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Antibacterianos , Nefrite , Humanos , Criança , Doença Aguda , Antibacterianos/uso terapêutico , Nefrite/diagnóstico , Nefrite/tratamento farmacológico , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/tratamento farmacológico , Imageamento por Ressonância Magnética , Ultrassonografia , Rim/patologia , Rim/diagnóstico por imagem , Pielonefrite/diagnóstico , Pielonefrite/tratamento farmacológico , Pielonefrite/terapia , Tomografia Computadorizada por Raios X , Pré-Escolar , Interleucina-6/sangueRESUMO
OBJECTIVE: Previous trials demonstrated the effectiveness of exercise in improving pain and functional impairment in patients with knee osteoarthritis (KOA). However, a bibliometric analysis of top-cited papers on exercise treatment for KOA has not yet been conducted. The aim of the present study was to critically analyze the bibliometric characteristics of the most frequently cited articles on exercise treatment for KOA. MATERIALS AND METHODS: Publications about exercise treatment for KOA from 2000 to 2021 were searched from the Web of Science database. Two authors independently collected 100 top-cited articles, and a consensus was reached to form the final list. The title, journal, author, year of publication, country and institution of origin, total citations, citations in 2021, main topics, research nature, and level of evidence were extracted, and the publication trends in exercise treatment for KOA were evaluated. RESULTS: A total of 1,258 papers were retrieved from the database. According to the final list, clinical research accounted for 81% of the studies, but no statistical difference in the number of citations was found among the four types of articles (p=0.194). Seventy articles had a level of evidence of Ib, and no statistical differences in citations were found per level of evidence (p=0.767). Most of the top-cited articles were published between 2005-2014, and Dr Messier was the prominent writer in this field. CONCLUSIONS: This bibliometric study is the first to identify the most cited papers in exercise treatment for KOA research. Traditional Chinese exercise, comorbidity, and exercise adherence may be the next popular research trends that will receive more attention in the future.
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Osteoartrite do Joelho , Humanos , Osteoartrite do Joelho/terapia , Bibliometria , Bases de Dados FactuaisRESUMO
OBJECTIVE: To determine the association of SOX2 with the prognosis in lung cancer, studies providing survival information were selected based on multivariate Cox regression analysis. MATERIAL AND METHODS: PubMed, Embase, and Web of Science databases were searched to identify eligible studies before June 19, 2021. The hazard ratios (HR) with 95% confidence intervals (CI) were calculated to assess the prognostic impact of SOX2 based on multivariate Cox regression analysis. Publication bias was used to assess the risk of bias. Functional analysis of SOX2 was also conducted. RESULTS: 13 studies with a total of 2008 patients with lung cancer were included. SOX2 expression was not correlated with overall survival in lung cancer (10 studies with 1591 cases). Between-study heterogeneity was noted (I2=85.6%, p<0.0001). Subgroup analysis suggested that no correlation was found between SOX2 expression and overall survival in non-small cell lung cancer (NSCLC: eight studies with 1319 cases) and small-cell lung cancer (SCLC: two studies with 272 cases). SOX2 expression was significantly associated with worse time-to-progression (two studies with 104 cases: HR=3.50, 95% CI=1.34-9.15) and recurrence-free survival (two studies with 335 cases: HR=1.45, 95% CI=1.12-1.87) in NSCLC. Function analysis demonstrated that SOX2 was involved in DNA repair, cell cycle, regulation of stem cell population maintenance, and Hippo signaling pathway. CONCLUSION: SOX2 may be an independent prognostic factor in time-to-progression and recurrence-free survival and may become a promising therapeutic target. More studies are essential to further our findings.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Carcinoma de Pequenas Células do Pulmão , Humanos , Carcinoma Pulmonar de Células não Pequenas/genética , Estadiamento de Neoplasias , Neoplasias Pulmonares/genética , Estudos Retrospectivos , Prognóstico , Fatores de Transcrição SOXB1/genéticaRESUMO
We report an unusual pressure-induced superconducting state that coexists with an antiferromagnetic ordering of Eu2+ moments and shows a large upper critical field comparable to the Pauli paramagnetic limit in EuTe2. In concomitant with the emergence of superconductivity with Tc ≈ 3-5 K above Pc ≈ 6 GPa, the antiferromagnetic transition temperature TN(P) experiences a quicker rise with the slope increased dramatically from dTN/dP = 0.85(14) K/GPa for P ≤ Pc to 3.7(2) K/GPa for P ≥ Pc. Moreover, the superconducting state can survive in the spin-flop state with a net ferromagnetic component of the Eu2+ sublattice under moderate magnetic fields µ0H ≥ 2 T. Our findings establish the pressurized EuTe2 as a rare magnetic superconductor possessing an intimated interplay between magnetism and superconductivity.
