[Application Value of Abbreviated Comprehensive Geriatric Assessment in Elderly Female Breast Cancer Patients].

Objective To evaluate the application value of abbreviated comprehensive geriatric assessment(aCGA)in elderly female breast cancer patients. Methods Eight aspects of the traditional CGA were simplified to form the aCGA assessment table,based on which the patients were classified into three grades of A,B and C according to the total scores.This study enrolled the elderly female patients with breast cancer aged 70 years and above who were treated in PUMC Hospital from June 2018 to January 2020.Eastern Cooperative Oncology Group(ECOG)scoring and aCGA grading were performed respectively,and the results of the two methods were compared. Results Of the 162 patients,111(68.5%)were classified by the aGGA method as grade A,43(26.5%)as grade B,and 8(5.0%)as grade C;131(80.9%)cases have concurrent diseases,and the most common complications were hypertension(n=89),cardiovascular diseases(n=47)and diabetes mellitus(n=39).The ECOG score was 0-1 in 133(82.0%)cases,2 in 24(14.8%)cases and 3 in 5(3.2%)cases.The ECOG score showed 133(82.0%)cases with good status and 29 cases with poor status.However,according to the aCGA classification,111 cases were in good health status and 51 cases were in poor health status;the difference in the result between the two groups was statistically significant(χ 2=14.24,P<0.001).Conclusion Compared with ECOG score,aCGA grading can more comprehensively evaluate the health status of elderly female breast cancer patients and can be applied to the patients aged 70 and above.

Anatomical study of simple landmarks for guiding the quick access to humeral circumflex arteries.

BACKGROUND: The posterior and anterior circumflex humeral artery (PCHA and ACHA) are crucial for the blood supply of humeral head. We aimed to identify simple landmarks for guiding the quick access to PCHA and ACHA, which might help to protect the arteries during the surgical management of proximal humeral fractures. METHODS: Twenty fresh cadavers were dissected to measure the distances from the origins of PCHA and ACHA to the landmarks (the acromion, the coracoid, the infraglenoid tubercle, the midclavicular line) using Vernier calipers. RESULTS: The mean distances from the origin of PCHA to the infraglenoid tubercle, the coracoid, the acromion and the midclavicular line were 27.7 mm, 50.2 mm, 68.4 mm and 75.8 mm. The mean distances from the origin of ACHA to the above landmarks were 26.9 mm, 49.2 mm, 67.0 mm and 74.9 mm. CONCLUSION: Our study provided a practical method for the intraoperative identification as well as quick access of PCHA and ACHA based on a series of anatomical measurements.

Significantly upregulated TACSTD2 and Cyclin D1 correlate with poor prognosis of invasive ductal breast cancer.

The tumor-associated calcium signal transducer 2 (TACSTD2) gene has been reported to be highly expressed in many types of human epithelial cancers, and is associated with tumor metastasis and poor prognosis. The aims of the present investigation were to analyze the TACSTD2 and Cyclin D1 expression at the mRNA and protein levels and to assess its prognostic significance in invasive ductal breast cancer (IDC). The expressions of TACSTD2 and Cyclin D1 in IDC tissues were consistently higher than those in the tumor-adjacent non-malignant tissues by a one-step real-time polymerase chain reaction and immunohistochemistry (P<0.001 and P=0.023, respectively). The statistical analysis of clinicopathologic characteristics and immunohistochemistry by the χ(2) test showed that the high expression of TACSTD2 in IDC was correlated to histological grade (P=0.023), P53 status (P=0.042), Cyclin D1 status (P<0.001), lymph node metastasis (P<0.001), distant metastasis (P=0.004) and TNM staging (P<0.001). Kaplan-Meier survival and Cox regression analyses were performed to evaluate the prognosis of IDC. These analyses also showed that a high TACSTD2 expression (P=0.003), a high Cyclin D1 expression (P=0.041), and lymph node metastasis (P=0.006) were independent prognosis factors. Collectively, our studies demonstrated that the high expression of TACSTD2 correlates with a poor prognosis in IDC.

Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable.

BACKGROUND: The ulnar styloid is an important supportive structure for the triangular fibrocartilage complex. However, it remains inconclusive whether or not a fractured ulnar styloid should be fixed in an unstable distal radius fracture (DRF) with a stable distal radioulnar joint (DRUJ). The purpose of this study is to evaluate the effect of an untreated ulnar styloid fracture on the outcome of unstable DRF treated with transarticular external fixation when the DRUJ is stable. METHODS: 106 patients with an unstable DRF and a stable DRUJ were included in this study following external fixation. The patients were divided into the non-fracture, the tip-fracture and the base-fracture groups according to the location of the ulnar styloid fracture at the time of injury. Postoperative evaluation included the range of wrist motion, the radiological index, the grip strength, the PRWE-HK scores, the wrist pain scores, and the instability of DRUJ at the external fixator removal time, three months postoperatively and the final follow-up visit. RESULTS: The patients were followed for 12 to 24 months (15 months in average). Sixty-two of 106 patients (58%) had ulnar styloid fracture and 16 patients (26%) showed radiographic evidence of union of ulnar styloid fractures at the final follow-up visit. No significant difference in the radiological findings, the range of wrist motion, the grip strength, the PRWE-HK scores, and the wrist pain scores among three patient groups was detected at the external fixator removal time, three months postoperatively, or the final follow-up visit. Six of the 106 patients (5.7%) complained of persistent ulnar-side wrist pain during daily activities. One patient (0.9%) showed a positive sign in a stress-test, three patients (2.8%) showed a positive sign in a provocative-test, and five patients (4.7%) showed a positive sign in a press-test. There was no significant difference in the percentages of patients who complained of persistent ulnar-side wrist pain or showed a positive sign in the physical examination of the distal radioulnar joint among the three groups at the final follow-up time points. CONCLUSION: When the DRUJ is stable, an untreated ulnar styloid fracture does not affect the wrist outcome of the patient with an unstable DRF treated with external fixation.

[The preliminary exploration into regulating sub-health as preventive and therapeutic strategies for tumor].

The definition of sub-health was studied from the angle of tumor dormancy again. We believe it is necessary to further supplement the present definition, diagnosis criteria, and assessment means. The definition of sub-disease and the division of a disease into four development stages (health --> sub-health --> sub-disease --> disease) were also brought up. Furthermore, we believe that application of regulating sub-health as preventive and therapeutic strategies for tumor is an anti-cancer method with Chinese features, which enriches the modern theories of tumor prevention and therapy.

Effect of Yttrium on the Microstructure and Mechanical Properties of PH13-8Mo Stainless Steels Produced by Selective Laser Melting.

In the present work, PH13-8Mo stainless steel parts without yttrium and with yttrium (Y) were manufactured by selective laser melting (SLM). The microstructure, phase composition and grain orientation of the stainless steels parts with Y and without Y were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), electron-backscatter diffraction (EBSD), transmission electron microscopy (TEM) and high-resolution transmission electron microscopy (HRTEM). The characterization results revealed that the addition of Y clearly refined the grain size of the PH13-8Mo steel formed part, resulting in more equiaxed massive grains and in a less anisotropic microstructure. PH13-8Mo stainless steel formed parts were mainly composed of martensite and retained austenite. The addition of Y could significantly increase the content of retained austenite and also generate nano-sized precipitates containing Y. The mechanical test results showed that both strength and toughness of the shaped parts containing Y were improved synergistically. The yield strength reached 1443 MPa, the elongation was 12.2%, and the room temperature impact energy reached 124.25 J/cm2. The strengthening and toughening by Y of the formed parts were mainly attributed to grain refinement, higher volume fraction of the retained austenite and the formation of nano-sized precipitates containing Y.

