Objective:To analyze the influence factors of urinary tract infection after transurethral bipolar plasma enucleation of the prostate (TUPEP) in patients with benign prostatic hyperplasia(BPH), and the early predictive value of serum inflammatory indicators for postoperative urinary tract infection.Methods:A total of 300 patients with BPH who received TUPEP treatment in the Department of Urology, Kailuan General Hospital from January 2021 to August 2023 were selected, according to whether they had urinary tract infections after the operation, they were divided into infection group ( n=117) and non-infection group ( n=183). The clinical data of the two groups were collected, and the serum inflammatory indexes of the two groups were recorded within 24 hours after the operation, including white blood cell count (WBC), neutrophil granulocyte (NE%), high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA), procalcitonin (PCT), heparin-binding protein (HBP), interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and serum ferritin (SF). The differences of clinical data and serum inflammatory indexes between the two groups were analyzed. The measurement data of normal distribution were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used for inter-group comparisons. The measurement data of non- normal distribution were represented by median (interquartile range) [ M ( Q1, Q3)], and the Mann-Whitney U test was used for inter-group comparison. The count data were expressed as cases and percentage, and inter-group comparisons were conducted using the Chi-test. Multivariate Logistic regression analysis was used to explored the influencing factors of urinary tract infections in BPH patients after TUPEP surgery. The receiver operating characteristic (ROC) curve was plotted using GraphPad Prism 8.0.1 medical plotting softwar to evaluate the predictive value of serum inflammatory markers and combined detection of multiple markers for early postoperative urinary tract infections. Results:The duration of disease, history of diabetes, international prostate symptom score (IPSS), prostate volume, preoperative serum prostate-specific antigen (PSA) level, preoperative urine residual volume, operation time, intraoperative blood loss, postoperative catheter indwelling time, and hospitalization time in the infection group were higher than those in the non-infection group ( P<0.05). The preoperative 25-hydroxyvitamin D (25OHD) level and maximum urinary flow rate were lower in the infection group than those in the non- infection group ( P<0.05). Multivariate Logistic regression analysis showed that the course of the disease, history of diabetes, IPSS score, prostate volume, preoperative PSA level, preoperative urine residual volume, operation time, intraoperative blood loss, postoperative catheter indwelling time was positively correlated with urinary tract infection after TUPEP ( B=0.660, 0.242, 0.164, 0.125, 0.230, 0.066, 0.382, 0.022, 0.436, P<0.01), and preoperative 25OHD level and preoperative maximum urinary flow rate were negatively correlated with urinary tract infection after TUPEP ( B=-0.216, -0.372, P<0.01). The levels of hs-CRP, SAA, PCT, HBP, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, SF in the infection group were higher than those in the non-infection group ( P<0.001). The ROC curve analysis showed that the area under the curve (AUC) of hs-CRP, SAA, PCT, HBP, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, SF in early predicting urinary tract infection after TUPEP in BPH patients were 0.697, 0.775, 0.902, 0.873, 0.884, 0.904, 0.917, 0.823, 0.906, 0.852, 0.807, 0.787. The AUC of the combined detection of multiple serum inflammatory markers was 0.972, the sensitivity and specificity were 93.18% and 96.63%, and the sensitivity and specificity of the combined detection of multiple serum inflammatory markers were higher than those of separate detection. Conclusion:The course of BPH, whether to combine history of diabetes, preoperative IPSS score, prostate volume, preoperative PSA level, preoperative 25OHD level, preoperative maximum urinary flow rate, operation time, intraoperative blood loss, and postoperative catheter indwelling time are influencing factors of urinary tract infection after TUPEP, hs-CRP, SAA, PCT, HBP, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, SF had certain value in the early prediction of urinary tract infection after TUPEP in patients with BPH, the combination of multiple indicators can improve the predictive value of early urinary tract infection.

