Dihydromyricetin is a flavonoid mainly found in Ampelopsis grossedentata,which has attracted extensive attention due to its diverse pharmacological activities in recent years.However,its low oral bioavailability limits its clinical application.In this article,the pharmacological effects of dihydromyricetin on antibacterial,antiviral,antitumor,inhibition of neuroinflammation,antioxidant,and hepatorenal protection were reviewed.By summarizing,it can be seen that the pharmacological effects of dihydromyricetin are related to the traditional efficacy of Ampelopsis grossedentata.Scholars have used new preparation technologie to design dosage forms and new drug delivery systems such as liposomes,nanoparticles,microemulsions and nanoemulsions,microcapsules and nanocapsules,which can improve the bioavailability and efficacy of dihydromyricetin.Which can provide reference for the development of new drugs.

Objective:To explore the application of full-thickness advancement flap of upper abdominal wall in breast-conserving surgery for lower quadrant breast cancer.Methods:This is a retrospective case series study. The clinic data of 25 lower quadrant breast cancer patients who underwent a breast-conserving surgery with advancement flap of full-thickness of upper abdominal wall at the Breast Center, Beijing Tongren Hospital, Capital Medical University, from June 2022 to September 2023 were analyzed retrospectively. All patients were female, aged (47.6±5.8) years (range: 38 to 57 years). Tumor staging included stageⅠ in 8 cases, stageⅡA in 13 cases, stageⅡB in 4 cases. The subcutaneous fat thickness of the upper abdominal walls and the volume of wide local excision of the tumor were measured and recorded. The operation time of repairing the breast, the duration of retention of postoperative drainage tubes, postoperative complications, and cosmetic results were recorded.Results:The subcutaneous fat thickness in the upper abdominal walls was (1.7±0.2) cm (range: 1.3 to 2.2 cm), the excision volume of breast-conserving surgery was (70.8±13.6) mm 3 (range: 49 to 97 mm 3), the operation time of repairing the breast was (55.4±5.1) minutes (range: 45 to 65 minutes) and the retention time of the drainage tube was (7.4±0.8) days (range: 6 to 9 days). Cosmetic results: excellent in 12 cases (48.0%), good in 9 cases (36.0%) and fair in 4 cases (16.0%). There was 1 case of postoperative seroma in the donor area, which healed after repositioning the negative pressure drain. Conclusion:In breast-conserving surgery for lower quadrant breast cancer, using a full-thickness abdominal wall advancement flap to repair breast defects is a simple and effective tumor reconstructive technique, yielding good results in achieving postoperative symmetry of the lower quadrant of the breast.

Dihydromyricetin is a flavonoid mainly found in Ampelopsis grossedentata,which has attracted extensive attention due to its diverse pharmacological activities in recent years.However,its low oral bioavailability limits its clinical application.In this article,the pharmacological effects of dihydromyricetin on antibacterial,antiviral,antitumor,inhibition of neuroinflammation,antioxidant,and hepatorenal protection were reviewed.By summarizing,it can be seen that the pharmacological effects of dihydromyricetin are related to the traditional efficacy of Ampelopsis grossedentata.Scholars have used new preparation technologie to design dosage forms and new drug delivery systems such as liposomes,nanoparticles,microemulsions and nanoemulsions,microcapsules and nanocapsules,which can improve the bioavailability and efficacy of dihydromyricetin.Which can provide reference for the development of new drugs.

