Purpose To investigate the clinicopathological features,differential diagnosis,and prognosis of breast carcinoma within fibroadenoma(FA).Methods A retrospective analysis was performed on the clinical and imaging data of 21 cases of FA-associated carcinoma.HE staining,immunohistochemistry using the EnVision method,and next-generation sequencing were employed to assess the clinicopathological characteristics and genetic alterations,with a review of the relevant literature.Results All patients were female,aged 21-67 years,with a median age of 48 years.Clinically,all lesions presented with well-circumscribed mass lesions.On imaging,12 cases demonstrated punctate or coarse calcifications,while 3 cases exhibited locally indistinct margins.Pathological examination revealed that the tumors had an average maximum diameter of 2.25 cm,with a gray-white nodular cut surface resembling FA.Microscopically,there was proliferation of either epithelial or spindle cells.The pathological diagnosis was FA-associat-ed in situ carcinoma in 16 cases(15 cases of low-grade ductal carcinoma in situ and 1 case of lobular carcinoma in si-tu),and invasive carcinoma in 5 cases(comprising 2 cases of invasive carcinoma-no special type,1 case of invasive lobular carcinoma,1 case of low-grade adenosquamous carcinoma and 1 case of fibromatosis-like metaplastic carcino-ma).In 18 cases,the carcinoma was confined within the FA,whereas in 3 cases the tumor locally extended beyond the FA,and 1 case exhibited ipsilateral axillary lymph node metastasis.Immunophenotypically,tumor cells in in situ carcinomas were negative for CK5/6,while the myoepithelial cells were p63-positive,and both estrogen receptor(ER)and progesterone receptor(PR)were diffusely and consistently positive.In invasive carcinoma,both ductal and lobular subtypes were ER and PR positive and HER2 negative.Conversely,in the low-grade adenosquamous carcinoma and fi-bromatosis-like metaplastic carcinoma,ER,PR,and HER2 were all negative,with p63 and CK5/6 positivity.Two ca-ses were negative for mismatch repair protein PMS2.Six cases had a family or personal history of malignant tumors;a-mong the 5 cases that underwent next-generation sequencing,2 cases harbored germline BRCA2 mutations,2 cases had germline PMS2 mutations,and 1 case exhibited no definitive genetic alteration.Conclusion Carcinoma arising within FA exhibits atypical clinical and imaging features.In patients with high-risk factors for breast cancer or family history of malignancy,or when calcifications are observed on imaging,prompt excision and biopsy are recommended.Recogniz-ing the abnormal morphology within FA and the use of immunohistochemistry are essential for accurate diagnosis,with careful differentiation from spindle cell metaplastic carcinoma and low-grade adenosquamous carcinoma.Overall,the prognosis is relatively favorable,and treatment should be tailored according to tumor type,molecular subtype,and stage.

Objective To compare the efficacy of recombinant human interleukin-11(rhIL-11)and herombopag olamine tablets on chemotherapy-induced thrombocytopenia(CIT)in breast cancer.Methods Eighty-six prospectively selected breast cancer patients with CIT were randomly divided into the control group(administered rhIL-11)and the study group(administered herombopag olamine tablets),with 43 cases in each group.Before treatment and 14 days after treatment,platelet parameters[platelet count(PLT),plateletcrit(PCT),platelet distribution width(PDW)and mean platelet volume(MPV)]and flow cytometry were measured by automated hematology analyzer.Cellular immune indicators(CD3+,CD4+,CD8+and CD4+/CD8+)were detected by flow cytometer.Enzyme-linked immunosorbent assay was used to determine the levels of thrombopoietin(TPO)and interleukin-11(IL-11).The above parameters were compared between the two groups,and the incidence of adverse reactions in the two groups was recorded.Results After treatment,PLT,PCT,CD3+,CD4+,CD4+/CD8+,TPO and IL-11 in both groups were higher than before treatment,and which was higher in the study group than the control group(P＜0.05).After treatment,PDW,MPV and CD8+of both groups were lower than before treatment,and the study group was lower than the control group(P＜0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(P＞0.05).Conclusion Both rhIL-11 and herombopag olamine tablets are effective in treating breast cancer with CIT.Compared with rhIL-11,herombopag olamine tablets have more advantages in improving platelet parameters,cellular immune indicators,TPO and IL-11,and do not increase the adverse reactions.

