Objective To investigate the prognosis of patients with triple-negative invasive lobular carcinoma (TN-ILC) undergoing breast-conserving surgery combined with radiotherapy (BCS+RT) versus total mastectomy. Methods A retrospective analysis was performed for 2 386 female patients with TN-ILC who underwent surgery in the SEER database from 2006 to 2018, and the baseline characteristics (age, histological grade, AJCC stage, etc.) were balanced by propensity score matching (PSM, 1∶1, caliper value 0.02), and breast cancer-specific survival (BCSS) and overall survival (OS) were compared by Kaplan-Meier method and COX regression analysis. Results A total of 1 056 pairs of patients were obtained after PSM, and the BCS+RT group had significantly better BCSS and OS than the total mastectomy group (both P<0.001). Stratified analyses showed that BCS+RT had a survival advantage in all subgroups except histologic grade Ⅰ and tumor stage Ⅰ. Multivariate analysis confirmed that BCS+RT was an independent protective factor (BCSS: HR=0.682, OS: HR=0.607, both P<0.001). Conclusions BCS+RT significantly improves survival compared with total mastectomy in patients with TN-ILC, supporting BCS+RT as the preferred treatment strategy for eligible patients.

Objective:To evaluate the effect of tissue engineering skin(TES) ,which was made of microskin combined with artificial dermis ,in the healing of huge wound on the back of SD rats .Methods:The models of huge wound on the back were made from the selected 32 SD rats at 8 weeks old .They were randomly divided into blank control group (Group A) ,artificial dermis group (Group B) ,microskin group (Group C) and TES group (Group D) .The wounds in Group B ,Group C and Group D were healed by artificial dermis with punching net ,in‐situ microskin autografts ,the TES made of autogenous in‐situ microskin combined with artificial dermis , respectively . The wounds in Group A were covered with vaseline gauze . The situations of wound healing at the 1st ,3rd and 5th week after operation were observed .The effects of ESCs during the wound healing process were observed by the CK15 and CD29 immunohistochemical stalning .The healing quality of dermis on wound was evaluated by HE stalning and Masson stalning of tissue biopsies of the back of rats and observation under scanning electronic microscopy .Results:The best healing effect was in Group D and the wounds were almost healed at the 5th week after grafting .The results of immunohistochemical stalning showed that ESCs of rats in Group D had moved to the epidermal layer gradually and took part in the wound healing .The thickness of dermal layer in Group D was larger than that in the other 3 groups(P<0 .01) and the collagen fibers in dermal layer were arranged compactly and neatly in Group D .Conclusions:The effect of the TES made of microskin combined with artificial dermis in the application of wound healing is superior to that of microskin and artificial dermis .

OBJECTIVETo compare the clinical and pathological manifestations of patients with antineutrophil cytoplasmic autoantibodies (ANCA) directed against proteinase 3 (anti-PR3) or myeloperoxidase (anti-MPO).

METHODSOne hundred and forty patients with ANCA were detected for anti-PR3 and anti-MPO by ELISA. The clinical features at presentation, histopathological characteristics and outcome of all patients who were tested positive for anti-PR3 or anti-MPO were analysed.

RESULTSIn anti-PR3 group (n = 21), 16 cases (76.2%) had systemic vasculitis, in which Wegener's granulomatosis prevailed (13 cases, 61.9%). In anti-MPO group (n = 31), 19 cases (61.3%) were diagnosed as systemic vasculitis and 12 cases (38.7%) as microscopic angiitis. For vasculitic patients with anti-PR3 and anti-MPO, the disease duration at diagnosis was 9.6 +/- 2.0 m and 4.4 +/- 0.9 m respectively, P < 0.05; vasculitis activity index (BVAS) and mean number of affected organ were 22.5 +/- 2.1, 5.0 +/- 0.4 and 25.1 +/- 1.7, 4.8 +/- 0.4 respectively, P > 0.05; upper respiratory tract, eye and joint involvements were 11(68.8%), 7(43.8%), 11(68.8%) and 7(36.8%), 2(10.5%), 5(26.3%) respectively, P < 0.05. Although there was no statistical difference in renal involvement between these two groups, patients with serum creatine > 500 micromol/L were more commonly seen in anti-MPO group than in anti-PR3 group, which were 8(42.1%) and 2(12.5%) respectively, P < 0.05. Ten relapses were seen in anti-PR3 group and only 2 in anti-MPO group, but the acute mortality rate in anti-MPO group (5/19, 27.4%) was much higher than that in anti-PR3 group (1/16, 6.3%).

CONCLUSIONSAnti-PR3 and anti-MPO occurred mainly in systemic vasculitis. A large divergence was seen in the disease spectrum between patients with anti-PR3 and those with anti-MPO. In particular, upper respiratory tract, eye and joint involvements, granuloma formation and relapse were more prominent in anti-PR3 patients. By contrast, the anti-MPO patients had a more acute disease onset, more rapid progressive renal involvement and a higher acute mortality rate.

Antibodies, Antineutrophil Cytoplasmic ; analysis ; Autoantibodies ; analysis ; Follow-Up Studies ; Granulomatosis with Polyangiitis ; drug therapy ; immunology ; pathology ; Humans ; Immunosuppressive Agents ; therapeutic use ; Kidney ; pathology ; Myeloblastin ; Peroxidase ; immunology ; Respiratory System ; pathology ; Serine Endopeptidases ; immunology ; Vasculitis ; drug therapy ; immunology ; pathology