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OBJECTIVE: Current evidence of the maternal, perinatal and neonatal outcomes in twin pregnancies among mothers with advanced age is unclear, especially for mothers with age above 40 years. MATERIALS AND METHODS: A systematic search was conducted using the PubMed, Scopus, and Google Scholar databases. Studies that were observational in design or analysed retrospective data were considered for inclusion. The included studies had to be conducted in twin pregnancies and should have documented the effect of maternal age on obstetric and/or neonatal outcomes. Statistical analysis was performed using STATA software. RESULTS: A total of 20 studies were considered for inclusion. All the studies were based on retrospective data. Compared to mothers aged under 40 years, those with advanced age (≥40 years) had increased risk of caesarean delivery [RR 1.20, 95% CI: 1.05, 1.37], gestational hypertension [RR 2.71, 95% CI: 1.72, 4.27], gestational diabetes mellitus [RR 2.03, 95% CI: 1.28, 3.21], preterm birth [RR 2.47, 95% CI: 1.09, 5.80], neonatal admission to intensive care unit [RR 1.78, 95% CI: 1.21, 2.64] and perinatal and/or neonatal mortality [RR 5.76, 95% CI: 1.11, 29.7]. The risk of gestational diabetes mellitus [RR 1.52, 95% CI: 1.21, 1.90] and having caesarean delivery [RR 1.19, 95% CI: 1.10, 1.28] was higher in mothers with ≥35 years of age, compared to those <35 years. There were no significant differences in the risk of adverse neonatal outcomes among the mothers with age ≥35 years. However, in these mothers, the risk of perinatal/neonatal mortality [RR 0.82, 95% CI: 0.76, 0.88] was comparatively lower than in mothers under 35 years of age. There appeared no significant risk of advanced maternal age for postpartum haemorrhage, hospitalization during pregnancy and premature rupture of membranes. CONCLUSIONS: The increased risk of maternal, neonatal and perinatal outcomes in mothers with advanced age highlights the need for close follow-up, early detection and management of medical complications in twin pregnancies.
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Gravidez de Gêmeos , Nascimento Prematuro , Adulto , Idoso , Cesárea , Feminino , Humanos , Recém-Nascido , Idade Materna , Gravidez , Resultado da Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Estudos RetrospectivosRESUMO
ABSTRACT: Objective To construct a polymerase chain reaction-capillary electrophoresis ï¼PCR-CEï¼ detection method using ChlB gene and NIES gene, investigate the method's specificity and sensitivity, and to evaluate its application value in drowning diagnosis. Methods The specific primers ChlB and NIES were designed for the conserved sequence of chlorophyte ChlB gene and cyanophyte NIES gene in GenBank to construct PCR-CE detection method; 50 species of standard DNA samples were amplified; the sensitivity was determined by gradient concentration detection of positive standard samples; 25 actual cadaver lung tissue samples ï¼drownedï¼ 20, natural deathï¼ 5ï¼ were detected, and the simultaneous detection results of microwave digestion-vacuum filtration-automated scanning electron microscopy ï¼MD-VF-Auto SEMï¼ were simultaneously compared. Results The minimum DNA detection concentration of primers ChlB and NIES was 0.161 ng and 0.109 ng, respectively, which could specifically amplify chlorophyte ï¼Chlorella pyrenoidosaï¼ and cyanophyte ï¼»Microcystis aeruginosa ï¼producing and not producing toxinï¼ï¼½ widespread in water. The product fragments were 156 bp and 182 bp, respectively. The results of non-drowning tissues were negative. Conclusion This method has high sensitivity and specificity. It can be applied to the detection of plankton related to drowning and combined with MD-VF-Auto SEM method, can increase the detection range of plankton related to drowning and improve the evidence power of drowning diagnosis.
