Objective:To analyze the correlation between the level of circulating tumor cells(CTC)and the efficacy of neoadjuvant therapy in breast cancer.Methods:A total of 79 patients with breast cancer who underwent neoadjuvant therapy between October 2020 and December 2022 were included in this study.Venous blood samples were collected before and after treatment to measure the number of mononuclear cells and the presence of cytokeratin-19(CK-19)positive circulating tumor cells(CTCs).Results:The pre-treatment positive detection rate of CTC in patients was 26.6%(21/79), and it was found to be correlated with HER-2 expression, TNM staging, and KI-67 percentage.After neoadjuvant therapy, the positive rate of CTC decreased to 8.9%(7/79), which was lower than the rate before neoadjuvant therapy( χ2=16.185, P<0.001).Based on the CTC results measured before and after neoadjuvant therapy, the groups were classified into negative/negative, positive/positive, negative/positive, and positive/negative groups.In accordance with the RECIST standard, the predicted efficacy was 75.0%(36/48)in the CTC negative/negative group and 83.3%(20/24)in the positive/negative group.The treatment effectiveness rate was notably higher compared to the CTC positive/positive group, which had a rate of 25.0%(1/4), and the negative/positive group, which had a rate of 0.0%(0/3)( χ2=13.886, P=0.003).According to Miller Payne's standard for predicting efficacy, the treatment effectiveness rate in the CTC negative/negative group was 72.9%(35/48), while in the positive/negative group it was 79.2%(19/24).These rates were significantly higher than the rates in the CTC positive/positive group(50.0%, 2/4)and the negative/positive group(0.0%, 0/3).( χ2=9.043, P=0.029). Conclusion:There is a correlation between the level of circulating tumor cells(CTC)and the efficacy of neoadjuvant therapy.CTC can be considered as an evaluation indicator for assessing the efficacy of neoadjuvant therapy.

Objective:To explore the pathogenic characteristics of incision wound infections after breast cancer surgery and related influencing factors.Methods:Clinical files of 200 middle-aged and elderly patients who underwent breast-conserving surgery for breast cancer in the Affiliated Three Gorges Hospital from May 2016 to April 2021 were retrospectively analyzed.The results of pathogenic bacteria and drug sensitivity tests were examined, and the influencing factors of postoperative incision infections after breast cancer surgery were analyzed.Results:Among 200 middle-aged and elderly patients aged 55-75 years who underwent breast-conserving surgery for breast cancer, 13 patients(4.64%)developed postoperative incision infections, with 40 strains of pathogenic bacteria isolated, including 14 strains of gram-positive bacteria, 25 strains of gram-negative bacteria and 1 fungal strain.Univariate and multivariate logistic regression analysis showed that age( OR=3.40), duration of surgery( OR=2.50), albumin level( OR=2.83), underlying diseases( OR=4.23), preventive use of antibiotics( OR=3.14)and length of hospital stay( OR=2.33)were independent risk factors for postoperative incision infections in breast cancer patients(all P<0.05). Conclusions:Common pathogens of incision infections after breast-conserving surgery are Gram-negative bacteria.There are many factors affecting postoperative incision infections.Clinical measures need to be taken to reduce or prevent postoperative incision infections.

Objective To explore changes of invasion capability of cancer stem cells loading miR30a derived from enlarging and proliferative axillary lymph node of patients with breast cancer in nude mice.Methods MiR30a oligonucleotide fragment loaded by adenovirus vector was transfected into breast cancer stem cells isolated from enlarging and proliferative axillary lymphnodes of patients with breast cancer,MDA-MB-231 cell lines as the control.The cancer cells were injected into axillary subcutaneous fat of the nude mice for several weeks,and then,the expression of Vimentin or N-Cadherin in tumor tissues of each group of the mice was determined by immunohistochemistry and western blot.Results The average transfection rate of cancer stem cells loaded by miR30a was 62.5％,while it was 78.2％ for MDA-MB-231.The tumor volume was larger in adenovirus vector groups or in control groups of nude mice than in experimental groups induced by mir30a.Vimentin or N-cadherin in tumor tissues was significantly downexpressed in experimental groups with mir30a ((13.1±1.7)％,(15.3％±2.1)％)compared with that in adenovirus vector groups or in control groups((21.1±1.4)％,(25.3±1.6)％,P＜0.05),respectively.The difference between adenovirus vector groups and in control groups had no significant difference (P＞0.05).After inoculated for 6 weeks,except the subcutaneous plantations,no distant metastasis in nude mice was found.MDA-MB-231 cell lines groups had similar results.Conclusion The proliferative and invasive capability of cancer stem cells can be inhibited by miR30a,suggesting a new therapy for breast cancer.

