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In order to explore the treatment of Her-2 positive breast cancer patients who failed in multi-line treatments, we retrospectively analyzed the clinical data of a patient with refractory Her-2 positive breast cancer.The patient was initially diagnosed as Her-2 positive advanced breast cancer.After six line treatment in the outer hospital, the patient′s condition was basically in a progressive state.The breast tumor was broken and purulent, the lung metastasis increased, and the patient′s quality of life was poor.The patient was admitted to Department of Breast Surgery of Affiliated Suqian Hospital of Xuzhou Medical University, after MDT discussion, we gave pyrrolotinib combined with capecitabine treatment, the chest wound healed gradually, the lung metastasis gradually reduced, and the quality of life was better.A retrospective analysis of this case showed that pyrrolidine combined with capecitabine may bring hope to Her-2 positive breast cancer patients who failed to receive multi-line therapies, especially those who failed to target therapy.
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Background/Aims@#Colorectal cancer (CRC) patients often exhibit peritoneal metastasis, which negatively impacts their prognosis. CD31 and D2-40 have recently been suggested to be predictors of breast cancer prognosis, but their role in colorectal peritoneal metastasis (CRPM) remains unknown. @*Methods@#The expression profiles of CD31 and D2-40 were analyzed in CRC patients with or without CRPM and in CRC cell lines with increasing metastatic potential. Overexpression and short hairpin RNA knockdown assays were performed in CRC cells, and the effects of these alterations on epithelial-mesenchymal transition (EMT) in vitro, growth of xenograft tumors in vivo, and peritoneal metastasis potential in a mouse model of CRPM were examined. @*Results@#The expressions of CD31 and D2-40 were upregulated in CRC tumor tissues and was elevated further in tumor tissues from patients with CRPM. CD31 and D2-40 expression levels exhibited increasing trends parallel to the EMT potential of CRC cells. CD31 and D2-40 are essential for CRC cell EMT in vitro as well as for xenograft tumor growth and peritoneal metastasis in vivo. @*Conclusions@#CD31 and D2-40 contribute to CRPM by promoting EMT and may serve as prognostic markers and therapeutic targets for CRC, particularly in patients with peritoneal metastasis.
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Objective To explore the application of paclitaxel or docetaxel combined with cisplatin (TP) with cyclophosphamide,pirirubicin and fluorouracil (FAC) in the primary tumor molecular typing Luminal A,axillary lymph node metastasis three negative breast cancer. Methods From January 2012 to January 2014, the clinical data of forty-nine patients with were selected. All patients were divided into two groups by balance randomization method, TP group and FAC group. Twenty-five patients were treated with TP regimen and 24 patients were treated with FAC regimen. The clinical efficacy was evaluated after six cycles of chemotherapy. Chemotherapy effects,adverse reactions and survival rates of two groups were compared. Results All patients were given intravenous chemotherapy according to the plan and were evaluated for clinical efficacy. The response rate (RR) was 64. 0％ in TP group,including 4 cases of complete remission (CR),12 cases of partial remission (PR),7 cases of stable disease(SD) and 2 cases of progressive disease(PD). The adverse reactions were gastrointestinal reactions and granulocytopenia. The median progression-free survival ( PFS) and overall survival ( OS) were respectively 12. 4 months and 34. 1 months. In FAC group,the response rate ( RR) was 33. 3％,including 2 cases of CR,6 cases of PR,11 cases of SD and 5 cases of PD. The adverse reactions were gastrointestinal reactions,granulocytopenia and premature atrial contraction. The median PFS and OS were 7. 2 months and 20. 7 months respectively. The effective rate of TP group was higher than that of FAC group (χ2=4. 608,P=0. 032),and the progression-free survival time and total survival time were longer than those of FAC group (χ2 =8. 317, 8. 563, P=0. 004, 0. 003 ) . Conclusion Compared to FAC regimen, TP regimen could improve the survival rate of patients better with breast cancer of Primary tumor Luminal A and Axillary Lymph Node Metastasis Triple negative type, and adverse reactions were tolerated, it may be an optimized chemotherapy.