A second monoclinic polymorph of 1-benzyl-N-methyl-1H-pyrrole-2-carboxamide.

In the title compound, C(13)H(14)N(2)O, the N(pyrrole)-C(H(2))-C-C torsion angle is -7.7 (3)° and the dihedral angle between the pyrrole and benzene rings is 83.6 (2)°. In the crystal, inter-molecular N-H⋯O hydrogen bonds link the mol-ecules into chains extending along the c axis. We have previously reported another polymorphic form of this title compound, which has the same space group with different cell parameters: a = 9.8285 (18) Å, b = 23.588 (4) Å, c = 9.9230 (17) Å, ß = 90.107 (3)°, Z = 8 and V = 2300.5 (7) Å(3) [Zeng et al. (2010 ▶). Acta Cryst. E66, o2051].

[Diagnosis and treatment of 166 patients with early gastric cancer].

OBJECTIVE: To summarize our experiences in the diagnosis and treatment of early gastric cancer (EGC). METHODS: The clinicopathological data of the 166 EGC inpatients who were treated in our hospital from January 1999 to January 2009 were retrospectively analyzed and their treatment outcomes were followed up. RESULTS: Surgical treatment for ECG accounted for 9.04% (176/1946) among all the surgeries performed for gastric cancers. Among the analyzed 166 cases, 9 asymptomatic patients were diagnosed by routine examination, 29 (17.47%) had a history of gastric ulcer or chronic gastritis, and 20 (12.05%) had a family history of esophageal or gastric cancer. Of 64 patients who received double-contrast gastric X-ray examination, 57 patients (89.06%) were found to be with abnormalities. Endoscopy revealed lesions in lower third, middle third, and upper third of the stomach in 115 patients (69.28%), 26 patients (15.66%), and 25 patients (15.06%), respectively. A total of 126 patients received D(0) or D1 operations and 40 patients received operations more than D+1 operation. As shown by post-operative pathological examinations, the mean diameter of the lesions was (2.52±1.62) cm; 75 patients (45.18%) had mucosal gastric cancer, 91 (54.82%) had submucosal gastric cancer, 20 patients with submucosal gastric cancer had lymph node metastasis, and 8 patients had lymphatic vessel involvement. The overall 5-year survival rate was 70.0% and 89.7% among patients with or without lymph node metastasis (P=0.002). Univariate analysis revealed that depth of tumor invasion (submucosa) and lymphatic vessel involvement were significantly correlated with lymph node metastasis (P=0.000, P=0.001). Multivariate analysis showed that lymphatic vessel involvement was significantly correlated with lymph node metastasis (odds ratio: 15.67; 95% confidence interval, 3.40-72.14). CONCLUSIONS: The proportion of EGC patients undergoing gastrectomy is relatively low among all gastric cancer patients. Lymph node metastasis is a key prognostic factor for EGC. A proper staging of gastric cancer, a precise evaluation of the depth of infiltration, and appropriate and standardized treatment are important to improve the outcomes.

[How to choose the appropriate surgical approach and time for treatment of blepharoptosis].

Blepharoptosis is one of the most common oculoplastic problems. There has been an ongoing debate regarding the choice of appropriate surgical approach and time for congenital blepharoptosis. This paper addresses several common misunderstandings regarding the diagnosis and treatment of blepharoptosis, as well as emphasizes the importance of the classification and preoperative evaluation of the blepharoptosis. Furthermore, some personal viewpoints on the choices of appropriate surgical approach and time for blepharoptosis are mentioned, which might initiate scientific argument and discussion to reach a consensus on the standardization of diagnosis and management of blepharoptosis in China.

Successful recovery of COVID-19-associated recurrent diarrhea and gastrointestinal hemorrhage using convalescent plasma.

