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Treatment sequencing in early-stage breast cancer has significantly changed in recent years. Instead of surgery-adjuvant chemotherapy mode, several clinical trials showed benefits using administering systemic chemotherapy (and human epidermal growth factor receptor 2 targeted therapies) prior to surgery. Neoadjuvant therapy (NAT) could frequently downstage the primary tumor and lymph nodes, allowing conversion of the planned surgery form inoperable to operable one, from a mastectomy to a lumpectomy, and potentially allowing omission of axillary lymph node dissection. These benefits also include providing the opportunity to monitor the individual drug response and more accurate prognostic estimates based on the extent of residual cancer that can guide additional adjuvant treatment. This allows escalation or de-escalation of NAT: patients who achieved pathologic complete response could be spared further chemotherapy or de-escalation of locoregional therapies, while those with residual cancer could receive additional systemic therapy postoperatively. NAT is not an option anymore but a platform for personalized breast cancer therapy.
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Data of 643 patients who underwent endoscopic polypectomy with high-frequency electrotome in 6 hospitals of Sichuan Province between June 2020 and September 2020 were summarized. The rate of complete polypectomy and the incidence of delayed post-polypectomy bleeding (DPPB) and perforation were analyzed. DPPB occurred in 18 cases (2.80%) and postoperative perforation occurred in 1 case (0.16%). All of the 1 828 polyps were completely resected (100.0%). Univariate analysis showed that polyps′ diameter≥10 mm, long peduncle or laterally spreading tumor (LST), adenomatous polyp, endoscopic mucosal resection, mixed cutting mode 1 of electrocoagulation were significantly correlated with DPPB( P<0.05). Multivariate Logistic regression analysis revealed that polyp diameter≥10 mm ( P=0.001, OR=3.575, 95% CI: 1.175-9.955), morphology of long peduncle or LST ( P=0.004, OR=2.981, 95% CI: 1.233-14.858) were independent risk factors for DPPB. Endoscopic colorectal polypectomy with high-frequency electrotome is effective and safe. Polyps′ diameter≥10 mm, polyps with long pedicle or LST are the risk factors for DPPB.
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Objective To investigate the resistance of Helicobacter pylori (H. pylori) strains to common antibiotics and to analyze the sites of genetic mutations carried by clarithromycin-resistant strains in order to provide reference for selecting sensitive antibiotics against H. pylori and for providing individualized treatment for patients in Changchun area. Methods Drug resistance of H. pylori clinical isolates to common antibiotics was detected by disk dilution method. The 23S rRNA genes of clarithromycin-resistant strains were amplified by PCR and then sequenced to analyze the presence of mutations. Results In this study, 69 strains of H. pylori were successfully isolated with a positive rate of 23. 1％ . Results of the drug susceptibility test to seven commonly used antibiotics showed that there were 52. 2％ of the isolates resistant to clarithromy-cin, 47. 8％ to tinidazole, 37. 7％ to levofloxacin, 33. 3％ to tetracycline hydrochloride, 30. 4％ to furazoli-done, 30. 4％ to metronidazole and 5. 8％ to amoxicillin. Amoxicillin could continue to be used as a first-line antimicrobial agent. Seven mutation sites were found in the 23S rRNA genes carried by the clarithromy-cin-resistant strains, which were A1821G, G1826A, T1830C, G1940A, A2143G, T2182C and A2223G. The A2143G site mutation accounted for 54. 2％ and was the predominant mutation resulting in the resistance to clarithromycin of H. pylori strains circulating in this area. Conclusions The H. pylori strains isolated from patients with gastroduodenal diseases in Changchun area had a high resistance rate to clarithromycin, which was mainly caused by the A2143G mutation in 23S rRNA gene.
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Background:Ulcerative colitis (UC)is a chronic inflammatory disorder. Studies have shown that intestinal injury of UC is related to changes of tight junction proteins. Aims:To investigate the expressions and localizations of tight junction protein claudin-1,-2,-4. Methods:Forty female Wistar rats were randomly divided into normal control group and model group. Rats in model group received 7. 5 mg/ mL oxazolone enema to induce experimental colitis. Rats received 0. 9%NaCl solution enema were served as normal controls. Macroscopic score and histological score were assessed. ELISA was used to determine serum and colon tissue inflammatory factor TNF-α,IL-4,IL-5,IL-10 levels. Protein expressions of tight junction protein claudin-1,-2,-4 were measured by immunohistochemistry and Western blotting. mRNA expressions of claudin-1,-2,-4 were determined by real-time PCR. Results:Compared with normal control group,macroscopic score and histological score were significantly increased (P < 0. 05),serum and colon tissue IL-4 and IL-5 levels were significantly increased (P < 0. 05)in model group,however,no significant differences in TNF-α and IL-10 levels were found between the two groups (P > 0. 05). mRNA and protein expressions of claudin-1,-4 were significantly decreased in model group than in normal control group (P < 0. 05),while mRNA and protein expressions of claudin-2 were significantly increased (P < 0. 05). Conclusions:Changes of distributions and expressions of tight junction protein claudin-1,-2,-4 are found in experimental colitis rats,which may lead to impaired epithelial barrier,and might be served as potential target for treatment of UC.