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Objective To explore the expression of HR and Her?2 in breast cancer primary tumor and axillary lymph node metastasis. Methods Four hundred and twenty?eight female patients with unilateral breast cancer combined with axillary lymph node metastasis treated in the Affiliated Suqian Hospital of Xuzhou Medical University from January 2011 to January 2016 were selected in this study. Immunohistochemistry was used to detect the expression of ER,PR,Her?2 and Ki67 in primary tumor and axillary lymph node metastasis. Results The positive rates of ER expression were 75. 9% ( 325/428 ) and 70. 3% ( 301/428 ) respectively in primary tumor and axillary lymph node metastasis. The positive rates of PR expression were 61. 4% ( 263/428) and 56. 1% ( 240/428 ) respectively in primary tumor and axillary lymph node metastasis. The rates of Her?2 overexpression were 20. 1% ( 86/428) in primary tumor and the positive rate of Her?2 in axillary lymph node metastasis was 22. 7%( 97/428 ) . The positive rates of Ki67 expression were 45. 6%( 195/428 ) and 39. 7%(170/428) respectively in primary tumor and axillary lymph node metastasis. The expression of ER,PR,Her?2 and Ki67 in primary and axillary lymph node metastasis showed no statistical significance ( P>0. 05 ) . The molecular typing of primary tumor and axillary lymph node metastasis were not consistent in 31 patients ( 31/428,7. 24%) ,including 14 cases of primary tumor Luminal A,9 cases of Her?2 overexpression in axillary lymph node metastasis and 5 cases of triple negative breast cancer. Primary tumor Luminal B was detected in 10 cases, while 6 cases of Her?2 overexpression in axillary lymph node metastasis and 4 cases of triple negative breast cancer. Primary tumor Her?2 was overexpressed in 4 cases,while 1 case of Luminal A,3 cases of Luminal B in axillary lymph node metastasis. There were 3 cases of primary tumor triple negative breast cancer,while 2 cases of Luminal B in axillary lymph node metastasis and 1 case of Her?2 overexpression. Conclusion The expressions of ER, PR, Her?2 and Ki67 in primary tumor and axillary lymph node metastasis of some breast cancer were different. Immunohistochemistry for primary tumor and axillary lymph node metastasis of stage II?III breast cancer patients should be routinely carried out. Based on molecular typing of primary tumor and axillary lymph node metastasis,individualized treatment plan can be developed,so that patients will benefit from it.
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Objective To investigate effect of autologous periosteum transplantation in the repair of anterior cruciate ligament (ACL) injury.Methods Transected ACL injury was induced in 24 white rabbits randomly allocated to receive autologous periosteum transplantation with suture fixation (study group,n =12),isolated suture fixation (control group,n =12),and arthrotomy (blank group,n =3).Gross observation of ACL repair was performed and degeneration of knee joint was evaluated using the Markin score.ACL pathology,collagen fiber formation and insertion degenerative changes were histologically investigated using the HE staining,Masson staining and Picric-Sirius red staining.Results Twelve weeks after the operation,gross observation showed ligamentous continuity and minor joint degeneration in study group.Opposite results were seen in control group.Markin joint degeneration score calculated 7.2 ± 1.6 in study group,12.4 ± 1.8 in control group and 0.6 ± 0.4 in blank group,with significant differences between groups (P ＜ 0.05).Using the HE and Masson staining in study group,rich collagen fibers and microvessel as well as cell infiltration were found in wound tissue and the ligaments were covered with synovial membrane.However,wound tissue did not heal in control group,leaving ligament remnants with loosely disorganized fibers and rich microvessel as well as cell infiltration.And only the residual stump was wrapped with synovial membrane.Using the HE and Picric-Sirius red staining,the typical four-layer structure of ACL insertion remained intact in study group,whereas in control group the layer structure of ACL insertion in control group became disorganized and the tidemark of enthesis almost disappeared.Conclusion Autologous periosteum transplantation is effective to improve the injury healing and mitigate the degeneration of joint.
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Background:With the increasing of antibiotic resistance and decreasing of eradication rate of standard triple therapy, bismuth-containing quadruple regimens were recommended by the update Chinese consensus report for eradication of Helicobacter pylori( Hp ) infection. Aims:To evaluate the eradication rate of the recommended bismuth-containing quadruple regimens for guiding the choice of low cost and high efficiency eradication regimens. Methods:A search of online database( CNKI,Wanfang and VIP)was carried out. Clinical trials published in Chinese from 2011 to 2013 that evaluated the eradication rate of the recommended bismuth-containing quadruple regimens were retrieved. Data were extracted by standardized data forms. According to the categories raised by Dr. Graham,the eradication rates were graded and analyzed. Results:A total of 166 eligible articles including 192 clinical trials for eradication of Hp infection were obtained. Nationwidely,the eradication rates of amoxicillin-containing regimens were acceptable,among which PAFB( PPI+amoxicillin+furazolidone+bismuth)regimen was more prone to achieve excellent eradication rate(≥95%). PACB ( PPI+amoxicillin+clarithromycin+bismuth)regimen was optimal for Hp eradication in East China,and PAFB regimen was optimal in Central South China. A 14-day treatment course was appropriate. Conclusions:In the recommended bismuth-containing quadruple regimens,PAFB regimen might be the first choice nationwidely for eradication of Hp infection in individuals without amoxicillin-hypersensitivity because of its low cost and high efficiency. The recommended treatment course is 14-day.
