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Objective:To investigate the feasibility and clinical significance of near-infrared fluorescence positive imaging combined with intraoperative rapid parathyroid hormone (PTH) determination in identification and function protection of the parathyroid gland during thyroidectomy.Methods:According to the inclusion and exclusion criteria, patients in the Affiliated Lihuili Hospital of Ningbo University, who needed bilateral thyroidecto-my and central lymph node dissection due to suspected bilateral thyroid cancer from Mar. 2020 to Oct. 2020 were selected for a prospective clinical study. They were randomly divided into the study group (near-infrared fluorescence positive imaging combined with intraoperative rapid PTH determination) and the control group (intraoperative experience identification) . The number of parathyroid glands found during operation, PTH before and after the operation, blood calcium, blood phosphorus, the presence of parathyroid tissues in routine pathological section examinations, and postoperative symptoms were collected. SPSS 25.0 statistical software was used for analysis, the measurement data were expressed by mean±standard deviation ( ± s) , t test was used for comparison between groups, and χ2 test was used for counting date. Results:In the study group of 33 cases, 135 suspicious parathyroid glands were exhibited during operation, with an average of (4.09±0.52) ; Hand and foot numbness occurred in 1 case (3.03%) ; On the 1st after the operation, PTH was (23.68±9.48) ng/L. In the control group of 31 cases, 109 parathyroid glands were identified by naked eyes, with an average of (3.52±0.63) ; Hand and foot numbness occurred in 6 cases (19.35%) ; On the 1st after the operation, PTH was (17.93±11.58) ng/L. The differences were statistically significant ( P<0.05) . But no statistical significance was found in operation duration (79.45±30.18) min, postoperative hospitalization days (5.85±2.27) days, PTH (27.10±9.80, 33.08±10.21) ng/L, blood calcium (2.11±0.10,2.25±0.09) mmol/L, and blood phosphorus (1.20±0.20,1.15±0.12) mmol/L on the 3rd day and the 6th month after the operation. Conclusion:Near-infrared fluorescence positive imaging combined with intraoperative rapid PTH determination can improve the recognition rate of the parathyroid gland and reduce postoperative complications, which is a safe, effective and rapid method for intraoperative parathyroid gland recognition.
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Objective To investigate the effect and prognosis of breast conserving surgery on triple-negative breast cancer patients ≤35 years old. Methods 60 cases of ≤35-year-old triple negative breast cancer from July 2011 to July 2016 in our hospital were selected as the observation group. Other 60 triple-negative breast cancer patients who underwent modified radical mastectomy from July 2011 to July 2016 at the same period were selected as control group. The surgical observation index, complications, local recurrence, distant metastasis and 1-year survival rate between the two groups were compared. Results The operation time of the observation group was significantly shorter than that of the control group, and the difference was significant(P＜0. 05). The intraoperative blood loss in the observation group was significantly less than that of the control group. There was significant difference between the two groups (P＜0. 05). The incidence of postoperative complications in the observation group was significantly less than that in the control group. There was significant difference between the two groups (6. 67％ vs 20. 00％, P＜0. 05). Among them, there were 2 cases of subcutaneous effusion, 2 cases of flap ischemia in the observation group. And there were 3 cases of subcutaneous effusion, 3 cases of ischemic skin flap and 6 cases of upper limb swelling in the affected side in the control group. The follow-up of 1 year showed that the local recurrence rate and distant metastasis rate in the observation group was significantly lower than that in the control group. There was significant difference between the two groups (P＜0. 05). However, there was no significant difference in one-year survival rate between the two groups (98. 33％ vs 83. 33％, P＞0. 05). One case died in the observation group and died of brain metastases at 11 months after operation. Two patients in the control group died of liver metastases at 6 months and 12 months after operation. Conclusion Breast-conserving surgery for triple-negative breast cancer patients ≤35 years has definite effect, which can significantly reduce postoperative recurrence and distant metastasis and improve the success rate of operation.
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Objective To investigate the effect of trastuzumab for injection on apoptosis and the expression of related genes in locally advanced breast cancer and related indexes.Methods 166 patients with locally advanced breast cancer were selected and divided into two groups, 83 cases in the control group treated with neoadjuvant chemotherapy before operation, 83 cases in the experimental group received trastuzumab for injection on the basis of the control group, serum tumor marker levels, tumor cell apoptosis index and proliferation activity, Bcl-2, Bax gene expression levels, the clinical effect and incidence of adverse reactions were compared after the treatment.Results The effective rate in the control group(78.32%)was lower than the experimental group(90.36%), with significant difference (P<0.05).Compared with the control group, serum levels of CA153,CA125,CEA,TSGF were lower in the experimental group after chemotherapy, levels of apoptosis index(AI) in tumor tissue was higher, levels of S-phase fraction (SPF), proliferation index ( PI) were lower after treatment, Bcl-2 gene in tumor tissue expression level was lower, Bax gene expression level was higher after treatment, all with significant difference (P<0.05).There was no significant difference in the incidence of adverse reactions between two groups. Conclusion The trastuzumab for injection treatment can significantly improve the total remission rate of patients with locally advanced breast cancer , reduce the levels of serum tumor markers, can down-regulate the expression of apoptosis related gene Bcl-2, up-regulate the expression of Bax gene, promote the apoptosis of tumor cells.
