Breast cancer-related lymphedema(BCRL)is a common and severe complication of axillary lymph node dissection,with its patho-genesis closely linked to the disruption of axillary lymphatic drainage.This article systematically reviews the preventive strategies for BCRL(de-escalation of axillary surgery,non-surgical interventions,and prophylactic microsurgical techniques),along with treatment modalities(non-surgical complex decongestive therapy,lymphatic reconstruction surgery,and debulking procedures).Current clinical controversies and future research directions have also been discussed,by integrating the latest evidence-based medical data,to provide a reference for stand-ardized BCRL management.

Objective To explore the dosimetric influence of tetrahydrocurcumin(THC),a metabolite derived from the Chi-nese herbal compound curcumin,on the antitumor Hormesis effect observed in breast cancer.Methods Human breast cancer MCF-7 and mouse breast cancer 4T1 cell lines were exposed to THC of various concentrations.Cellular responses were evalua-ted through a series of assays,including cell viability assessments,cell cycle phase distribution analysis,measurement of intracel-lular reactive oxygen species(ROS)levels,wound healing migration assays,and invasion assays.Results In comparison to the untreated control group,low concentrations of THC(4,8 μmol/L)exhibited a stimulatory effect on the proliferative activity of both MCF-7 and 4T1 cells.Conversely,the proliferative capacity of MCF-7 cells was significantly suppressed under higher con-centrations of THC(16,32 μmol/L).The accumulation of cells in the G0/G1 phase reduced and the number of cells in the S and G2/M phases increased for both cell lines under low doses of THC(2,4,8 μmol/L).However,G0/G1 phase cells were increased in MCF-7 cells under high doses of THC(16 μmol/L and 32 μmol/L),and this effect showed a concentration-dependent manner.Additionally,as the THC dose escalated,ROS levels in both MCF-7 and 4T1 cells increased.Following treatment with a low dose of THC(4 μmol/L),the migratory and invasive capabilities of both cell lines were enhanced.In contrast,the migration and invasion of both cell lines were inhibited in a dose-dependent manner after high doses THC treatment(16 μmol/L and 32 μmol/L).Conclusion The effects of THC on breast cancer cells demonstrate a pronounced concentration-dependent pat-tern.Lower concentrations of THC may exhibit pro-growth and pro-metastatic properties,whereas higher concentrations of THC inhibits cell proliferation,migration,and invasion,and induces cell cycle arrest.

Objective To explore the dosimetric influence of tetrahydrocurcumin(THC),a metabolite derived from the Chi-nese herbal compound curcumin,on the antitumor Hormesis effect observed in breast cancer.Methods Human breast cancer MCF-7 and mouse breast cancer 4T1 cell lines were exposed to THC of various concentrations.Cellular responses were evalua-ted through a series of assays,including cell viability assessments,cell cycle phase distribution analysis,measurement of intracel-lular reactive oxygen species(ROS)levels,wound healing migration assays,and invasion assays.Results In comparison to the untreated control group,low concentrations of THC(4,8 μmol/L)exhibited a stimulatory effect on the proliferative activity of both MCF-7 and 4T1 cells.Conversely,the proliferative capacity of MCF-7 cells was significantly suppressed under higher con-centrations of THC(16,32 μmol/L).The accumulation of cells in the G0/G1 phase reduced and the number of cells in the S and G2/M phases increased for both cell lines under low doses of THC(2,4,8 μmol/L).However,G0/G1 phase cells were increased in MCF-7 cells under high doses of THC(16 μmol/L and 32 μmol/L),and this effect showed a concentration-dependent manner.Additionally,as the THC dose escalated,ROS levels in both MCF-7 and 4T1 cells increased.Following treatment with a low dose of THC(4 μmol/L),the migratory and invasive capabilities of both cell lines were enhanced.In contrast,the migration and invasion of both cell lines were inhibited in a dose-dependent manner after high doses THC treatment(16 μmol/L and 32 μmol/L).Conclusion The effects of THC on breast cancer cells demonstrate a pronounced concentration-dependent pat-tern.Lower concentrations of THC may exhibit pro-growth and pro-metastatic properties,whereas higher concentrations of THC inhibits cell proliferation,migration,and invasion,and induces cell cycle arrest.

Breast cancer-related lymphedema(BCRL)is a common and severe complication of axillary lymph node dissection,with its patho-genesis closely linked to the disruption of axillary lymphatic drainage.This article systematically reviews the preventive strategies for BCRL(de-escalation of axillary surgery,non-surgical interventions,and prophylactic microsurgical techniques),along with treatment modalities(non-surgical complex decongestive therapy,lymphatic reconstruction surgery,and debulking procedures).Current clinical controversies and future research directions have also been discussed,by integrating the latest evidence-based medical data,to provide a reference for stand-ardized BCRL management.

