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HER2 gene is expressed in 20%-30% of breast cancer patients, and HER2 expression provides a new direction for treatment. However, breast cancer with positive HER2 still has a poor prognosis and is prone to recurrence and metastasis. Trastuzumab is a classic basic drug for anti-HER2 therapy. However, the problem of primary and acquired drug resistance of trastuzumab has attracted people's attention. Studies have found that the occurrence of insensitive and drug resistance mechanism is related to PD-L1 up-regulation on tumor cell surface. Therefore, a large number of studies on PD-1/PD-L1 inhibitor combined with trastuzumab were carried out to improve its sensitivity and drug resistance. This article reviews the preclinical and clinical studies on PD-1/PD-L1 inhibitors in breast cancer with positive HER2.
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Objective To provide application stellate ganglion block treatment of hot flashes′latest data by clinical.Methods 24 patients who were put in the research were taken record of each patient after stellate ganglion block when two months later,especially of the clinical symptoms and hot -flashes -onset,and they were asked to fill a symptom questionnaire for each one.The main concern of hot flashes in patients with seizure frequency of hot flashes and score changes were observed.The data were analyzed.Results After the implementation of stellate ganglion block,the number of episodes of hot flashes in breast cancer patients,and ratings declined,and after 6 weeks decreased by 46% and 49%.21 patients observed in Horner's syndrome.Conclusion Stellate ganglion block for the control of hot flashes in breast cancer is effective.
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Objective To investigate the value of one-stage lymphatics-venous anastomosis in radical mastectomy of breast cancer to prevent post-mastectomy upper limb lymphedema.Methods Ninety patients requiring radical mastectomy of breast cancer in Tangshan Tumor Hospital Affiliated to North China University of Science and Technology from March 2010 to May 2013 were collected as the objects.They were divided into the control group (45 cases) and the treatment group (45 cases) using block randomized grouping (concealment of allocation).Both groups underwent radical mastectomy of breast cancer, and the treatment group was treated with one-stage lymphatics-venous anastomosis on the basis of radical mastectomy.The operation times, amount of bleeding, hospitalization times, postoperative complications and the numbers of axillary lymph node dissection of the patients in the two groups were compared, and the postoperative upper limb lymphedema incidence rates of the patients in the two groups were compared.Results The operative times of the patients in the treatment group and the control group were (152.82 ± 18.76) min and (78.92 ± 10.33) min respectively, and amount of bleeding were (416.64 ± 94.65) ml and (250.84 ± 63.17) ml, with statistical significances (t =-20.39, P =0.00;t =-4.48, P =0.00).The average hospitalization times of the patients in the treatment group and the control group were (14.91 ± 5.44) d and (13.45 ± 2.36) d respectively, the numbers of axillary lymph node dissection were 14.63 ± 3.37 and 14.37 ± 3.18, the numbers of postoperative complications occurred were 9 cases (20.00％) and 5 cases (11.11％), with no statistical significances (t =-0.47, P =0.64;t =0.75, P =0.46;x2 =1.35, P =0.38).Compared with the control group, the treatment group has lower incidence of upper extremity lymphedema (13.95％ vs.40.91％) and lower swelling degree, with statistical significance (x2 =8.48, P =0.03).Conclusion One-stage lymphatics-venous anastomosis in radical masteetomy of breast cancer can effectively transfer lymph diversion to the venous circulation and reduce the incidence of limb lymphedema, which has significant preventive effect.
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The tralning system for orthopedic surgeon in Britaln is mature and complete. After completing education in medical college, medical students receive a 2-year base tralning (FY1, FY2), which focus on learning and consolidating basic medical knowledge and clinical skill, followed by a 6-year specialist tralning, which subdivides into tralning of ankle and foot, hand, should and elbow, hip, knee, spine, and pediatric surgery, provided by several district hospital (Peripheral hospitals). Students are required to return to teaching center for review, ward inspection, case discussion at regular inter-vals. Compared with the specialist tralning system based on the hospital staffs in chi-na, the role ofsocial workersin British during the period of tralning makes better mobility of tralnee among medical institutions and medical treatments, which makes the tralning more comprehensive and professional. In addition, there is no consistent system for examination and admittance of specialist, and awareness of specialist tralning among medical institutions and doctors is weak. Therefore, it should be done to form a single tralning system and unify the tralning specification and assessment standard.