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To investigate the relationship between insomnia and qi-stagnation by using the international standardized measurement of sleep quality and the Traditional Chinese Medicine (TCM) Constitution Scales.
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Objective To explore the effect of endocrine therapy in breast cancer patients whose estrogen receptor (ER) and progesterone receptor(PR) was preoperatively negative and turned positive after neoadjuvant chemotherapy. Methods The clinical experimental study was carried out in 97 cases of breast cancer which were divided into endocrine treatment group and control group. The follow-up time ranged from 15 to 60 months. Results In endocrine treatment group, 3 and 5-year disease-free survival were respectively 74.5% (38/51), 60.7% (31/51), and 3 and 5-year overall survival were respectively 80%(41/51), 74. 5% (38/51). In control group, 3 and 5-year disease-free survival were respectively 54.2% (26/46), 41.7%(20/46), and 3 and 5-year overall survival were 60.9%(28/46),50%(23/46),respectively. The corresponding values were significantly higher in endocrine treatment group than in control group(P＜0.05).Conclusions Remedy endocrine therapy improves the disease-free and overall survival rate in breast cancer patients with the expression of ER and PR turning positive after initial neoadjuvant chemotherapy.
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Objective To explore the effects of preoperative neoadjuvant endocrine therapy on expression and significance of ER, PR, C-erbB-2 in pestmenopause breast cancer patients over 60 years old. Methods 36 patients were treated with endrocrine therapy by oral tamoxifen for 60 ～ 90 days, and the expression of ER, PR and C-erbB-2 was examined before and after the endrocrine therapy. Results In 36 patients the negative expres-sion rate of ER, PR was 16.78% and 11.11% respectively before the endrocrine therapy, compared to 50% and 33.33% after the endrocrine therapy. There was significant difference(P<0.05). The expression of C-erbB-2 was 13.8% and 16.67% before and after the endrocrine therapy, and there was no significant difference between the two figures. Conclusions The neoadjuvant endocrine therapy by tamoxifen alone can down-regulate the ex-pression of ER, PR, and can inhibit tumor growth. Some patients may get partially relieved.
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Objective To investigate the role of CD4+CD25+Foxp3 regulatory T cells in chronicity of hepatitis B and viral clearance of hepatitis B virus(HBV).Methods Nineteen patients with chronic active hepatitis B(CAH).21 HBV carriers(AsC)and 12 patients with resolved HBV infection and 1 5 healthy controls were enrolled.The frequency and phenotype of peripheral CD4+CD25+Foxp3+ T cells were detected by flow cytometry.CD4+CD25+T cells were sorted by magnetic-activated cell sorting(MACS)assay.Level of Foxp3 mRNA in CD4+CD25+T cells was examined by real time polymerase chain reaction(PCR)assay.The data were analyzed by one-way ANoVA or nonparametric statistics.Results Both frequencies of CD4+CD25+Foxp3+T cells and levels of Foxp3 mRNA in CD4+CD25+T ceils in patients with CAH or AsC were significantly higher than those in healthy controls Or resolved HBV infection(F=6.8,F=3.72,respectively;both P<0.05).Accumulation of Foxp3+T cells in liver tissue of CAH patients was higher than that of healthy controls,while that in AsC was lower than CAH.The frequency of CD4+CD25+Foxp3+T cells of hepatitis B e antigen(HBeAg)positive patients(including CAH and AsC)was significantly higher than that of HBeAg negative patients(t=2.3,P<0.05),and that of antFHBe negative patients were significantly higher than anti-HBe positive patients(t=2.4,P<0.05).Furthermore,the frequency of CD4+CD25+Foxp3 regulatory T cells was positively correlated with serum HBV DNA level of patients with chronic hepatitis B(r=0.56,P<0.01).Conclusion The findings have important implication in the understanding of the role of CD4'CD25'regulatory T cells in chronicity and viral clearance in HBV infection.