Objective:To investigate auricular acupressure combined with massage-tapping exercises on body indicators, blood lipids, and liver function in patients with obesity-related fatty liver disease.Methods:This retrospective study included 78 patients with obesity-related fatty liver disease admitted to Hangzhou Hospital of Traditional Chinese Medicine from April to December 2023. The patients were divided into two groups based on different treatment methods: the conventional group (36 patients receiving conventional interventions) and the combined group (36 patients receiving auricular acupressure combined with massage-tapping exercises in addition to conventional interventions). The total response rates, physical indicators (body weight, body mass index), blood lipid levels (triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol), and liver function indicators (aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase were recorded and compared between the two groups.Results:The total response rate in the combined group was 94.87% (37/39), which was significantly higher than the 76.92% (30/39) in the conventional group ( χ2 = 5.19, P < 0.05). After intervention, the combined group showed lower body weight [(70.42 ± 8.32) kg vs. (75.84 ± 8.46) kg], lower body mass index [(24.32 ± 1.26) kg/m2 vs. (25.48 ± 1.30) kg/m2], lower triglycerides [(1.62 ± 0.42) mmol/L vs. (2.94 ± 0.78) mmol/L], lower total cholesterol [(5.24 ± 0.54) mmol/L vs. (6.72 ± 0.66) mmol/L], lower low-density lipoprotein cholesterol [(2.14 ± 0.46) mmol/L vs. (2.78 ± 0.50) mmol/L], lower aspartate aminotransferase [(35.32 ± 4.38) U/L vs. (40.16 ± 5.14) U/L], lower alanine aminotransferase [(31.05 ± 4.20) U/L vs. (37.24 ± 4.56) U/L], and lower gamma-glutamyltransferase [(43.35 ± 8.74) U/L vs. (57.62 ± 9.04) U/L] levels compared with the conventional group. The combined group showed higher high-density lipoprotein cholesterol level compared with the conventional group [(1.85 ± 0.26) mmol/L vs. (1.26 ± 0.30) mmol/L]. All differences were statistically significant ( t = 2.85, 4.00, 9.31, 10.84, 5.88, 4.48, 6.24, 7.09, 9.28, all P < 0.05). Conclusions:The combination of auricular acupressure and massage-tapping exercises is effective in treating obesity-related fatty liver disease in patients. This approach can regulate physical indicators, improve lipid metabolism, and enhance liver function, making it a method worth promoting in clinical practice.

Objective:To compare the benefits and prognostic risks of unilateral lobectomy (with or without isthmusectomy) or total (or near-total) thyroidectomy for primary foci of unilateral papillary thyroid cancer (PTC) patients with ipsilateral lateral cervical lymph node metastasis (LLNM) , so as to find out the optimal surgery for these patients.Methods:A total of 505 unilateral PTC patients with ipsilateral LLNM who underwent initial surgical treatment at the Thyroid Surgery Department of Zhejiang Cancer Hospital from Feb. 2012 to Jan. 2020 were retrospectively reviewed. The patients were divided into unilateral lobectomy group ( n=314) and total thyroidectomy group ( n=191) according to the extent of resection of primary foci. Then 177 pairs of cases were screened out after eliminating the potential confounding bias between the two groups by using propensity score matching (PSM) , analyzing the differences in clinical outcomes such as recurrence-free survival (RFS) , overall survival (OS) , hospitalization costs, and postoperative complications between the two groups. Results:After PSM, the postoperative complication rate was 37.3% ( n=66) in the total thyroidectomy group and 3.4% ( n=6) in the unilateral lobectomy group. The complication was mainly characterized by temporary hypoparathyroidism (HP) . Although the difference in length of hospitalization between the two groups was not statistically significant ( P=0.792) , patients in the unilateral lobectomy group used less surgical time ( P<0.001) , had lower hospitalization and surgical costs ( P<0.0001) , and took a relatively smaller dose of levothyroxine (L-T4) one month after the operation ( P<0.0001) , as compared with the total thyroidectomy group. Univariate analysis showed that the number of LLNM total lymph node metastasis (LNM) rate, LLNM rate, and T stage were significant risk factors for relapse. Multi-factor regression analysis indicated that T-staging was a risk factor for recurrence. After a median follow-up of 60 (3-138) months, 19 patients (10.7%) in the unilateral lobectomy group and 11 patients (6.2%) in the total thyroidectomy group recurred, with no statistical difference between the two groups ( P=0.133) . The OS curve displayed no significant difference between the unilateral lobectomy and total thyroidectomy groups ( P=0.740) . Conclusion:For unilateral PTC patients with ipsilateral LLNM without other high-risk features, unilateral lobectomy could be a better option.