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Background and purpose:B-cell translocation gene 1(BTG1) can inhibit cell proliferation, promote cell apoptosis and regulate cell cycle progression and differentiation in a variety of cell types. This study aimed to explore the inlfuence on cell proliferation, apoptosis and cell cycle and its related mechanism of laryngeal cancer Hep - 2 cell lines through BTG1 overexpression byin vitro experiments.Methods:The BTG1 expression plasmids were constructed and transfected into Hep-2. They were divided into experimental group (transfected BTG1 of Hep-2 cells) and control group (transfected empty plasmid of Hep-2 cells). Western blot method was used to identify BTG1 protein expression levels of cells; proliferation activity of cells was detected by MTT assay; lfow cytometry was used to analyze the cell cycle distribution and AnnexinⅤ-FITC/PI cell apoptosis; Western blot was also used to assay cell cycle regulatory protein and apoptosis-related protein expression.Results:The pEGFP-N1-BTG1 plasmid was constructed successfully, and the expression of BTG1 protein was higher in experimental group than that in control group (0.921±0.091vs 0.308±0.047,P<0.05). Compared with the two group of laryngeal cancer Hep-2 cells, the cell growth in experimental group was slowed down and the proliferation was reduced (P<0.05); Cyclin D1 protein expression level was decreased (0.436±0.023vs 0.916±0.092,P<0.05), the proportion of G0/G1 phase cell cycle was increased [(85.1±5.2)%vs (63.8±3.1)%,P<0.05], the proportion of S phase cell was decreased [(8.3±1.1)%vs (23.1±1.5)%, P<0.05], phosphatidylserine ectropion in experimental group was increased, cell early apoptosis was significant [(10.3±1.1)%vs (2.8±0.3)%,P<0.05] and anti-apoptotic protein Bcl-2 expression level was reduced(0.167±0.009vs 0.834±0.084,P<0.05).Conclusion:BTG1 high expression could inhibit the proliferation growth of laryngeal Hep-2 cells and promote its apoptosis, and the possible mechanisms are interrelated with BTG1 involved in cell cycle regulation and causing cell apoptosis.
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Objective To compare the complication and cost-effectiveness of the deep inferior epigastric perforator(DIEP) flap and transverse rectus abdominis myocutaneous(TRAM) flap.Methods From January 2000 to December 2014,all patients who underwent DIEP flap and TRAM flap in the People's Hospital of Tangshan and the Affiliated Hospital of North China University of Science and Technology, were selected.Eleven patients underwent immediate breast reconstruction with TRAM flaps and 19 patients with DIEP flaps.The treatment cost,length of hospitalization, and complication in the two year after surgery for each group were compared.Results For the major complications,there were 5 cases appeared fat necrosis in TRAM group, and 1 case in DIEP group,the differences was statistically significant(P=0.016).One case appeared flap loss in TRAM group,and DIEP group was zero,both of the two group had no abdominal wall hernia, there was no significant difference (P ＞ 0.05).For the minor complications, there were 4 cases appeared postoperative hematoma in TRAM group, and 1 case in DIEP group, the difference was statistically significant(P =0.047).Two cases appeared wound dehiscence in TRAM group,and DIEP group was 1 case, 1 case happened infection in TRAM group,there was no statistically significant difference(P＞0.05).The treatment costs were (14 133.12±1 546.88)yuan for the TRAM group and (16 838.94± 3 006.05)yuan the DIEP group, the difference was statistically significant (P =0.010).The hospital stay was (17.28± 2.08)days for the pedicled TRAM group and (18.39±2.87) days for the DIEP group,the different was not statistically significant(P＞0.05).Conclusion The DIEP flap has a better clinical outcomes,but more expensive.
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Objective:To evaluate the clinical effects of oncoplastic breast-conserving surgery on patients with early breast can-cer near the mammary areola. Methods:A total of 60 patients with early breast cancer underwent breast-conserving surgery in the Sec-ond Department of Breast Surgery, Tangshan People's Hospital from February 2011 to November 2013. These patients were random-ized into two groups, namely, the experimental Group A (n=30) and the control Group B (n=30). Oncoplastic breast-conserving surgery was performed on the patients in Group A, whereas Group B underwent standard breast-conserving surgery. The specimen weight of the locally excised breast, the nearest distance of the tumor to the surgical margins, and the postoperative cosmetic result of the affected breast were compared between the two groups. Results: The specimen weights of the locally excised breast were 71.03 ± 12.92 and 41.53±7.13 g, and the nearest distances of the tumor to the surgical margins were 13.30±2.97 and 10.63±1.65 mm in Groups A and B, respectively, with significant differences between the two groups (P0.05). Con-clusion:A larger amount of excised breast tissue and a wider scope of surgical margins were observed in Group A patients. However, the postoperative cosmetic result of the affected breast was almost similar for both groups. Therefore, oncoplastic breast-conserving sur-gery is a feasible and effective approach for early breast cancer patients.
