ABSTRACT
Objective: To investigate the discordance for estrogen receptor (E R), progestin receptor (PR) and human epidermal growth factor receptor 2 (Her-2) expressions in the primary lesion of breast cancer and ipsilateral axillary lymph node metastases, and to discuss the effect of discordance on the prognosis of patients. Methods: The climical materials and pathological samples of 120 cases of breast cancer patients with ipsilateral axillary lymph node metastasis were collected. The expressions of ER, PR, Her-2 and Ki-67 in the primary lesion and axillary lymph node metastasis of the breast cancer patients were detected by immunohistochemistry. Paired Chi-square test was used to analyze the differences in the receptor expressions between the primary lesion and the axillary lymph node metastasis. Chi-square test was used to evaluate the correlations between the Ki-67 expression and the receptor expressions and the correlations between the clinical characteristics of breast cancer and the expression differences in ER, PR and Her-2. Spearman correlation analysis was used to analyze the correlations between the clinical stages of breast cancer and the expression differences of ER, PR and Her-2. Survival analysis was conducted by Kaplan-Meier method. Results: There were some differences in the expression of levels of ER, PR and Her-2 between the primary lesion and the ipsilateral lymph node metastasis, but there was no statistically significant differences (P> 0. 05). The clinical stages of breast cancer were related to the expression differences of ER and PR (P < 0 . 05). The Ki-67 expression was significantly associated with the expressions of ER and PR in primary lesion of breast cancer patients (P < 0 . 05). There were a statistically significant differences in the overall survival (OS) and disease-free survival (DFS) between concordant and discordant cases for ER status in the primary lesion and the corresponding lymph node metastasis (P < 0 . 05). The OS and DFS were significantly lower in the discordant cases for ER status. The OS and DFS of the patients with ER-positive in the primary lesion and ER-positive in the lymph node metastasis were higher than those of the patients with ER positive in the primary lesion and ER negative in the lympy node metastasis (+ /+ vs. +/ -) (P
ABSTRACT
Objective To compare the application of two different radial artery puncture and cannulation methods in septic shock patients. Meth-ods A total of 80 septic shock patients who need emergency operation were enrolled in this study. The shock index was>1.0. The patients were randomly divided into two groups:ultrasound group(group U)and palpation group(group A),with 40 cases in each group. For the patients in group U,Sonosite S-Nerve ultrasound in the wrist was used to determine the location of the radial artery puncture. For the patients in group A ,pal-pation method was used to determine the location of the radial artery puncture. The heart rate,blood pressure,first puncture success rate,total suc-cess rate,number of punctures,puncture time and complication rate of the two groups were monitored. Results The success rate of first puncture and total success rate of group U were higher than those of group A ,the number of puncture was less than that of group A ,the puncture time was shorter than that of group A,and the incidence of complications was lower than that of group A(P<0.05). Conclusion The application of ultra-sound for radial artery puncture and catheterization in septic shock patients is accurate ,and with higher first success puncture rate and total success rate,less number of puncture,shorter puncture time,and lower incidence of complications compared with palpation method.