Objective:To understand the thyroid function of the physical examination population in Tangshan area, and analyze the effects of thyroid function on blood lipids, fasting blood glucose (FPG), and serum 25 hydroxyvitamin D [25(OH)D].Methods:A population from the Tangshan area who underwent physical examinations at the Kailuan General Hospital from June 2020 to June 2021 was selected as the study subjects and the levels of their thyroid serological indicators [thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (TT3), and thyroid hormone (TT4)] were tested. According to thyroid function, they were divided into normal group, hyperthyroidism group, hypothyroidism group, subclinical hyperthyroidism group, and subclinical hypothyroidism group. We compared the blood lipid indicators [triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)], FPG, and 25(OH)D levels in different subgroups, and the Pearson correlation analysis was used to investigate the correlation between TSH levels and blood lipids, FPG, and 25(OH)D levels.Results:In this study, 2 884 subjects were selected from the physical examination population in Tangshan area. The proportion of people with abnormal thyroid function was 12.03%(347/2 884), among which the proportion of subclinical thyroid function abnormal population in the total thyroid function abnormal population was 80.69%(280/347). As men age, the proportion of thyroid dysfunction in the age groups of 21-<30 years old, 30-<40 years old, 40-<50 years old, and ≥50 years old was 5.06%(4/79), 7.52%(33/439), 8.91%(53/595), and 9.95%(66/663), respectively. The proportion of thyroid dysfunction in the above age group of women was 14.02%(15/107), 15.06%(61/405), 15.47%(67/433), and 29.45%(48/163). The serum TG, TC, LDL-C, and 25(OH)D levels in the hyperthyroidism group were lower than those in the normal group, while HDL-C and FPG levels were higher than those in the normal group, with statistically significant differences (all P<0.05). The serum TG and TC in the hypothyroidism group were higher than those in the normal group, while FPG and 25(OH)D were lower than those in the normal group, with statistically significant differences (all P<0.05). TSH levels were positively correlated with TC and LDL-C, while negatively correlated with FPG and 25(OH)D (all P<0.05). Conclusions:Subclinical thyroid dysfunction is the main cause of thyroid dysfunction in the Tangshan area, and TSH levels are correlated with blood lipids, fasting blood glucose, and serum 25(OH)D levels.

Objective:To examine treatment outcomes of breast phyllodes tumors and the prognosis factors of local recurrence.Methods:This retrospective cohort study included 276 patients who underwent surgical resection at Breast Center, Peking University People′s Hospital from January 2011 to December 2019. Tumor subtype and histopathological features were determined from pathology reports, and the deadline of follow-up was September 30 th, 2020. All 276 patients underwent open surgery, including 17 patients of mastectomy, and 259 patients of lumpectomy. The enrolled patients were all female, with age of (41.5±11.3) years (rang: 11 to 76 years), and tumor diameter of 35(28) mm ( M( Q R)). The Kaplan-Meier method and Log-rank test were used for survival analysis. The multivariate analysis was implemented using the Cox proportional hazard model. Results:According the pathologic test, there were 191 patients of benign phyllodes tumor, 67 patients of borderline tumor and 18 patients of malignant tumor. There were 249 patients with a follow-up of more than 6 months, and 14.1% (35/249) had local recurrence. The time-to-recurrence was (28.6±22.2) months (range: 2 to 96 months), (29.1±18.1) months (range: 2 to 80 months), (32.1±30.1) months (range: 5 to 96 months) and (12.0±6.9) months (range: 8 to 20 months) for benign, borderline and malignant phyllodes tumors. Tumor diameter (≥100 mm vs.<50 mm, HR=3.968, 95%CI: 1.550 to 10.158, P=0.004) and malignant heterologous element (yes vs. no, HR=26.933, 95%CI: 3.105 to 233.600, P=0.003) were prognosis factors of local recurrence. One death from malignant phyllodes occurred after distant metastasis. The 3-year disease-free survival rates of benign, borderline and malignant phyllodes tumor were 88.2%, 81.7% and 81.4% ( P=0.300). Conclusion:Phyllodes tumors have a considerable local recurrence rate, which may be associated with tumor diameter and malignant heterologous element.

Objective:To examine treatment outcomes of breast phyllodes tumors and the prognosis factors of local recurrence.Methods:This retrospective cohort study included 276 patients who underwent surgical resection at Breast Center, Peking University People′s Hospital from January 2011 to December 2019. Tumor subtype and histopathological features were determined from pathology reports, and the deadline of follow-up was September 30 th, 2020. All 276 patients underwent open surgery, including 17 patients of mastectomy, and 259 patients of lumpectomy. The enrolled patients were all female, with age of (41.5±11.3) years (rang: 11 to 76 years), and tumor diameter of 35(28) mm ( M( Q R)). The Kaplan-Meier method and Log-rank test were used for survival analysis. The multivariate analysis was implemented using the Cox proportional hazard model. Results:According the pathologic test, there were 191 patients of benign phyllodes tumor, 67 patients of borderline tumor and 18 patients of malignant tumor. There were 249 patients with a follow-up of more than 6 months, and 14.1% (35/249) had local recurrence. The time-to-recurrence was (28.6±22.2) months (range: 2 to 96 months), (29.1±18.1) months (range: 2 to 80 months), (32.1±30.1) months (range: 5 to 96 months) and (12.0±6.9) months (range: 8 to 20 months) for benign, borderline and malignant phyllodes tumors. Tumor diameter (≥100 mm vs.<50 mm, HR=3.968, 95%CI: 1.550 to 10.158, P=0.004) and malignant heterologous element (yes vs. no, HR=26.933, 95%CI: 3.105 to 233.600, P=0.003) were prognosis factors of local recurrence. One death from malignant phyllodes occurred after distant metastasis. The 3-year disease-free survival rates of benign, borderline and malignant phyllodes tumor were 88.2%, 81.7% and 81.4% ( P=0.300). Conclusion:Phyllodes tumors have a considerable local recurrence rate, which may be associated with tumor diameter and malignant heterologous element.