BACKGROUND: Gastrointestinal symptoms are not rare among coronavirus disease 2019 (COVID-19) patients, but there have been no reports regarding convalescent plasma therapy for the recovery of gastrointestinal problems in COVID-19 patients. CASE PRESENTATION: We present two cases of patients with COVID-19-associated recurrent diarrhea and positive fecal occult blood who successfully recovered after a one-time convalescent plasma administration. CONCLUSION: When COVID-19 patients develop recurrent or refractory gastrointestinal symptoms and fail to respond to the available treatment, alternative therapy with convalescent plasma administration may be considered.

Breast-conserving therapy is safe both within BRCA1/2 mutation carriers and noncarriers with breast cancer in the Chinese population.

BACKGROUND: BRCA1/2 mutation is associated with a high risk of breast cancer, which may preclude breast cancer patients with BRCA1/2 mutation from breast-conserving therapy (BCT) [breast-conserving surgery (BCS), followed by radiotherapy, BCT]. It is debatable whether BCT could be a rational choice for Chinese breast cancer patients with a BRCA1/2 mutation. METHODS: The study comprised a cohort of women with invasive breast cancer either receiving BCT or mastectomy following the criteria for the germline BRCA1/2 mutation test. Germline DNA for BRCA1/2 testing was derived from blood samples. Survival analyses were performed. The correlations were analyzed between survival and distinct types of surgery. To compare the survival between different surgical management, Kaplan-Meier univariate analysis and multivariate Cox regression was used. RESULTS: In BRCA1/2 mutation carriers (N=176) and noncarriers (N=293), 25% and 27.3% of the patients received BCT, respectively (P=0.675). Patients receiving mastectomy (without radiotherapy or followed by radiotherapy) have larger tumor size (P<0.05 both in BRCA1/2 mutation carriers and noncarriers), prognostically worse tumor characteristics including significantly more advanced TNM stage (P=0.017 and P<0.0001 respectively) and more positive lymph nodes (P=0.008 and P<0.0001, respectively) both in BRCA1/2 mutation carriers and noncarriers. Still, more often received systemic therapy has also been observed. After adjustment for clinical-pathological characteristics and systemic treatment, patients who received BCT had a similar breast cancer disease-free survival compared with patients who received mastectomy, both in BRCA1/2 mutation carriers and noncarriers [HR BRCA1/2 =1.17, confidence interval (CI): 0.57-2.39, P=0.68; HRnoncarriers =0.91, CI: 0.47-1.77, P=0.79, respectively). The recurrence free survival after BCT did not differ from mastectomy in BRCA1/2 mutation carriers [BCT, 5-year cumulative recurrence-free survival (RFS) =0.95, CI: 0.89-1.00; mastectomy, 5-year cumulative RFS =0.93, CI: 0.85-1.00], even better for BCT in noncarriers (BCT, 5-year cumulative RFS =0.67, CI: 0.42-0.89; mastectomy, 5-year cumulative RFS =0.83, CI: 0.71-0.95). CONCLUSIONS: Thus, BCT may be a safe and rational choice for Chinese female breast cancer patients with a BRCA1/2 mutation. However, tumor size, the TNM stage, the number of positive lymph nodes, might be taken into consideration when choosing surgical management.

Platinum-Based Neoadjuvant Chemotherapy for Breast Cancer With BRCA Mutations: A Meta-Analysis.