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Background:Ulcerative colitis (UC)is a chronic inflammatory disorder. Studies have shown that intestinal injury of UC is related to changes of tight junction proteins. Aims:To investigate the expressions and localizations of tight junction protein claudin-1,-2,-4. Methods:Forty female Wistar rats were randomly divided into normal control group and model group. Rats in model group received 7. 5 mg/ mL oxazolone enema to induce experimental colitis. Rats received 0. 9%NaCl solution enema were served as normal controls. Macroscopic score and histological score were assessed. ELISA was used to determine serum and colon tissue inflammatory factor TNF-α,IL-4,IL-5,IL-10 levels. Protein expressions of tight junction protein claudin-1,-2,-4 were measured by immunohistochemistry and Western blotting. mRNA expressions of claudin-1,-2,-4 were determined by real-time PCR. Results:Compared with normal control group,macroscopic score and histological score were significantly increased (P < 0. 05),serum and colon tissue IL-4 and IL-5 levels were significantly increased (P < 0. 05)in model group,however,no significant differences in TNF-α and IL-10 levels were found between the two groups (P > 0. 05). mRNA and protein expressions of claudin-1,-4 were significantly decreased in model group than in normal control group (P < 0. 05),while mRNA and protein expressions of claudin-2 were significantly increased (P < 0. 05). Conclusions:Changes of distributions and expressions of tight junction protein claudin-1,-2,-4 are found in experimental colitis rats,which may lead to impaired epithelial barrier,and might be served as potential target for treatment of UC.
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Objective To investigate the distribution of cytotoxin-associated gene A (cagA) of Helicobacter pylori (Hp) and the polymorphism of EPIYA motifs in patients with upper gastrointestinal diseases in Changchun area of China and to evaluate the association between EPYIA motifs patterns and gastrointestinal diseases.Methods Hp strains were isolated from clinical samples.Their cagA gene was analyzed by PCR and sequencing analysis.Nucleotide sequence of cagA gene was translated into amino acid sequence by using DNAMAN software,and then the amino acid sequence was imported into software MEGA6.0 for multiple comparisons and construction of a phylogenetic tree.Results A total of 60 Hp strains were isolated and identified from gastric mucosa specimens collected from 298 patients.Hp infection was not correlated with patient's age or sex (P>0.05).The isolation rate of Hp in peptic ulcer disease (PUD) group was higher than that in non-peptic ulcer dyspepsia (NUD) group (P<0.05).Of the 60 Hp strains,90% (54/60) carried cagA gene.Twenty-three out of 26 successfully sequenced strains (88.4%) were East Asian-type including 22 containing EPIYA-ABD motif and one containing EPIYA-ABBD motif.The other three strains (11.6%) were Western type including two carrying EPIYA-ABC motif and one carrying EPIYA-BC motif.Results of the phylogenetic tree showed that the sequences of cagA gene were clustered into two groups,East Asian-type and Western-type groups.East Asian-type strains caused no disease cluster of statistical significance.All Western-type Hp strains were isolated from patients with peptic ulcer disease (PUD).Four mutant Hp strains were detected in the PUD group and the amino acid mutations preferentially occurred in the EPIYA-B segment.Conclusion The positive rate of Hp cagA gene is 90% in this region.Its distribution is not related to the type of gastrointestinal diseases.EPIYA-ABD (84.6%,22/26) is the predominant EPIYA motif.The amino acid mutation of EPIYA-B segment is closely related to peptic ulcer disease.Neither significant change in the sequence of 3' region of Hp cagA gene nor regional difference is observed in those Hp strains circulating in Changchun area of China.