Objectives To detect the expression level of miR-155 in tissues of colon cancer,and to investigate its influence on the occurrence,development and metastasis of colon cancer.Methods 69 cases with primary colon cancer treated with surgical resection in our hospital were chosen.Tissue samples of the tumor and tissue in the side of tumor(control)were collected and the expression level of miR-155 in the samples was detected by fluorescence quantitative polymerase chain reaction.The results were statically analyzed.Results The expression level of miR-155 was 0.471±0.100,0.238 ±0.108,0.719 ± 0.135 in three groups of colon cancer patients with tumor sizes ≥ 5 cm,high differentiation of tumor,and occurrence of lymphatic metastasis,respectively,and 0.623 ± 0.134,0.142 ±0.094,0.390±0.121 in their controls.And the level of miR-155 was 0.395±0.101 in patients with T1 + T2 tumor local infiltration,0.466±0.128 in T3 + T4 local infiltration,0.404±0.108 in Ⅰ + Ⅱ stage of TNM and 0.457±0.119 in Ⅲ± Ⅳ stage.The miR-155 was relatively higherly expressed in patients with tumor sizes≥5 cm,lower degree of differentiation,higher tumor infiltration degree,Ⅲ and Ⅳ stage of TNM,(t=3.002,12.531,20.425,2.576,1.908,P ＜ 0.05).Conclusions The expression level of miR-155 is correlated with tumor sizes,differentiation degrees,tumor infiltrating degrees,TNM and lymphatic metastasis,which could be used as diagnostic indexes for occurrence,development and metastasis of colon cancer.

Objective:To research whether ectopic over-expression of Pim-2 could cause chang-liver cell (LO2) malignant transformation,to explore the relationship between Pim-2 protein and hepatocellular carcinoma.Methods:Three groups of cells were arranged including human chang liver cell line LO2 (group C),LO2 cells transfected with empty-vector (group B) and LO2 cells transfected with Pim-2 gene (group A).Pim-2 expression levels were detected.The morphology,proliferation level,apoptosis rate and migration ability of the cells were detected respectively.The cells were subcutaneously inoculated into athymic mice and the microstructures of the neoplasm were observed by optical and electron microscopy.Results:Compared with group B,Pim-2 expression levels were significantly higher in group A (P＜0.05),and their morphology had obvious malignant changes.They also showed a significantly increased proliferation rate (P＜0.05) and migration capacity (P＜0.05),as well as a significantly decreased apoptosis rate (P＜0.05).Only the athymic mice inoculated with group A could generate neoplasm,and the morphology of the neoplasm coincided with that of the hepatoma.Conclusion:Both the morphological and biological changes of LO2/Pim-2 cells indicate the trend of malignant transformation,which could generate hepatoma in athymic mice.Pim-2 could induce malignant transformation of human liver.

Objective To detect the mitochondrial microsatellite instability (mtMSI) and Helicobacter pylori (Hp) infection status in esophageal squamous cell carcinoma (ESCC),and to analyze their clinical significance in the diagnosis of ESCC.Methods The mtMSI and Hp infection status were examined by immunohistochemical SP method in 93 cases of ESCC and their normal control tissues.The relationship between Hp and mtMSI and their correlations with the clinicopathological features of ESCC were analyzed.Results The Hp positive rates of ESCC group and control group were 61.3％ (57/93) and 20.4％ (19/93) respectively,and there was statistically significant difference between the two groups (x2 =32.127,P ＜0.001).The mtMSI positive rates of ESCC group and control group were 34.4％ (32/93) and 0 (0/93) respectively,and there was statistically significant difference between the two groups (x2 =38.649,P ＜0.001).The Hp infection was correlated with tumor infiltrating degree (x2 =22.213,P ＜ 0.001) and lymph node metastasis (x2 =8.318,P =0.004),but was not correlated with gender (x2 =0.330,P =0.565),major axis of tumor (x2 =0.692,P =0.406),gross type (x2 =1.006,P =0.316),differentiated degree (x2 =0.665,P =0.415).The mtMSI was not correlated with gender (x2 =0.163,P =0.686),major axis of tumor (x2 =0.384,P =0.530),gross type (x2 =0.422,P =0.516),differentiated degree (x2 =0.213,P =0.645),infiltrating degree (x2 =0.001,P =0.979) or lymph node metastasis (x2 =0.039,P =0.843).The Hp infection was positively associated with mtMSI in ESCC (r =0.864,P =0.006).Conclusion The positive rates of Hp and mtMSI in ESCC are higher than those in normal tissues,and there is a close relationship between Hp and mtMSI.Hp is also associated with the progression of ESCC.

