides and 22 cases with lesions in unilateral side. Sixty-six lesions located behind and below the superficial lobe of the parotid gland. The lesions showed moderate to obvious enhancement at arterial phase, and the cystic region within the lesions showed no enhancement. CONCLUSION The relatively specific enhanced MSCT manifestations of parotid adenolymphoma in parotid gland include lesions located behind and below the superficial lobe of parotid gland unilaterally or bilaterally, sometimes exhibited as multiple masses, with clear edge, obvious enhancement and cystic degeneration inside.
Adenolymphoma ; diagnosis ; pathology ; Humans ; Parotid Gland ; pathology ; Parotid Neoplasms ; diagnosis ; pathology ; Tomography, X-Ray Computed

The two verities of Crgptococcus neoforinans were first observed as well growing with brown color changes on Guizotia abyssinica seed agar(GASA)and caffeic acid commeal agar(CACA.Then,C.neoformans var.neoformans was found in 18/26 pigeon droppings by both two media.C.neoformans var.gattii was not isolated by the two media in 76 Eucalyptus camaldulensis samples.However,an,overgrowth of filamentous fungus was more frequently seen on GASA.Our results suggest that CACA be capable of selevtively isolating C.neoformans with the advantages of less interference fron the overgrowth of filamentous fungi.