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Objective To explore the clinical effect of suprapubic small cut method combined with transurethral resection prostate(TURP) on the treatment of benign prostatic hyperplasia(BPH) complicated with bladder stones.Methods Sixty patients with BPH complicated with bladder stones ≥ 3 cm in the People's Hospital of Futian Affiliated to Guangdong Medical College from January 2013 to September 2014 were selected as the study group,and another 60 patients with BPH complicated with bladder stones＜3 cm during the same period were selected as the control group.The cases in the study group were treated with suprapubic small cut method combined with TURP,and the cases in control group were treated with transurethral method combined with TURP.The intraoperative indicators (including the time used for crushed stone,total operation time,blood loss,conversion to laparotomy,blood transfusion and bladder perforation),residual bladder stones and complications of postoperative were compared.Results The operations of the two groups of patients were successfully,and there was no conversion to laparotomy and either bladder perforation.The stone removal time and total operative time of patients of the study group were shorter than of the control group,the difference was statistically significant((12.20±3.55) min vs.(24.05±7.68) min,(62.31± 10.49) min vs.(82.46± 16.75)min;t =10.849,7.897;P＜0.001).The intraoperative blood loss and the cases of blood transfusion of patients of the study group were less than the control group,but the prevalence of urinary tract infection were higher(6vs.4),but the difference was not statistically significant(P＞0.05).Residual stones were more commonly in the control group than in the study group (study group:0,control group:6 cases),the difference was statistically significant(x2 =6.316,P=0.012).Conclusion BPH complicated with bladder stones can be treated by the suprapubic small cut method combined with TURP or transurethral method combined with TURP,but suprapubic small cut method combined with TURP is safer and more effective,which is worthy of popularization and application in clinic.
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Objective The study aimed to evaluate the incidence rate and risk factors of early post-mastectomy pain syndrome (EPMPS) after surgery for breast cancer.Methods A retrospective study was carried out in 231 female patients with breast cancer who appeared EPMPS after surgery in the First Hospital of China Medical University from September 2012 to September 2014.They were followed-up for 3 months.Results Among 231 female patients with breast cancer,41.1％ (95/231) suffered from EPMPS.The incidence of EPMPS in women of 40-59 years old was 66.3％ (63/95),significantly higher than other age groups,RR=l.83,P＜0.05.Those who were submitted to axillary lymph node dissection and those without preservation of intercostobrachial nerve had shown a significantly increased risk of EPMPS compared with those with sentinel lymph node biopsy plus no surgery and preservation of intercostobrachial nerve patients (81 cases vs.14 cases,41 cases vs.18 cases,x2=19.921,P＜0.01;x2=11.045,P＜0.05).Conclusions The frequency of EPMPS in the middle-age women is high and possible explanations are unclear.Surgery of axilla affects the incidence of EPMPS,reassurance is key to coping with EPMPS in nursing and rehabilitation.
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Objective To investigate the application value of 16S rDNA-based detection technique in the rapid screening for and confirmation of gonococcemia. Methods A 41-year-old male patient was hospitalized for recurrent regular fever and chills for 1 month. Several days before the admission, he developed urgent micturition, frequent micturition and pain in urination, anemia with emaciation appearance, slightly pale-looking skin and mucous membranes. No petechia, skin eruption or superficial lymphadenectasis was observed, but routine blood test and urine test results were abnormal. No abnormality was found in stool test or hepatic and renal function. DNA was extracted from the blood of the patient and subjected to PCR for the amplification of 16S rDNA followed by sequence analysis and homology analysis. At the same time, bacterial culture of blood and drug sensitivity test for the bacterial isolate were performed. Results Homology analysis indicated that the amplicon sequence was consistent with the known sequence of 16S rDNA of Neisseria gonorrhoeae in GeneBank, which agreed well with the culture result of peripheral blood. Conclusion The detection of 16s rDNA with PCR from peripheral blood is highly efficient, specific, sensitive, rapid and accurate for the screening for and confirmation of gonococcemia.
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OBJECTIVE@#By detecting the myelin structure in acoustic tumor tissues, the cell origin and state of acoustic tumor tissues were investigated.@*METHOD@#Immunofluorescence labeling, immunoblot analysis and electron microscopic study were performed to identify myelin structure and myelin protein in acoustic tumor tissues.@*RESULT@#In this work, we found some early stage of myelin forming in acoustic tumor tissues, but there were no axon nor compact myelin formed and the myelin basic protein whose expression indicates the beginning of myelination was negative detected. We also found that the cell of acoustic tumor express p75,a marker for immature Schwann cells and mature non-myelin-forming Schwann cells.@*CONCLUSION@#The date shown in this experiment indicates that the cell of acoustic tumor is in a remyelinating state.
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Humans , Microscopy, Electron , Myelin Sheath , Pathology , Neuroma, Acoustic , Pathology , Schwann Cells , PathologyABSTRACT
Composite materials are widely used in various areas including medicine.They are constructed with two or above kinds of materials by using physical or chemical methods in macroscopic scale and possess new properties.Based on the characters of composite materials,several theoretical methods for studying the mechanical properties of composite materials are introduced in detail as well as their wide application in medicine.