BACKGROUND: Triple-negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer and the major phenotype of BRCA related hereditary breast cancer. Platinum is a promising chemotherapeutic agent for TNBC. However, its efficacy for breast cancer with BRCA germline mutation remains inconclusive. Here we present a meta-analysis to evaluate the effect of platinum agents for breast cancer patients with BRCA mutation in neoadjuvant setting. MATERIALS AND METHODS: Pubmed, Embase, and Cochrane Central Register of Controlled Trials databases were searched for relevant studies on neoadjuvant platinum treatment and BRCA related breast cancer. Fixed- and random-effect models were adopted for meta-analyses. Heterogeneity investigation was conducted by sensitivity and subgroup analyses. Publication bias was evaluated by funnel plot and Begg's test. RESULTS: In all, five studies with 363 patients were included for meta-analysis. The pooled pathological complete response (pCR) rates were 43.4% (59/136) and 33.9% (77/227) for platinum and control groups, respectively. Adding platinum to neoadjuvant regimen did not significantly improved pCR rate (odds ratio [OR]: 1.340, 95% confidence interval [CI] = 0.677-2.653, p = 0.400). Sensitivity analyses also revealed platinum did not significantly increase pCR rate in either TNBC or HER2- patients (TNBC subgroup: OR: 1.028, 95% CI = 0.779-1.356, p = 0.846; HER2- subgroup: OR: 0.935, 95% CI = 0.716-1.221, p = 0.622). CONCLUSIONS: Our meta-analysis suggested that the addition of platinum to neoadjuvant chemotherapy did not significantly improve pCR rate for patients with BRCA mutations. Further large-scale randomized control trial with survival data may provide more robust evidence on therapeutic value of platinum for breast cancer neoadjuvant treatment.

Extensor digitorum brevis and extensor hallusis brevis transplantation for treatment of long-standing facial paralysis.

OBJECTIVE: To evaluate the efficacy of free transplantation of denervated muscles and vessels in the treatment of long-standing facial paralysis. METHODS: A total of 26 patients with facial paralysis (10 males and 16 females, aged 16-65 years, mean: 47 years) were enrolled in this study to receive transplantation of denervated extensor digitorum brevis (EDB) and extensor hallusis brevis (EHB). The muscle tendon was slung to the ala nasi, the middle point of the nasolabial sulcus, the angulus oris and the chin to correct the nasal and oral deformity. The muscle belly was buried around the nerves that innervated the masseter muscle. Microsurgery was applied to anastomosing the tarsus lateral vessels to the superficial temporalis vessels. RESULTS: After operation, all the patients immediately obtained satisfied static appearance. The movement of the paralyzed corner of the mouth could be obtained one month later and the smile of the paralyzed side could be restored after 3 months of training. And 88% patients achieved perfect results, 8% obtained satisfactory results, and 4% got improvement 6 months after operation according to Stennert's paresis scoring system. CONCLUSIONS: Free transplantation of denervated muscles and vessels for the treatment of long-standing facial paralysis, which seldom causes atrophy or liquefaction of the transferred muscles, can maintain muscle viability and induce reliable nerve regeneration. Therefore, it is a safe and efficient treatment method for the patients suffering from facial paralysis.

[Effects of danhong injection on experimental atherosclerosis rabbit model and its mechanism].

OBJECTIVE: To observe the effects of Danhong injection on experimental atherosclerosis rabbits and explore its possible mechanism. METHODS: Forty New-Zealand male rabbits were randomly divided into four groups: normal control group, high-cholesterol group, danhong injection group and aspirin group, all rabbits were administered for fourteen weeks. The plaque area of aorta in each group was determined by image analysis. The blood lipid level was tested by ELISA method, malonaldehyde (MDA) in aorta wall was analyzed with thiobarbituric acid method, the iNOS and COX-2 in aorta wall was tested with RT-PCR method. RESULT: There were significant difference between danhong injection group and other groups (P < 0.5), danhong injection and Aspirin decreased the TG, TC and LDL-C level in plasma of rabbit model and decreased the expression of inflammatory cytokines and the oxidative stress level in aorta wall. CONCLUSION: Danhong injection can inhibit the formation of experimental atherosclerosis in rabbits, which may be related to decreasing blood lipid, plaque inflammation and oxidative stress level.

Probing the glass transition in reversible cross-linked polymer composites.