ObjectiveTo investigate the influencing factors of portal vein thrombosis (PVT) after splenectomy in patients with portal hypertension.MethodsClinical data of 67 patients with liver cirrhosis and portal hypertension undergoing splenectomy + endoscopicvariceal ligation in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University between March 2012 and April 2015 were retrospectively studied. Among the 67 patients, 47 were males and 20 were females with the average age of (47±8) years old. Thirty-five patients underwent laparoscopic splenectomy and 32 patients underwent open splenectomy. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the PVT group and the non-PVT group according to whether PVT developed after surgery. The influencing factors of PVT in two groups were compared. The comparison of the influencing factors of PVT was conducted usingt test or chi-square test.ResultsEleven cases developed PVT after splenectomy with the incidenceof 16% (11/67) including 6 cases of laparoscopic splenectomy and 5 of open splenectomy. The incidence of PVT was associated with Plt and the concentration of D-dimer in blood circulation. Blood Plt of the PVT group was (739±39) ×109/L, which was significantly higher than (318±51)×109/L of the non-PVT group (t=14.678,P<0.05). The concentration of D-dimer of the PVT group was (7.4±1.1) mg/L, which was significantly higher than (4.0±0.9) mg/L of the non-PVT group (t=5.458, P<0.05). The incidence of PVT was not associated with surgical procedure (χ2=0.028,P>0.05).Conclusion The incidence of PVT after splenectomy is associated with Plt and the concentration of D-dimer and is not associated with surgical procedure.

ObjectiveTo investigate the application value of laparoscopic splenectomy combined with endoscopic variceal ligation in cirrhosis and portal hypertension.MethodsSixty-three patients with cirrhosis and portal hypertension undergoing laparoscopic splenectomy combined with endoscopic variceal ligation in Lingnan Hospital, the Third Afifliated Hospital of Sun Yat-sen University between September 2011 and September 2014 were included in the prospective study. The patients were randomized into the laparoscopy group and the laparotomy group according to different surgical procedures. Among the 28 patients in the laparoscopy group, 25 were males and 3 were females with the age ranging from 40 to 69 years old and the median of 55 years old. Among the 35 patients in the laparotomy group, 32 were males and 3 were females with the age ranging from 43 to 69 years old and the median of 53 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients of two groups underwent endoscopic variceal ligation during the splenectomy. The duration of operation, intraoperative blood loss, length of hospital stay, treatment costs and incidence of postoperative complications of two groups were observed. The comparison of the observed indexes of two groups was conducted usingt test and the rate comparison was conducted using Fisher's exact test.ResultsAll the patients completed the surgery successfully. The duration of operation and the intraoperative blood loss were (113±8) min and (204±52) ml for the laparoscopy group, and were (106±6) min and (226±63) ml for the laparotomy group where no significant difference was observed (t=1.97,-0.75;P>0.05). The length of hospital stay and treatment costs of laparoscopy group were (6.0±1.2) and (35 000±3 000) RMB, which were signiifcantly lower than (11.2±2.7) and (45 000±1 000) RMB of laparotomy group (t=-4.87,-6.81;P<0.05). Eight patients in the laparoscopy group developed complications, among them, 7 were with portal venous thrombosis and 1 was with recurrent hemorrhage. Seventeen patients in the laparotomy group developed complications, among them, 10 were with portal venous thrombosis and 7 were with fat liquefaction of incisions. The incidence of fat liquefaction of incisions in laparoscopy group was signiifcantly lower than that of the laparotomy group (P=0.035).ConclusionLaparoscopic splenectomy combined with endoscopic variceal ligation can achieve the similar curative effect with laparotomy and has the advantages of small operational wound, quick recovery, less complications, as well as shorter length of hospital stay and lower total treatment costs.