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ed in a Chinese pedigree with HHD.
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Objective To examine the changes of brain inhibitory neurotransmitters and their precursors with glutamine supplement. The hypothesis is that the supplement of glutamine may delay the fatigue of central nervous system involved in exercise. Methods Rats were suffered with exhaustion treadmill running after different dosages of glutamine supplement of twenty days duration and sacrificed right after the running. Rat free tryptophan (F-Trp), branched chain amino acids (BCAA) in serum and brain, glucose in serum, and 5-hydroxytryptamine (5-HT) in the brain had been quantified with the double blind procedure. Results The results showed that the serum glutamine had no statistical significance among each group. The ratios of F-Trp/BCAA in the serum and brain were lower significantly in large dosage group than the placebo group. The 5-HT level of large dosage group was lower significantly than the other groups, while serum glucose was significantly higher than all the other groups. The ratios of F-Trp/BCAA in the brain were lower significantly in small dosage glutamine supplement rats than the other groups. Conclusion The results suggest that glutamine supplement take advantage of the balance of serum glutamine level. Glutamine supplement improves rat central nerves performance in long time treadmill running, that may due to the decrease of precursor of inhibitory neurotransmitter and itself, and large dosage supplement is more effective than small one.
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Objective To study the short term and long term response and the safety of the different doses of recombinant interferon alfa 1b(IFN? 1b) for the treatment of the patients with chronic hepatitis B and the predictive factors of the response. Methods 146 Chinese patients with chronic hepatitis B entered randomly into four groups. Three groups were given with IFN ? 1b 3 million unit (MU), 5 MU and 10 MU respectively. The control group was given placebo. The short term(ETR) and long term(SR 12) responses and side effect were observed. Selected nineteen items (host related, drugs related and virus related), which affected the response of IFN alfa 1b probably (host, virus and drugs, et al) were analyzed. Results The end treatment response (ETR) of the IFN ? 1b 5 MU therapy was 55.3%, and 10 MU was 58.1%. Both efficacy were higher than the group of 3 MU IFN alfa 1b (32.6%) and control therapy group (5.9%, P
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Objective Seeking for a new therapy for effectively correc ting hypoxemia of severe hepatitis cases in terms of oxygen-enriched liquids in f usion, for a rapid boost of the pressure of blood oxygen bypassing the pathologi cally damaged alveolus of such patients.Method Intravenous drip with oxygen -enriched liquids for 23 cases who suffered from Severe hepatitis in courses of tre atment varying between 14 to 30 days, 500-700 mL per day.Result For all the 23 c ases, their hypoxemia was gradually corrected to normal in 20 minutes' or 7 hour s du ring intravenous drip with oxygen-enriched liquids and TNF ?IL-6?IL-8 were dec r eased after the treatment courses.The death rate of treatment group was l ess.Conclusion Intravenous drip the oxygen-enriched liquids has effectively helped to corre ct the hypoxemia of severe hepatitis cases bypassing the malady alveolus throug h which the oxygen failed in by conventional oxygen halation. Death rate hase been decreased after the courses .This therapy of oxygen-enriched liquid infusion can be quite useful to save their life in the combined treatment for severe hepatitis.
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Objective To investigate the prevalence of TT virus infection in pregnant women in Shenzhen and the role of mother-to -child transmission route in the TTV infection. Methods TTV DNA were detected by nested PCR in sera, cord blood and breast milk samples from 400 mother-infant pairs. TTV DNA positive mothers were followed up for 6 months for monitoring TTV DNA. Thirty two TTV DNA PCR products amplified from blood and milk samples of 13 mother-infant fairs were cloned and sequenced. Results By means of PCR, TTV DNA were detected in 62 of mothers' serum samples, 4 of 400 cord blood samples, and 20 of 400 milk samples, respectively. Therefore, 6.5%(4/62) of infants are likely to be infected with TTV from their mothers during the fetal period. Direct sequencing of TTV DNA from 13 mother-child pairs showed identical isolates (nucleotide homology from 97.5% to 99%), Follow-up sera of 42children, whose mothers were TTV DNA positive, showed 16 cases turned out to be existence of TTV viremia at 6 months old. Conclusions Our data proved the mother-to-child transmission route of TTV infection.TTV can be transmitted transplacentally and postnatally by the way of breast feeding as well. The increase of TTV prevalence during the 6 months after birth, suggests the postnatal transmission route of TTV may be of more importance, and further study is needed to address whether preventive measure should be done.