Understanding the nature of glass transition is still a great challenge. Glass transition is widely observed in many glassy materials; however, it has never been unambiguously observed in reversible cross-linked polymer, which is an ideal model of the percolation process. Herein, we report the synthesis of a reversible cross-linked polymer incorporated with four-armed Diels-Alder (DA) dynamic covalent bonds, and the robust experimental observation of percolation-induced glass transition in this reversible four-armed cross-linked polymer (DAMF1). Temperature-modulated differential scanning calorimetry (TMDSC) experiment results clearly revealed the presence of a glass transition along with an endothermic or exothermic peak associated with DA/retro-DA (RDA) reaction related to the reconstitution/disassociation of the DAMF1's four-armed cross-linked network. In situ 13C variable-temperature solid-state NMR experiments further confirmed the DA/RDA reaction during glass transition at a molecular level. The above experimental results provide a direct experimental evidence for the recently developed percolation model of glass transition, which provides new insights into the nature of glass transition.

The prognostic comparison among unilateral, bilateral, synchronous bilateral, and metachronous bilateral breast cancer: A meta-analysis of studies from recent decade (2008-2018).

BACKGROUND: The incidence of bilateral breast cancer (BBC) is increasing nowadays comprising 2%-11% of all breast cancer (BC). According to the interval time between the first and second cancer, BBC could be divided into synchronous (SBBC) and metachronous (MBBC). However, this interval time is quite different across studies. It remains controversial whether the survival of BBC, SBBC, and MBBC is similar or worse compared to that of unilateral breast cancer (UBC), and whether the survival of SBBC is similar or worse compared to MBBC. To better understand the survival of UBC, BBC, SBBC, and MBBC and how the interval time would influence the prognosis of SBBC and MBBC, we performed this meta-analysis on studies from recent 10 years (2008-2018). METHODS: Databases of PubMed, Embase, and Web of Science were searched for relevant studies within recent 10 years. Hazard ratio (HR) was adopted to evaluate the difference of overall survival (OS) of UBC, BBC, SBBC, and MBBC. HR of OS comparisons were performed between BBC vs UBC, SBBC vs UBC, MBBC vs UBC, and SBBC vs MBBC with 3, 6, 12 months as the interval time, respectively. RESULTS: There were 15 studies of 72 302 UBC and 2912 BBC included in the meta-analysis. The summary HR of OS comparison between BBC vs UBC was 1.68 (95% CI: 1.28-2.20), SBBC vs UBC was 2.01 (95% CI: 1.14-3.55), MBBC vs UBC was 3.22 (95% CI: 0.75-13.78). When 3, 6, 12 months were used as the interval time, the summary HR of the OS comparison between of SBBC vs MBBC were 0.64 (95% CI: 0.44-0.94), 1.17 (95% CI: 0.84-1.63) and 1.45 (95% CI: 1.10-1.92), respectively. CONCLUSION: BBC and SBBC showed worse prognosis in terms of OS compared to UBC while MBBC manifested similar or non-superior survival as UBC. The OS comparison between SBBC and MBBC changed with different interval time used. The longer the interval time used, the worse the survival of SBBC. SBBC with interval of 3-12 months between the two cancers had the worst prognosis. When 6 months was used to differentiate SBBC from MBBC, these two clinical entities showed similar OS.

[Ferumoxide labeled Flk1+ CD31- CD34- human bone marrow mesenchymal stem cells and its in vivo tracing in the brains of Macaca Fascicularis].

OBJECTIVE: To explore the method for labeling Flk1+ CD31- CD34- human bone marrow mesenchymal stem cells (hBMSCs) with ferumoxide-PLL and evaluate the feasibility of its tracing after transplantation into the brains of Macaca Fascicularis. METHODS: The hBMSCs were incubated with ferumoxide-PLL. Trypan blue staining, Prussian blue staining, and transmission electron microscope were performed to show intracellular iron, marking efficiency, and the vigor of the labeled cells. After the hBMSCs were transplanted into the brains of cynomolgus monkeys by stereotaxis, magnetic resonance imaging (MRI) was performed to trace the cells in vivo. Cell survival and differentiation were studied with immunohistochemistry, Prussian blue staining, and HE staining. RESULTS: The marking efficiency of the ferumoxide-PLL was 96%. Iron particles were found intracytoplasmic of the hBMSCs by Prussian blue staining and transmission electron microscopy. The relaxation rates of labeled cells in MRI were 4.4 and 4.2 times higher than those of the unlabeled cells. Hypointensity area was found by MRI three weeks after transplantation. Many hBMSCs and new vessels were found in the transplantation zone by pathological and immunofluorescence methods. CONCLUSIONS: Ferumoxide-PLL can effectively label hBMSCs and thus increase its contrast in MRI results. The cells can survive in the brains of cynomolgus monkeys. The labeled hBMSCs can be traced in vivo by MRI.