Objective To evaluate the long-term safety of sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue in breast cancer patients.Methods 198 breast cancer patients with clinical negative axillary lymph node received sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue.Patients were followed up and regional lymph node recurrence,disease free survival(DFS) and overall survival(OS) were analyzed.Results After a median follow-up of 70 months,2 patients had ipsilateral lymph node recurrence with a regional lymph node recurrence rate of 1％ (2/198).14 patient had recurrence or metastasis and 6 patients died of distant metastasis.The estimated 6 years DFS was 94.4％ and OS was 96.5％.The incidence of arm lymphoedema within patients who received axillary lymph node dissection was 4.5％ and it was 2.5％ in patients who received sentinel lymph node biopsy.Conclusions The sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue was safe and reliable method for further staging axillary lymph node stastus.

Objective: To summarize the impacts of the archived medical record value fund as established by the hospital, on the medical quality management, and propose improvement strategies. Methods: Retrospective analysis was made on 1 149 medical record scoring sheets, and the rate of connotations deducting scores in 197 of such sheets were compared. A statistical analysis was made on the archived medical records, regarding the rate of grade A medical records, defects composition of grade B medical records, the rate of connotation deducting scores, and the ability of the quality control experts (error correction ratio). Results: The archived medical record value fund has pushed up significantly the quality of medical records. For example, the rate of grade A medical records rose step by step from 89% to 95%; the rate of grade B medical records with single-item vetoes fell sharply, a difference of statistical significance (P<0.05); the connotation quality management of medical records was constantly improving, with the rate of connotation deducting scores gradually elevating (t=-4.409, P<0.05); the proportion of experts with strong error correction ability (error correction ratio≥80%) was elevated from 32.2% to 50.9%, a difference of statistical significance (P<0.05). Conclusions Archived medical record management can encourage medical quality management. The quality of medical records, especially the connotation quality of medical records has been improved. The ability of some quality control experts was also enhanced. The quality management system at hospital and department levels has made major progress.

Objective:To evaluate the frequency and predictive factors of nipple involvement in a large contemporary cohort of pa-tients and to improve patient selection for the preservation of the nipple-areolar complex. Methods: This retrospective study re-viewed the medical charts of 1,190 patients who underwent traditional mastectomy in Peking University People's Hospital between October 2008 and March 2014. Nipple involvement incidence was compared between the cases of clinically abnormal and clinically normal breasts. Other clinicopathological features and nipple status were analyzed to evaluate the association between these factors and occult nipple involvement. Univariate and multivariate analyses were conducted to identify predictive factors. Results:Nipple in-volvement was detected in 6.0%of the mastectomy specimens. Meanwhile, incidence was 40.7%(22 out of 54) in clinically abnormal nipple cases and 4.3%(49 out of 1,136) in clinically normal nipple cases (χ2=121.9, P<0.001). Univariate analysis revealed that tumor lo-cation, tumor to nipple distance (≤2 and>2 cm), lymphovascular invasion, diameter (including carcinoma in situ;≤3.5 and>3.5 cm), T stage, N stage, and TNM stage were associated with occult nipple involvement. By logistic regression analysis, tumor location, tumor to nipple distance, T stage, and N stage were determined to be the independent predictors of nipple involvement. Conclusion:Clinical abnormalities of the nipples are reliable and potent predictors of nipple pathology. The cases with peripheral tumor, T1-T2 stage, and N0-N1 stage have lower probability of occult nipple involvement.