Objective:To explore the application of full-thickness advancement flap of upper abdominal wall in breast-conserving surgery for lower quadrant breast cancer.Methods:This is a retrospective case series study. The clinic data of 25 lower quadrant breast cancer patients who underwent a breast-conserving surgery with advancement flap of full-thickness of upper abdominal wall at the Breast Center, Beijing Tongren Hospital, Capital Medical University, from June 2022 to September 2023 were analyzed retrospectively. All patients were female, aged (47.6±5.8) years (range: 38 to 57 years). Tumor staging included stageⅠ in 8 cases, stageⅡA in 13 cases, stageⅡB in 4 cases. The subcutaneous fat thickness of the upper abdominal walls and the volume of wide local excision of the tumor were measured and recorded. The operation time of repairing the breast, the duration of retention of postoperative drainage tubes, postoperative complications, and cosmetic results were recorded.Results:The subcutaneous fat thickness in the upper abdominal walls was (1.7±0.2) cm (range: 1.3 to 2.2 cm), the excision volume of breast-conserving surgery was (70.8±13.6) mm 3 (range: 49 to 97 mm 3), the operation time of repairing the breast was (55.4±5.1) minutes (range: 45 to 65 minutes) and the retention time of the drainage tube was (7.4±0.8) days (range: 6 to 9 days). Cosmetic results: excellent in 12 cases (48.0%), good in 9 cases (36.0%) and fair in 4 cases (16.0%). There was 1 case of postoperative seroma in the donor area, which healed after repositioning the negative pressure drain. Conclusion:In breast-conserving surgery for lower quadrant breast cancer, using a full-thickness abdominal wall advancement flap to repair breast defects is a simple and effective tumor reconstructive technique, yielding good results in achieving postoperative symmetry of the lower quadrant of the breast.

Stomach exuberance and spleen deficiency are common pathogenesis of many metabolic diseases. Through analyzing the pathogenesis of stomach exuberance and spleen deficiency， it is believed that its essence is stomach heat and spleen deficiency. Stomach heat includes gastrointestinal heat， spleen and stomach damp-heat， and spleen deficiency is divided into deficiency of spleen yin， deficiency of spleen qi ， and deficiency of spleen yang. It is suggested that the metabolic diseases of stomach-exuberance and spleen-deficiency syndrome can be divided into three categories，i.e. stomach-heat and spleen yin-deficiency， stomach-heat and spleen qi-deficiency， and stomach-heat and spleen yang-deficiency， and the main treatment methods are clearing and draining heat， nourishing yin and moistening intestine， clearing dampness and heat， strengthening spleen and qi， clearing dampness and heat， strengthening spleen and warming yang， respectively， with prescriptions as Maziren Pills （麻子仁丸）， Qinlian Pingwei Powder （芩连平胃散）， and Jiawei Lianli Decoction （加味连理汤） accordingly.

Objective:To investigate the feasibility of using body surface marker localization method to determine the correct position of catheter tip (lower 1/3 of the superior vena cava or the junction of superior vena cava and right atrium) in totally implantable venous access port (TIVAP) implantation via internal jugular vein approach.Methods:The clinical data of 220 patients who underwent TIVAP implantation in Beijing Tongren Hospital, Capital Medical University from June 2019 to June 2021 were retrospectively analyzed. Among them, 168 patients used the internal jugular vein approach. According to the method implemented for determining the length of central venous catheter (CVC) during the operation, the patients were divided into two groups: 136 patients using the body surface marker localization method were defined as the study group; and the remaining 32 cases treated by the intraoperative X-ray fluoroscopic localization method were defined as the control group. The difference in the excellent or good rate of CVC tip position immediately after implantation and the time of implantation was compared between the two groups. In addition, the correlation between the length of CVC indwelling, height, age, and the distance between the catheter tip and tracheal carina was analyzed for the patients with right and left internal jugular vein catheterization. Kolmogorov-Smirnov test was used for statistical distribution of measurement data. Normal distribution of measurement data was expressed as mean ± standard deviation ( ± s), independent sample t-test was used for comparison between groups. Chi-square test was used for comparison between counting data. With TIVAP catheter indenture length as dependent variable and height as independent variable, Pearson correlation analysis was performed, the relationship equation between ideal catheter indenture length and patient height was analyzed by unitary linear regression. Results:When the CVC tip was located at the second intercostal space, the third sternocostal joint and the third intercostal space, the corresponding probability of being in the correct position was 34.8%, 83.3% and 95.0% respectively. The third sternocostal joint or the third intercostal space had a higher probability of correct CVC tip location than the second intercostal space, and the difference were statistically significant ( P<0.001). Furthermore, there was no significant difference in the possibility of the CVC tip located in the correct position between the third sternocostal joint and the third intercostal space ( P=0.149). Compared with the control group (before adjusting catheter position), the proportion of excellent or good CVC position in the study group was significantly improved (94.1% vs 46.9%), and the difference was statistically significant ( χ2=41.99, P<0.001); while the total operation time was significantly shortened [(33.04±6.69) min vs (42.50±5.54) min], and the difference was statistically significant ( P<0.05). There was a linear correlation between the length of CVC insertion and height. Indwelling catheter length via right internal jugular vein approach (cm) =0.159× height (cm)-1.284 ( r=0.597, r2=0.356, P<0.001); length of catheter indwelling through the left approach (cm) =0.097× height (cm) + 12.139 ( r=0.322, r2=0.104, P=0.020). Conclusions:The third sternocostal joint or the third intercostal space would be the corresponding correct surface landmark of the CVC tip when the body surface marker localization method was adopted during the TIVAP implantation via the internal jugular vein approach. Compared with the intraoperative X-ray fluoroscopy localization, the operation time is significantly shortened with the application of the body surface marker localization method. This technique is simple and easy to master and has high reliability in determining the length of catheter and the position of CVC tip.