With the extended survival period of breast cancer patients and the increasing health demands, the concomitant diseases of breast cancer have gradually attracted the attention of both doctors and patients, and it is imperative to conduct comprehensive management of these diseases, in which the general practitioners, as the more comprehensive and complex medical talents, have not yet played their due roles. In this article, we report two cases of comprehensive management of concomitant diseases of breast cancer through collaboration of general practitioners and specialists (integrated general and specialist care). The role and function of general practitioners in this process were deeply analyzed, and the establishment of a consultation-liaison general practice model to further promote the role of integrated general and specialist care in integrated oncology care was advocated.

With the improvement of diagnosis and treatment level, most breast cancer patients survive in a chronic state for a long time, and the issue of concomitant diseases of breast cancer (CDBC) has become increasingly prominent. All-round and full-cycle management of these comorbidities can help improve patients’ quality of life and prognosis. General practice, with its long-term, comprehensive and responsible health care that is person-centered, family-based, community-wide and oriented to the maintenance and promotion of overall health, presents new opportunities for the health management of CDBC. This article will explore the application of consultation-liaison general practice through the integrated general and specialist care in the comprehensive management of CDBC, aiming to raise people’s awareness of it and promote the development of consultation-liaison general practice and the management model of the "Internet plus general practitioner team" , which will surely contribute to the all-round management of concomitant diseases in breast cancer patients.

Purpose To investigate the clinicopathological features,differential diagnosis,and prognosis of breast carcinoma within fibroadenoma(FA).Methods A retrospective analysis was performed on the clinical and imaging data of 21 cases of FA-associated carcinoma.HE staining,immunohistochemistry using the EnVision method,and next-generation sequencing were employed to assess the clinicopathological characteristics and genetic alterations,with a review of the relevant literature.Results All patients were female,aged 21-67 years,with a median age of 48 years.Clinically,all lesions presented with well-circumscribed mass lesions.On imaging,12 cases demonstrated punctate or coarse calcifications,while 3 cases exhibited locally indistinct margins.Pathological examination revealed that the tumors had an average maximum diameter of 2.25 cm,with a gray-white nodular cut surface resembling FA.Microscopically,there was proliferation of either epithelial or spindle cells.The pathological diagnosis was FA-associat-ed in situ carcinoma in 16 cases(15 cases of low-grade ductal carcinoma in situ and 1 case of lobular carcinoma in si-tu),and invasive carcinoma in 5 cases(comprising 2 cases of invasive carcinoma-no special type,1 case of invasive lobular carcinoma,1 case of low-grade adenosquamous carcinoma and 1 case of fibromatosis-like metaplastic carcino-ma).In 18 cases,the carcinoma was confined within the FA,whereas in 3 cases the tumor locally extended beyond the FA,and 1 case exhibited ipsilateral axillary lymph node metastasis.Immunophenotypically,tumor cells in in situ carcinomas were negative for CK5/6,while the myoepithelial cells were p63-positive,and both estrogen receptor(ER)and progesterone receptor(PR)were diffusely and consistently positive.In invasive carcinoma,both ductal and lobular subtypes were ER and PR positive and HER2 negative.Conversely,in the low-grade adenosquamous carcinoma and fi-bromatosis-like metaplastic carcinoma,ER,PR,and HER2 were all negative,with p63 and CK5/6 positivity.Two ca-ses were negative for mismatch repair protein PMS2.Six cases had a family or personal history of malignant tumors;a-mong the 5 cases that underwent next-generation sequencing,2 cases harbored germline BRCA2 mutations,2 cases had germline PMS2 mutations,and 1 case exhibited no definitive genetic alteration.Conclusion Carcinoma arising within FA exhibits atypical clinical and imaging features.In patients with high-risk factors for breast cancer or family history of malignancy,or when calcifications are observed on imaging,prompt excision and biopsy are recommended.Recogniz-ing the abnormal morphology within FA and the use of immunohistochemistry are essential for accurate diagnosis,with careful differentiation from spindle cell metaplastic carcinoma and low-grade adenosquamous carcinoma.Overall,the prognosis is relatively favorable,and treatment should be tailored according to tumor type,molecular subtype,and stage.