Objective To analyze the prognostic factors and their influences on breast cancer patients with local-regional recurrence.Methods From Jan.1st,1998 to Dec.30th,2007,66 breast cancer patients with local-regional recurrence were treated at Breast Center of Peking University People's Hospital.The overall survival of the patients was analyzed using Kaplan Meier survival analysis and the prognostic factors such as primary tumor status,initial treatment,location of recurrence and treatment strategy after local recurrence were analyzed using Cox regression model.Results The median follow-up was 111 months.The median survival for the 66 patients with recurrence was 99 months,ranging from 3 to 188 months and 5-year survival rate was 60％.Kaplan-Meier analysis revealed statistically significant better survival for patients with unifocal primary tumor,undergoing initial breast conservation surgery,with local recurrence only and undergoing radical local treatment after local recurrence (P =0.003,P =0.017,P =0.050,and P =0.000 respectively).COX regression analysis showed that age at initial diagnosis and radical local treatment after recurrence had influences on post-recurrence survival of patients without distant metastasis (P =O.004 and 0.000 respectively).Conclusion The clinical and pathological features of primary tumor,initial surgery,site of recurrence and treatment strategy after recurrence have influences on prognosis of breast cancer patients with local-regional recurrence.

OBJECTIVETo compare the efficacy and toxicity of two different regimens as neoadjuvant chemotherapy for breast cancer.

METHODSForty-eight patients with stage II, III breast cancer as proved by cytology biopsy, were treated with either 5-Fu, epirubicin, cyclophosphamide (FEC) or epirubicin, paclitaxel (ET) regimens for 2 cycles every 3 - 4 weeks. Clinical responses in the breast and lymph nodes were assessed after 2 cycles of neoadjuvant chemotherapy. Patients in FEC arm received combination of 5-fluorouracil (5-Fu) 500 mg/m(2) by 4-hour continuous infusion on D1 and D8, epirubicin (EPI) 50 mg/m(2) by intravenous injection on D1, and cyclophosphamide (CTX) 500 mg/m(2) by intravenous injection on D1 and D8. Patients assigned to the ET arm received EPI 60 mg/m(2) by intravenous injection on D1, paclitaxel (TAX) 150 mg/m(2) by 3-hour continuous infusion on D2. All patients were treated by operation 2 weeks later and radiotherapy was added to some.

RESULTSFor primary tumor in the breast, the overall response rate (RR) was 50.0% (12/24) in FEC arm and 79.2% (19/24) in ET arm. One patient showed clinical complete response (cCR), 11 partial response (PR), 12 no change (NC) after the FEC therapy, while 1 patient showed CR, 18 PR, 5 NC after ET therapy. There was no pathologic complete response or progressive disease, though a higher proportion of RR was observed in stage II than stage III patients in these two groups. Clinically palpable axillary lymph nodes which had been found in all 48 patients before 2 cycles of treatment, 50.0% (12/24) in the FEC patients and 66.7% (16/24) in the ET patients became in-palpable. The major toxicity, including leukopenia, gastroenteric reactions, were similar in both groups, but alopecia was more severe and arthralgia, myalgia, neurotoxicity and flushing of face were the unique features of the ET regimen.

CONCLUSIONNeoadjuvant chemotherapy with two different regimens were effective to the primary tumor and axillary metastatic lymph nodes of breast cancer, and the side effects were tolerable. Higher efficacy and more side effects are observed in ET than in FEC regimen.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Breast Neoplasms ; drug therapy ; Cyclophosphamide ; adverse effects ; therapeutic use ; Epirubicin ; adverse effects ; therapeutic use ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Paclitaxel ; adverse effects ; therapeutic use ; Taxoids ; Treatment Outcome

Objective To compare the efficacy and toxicity of different cycles of neo-adjuvant chemotherapy for locally advanced breast cancer. Methods Seventy-five patients with locally advanced breast cancer were treated with epirubicin (Epi) plus paclitaxel (TAX, ET regimen). Two cycles were used in 39 patients (2 cycles group) and 4 cycles were used in 36 patients (4 cycles group). Results The overall response rate (RR) was 74% (29/39) in 2 cycles group and 94% (34/36) in 4 cycles group. One patient got clinically complete response (CR), 28 cases had partial response (PR),10 with no change (NC) in 2 cycles group, while 21 patients showed CR including 11 patients with pathologically complete response, 13 with PR, and 2 with NC in 4 cycles group. There was no progression to advanced stage in either groups. Axillary lymph nodes were palpable in all 75 patients before ET regimen, lymph nodes became non-palpable in 46% (18/39) cases in 2 cycles group and in 75% (27/36) cases in 4 cycles group. Toxicities including leukopenia, gastroenteric reactions were similar in the 2 groups, though arthralgia, myalgia, and neurotoxicity were more common in 4 cycles group than 2 cycles group. Conclusion Neo-adjuvant chemotherapy with ET regimen for 4 cycles were more effective than 2 cycles to down staging locally advanced breast cancer. Toxicities including arthralgia, myalgia, and neurotoxicity were more common in 4 cycles group than 2 cycles group.