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Chlorella , Diatomáceas , Afogamento , Diatomáceas/genética , Afogamento/diagnóstico , Humanos , Rim , Fígado , Pulmão , Plâncton/genéticaAssuntos
Síndrome Nefrótica , Animais , Modelos Animais de Doenças , Humanos , Camundongos , Síndrome Nefrótica/genéticaRESUMO
Objective: To examine genetic variants of familial hematuria (FH) associated genes in 3 families with hematuria with probands initially diagnosed with IgA nephropathy (IgAN). Methods: A retrospective analysis was performed on the clinical data, laboratory tests and genetic test results of three children with hematuria and the probands in three families with hematuria. The families were ascertained at the Department of Pediatrics, Fuzhou General Hospital of Nanjing Military Command from August 2014 to May 2018. Results: The proband of Family One, an 8-year-old boy, manifested gross hematuria. His renal biopsy pathology revealed IgAN. His father also manifested hematuria. Genetic testing showed that the proband and his father carried a heterozygous variant of the CFHR5 gene,533A>G (Asn178Ser). The child of Family Two, a 4-year-old girl, manifested hematuria. Her father, the proband of the family, was 36 years old, and manifested hematuria, proteinuria, high-frequency sensorineural deafness and renal insufficiency. He was diagnosed as IgAN according to clinical manifestations, renal pathology and routine immunohistochemistry without renal biopsy electron microscopy, renal tissue type â £ collagen α3, α4, α5 chains immunofluorescence and skin type â £ collagen α5 chain immunofluorescence. Genetic testing showed that the girl carried a heterozygous variant of the COL4A5 gene,566G>T (Gly189Val), and her father carried the hemizygous variant. The child of Family Three, a 7-year-old girl, manifested hematuria and proteinuria. Her mother, the proband of the family, was 34 years old, and manifested hematuria and proteinuria as well. The proband was diagnosed as IgAN by the same method used for Family Two. The girl's grandfather died of uremia at the age of 44. Genetic testing showed that the girl and her mother carried a heterozygous variant 539G>A (Gly180Glu)in COL4A5 gene. Conclusions: The variant of the CFHR5 gene identified in Family One is of uncertain signifance, and the two variants of the COL4A5 gene identified in Families Two and Three are pathogenic. The probands of Families Two and Three are diagnosed as Alport syndrome. The study suggests that clinicians should examine genetic variants of FH associated genes in families with hematuria when the probands were diagnosed as IgAN by their clinical manifestations, renal pathology and routine immunohistochemistry.
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Variação Genética/genética , Hematúria/diagnóstico , Nefrite Hereditária/diagnóstico , Adulto , Criança , Pré-Escolar , Feminino , Testes Genéticos/métodos , Glomerulonefrite por IGA/diagnóstico , Glomerulonefrite por IGA/patologia , Hematúria/genética , Humanos , Rim , Masculino , Nefrite Hereditária/genética , Estudos Retrospectivos , Sequenciamento do ExomaRESUMO
Objective: To validate whether the prognostic stage groups by the 8th edition of the American Joint Committee on Cancer (AJCC) staging system provides improved prognostic accuracy in T1-2N1M0 postmastectomy breast cancer patients compared to 7th edition. Methods: a total of 1 823 female patients with T1-2N1M0 breast cancer who underwent mastectomy and axillary lymph node dissection without neoadjuvant chemotherapy were analyzed and restaged according to 8th edition. Univariate analysis of prognostic factors was evaluated by using log-rank test. Multivariate analysis was estimated by using the Cox proportional hazards model. The prognostic accuracy of the two staging systems was compared using receiver operating characteristic (ROC) analyses and the concordance index (C-index). Results: 5-year locoregional recurrence rate (LRR) for the whole group was 6.0%, 5-year distant metastasis (DM) rate was 11.5%, 5-year disease-free survival (DFS) was 85.0%, and 5-year overall survival (OS) was 93.1%. Cox analysis showed that 7th edition of the AJCC staging system and progesterone receptor status were independent risk factors for LRR, DM, DFS and OS (P<0.05). Compared with stage by 7th edition, 1 278(70.1%) were assigned to a different prognostic stage group: 1 088 (85.1%) to a lower stage and 190 (14.9%) to a higher stage. LRR, DM, DFS and OS were significantly different between prognostic stage â A, â B, â ¡A, â ¡B and â ¢A according to 8th edition of the AJCC staging system(P<0.001). Prognostic stage had significantly higher C-indexes and provided better estimation of prognosis compared to stage by 7th edition of the AJCC staging system (P<0.001). Conclusion: The prognostic stage groups of 8th edition AJCC staging system has superior prognostic accuracy compared to 7th edition in T1-2N1M0 breast cancer, and has better clinical therapeutic guidance value.
