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Objective@#To explore the clinical application of the deep inferior epigastric artery perforator flap in bilateral breast reconstruction of patients with breast cancer.@*Methods@#Deep inferior epigastric artery perforator flap was applied for breast reconstruction in four cases of breast cancer patients received radical or modified radical surgery in Hunan Provincial Cancer Hospital. All patients are female, age ranged from 31 to 53 years old (36.2±5.9).@*Results@#The length of flap was (15.1±0.4) cm, the width of flap was (12.6±0.3) cm, the thickness of flap was (4.3±0.5) cm. The length of pedicle was (12.6±0.3) cm, the outer diameter of artery was (1.8±0.2) mm, the outer diameter of vein was (2.1±0.4) mm.The average weight of flaps was 235 g(ranged from 195 g to 335 g). In one case flap fat necrosis occurred and in other one donor site fat necrosis was noted. The two flaps both healed with dressing treatment and no other complications were found. The reconstructed breasts′shape, texture and elasticity were good and no flap contracture deformation happened. Only linear scar left in the donor sites, the function of abdomen did not affected. All 4 patients were followed up for 14 to 33 months (21.7 months on average) with satisfied result. No local recurrence happened.@*Conclusions@#Free deep inferior epigastric artery perforator flap is suitable to reconstruct bilateral breast for breast cancer patients.
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Objective To investigate the characteristic sonographic and pathological features of breast ductal carcinoma in situ (DCIS) without microcalcifications on mammography (MG).Methods Forty cases of DCIS without microcalcifications on MG were retrospectively reviewed.The 40 lesions were classified into mass and non-mass groups according to their sonographic findings.The pathological subtypes and nuclear grades of these cases were also analyzed.Fisher exact test was used to compare the differences of the sonographic accuracy rate,sonographic microcalcification rate,pathological nuclear grade and subtype rate between mass and non-mass groups.Results No abnormal finding was found in sixteen cases (40.0％)on MG and only one case (2.5％) on ultrasonography (US),respectively.The most common sonographic feature of DCIS without microcalcifications on MG were masses (75.0％,30/40),and other sonographic findings were round/oval and irregular shape,microlobulated margin,heterogeneous hypoechogenicity and isoechogenicity,and posterior acoustic feature.Ductal dilatations and heterogeneous isoechogenicity were present in most non-mass lesions of DCIS without microcalcifications on MG (22.5％,9/40).The ultrasonographic microcalcifications were found in 5 cases of DCIS without microcalcifications on MG.The common pathological features of DCIS without microcalcifications on MG were medium-low nuclear grade (85.0％,34/40) and noncomedo (87.5％,35/40).The difference of US accuracy rate in mass and non-mass groups was statistically significant [73.3％ (22/30) vs 33.3％ (3/9),P=0.047].The differences of US microcalcification rate,pathological subtype and nuclear grade were not significant (P=1.000,0.070).Conclusions The mass appearance and medium-low nuclear grade were most common sonographic findings and pathological features of DCIS without microcalcifications on MG.Ultrasonography should be an helpful tool for improving the diagnostic sensitivity ofmammography in breast DCIS.
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Background and purpose:Estrogen receptor (ER)-positive breast cancer always presents a dilemma for resistance to endocrine therapy in a long time. The recent studies showed that the expression of estrogen-responsive ifnger protein (Efp) and polo-like kinase 3 (Plk3) had a close relationship with breast cancer development. This study was to explore the expression correlation between Efp and Plk3 in ER-positive breast cancer in order to understand the inlfuence of Efp and Plk3 on the drug resistance.Methods:The expression of Efp and Plk3 in 74 cases of ER-positive breast cancer was detected by SP immunohistochemistry. The clinical signiifcance was then analyzed. Real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot were used to detect the expression of Efp and Plk3 in ER-positive MCF-7 cells.Results:No signiifcant relationship was found between Efp and Plk3 expression and the clinicopathological features of 74 cases of ER-positive breast cancer (P>0.05). The number of cases whose Efp showed positive expression was 51 (68.9%), while the number of cases whose Plk3 showed positive expression was 23 (31.1%). Chi-square test analysis showed the expression of Efp and Plk3 was negatively correlated in 74 cases of ER-positive breast cancer (χ2=8.837,P<0.05). The result of RTFQ-PCR showed that the expression of Efp mRNA in MCF-7 cells was up-regulated by estrogen stimulation, whereas Plk3 mRNA was not changed. The result of Western blot showed that the expression of Efp protein in MCF-7 cells was increased by estrogen and MG132 stimulation, whereas Plk3 protein was decreased.Conclusion:The expression of the Efp protein is negatively correlated with Plk3 protein in ER-positive breast cancer. High expression of Efp may be involved in the resistance to endocrine therapy.
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Objective To investigate the effect of neoadjuvant chemotherapy on the proportion of G0-G1 phase cells and the expressions of ATP-binding cassette sub-family G member 2 (ABCG2)and CD44 +CD24 -/low in breast cancer patients.Methods Sixty untreated cases with breast invasive ductal carcinoma from May 201 3 to March 201 4 were chosen.All patients were tested by core needle biopsy and pathological diagno-sis,then treated by neoadjuvant chemotherapy.The proportion of G0-G1 phase cells and the contents of ABCG2 and CD44 +CD24 -/low before and after therapy were compared.Results After chemotherapy,the contents of ABCG2 and CD44 +CD24 -/low were (25.1 0 ±1 .50)% and (36.40 ±3.80)/1 05 ,and the proportion of G0-G1 phase cells was (70.50 ±1 .50)%,which were higher than those before treatment [(1 5.88 ±1 .22)%, (25.00 ±3.40)/1 05 ,(60.65 ±1 .30)%](t =8.685,P <0.05;t =9.226,P <0.05;t =8.898,P <0.05).All patients completed four courses of chemotherapy,and the cCR rate,cPR rate,SD rate were respec-tively 1 8.3% (1 1 /60),73.3% (44 /60),8.3%(5 /60).Conclusion Cell cycle can be arrested and the proportion of stem cells can be raised after neoadjuvant chemotherapy which has exact curative effect and clini-cal popularization value.