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Objective:To evaluate the clinical value of activated carbon nanoparticles for guiding lymphadenectomy in advanc-ing rectal cancer. Methods:Eighty rectal cancer patients who underwent laparoscopic curative resection for rectal cancer were divided into two groups:control group (40 cases) and experiment group (40 cases). The experiment group received carbon nanoparticle-labeled lymph nodes in surgery. The number of lymph nodes, lymph nodes≤5 mm in size, and positive lymph nodes, as well as the side effect of the procedure, were analyzed. Results:No complications were observed in the experiment group. The experiment group showed sig-nificantly higher values (P<0.05) than the control group for average number of lymph nodes (25.5 ± 8.78 vs. 16.05 ± 4.84), lymph nodes≤5mm in size (22.6 ± 8.25 vs. 13.65 ± 4.62), and positive lymph nodes (3.13 ± 4.14 vs. 1.35 ± 2.06). During operation, two dyed lymph nodes in two cases were found at the roof of the inferior mesenteric artery and along the side of the internal iliac artery. Dissec-tion was extended for these patients and the dyed lymph nodes were confirmed to be positive. Conclusion:Local injection of activated carbon nanoparticles around the tumor during surgical exploration was an effective, secure, and easy approach for guiding lymphade-nectomy in rectal cancer patients.
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Objective To observe therapeutic effect of levobupivacaine and roplvacaine in curing seroma after modified radical mastectomy of breast cancer by satellite ganglion block. Methods A total of 90 patients were collected and randomly divided into three groups. L group (Levobupivacaine) included 30 patients. 30 patients were in R group(roplvacaine). The rest 30 patients in the control group were treated without satellite ganglion block. The amount of drainage, the condition of incision concrescence, the number of drainage tube pulled out before the treatment as well as on the seventh day and tenth day after the treatment were recorded respectively. Results Statistical significance was found between C group and L, R group in prior and post treatment, the amount of seroma decreased on each observation point (P ＜ 0.05), the number of drainage tube pulled out increased ( P ＜ 0.05 ). No significant differences were found between L and R group ( P ＞ 0.05). Conclusion The application of levobupivacaine and roplvacaine in curing seroma after modified radical mastectomy of breast cancer by satellite ganglion block was safe and effective, both of them could be used.
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Objective To evaluate the effects of stellate ganglion block(SGB) in treating seroma after modi-fled radical mastectomy of breast cancer.Methods 76 patients were treated with SGB besides local compressed bind-ing and were evaluated after ten days.Results There were ten seroma with the incidence rate of 13.2% and no skin flap necrosis.Conclusions SGB combined with local compressed binding could treat secroma after modified radical mastectomy of breast cancer.
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Objective To observe the effects of stellate ganglion block (SGB) on humoral immunity func-tion in patients who received modified radical mastectory (MRM). Methods Eigty female patients were randomly divided into control group(group Ⅰ ,n =40) and intervention group (group Ⅱ,n =40). Blood samples were taken pre-intervention (T1), after intervention ( T2 ) and 30 rain after operation ( T3 ) for the determination of lgG, IgA, IgM. Results Compared with T1, IgG, IgA, IgM at T2 and T3 in two groups were lowered, IgG [ ( 11.8±2.2 ) g/L vs (9.5 + 1.5) g/L,t = 5. 4630,P =0.0041 ] and IgA [(1.9±0.3)g/L vs (1.7±0.4) g/L,t =2. 5298,P = 0.0134 ] at T3 in group Ⅱ were significantly different as compared with that of group Ⅰ ; IgM at T2 [ (2.5±0.8 ) g/L vs (2.1±0.6)g/L,t =2.8276,P=0.0072] and T3[ (2.1±0.5)g/L vs (1.6±0.5)g/L,t =4.4721,P = 0.0000 ] was significantly different between the two groups. Conclusions Preoperative-SGB can improve the inhibi-tion degree of humoral immunity caused by modified radical mastectory.