Objective To compare the efficacy of recombinant human interleukin-11(rhIL-11)and herombopag olamine tablets on chemotherapy-induced thrombocytopenia(CIT)in breast cancer.Methods Eighty-six prospectively selected breast cancer patients with CIT were randomly divided into the control group(administered rhIL-11)and the study group(administered herombopag olamine tablets),with 43 cases in each group.Before treatment and 14 days after treatment,platelet parameters[platelet count(PLT),plateletcrit(PCT),platelet distribution width(PDW)and mean platelet volume(MPV)]and flow cytometry were measured by automated hematology analyzer.Cellular immune indicators(CD3+,CD4+,CD8+and CD4+/CD8+)were detected by flow cytometer.Enzyme-linked immunosorbent assay was used to determine the levels of thrombopoietin(TPO)and interleukin-11(IL-11).The above parameters were compared between the two groups,and the incidence of adverse reactions in the two groups was recorded.Results After treatment,PLT,PCT,CD3+,CD4+,CD4+/CD8+,TPO and IL-11 in both groups were higher than before treatment,and which was higher in the study group than the control group(P＜0.05).After treatment,PDW,MPV and CD8+of both groups were lower than before treatment,and the study group was lower than the control group(P＜0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(P＞0.05).Conclusion Both rhIL-11 and herombopag olamine tablets are effective in treating breast cancer with CIT.Compared with rhIL-11,herombopag olamine tablets have more advantages in improving platelet parameters,cellular immune indicators,TPO and IL-11,and do not increase the adverse reactions.

Objective To analyze the reverse mechano-electric effect of the layered structure of articular cartilage and its influencing factors.Methods The cartilage samples were classified according to their physiological thickness(approximately 0.4 mm for the upper layer,1 mm for the middle layer,and 0.6 mm for the lower layer).Through a non-contact external electric field testing method,how different influencing factors affected the reverse mechano-electric effect of articular cartilage was analyzed.Results When the electric field spacing decreased,water content increased,and in vitro time decreased,the displacement of normal layered cartilage in a non-contact electric field increased by 18,10,15 μm,respectively.In the case of simulated arthritis defects,as the defect depth and radius increased,the overall deviation deflection of articular cartilage gradually decreased by about 7 μm.Conclusions The three-layer cartilage differed in their reverse mechano-electricity effects,showing the greatest deflection in the middle layer at 90％water content,under 7 mm electric field spacing,and after 12 hours ex vivo.

G protein-coupled receptor 120(GPR120)is one of the membrane receptors for long chain free fatty acids and is distributed in alveolus macrophages and airway epithelial Club cells.GPR120 activation alleviates the inflammation of respiratory tract,improves airway hyper-responsiveness,stimulates proliferation of Club cells and promotes the repair of respiratory epithelium,which may attenuate asthma and acute lung injury.