Laparoscopic surgery has been widely applied in various surgical fields, demonstrating its advantages in minimally invasive procedures. However, for breast surgery, which lacks natural cavities, there remain certain controversies and unresolved issues. This review summarized the background, development, challenges, and solutions regarding the endoscope in breast surgery, and discussed the theoretical and practical basis for its application. Endoscope will become a new iterative tool in the field of breast surgery and is expected to provide a safer and minimally invasive way to serve more patients.

Objective:To investigate the effectiveness and advantage of visual laryngoscope in the treatment of patients with sudden cardiac arrest who need spontaneous respiration tracheal intubation.Methods:Totally 60 patients who suffered from cardiac arrest and needed spontaneous respiration tracheal intubation were enrolled from June 2020 to February 2021 in the Affilicated Hospital of Chifeng University. Theywere randomlydivided into two groups-traditional laryngoscope (TL) group and visual laryngoscope (VL) group, with30 patients in each group. Then the success rate of glottis exposure, the operative time, success rate and complication rate of tracheal intubation were compared between the two groups. Subgroup assessment between the junior emergency resident doctor (A group) and the senior emergency resident doctor (B group) was conducted.Results:According to Cormack Lehan grades, the success rate of glottis exposure in VL group was higher than that in TL group ( P>0.05), and the success rate of Grade I in VL group was significant higer than that in TL group: 56.70%(17/30) vs. 30.00%(9/30), P<0.05. The trial times of successful intubation cases and the operative time of successful intubation cases were significantly less than those in TL group (1.30 vs 1.67, P = 0.049) and (56.37 s vs 67.12 s, P<0.05). In the subgroup, the one-time success rate of tracheal intubation in A-TL group was significantly lower than that in B-TL group (4/15 vs. 11/15, P<0.05), while the one-time success rate of tracheal intubation in A-VL group was 60.00%, which is lower than that in B-VL group ( P>0.05). The operative time consumed for successful intubation in A-TL group was significantly longer than that in B-TL group: 78.00 s vs. 55.57 s, P<0.05, while the operative time in A-VL group was a little longer than that in B-VL group ( P>0.05). Conclusions:Visual laryngoscope used in spontaneous respiration tracheal intubation can not only increase the success rate of glottis exposure, decrease trial times and shorten operative time of intubation, but also improve the success rate and decrease the complication rate of emergency tracheal intubation.

Objective: To explore the expression of AGR2 gene in breast cancer as well as to predict its relevant biological functions and molecular signaling pathways with bioinformatics tool. Methods: The expression of AGR2 in breast cancer tissues and normal tissues was analyzed in Oncomine and GEPIA databases, and the expression of AGR2 in breast cancer cell lines was evaluated in CCLE database. Meanwhile, HPA database was used to analyze the expression of AGR2 protein in normal and breast cancer tissues. Besides, the gene expression microarray data download from CCLE database was analyzed by using R software to obtain genes co-expressed withAGR2. Functional annotation ofAGR2 co-expressed genes was performed by using GO Enrichment and KEGG pathway analyses. Results: Oncomine and GEPIA databases showed that AGR2 gene was highly expressed in breast cancer tissues, and CCLE database analysis showed that AGR2 was highly expressed in all breast cancer cell lines. Immunohistochemistry results from the HPA database showed that the expression of AGR2 protein was significantly higher in breast cancer tissues compared with normal tissues. A total of 946 genes co-expressed with AGR2 in breast cancer were screened out with the R software. With the GO function Enrichment analysis, the co-expressed genes were demonstrated to be mainly involved in biological functions, such as protein localization to cell periphery, protein localization to plasma membrane, cell junction assembly, cell-substrate adhesion, and cell junction organization etc. In addition, the KEGG analysis results showed that co-expressed genes were mainly involved in the progression of gastric cancer and breast cancer, and were associated with proteoglycans in cancer, as well as proline, leucine and isoleucine degradation pathways. Conclusions:AGR2 is highly expressed in breast cancer tissues, which may be a potential oncogenic gene and a new therapeutic target of breast cancer.