Ursodeoxycholic acid combined with percutaneous transhepatic balloon dilation for management of gallstones after elimination of common bile duct stones.

AIM: To evaluate the effectiveness and safety of combined ursodeoxycholic acid and percutaneous transhepatic balloon dilation for management of gallstones after expulsion of common bile duct (CBD) stones. METHODS: From April 2014 to May 2016, 15 consecutive patients (6 men and 9 women) aged 45-86 (mean, 69.07 ± 9.91) years suffering from CBD stones associated with gallstones were evaluated. Good gallbladder contraction function was confirmed by type B ultrasonography. Dilation of the CBD and cystic duct was detected. Percutaneous transhepatic balloon dilation of the papilla was performed, ursodeoxycholic acid was administered, and all patients had a high-fat diet. All subjects underwent repeated cholangiography, and percutaneous transhepatic removal was carried out in patients with secondary CBD stones originating from the gallbladder. RESULTS: All patients underwent percutaneous transhepatic balloon dilation with a primary success rate of 100%. The combined therapy was successful in 86.7% of patients with concomitant CBD stones and gallstones. No remaining stones were detected in the gallbladder. Transient adverse events include abdominal pain (n = 1), abdominal distension (n = 1), and fever (n = 1). Complications were treated successfully via nonsurgical management without long-term complications. No procedure-related mortality occurred. CONCLUSION: For patients with concomitant CBD stones and gallstones, after percutaneous transhepatic removal of primary CBD stones, oral ursodeoxycholic acid and a high-fat diet followed by percutaneous transhepatic removal of secondary CBD stones appear to be a feasible and effective option for management of gallstones.

Mechanism of Bushen Jianpi decoction in preventing and treating osteoporosis caused by aromatase inhibitors in breast cancer treatment.

PURPOSE: Research on the mechanism of Bushen Jianpi decoction (BJD) for preventing and treating osteoporosis caused by aromatase inhibitors (AI) during treatment for breast cancer resection. METHODS: An ovariectomized mouse model was established using random division into 6 groups: a sham ovariectomized group, a blank control group, a control group, an alendronate group, a BJD group, and a drug combination group. Mice breast cancer cell lines (4T1) were cultured and seeded into the armpits of 6 groups of BALB/c mice. The mouse breast cancer postoperative model was built when resecting the tumor after 3 weeks following seeding tumor. After 1 weeks, the 6 groups of mice were given different drugs. Then the following analyses were made: estradiol (E2) levels and alkaline phosphatase (ALP) levels in the serum; detection of in vitro bone density and calcium and bone phosphorus content; tumor pathology and immunohistochemistry detection. RESULTS: The results suggested that BJD decreased levels of ALP in ovariectomized mice, and there was a trend for improved bone loss. BJD strengthened the trend of alendronate to improve bone loss, improved bone density, bone calcium and phosphorous, and reduced ALP. BJD had a certain role on the promotion of the expression of estrogen receptors (ERs) in the relapse of the tumor tissue. CONCLUSIONS: Combined therapy with BJD and alendronate can act synergistically against osteoporosis, which was possibly related to a reduced bone conversion rate through inhibiting bone resorption. BJD may block the MAPK signal pathway in breast cancer cells, increasing the expression of ERs and making cancer cells sensitive to endocrine treatment.