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0.05).The results of Western blotting and immunohistochemical method showed that HO-1 protein expression increased in DOX group and DOX-IR group,and was negative in normal group.More distruction of ultrastructural changes of hepatic cells in IR group was found than in DOX-IR group by transmission electron microscope.Conclusion Doxorubicin pretreatment could protect the liver from ischemia-reperfusion injury,which may be related to HO-1 expression induced by doxorubicin,low dosage of doxorubicin does little harm to rat liver.
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<p><b>OBJECTIVE</b>To study the quantitative measurement of the extent of malrotation after interlocking intramedullary nailing of femoral shaft fracture.</p><p><b>METHOD</b>CT scan ("routine method") applied in 36 femoral shaft fractures that had been treated with close reduction and interlocking intramedullary nailing. For the judgement of the extent of malrotation, the anteversion of both fracture side and contralateral side were measured and the difference between the 2 sides was evaluated. The increase of anteversion represented internal rotation of the distal fragment, whereas the decrease of anteversion represented external rotation.</p><p><b>RESULTS</b>The maximum anteversion of the fracture sides, whereas 48 degrees, the minimum anteversion -10 degrees, the mean value, 15.04 degrees, and the standard error is 11.34 degrees. The maximum anteversion of the contralateral side, whereas 31.3 degrees, minimum -4.8 degrees, the mean value was 13.96 degrees and the standard error was 10.20 degrees (P < 0.001). Compared with the contralateral side, half of the 36 cases showed increased anteversion and the other half decreased anteversion. The mean value of internal rotation is 11.56 degrees, and external rotation 9.39 degrees. The maximum internal rotation was 37 degrees, the minimum 0.9 degrees. Eight cases had internal rotation less than 8 degrees, 6 between 10 degrees - 15 degrees, and 4 over 15 degrees. The maximum external rotation was 24.3 degrees, and the minimum 1.8 degrees. Eleven cases had external rotation less than 10 degrees, 4 between 10 degrees - 15 degrees and 3 over 15 degrees. The incidence of malrotation more than 10 degrees was 47% (17/36), and more than 15 degrees 19.4% (7/36).</p><p><b>CONCLUSION</b>The incidence of malrotation after femoral shaft fracture treated with close reduction and interlocking intramedullary nailing is high. Attention should be paid to clinical management and strict control for rotational reduction intra-operatively.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Bone Nails , Femoral Fractures , Diagnostic Imaging , Pathology , General Surgery , Fracture Fixation, Intramedullary , Methods , Rotation , Tomography, X-Ray ComputedABSTRACT
Objective To evaluate the surgical method and results of the treatment of chronic rupture of the Achilles tendon using V Y tendinous flap. Methods Nine cases with old rupture of the Achilles tendon, with a mean course of illness of 112 days, were treated with V Y tendinous flap and the tendon gap was 3.2～ 6cm,averaging 4.6cm. Results The mean period of follow up was 2.7 years. The Arner Lindholm method was used to assess the results of surgical treatment, 7 cases of the 9 had excellent results (77.8% ) and 2 cases had good results (22.8% ), with the excellent and good rate being 100% . Conclusion The V Y tendinous flap is a simple and good method for treatment of old rupture of the Achilles tendon.
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Objective To study the surgical therapy and pre vention of the complications of the d istal femoral fractures.Methods From 1999to 2001,348patients with d istal femoral fractures were treate d oper-atively.Screw,DCP,condylar blade plate,DCS,condylar buttress plate and antegrade interlocking nail were used.Results13internal fixations failed,and 8c ases received second bone graft for d elayed union.Infection occurred in 14cases,late limb shortening(1～4cm)in 18cases,and 52cases underwent re leasing operations because the flexion of the knee was le ss than 90?.Conclusion An operation can get good results in t reatment of the distal femoral fractures.[
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Objective To explore the suppressive effect of survivin antisense oligonucleotide on transplanted human breast cancer in nude mice. Methods 30 nude mice were transplanted with human breast cancer MCF-7 cells to construct tumor models, which were divided into three groups (10 mice per group): (Lipofectin), ASODN/Lip, and NODN/Lip were injected in to the tumor or around the tumor, respectively. A total of 3 injections were given, once every five days. Observations were made on tumor suppression rate, tumor volume and changes in weight of the animals. TUNEL method and transmission electron microscopy were used to investigate cell apoptosis of the tumor; western blot was used to detemine the expression of survivin protein in the 3 groups. Results The subcutaneous tumor model in nude mice was successfully established. The tumor volume in the group of ASODN/Lip decreased during treatment, the rate of tumor suppression reached 70.10%; while the tumor volume of the other two groups increased. There was no statistical (difference) among the groups in weight changes of the 3 groups mice, the apoptosis rate in ASOND/Lip group was 38.6% detected by TUNEL and the rate was markedly higher than the other two groups(P