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Objective To evaluate the short-term efficacy, safety and effectiveness of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with radioactive 125I seed implantation in treating advanced non-small-cell lung cancer (NSCLC). Methods A total of 48 patients with inoperable and EGFR mutation-positive advance NSCLC were included in this study. The patients were divided into study group (n = 26) and control group (n = 22). Patients in the study group were treated with EGFR-TKIs combined with radioactive 125I seed implantation; while patients in the control group only received EGFR-TKIs treatment, which was kept on until the disease progressed. The clinical efficacy, and the incidence of side effect as well as the survival rate were determined, and the results were compared between the two groups. Results Local disease control rate of the study group and the control group was 92.3% and 68.2%respectively, the difference was statistically significant (P= 0.033), while the effective rate was 76.9% and 54.5%respectively, the difference was not significant (P=0.101). Progression-free survival (PFS) time of the study group and the control group was 14.1 months and 9.7 months respectively (P< 0.05). The one-year survival rate of the study group and the control group was 80.8%and 63.6%respectively (P<0.05), and the median survival time was 26.9 months and 17.1 months respectively (P < 0.05). The major complication caused by radioactive 125I seed implantation was pneumothorax. Conclusion For EGFR mutation-positive advance NSCLC, EGFR-TKIs together with radioactive 125I seed implantation is a safe and effective treatment.Its short-term efficacy is superior to pure EGFR-TKIs therapy. At present, this combination therapy is a new alternative for the treatment of EGFR mutation-positive advance NSCLC.
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Objective Investigate the significance of the antibody and antigen detection of Rh blood group.Methods Detecting Rh blood group antigen phenotypes and screen Rh blood group antibodies in 2 700 inpatients from August 2012 to May 2013.Re-sults Rh blood group antigen phenotypes in descending order of propotion were as follows:CCDee,CcDEe,CcDee,ccDEE,CCDEe. 5 antigen genes in descending order of frequency were D,e,C,c,E.Conclusion For donors and donees,in addition to routine tests, the other 4 types of antigen and antibodies in Rh blood group should be detected too,which helps avoid secondary transfusion diffi-culty because of the immunity antibodies generated in blood transfusion.
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Objective To study the expression and activation of signal transducer and activator of transcription 3(STAT3) in human nasopharyngeal carcinoma (NPC) tissues and its relation with the expression of latent membrane protein 1(LMP1) encoded by Epstein-Barr virus.Methods The expressions of LMP1,STAT3 and phosphated STAT3(p-STAT3) in 45 cases of NPC and 27 cases of chronic nasopharyngitis were studied by immunohistochemical method.Correlation between protein expressions was analyzed.Results The positive rates of LMP1,STAT3 and p-STAT3 in NPC were significantly higher than those in chronic nasopharyngitis(P0.05).Conclusion There are overexpression and abnormal activation of STAT3 protein in NPC tissues.LMP1 may play a role in the activation of STAT3.
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Forty laryngectomees were divided into 4 groups. Each group had 10 patients, who speech with Esophageal, Tracheo- esophageal, Electrolaryngeal and Pneumatic artificial laryngeal respectively. Ten normal speakers were included as control group. The average fundamental frequencies (F0) were included as calculated after speaking a sentense. The result showed that it was similar between normal speakers and Tracheo-esophageal speech,the average F0 of Esophageal and Pneumatic artifcial Laryngeal speech were highest, and that of Electrolaryngeal speech was lowest.
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Objective: To further study the effects of As 2 O 3 in various concentrations on the esophageal carcinoma cell line. Methods: The esophageal malignant transformed epithelial cells (SHEEC1) were induced by HPV18 in synergy with TPA in our laboratory. The cells cultured in flask and 24 wells plate were treated by As 2 O 3 with concentrations of 1, 3 and 5 ?mol/L for 2, 4, 8, 16, 24 h respectively. The morphologic changes of cells were observed under election microscopy. The mitotic index (MI) of living cells was calculated by phase contrast microscopy and the cells with TdR uptake were examined by autoradiography. The proliferative index (PI) and apoptotic index (AI) were assayed by flow cytometry. Results: A low dosage of As 2 O 3 (1.0 ?mol/L) enhancing the protiferative rate of SHEEC1 was demonstrated with TdR uptake, MI and PI increased. The high AI and low PI were found in the high concentrations (3 and 5 ?mol/L)of As 2 O 3 . The morphological changes of apoptosis and necrosis were found in 24 h after As 2 O 3 in high concentrations (3 and 5 ?mol/L) administrated. Conclusion: The effects of As 2 O 3 in various concentrations are different. Low concentration of As 2 O 3 promotes the proliferation of the esophageal carcinoma cells by increment of DNA synthesis. In high concentration of As 2 O 3 apoptosis and necrosis are induced.
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Objective: To investigate the antitumor effects of arsenic trioxide (As 2 O 3 ) on solid tumor in vivo , the transplanted hepatic carcinoma of mice were treated with various dosages of As 2 O 3 . Methods: After 50 mice were injected intraperitoneally with 0,2, 4, 6, 8 ?mol/g As 2 O 3 respectively for observation of acute toxicity, 1, 2, 3 ?mol/g were selected for this experiment. Eighty mice were transplanted with hepatic carcinoma cells (1.5?10 6 cells/each side) into both subaxillae. As 2 O 3 in 0, 1, 2 and 3 ?mol/g were injected into right subaxilla respectively once every day for 10 days. At the 30th day after transplanted hepatic carcinoma cell, mice were killed and the size of solid tumors was measured. The chronic cytotoxicity of As 2 O 3 was observed in these mice.Results: In right subaxillae tumors, which were injected directly with As 2 O 3 , were apparent smaller than that in the left ( P