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Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Mastectomia , Feminino , Humanos , Estadiamento de Neoplasias , Prognóstico , Reprodutibilidade dos Testes , Estados UnidosRESUMO
OBJECTIVE: Previous studies have shown that microRNA-765 (miR-765) is involved in certain biological behaviors of human cancers. However, abnormal expression and function of miR-765 have not been reported in osteosarcoma (OS). PATIENTS AND METHODS: Changes in the expression of miR-765 and MTUS1 (Microtubule-associated tumor suppressor 1) were examined via Real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot analysis. The function of miR-765 was investigated through Cell Counting Kit-8 (CCK-8) and transwell assays in OS. The target of miR-765 was identified using a Dual-Luciferase reporter assay. RESULTS: MiR-765 was upregulated in OS tissues. And upregulation of miR-765 promoted cell proliferation, migration and invasion in OS. In addition, MTUS1 was confirmed as a direct target gene of miR-765. Moreover, miR-765 promoted the progression of OS through targeting MTUS1. Furthermore, miR-765 was involved in tumorigenesis of OS through activating extracellular-signal-regulated kinase/ epithelial-mesenchymal transition (ERK/EMT) pathway. CONCLUSIONS: MiR-765 targets MTUS1 to promote the progression of OS via mediating the ERK/EMT pathway. Therefore, miR-765 may be used as a novel biomarker for the diagnosis of OS.
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Neoplasias Ósseas/genética , MicroRNAs/genética , Osteossarcoma/genética , Proteínas Supressoras de Tumor/genética , Regiões 3' não Traduzidas , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/patologia , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células , Progressão da Doença , Transição Epitelial-Mesenquimal , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Sistema de Sinalização das MAP Quinases , Masculino , Estadiamento de Neoplasias , Osteossarcoma/metabolismo , Osteossarcoma/patologia , Análise de Sobrevida , Proteínas Supressoras de Tumor/metabolismo , Regulação para CimaRESUMO
PURPOSE: To assess the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) in liver cancer patients with different times of previous conventional transarterial chemoembolization (cTACE) treatments. METHODS: 367 liver cancer patients about to receive DEB-TACE treatment were enrolled in this prospective cohort study. All patients were divided into no previous cTACE group (NPC group), 1-2 times previous cTACE group (PC group) and triple or above previous cTACE group (TPC group) according to the times of previous cTACE treatments. RESULTS: There was no difference in complete response (CR) (P = 0.671) and objective response rate (ORR) (P = 0.062) among three groups. Additionally, no difference in overall survival (OS) among groups (P = 0.899) was found. As to liver function, most liver function indexes were deteriorative at 1 week after DEB-TACE operation, but returned to baseline at 1-3 months after DEB-TACE operation in all three groups, while percentage of abnormal total bile acid (TBA) patients was higher in TPC group than NPC and PC groups at 1-3 month post-DEB-TACE (P = 0.018). As for safety profiles, the incidence of pain during DEB-TACE operation was lower in TPC group compared to NPC and PC groups (P = 0.005), while no difference of other adverse events was found during and 1 month post-DEB-TACE treatment among three groups. CONCLUSION: DEB-TACE treatment was equally efficient and tolerated in liver cancer patients with different times of previous cTACE treatments.
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Antibióticos Antineoplásicos/administração & dosagem , Quimioembolização Terapêutica/métodos , Doxorrubicina/administração & dosagem , Neoplasias Hepáticas/terapia , Adulto , Idoso , Quimioembolização Terapêutica/mortalidade , Portadores de Fármacos , Feminino , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/mortalidade , Masculino , Microesferas , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/terapia , Resultado do TratamentoRESUMO
Objective: To evaluate the patients with Cardiac amyloidosis (CA) and Hypertrophic cardiomyopathy (HCM) by using the strain indexes of three-dimensional speckle tracking imaging(3D-STI) technique, and to evaluate the prognosis. Methods: A total of 32 patients with pathologically confirmed cardiac amyloidosis and 34 patients with hypertrophic cardiomyopathy and 16 normal controls were enrolled from the First Affiliated Hospital of Zhejiang University College of Medicine from June, 2013 to January, 2018.The color Doppler echocardiography and three-dimensional speckle tracking echocardiography were used to measure strain indexes of each group, and the Logistic regression equation was used to analyze the index differences.The cut-off values were analyzed using the Receiver Operating Characteristic (ROC), and Kaplan-Meier and Cox were used for survival regression analysis. Results: The globe radial strain (GRS) (16%±7% vs 23%±9%), left ventricular wall peak time difference (PSD) (52 ms±17 ms vs 77 ms±25 ms), Sokolow-Lyon index (20 mm±6 mm vs 34 mm±14 mm) were significantly different between cardiac amyloidosis group and hypertrophic cardiomyopathy group by 3D-STI, which had high sensitivity and specificity by Logistic regression analysis.The area under the ROC curve of GRS was 0.725, PSD was 0.812, Sokolow-Lyon index was 0.832.In addition, the area strain and atrial septal thickness were significant prognostic factors according to survival regression analysis. Conclusions: For the differential diagnosis of cardiac amyloidosis with preserved LVEF, unlike echocardiographic parameters, the 3D-STI strain indicators could be used to differentiate cardiac amyloidosis from hypertrophic cardiomyopathy, reflecting obvious diagnostic advantages.When combined with area strain and atrial septal thickness, 3D-STI strain indicators could be used to predict the survival prognosis, which are important in clinical practice.