Objective: To analyze the clinicopathological features and prognosis of breast invasive ductal carcinoma patients receiving radical mastectomy according to the primary tumor location. Methods: From January 2008 to December 2008, 993 patients with breast invasive ductal carcinoma received radical mastectomy in Tianjin Medical University Cancer Institute and Hospital. Patients were grouped according to the primary tumor location when breast cancer was diagnosed. The clinicopathological characteristics and follow-up information of them was collected and analyzed retrospectively. Results: Of the 993 patients, primary tumor located in the upper-outer quadrant (UOQ) in 556 patients (56.0%), the lower-outer quadrant (LOQ) in 97 (9.8%), the central portion in 99 (10.0%), the upper-inner quadrant (UIQ) in 186 (18.7%), and the lower-inner quadrant (LIQ) in 55 (5.5%). Patients in the central portion tended to have larger tumors, and more patients in the upper-inner quadrant received endocrine therapy. The estimated 5-year disease-free survival (DFS) rates of patients with primary lesion in the UOQ, LOQ, central portion, UIQ and LIQ were 90.3%, 88.7%, 79.8%, 86.0% and 72.7%, respectively, with significant differences (P<0.001). The 5-year overall survival (OS) rates were 97.5%, 96.9%, 90.9%, 94.1% and 87.3%, respectively, with significant differences (P<0.001). Multivariate analysis showed that 5-year recurrence and metastasis risks were significantly increased in patients with primary lesion in the central portion, UIQ and LIQ compared to other groups (P<0.001), and 5-year mortality risks were increased in these three groups (P=0.002). Conclusion Primary lesion located in central portion and inner quadrant is an independent adverse prognostic factor for patients with breast invasive ductal carcinoma patients receiving radical mastectomy.

Objective: To analyze the feasibility of axillary lymph node staging through sentinel lymph node biopsy (SLNB) after neoad-juvant chemotherapy (NAC) in patients with node-positive breast cancer and to explore the follow-up treatment of these patients. Methods: Clinical data of 82 patients with node-positive breast cancer before NAC in Tianjin Medical University Cancer Institute and Hospital from January 2016 to January 2018 were analyzed retrospectively. All these patients accepted SLNB after NAC. The detection rate, accuracy, false negative rate (FNR), and influencing factors were analyzed. Results: A nodal pathological complete response (PCR) was achieved in 43 of 82 patients. The PCR rate was 52.4%. The detection rate, accuracy, and FNR were 97.56% (80/82), 88.75% (71/80), and 23.08% (9/39), respectively. The accuracy of 1, 2, and≥3 SLNs detected were 90.9% (20/22), 66.7% (10/15), and 95.3% (41/43), respectively. The FNRs were 20.0% (2/10), 71.4% (5/7), and 9.1% (2/22), respectively (both P<0.05). Conclusions: Due to its overall high FNR, without clinically acceptable limits, post-NAC SLNB cannot completely replace axillary lymph node dissection (ALND) in node-positive patients. However, with no less than 3 SLNs detected, SLNB can accurately evaluate the status of axillary lymph nodes.

Objective To analyze the clinicopathological features and prognosis of breast invasive ductal carcinoma patients receiving radical mastectomy according to the primary tumor location. Methods From January 2008 to December 2008, 993 patients with breast invasive ductal carcinoma received radical mastectomy in Tianjin Medical University Cancer Institute and Hospital. Patients were grouped according to the primary tumor location when breast cancer was diagnosed. The clinicopathological characteristics and follow?up information of them was collected and analyzed retrospectively. Results Of the 993 patients, primary tumor located in the upper?outer quadrant ( UOQ) in 556 patients ( 56.0%), the lower?outer quadrant (LOQ) in 97 (9.8%), the central portion in 99 (10.0%), the upper?inner quadrant (UIQ) in 186 (18.7%), and the lower?inner quadrant (LIQ) in 55 (5.5%). Patients in the central portion tended to have larger tumors, and more patients in the upper?inner quadrant received endocrine therapy. The estimated 5?year disease?free survival (DFS) rates of patients with primary lesion in the UOQ, LOQ, central portion, UIQ and LIQ were 90.3%, 88.7%, 79.8%, 86.0% and 72.7%, respectively, with significant differences (P＜0.001). The 5?year overall survival (OS) rates were 97.5%, 96.9%, 90.9%, 94.1% and 87.3%, respectively, with significant differences ( P＜0.001). Multivariate analysis showed that 5?year recurrence and metastasis risks were significantly increased in patients with primary lesion in the central portion, UIQ and LIQ compared to other groups ( P＜0.001), and 5?year mortality risks were increased in these three groups (P＝ 0.002). Conclusion Primary lesion located in central portion and inner quadrant is an independent adverse prognostic factor for patients with breast invasive ductal carcinoma patients receiving radical mastectomy.