Objective To investigate the impact of exogenous of triiodothyronine (T3) on the liver hyperplasia of mouse. Methods Forty-ifve healthy speciifc pathogen free (SPF) C57BL/6 mice were divided into group A, B and control group using random number table method with 15 mice in each group. Mice in group A, B were respectively injected with 2 ml exogenous T3 solutions 10, 5μg/kg intraperitoneally. Mice in control group were injected with 2 ml normal saline. Three mice of each group were put to death respectively on day 0, 7, 14, 21, 42 after treatment. The total liver weight of the mice was measured after death. The proliferation of liver cells was detected by immunohistochemistry. The experimental data were compared using t test or analysis of variance. Results Compared with control group, the liver weight of mice in group A increased signiifcantly on day 7, 14, 21, 42 after treatment (t=3.298, 6.760, 7.119, 6.128;P<0.05) , and the liver weight of mice in group B increased signiifcantly on day 14, 21, 42 after treatment (t=4.188, 4.570, 2.978;P<0.05). The increased liver weight in group A was signiifcantly more than that in group B on day 7, 14, 21, 42 after treatment (t=4.935, 4.303, 4.033, 4.480;P<0.05). The liver weight in group A, B rose to the top on day 21 after treatment (F=21.480, 11.244;P<0.05). Compared with control group, the liver cell count in group A increased signiifcantly on day 0, 7, 14, 21, 42 after treatment (t=28.383, 23.842, 40.194, 31.059, 15.841;P<0.05), and the same with group B (t=9.097, 7.680, 20.597, 42.192, 14.415;P<0.05). The increased liver cell count in group A was signiifcantly more than that in group B (t=8.016, 4.872, 10.719, 9.514, 7.831;P<0.05). The liver cell count rose to the top in group A on day 14 after treatment (F=169.190, P<0.05) and rose to the top in group B on day 21 after treatment (F=90.460, P<0.05). Extensive proliferation of liver cells was observed both in group A and B after treatment. Conclusions Exogenous T3 can effectively promotes the liver hyperplasia of mouse, and the hyperplasia becomes more signiifcant as the T3 concentration rises.

ObjectiveTo investigate the clinical characteristics and prognostic factors in intrahepatic cholangiocarcinoma (ICC) patients with positive alpha-fetoprotein (AFP).MethodsClinical data of 57 patients with ICC in the Third Afifliated Hospital of Sun Yat-sen University from September 2004 to December 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. There were 34 males and 23 females with an average age of (52±13) years old. According to serum AFP test result after admission in hospital, the patients were divided into AFP positive group (n=16) and AFP negative group (n=41). The difference of clinicopathological factors between two groups such as age, gender, hepatitis B surface antigen (HBsAg), liver cirrhosis, biliary lesions, preoperative carbohydrate antigen 19-9 (CA19-9), surgical procedure, metastastic lymph nodes, histological differentiation degree were compared byt-test , Chi-square test or Fisher's exact probability test. The patients were followed up and the survival of two groups was recorded. Prognostic factors analysis was conducted by Log-rank test and Cox proportional hazards regression model.ResultsMale patients accounted for 94% (15/16) in AFP positive group, which was signiifcantly higher than that in AFP negative group [46%(19/41)] (χ2=10.747,P<0.05). Patients complicated with liver cirrhosis accounted for 88% (14/16) , which was significantly higher than that in AFP negative group [37% (15/41)] (χ2=11.937,P<0.05). No patients were complicated with biliary lesions in AFP positive group but in AFP negative group, 12 cases were complicated with biliary lesions, where signiifcant difference was observed between two groups (P<0.05). Surgical procedure was the independent risk factor for patients in AFP positive group. Patients undergoing radical resection had better prognosis (RR=26.813,P<0.05).ConclusionsICC patients with positive AFP are mostly complicated with liver cirrhosis but a low incidence of biliary lesions. Surgical procedure is the independent risk factor for the prognosis. Radical resection is an effective way to improve the prognosis of ICC patients with positive AFP.