Objective:To investigate the role of embryonic stem cell pluripotent factor NANOG in mediating the activity and invasion of breast cancer cells via AMPK/mTOR pathway.Methods:A total of 58 breast cancer patients were collected from Jul. 2019 to Aug. 2020, and the clinical data of each patient at admission were collected for comparative analysis. qRT-PCR was used to detect the expression level of NANOG in adjacent tissues and cancer tissues, and Western blot was used to verify the regulation of AMPK/mTOR pathway by NANOG. Cells were treated with NANOG specific plasmid or AMPK inhibitor Compound C. Cell viability was detected by MTT and invasion ability was detected by Transwell.Results:The expression of NANOG was increased in breast cancer tissues (adjacent to cancer tissue: 1.00±0.31, cancer tissue: 1.45±0.27, t=8.34, P<0.004) and cell lines (MCF-10A: 1.00±0.12, BT474: 2.64±0.25, t=10.24, P=0.001; MCF-7: 1.56±0.13, t=5.48, P=0.005; ZR-75-30:1.84±0.16, t=7.28, P=0.002), which could be used as a specific biomolecule for predicting breast cancer (all P<0.05). The expression level of NANOG may be related to lymph node metastasis, histological grade and pathological type. Compared with patients with non-lymph node metastasis (1.36±0.23) or non-invasive patients (1.35±0.25), patients with lymph node metastasis (1.54±0.27, t=2.61, P=0.012) or invasive patients (1.53±0.26, t=2.60, P=0.012) had higher expression of NANOG. After NANOG knockdown, AMPK protein and phosphorylation levels were increased, while mTOR and p70S6K protein and phosphorylation levels were decreased (all P<0.05). Knockdown of NANOG in cells inhibited the activity and invasion of breast cancer cells (activity: si-RNA: 100±8.65, si-NANOG: 58.36±4.58, t=7.37, P=0.002; invasion: si-RNA: 121.41±10.34, si-NANOG: 58.34±8.41, t=8.20, P=0.001), and the effect of knockdown of NANOG was relieved after AMPK inhibitor was used in cells (all P<0.05) . Conclusions:Embryonic stem cell pluripotent factor NANOG promotes the activity and invasion of breast cancer cells by inhibiting the activation of AMPK/mTOR pathway. NANOG can be used as an effective biomolecule for predicting breast cancer.