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Cardiomiopatia Hipertrófica , Amiloidose , Ecocardiografia , Ecocardiografia Tridimensional , Humanos , Prognóstico , Reprodutibilidade dos TestesRESUMO
Objective: To establish comprehensive laboratory reference intervals for Chinese children. Methods: This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex. Results: In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old. Conclusion: This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.
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Análise Química do Sangue , Valores de Referência , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Lactente , Hormônio Luteinizante/sangue , MasculinoRESUMO
OBJECTIVE: PTENP1, a long noncoding RNA, has previously been reported to be involved in tumorigenesis and cancer progression. The relationship between PTENP1 and susceptibility tumors is reported, while, an association of PTENP1 with the risk of oral squamous cell carcinoma (OSCC) in Chinese population is lacked. This research is designed to investigate the association of PTENP1 with susceptibility of OSCC. PATIENTS AND METHODS: In this research, TaqMan technology was used to test genotype in 342 OSCC patients and 711 healthy controls, so as to analyze the association between PTENP1 polymorphisms (rs7853346 rs865005 and rs10971638) and susceptibility of oral squamous cell carcinoma. RESULTS: The results of this research showed that rs7853346 [Additive model: Adjusted odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.66-0.99] was related to the OSCC risk. It was not found that the other two sites were associated with the susceptibility of OSCC. CONCLUSIONS: This research indicated that rs7853346 is statistically correlated with the OSCC risk.
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Neoplasias Bucais/genética , Polimorfismo de Nucleotídeo Único , RNA Longo não Codificante/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Adulto , Idoso , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , RiscoRESUMO
Objective: To investigate the overall efficacy of early breast cancer after breast-conserving treatment. To analyze risk factors affecting local regional recurrence (LRR), distant metastasis (DM) and survival. Methods: 1 791 breast cancer patients treated with breast-conserving surgery were retrospectively analyzed. The inclusion criteria were pathologic diagnosis of invasive breast cancer without supraclavicular and internal mammary node metastasis, T1-2N0-3M0, and no neoadjuvant therapy. Univariate analysis of survival was performed by Kaplan-Meier method and log rank test. Cox regression model was used for multivariate analysis. Results: The median follow-up time was 4.2 years. For all patients, the 5-year LRR, DM, disease-free survival(DFS) and overall survival(OS) rates were 3.6%, 4.6%, 93.0% and 97.4%, respectively. The LRR rates of patients with Luminal A, Luminal B1, Luminal B2, HER-2 over-expressed and triple-negative breast cancer were 2.0%, 6.1%, 5.9%, 0 and 10.0%, while the DM rates were 3.2%, 6.7%, 8.3%, 4.8% and 7.3%, respectively. Among the N0 patients, axillary dissection was performed in 689 cases and sentinel lymph node biopsy in 652 cases. The 5-year LRR rates were 3.3% and 3.2% (P=0.859), and the OS rates were 98.2% and 98.3% (P=0.311) respectively, which showed no statistically significant. There were 1 576 patients that underwent postoperative radiotherapy. Postoperative radiotherapy significantly reduced the 5-year LRR compared with surgery alone (2.5% vs 12.9%). The 5-year LRR rates of patients who received conventional fractionated radiotherapy and hypo-fractionated radiotherapy were 2.7% and 3.1%, respectively. But the difference was not statistically significant (P=0.870). Multivariate analysis showed that age, lymphovascular invasion, pathological T staging, postoperative radiotherapy, ER/PR status and endocrine therapy were independent factors of LRR in breast cancer patients (all P<0.05). Histological grade and pathological N staging were independent factors of DM (all P<0.05). The age, lymphovascular invasion, pathological T and N staging, postoperative radiotherapy, ER/PR status and endocrine therapy were independent factors for DFS (all P<0.05). Histological grade, pathological N staging, ER/PR status and endocrine therapy were factors for OS (all P<0.05). Conclusions: With contemporary standard treatment, the recurrence rate of early breast cancer after breast conserving treatment is less than 10%. Node-negative patients after sentinel lymph node biopsy did not need axillary dissection. The overall utilization of radiotherapy after breast conserving surgery is satisfactory. Hypofractionated radiotherapy is as effective as conventional fractionated radiotherapy. Local regional recurrence and distant metastasis have different risk factors.