Objective:To explore the individualized surgical methods for elderly breast cancer patients.Methods:Elderly patients(aged≥70 years)with stage 0-Ⅲ breast cancer admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from January 2013 to June 2020 were retrospectively analyzed.They were divided into three groups based on surgical methods: breast-conserving surgery, nipple-areola complex-sparing mastectomy and traditional mastectomy.Age, tumor size, lymph node involvement, hormone receptor status, anesthesia mode, surgical operation mode and patient prognosis were retrospectively analyzed.Results:A total of 144 patients(147 cases)were followed up for 8-96(36.5±10.7)months, with a median of 27 months.The overall survival rate was 88.9%, with breast cancer-related deaths at 6.3%, non-breast cancer-related deaths at 4.9%, local recurrence at 3.5%, and systemic metastasis at 5.6%.Among the three groups, 38.5%, 82.0% and 73.3%, respectively, received general anesthesia.Breast-conserving surgery showed the shortest operation time[(71.7±31.6)min vs.(84.8±24.8)min vs.(100.0±34.4)min, F=7.264, P=0.001], the lowest postoperative drainage volume[(39.5±75.4)ml vs.(154.92±135.6)ml vs.(334.1±287.2)ml, F=31.481, P<0.001]and the shortest drainage duration[(2.8±3.3)d vs.(6.3±2.8)d vs.(8.5±3.7)d, F=38.101, P<0.001]. Conclusions:The surgical treatment of elderly patients with breast cancer should be based on comprehensive evaluation and accurate molecular typing.Breast-conserving surgery is the preferred surgical method for elderly patients with hormone receptor-positive and cN0 breast cancer.Mastectomy with skin and nipple areola preservation where appropriate can improve the therapeutic effect and quality of life for elderly breast cancer patients.

Objective:To investigate the efficacy and clinical value of two-stage implant-based breast reconstruction after total mastectomy for breast cancer patients.Methods:Thirty-two patients with breast cancer, who underwent nipple-sparing mastectomy or skin-sparing mastectomy, primary skin expander implantation, and permanent implant replacement after radiotherapy from January 2018 to December 2020 in the Breast Center, Beijing Tongren Hospital, Capital Medical University were analyzed retrospectively. Record the operation time of the patient, the interval between replacement surgery and radiotherapy, prosthesis volume, the difference between the volume of 0.9% sodium chloride solution in the dilator and the volume of the prosthesis, the retention time of the postoperative drainage tube, the satisfaction of the breast shape and the complications after the replacement.Results:The average operation time was (67.81±19.71) min; the average time interval between replacement surgery and radiotherapy was (9.88±2.00) months; the average volume of 0.9% sodium chloride solution in the dilator was (225.47±56.83) mL, and the average prosthesis volume was (259.06±70.88) mL, the average difference between the volume of the prosthesis and the volume of 0.9% sodium chloride solution in the dilator was (33.59±14.88) mL; the volume of the prosthesis is increased by an average of (13.65±5.19)% compared with the dilator; the average time of drainage tube retained after the operation was (9.03±1.40) d; satisfaction with breast shape after replacement: excellent in 23 cases (71.9%), general in 8 cases (25.0%), poor in 1 case (3.1%); postoperative complications: incision fat liquefaction 1 case of dehiscence (3.1%), 2 cases of seroma (6.3%), no serious complications such as external exposure and removal of the prosthesis.Conclusions:For patients with breast cancer, who need breast reconstruction after mastectomy, the two-stage implant-based breast reconstruction in which the replacement operation will be carried out more than 6 months after radiotherapy is safe. Moreover, achieve better symmetry and aesthetic effect by releasing the capsule, reconstructing the inframammary fold, and necessary plastic surgery of the contralateral breast.

Breast-contour preservation(BCP)encompasses all strategies to preserve the contour of the breast following breast-conserving surgery (BCS) and immediate postmastectomy breast reconstruction (IBR). With the continuous advancement of breast surgery, postoperative outcomes and quality of life of breast cancer patients have been significantly improved. Previous studies reported on BCP as a new comprehensive parameter for evaluating outcomes of breast cancer treatment. Based on preoperative comprehensive evaluation of patients′ general condition, characteristic of breast tumor, and breast morphology, individualized surgical strategy is formulated to improve BCP for early-stage breast cancer and improve postoperative outcomes of patients. Combined with the morphological characteristics of Chinese women′s breasts, breast contour can be preserved not only by BCS and IBR, but also by nipple-areola complex-sparing mastectomy in some breast cancer patients, thereby reducing psychosomatic impact as a result of losing breast mound.