ABSTRACT
Objective To analyze the effect of neoadjuvant chemotherapy in patients with breast cancer , and further to explore its mechanism in order to provide a reliable basis for its clinical application .Methods 425 cases of breast cancer patients admitted from Jan .2010 to Jun.2014 were the research object , and they were divided into the control group(n=322)and the observation group(n=103).The control group received operation treatment and the observation group were added with neoadjuvant chemotherapy besides routine operation treat -ment.Incidence of clinical efficacy and adverse reactions of the 2 groups were statistically analyzed .Changes of vascular endothelial growth factor ( s-VEGF) and microvessel density ( MVD) levels before and after treatment were compared between the 2 groups.VEGF-A, the positive rate of VEGF-C and estrogen receptor(ER), progesterone receptor(PR), human epidermal growth factor receptor-2(HER2), and P53 before and after treatment were com-pared between the 2 groups.Results The total effective rate was obviously higher in the observation group than in the control group(77.7%vs 53.7%,χ2 =18.6, P0.05).s-VEGF and MVD had no statistical difference between the 2 groups before treatment(P>0.05)while they were significantly lower in the observation group than those in the control group after treatment (P<0.05).The positive rate of VEGF-A, VEGF-C, ER, PR, HER-2, and P53 had no statistical difference while they were obviously lower in the observation group than those in the control group ( P<0.05 ) .Conclusions NAC can help to improve the operation efficiency in pa-tients with breast cancer , reduce s-VEGF and MVD levels and play a role in reducing the positive rate of VEGF-A, VEGF-CER, PR, HER-2 and P53.It is an effective adjuvant treatment for breast cancer with less adverse re-actions, which is worthy of clinical application .
ABSTRACT
Objective To investigate clinical effect of Miccoli surgical thyroid bilateral subtotal resection for Graves disease,to provide a reference for clinical treatment.Methods 80 patients with Graves disease were selected, they were divided into the observation group and the control group according to the surgical approach.44 patients in control group were taken small incision under direct vision routine bilateral subtotal thyroid treatment,36 patients in the observation group took Miccoli surgical.Surgical success rate,surgical index were compared between two groups. Results The patients of the two groups were operated smoothly,the success rate was 100.00% in the observation group,the incision length,blood loss,operative time were (3.04 ±0.64)cm,(32.25 ±3.29)mL,(81.19 ±6.68)min respectively,which were significantly less than those of the control group,the differences were statistically significant (t =5.214,P =0.004;t =14.514,P =0.000;t =6.514,P =0.001).The VAS score,length of stay,incidence rate of complication in the observation group were (1.93 ±0.43),(3.82 ±0.79)d,5.26%,which were significantly better than those in the control group,the differences were statistically significant (t =5.697,P =0.003;t =4.654,P =0.009;χ2 =11.214,P =0.000).The hospitalization cost of the observation group was (9 043.65 ±565.76)Yuan, which was significantly higher than the control group,the difference was statistically significant (P <0.05).The cut rating of the observation group was (8.35 ±2.15)points,which was significantly higher than the control group,the difference was statistically significant (t =8.364,P =0.001 ).The hyperthyroidism relapse during follow -up,the incidence of thyroid dysfunction between the two groups had no significant difference (χ2 =0.568,P =0.311;χ2 =0.604,P =0.294).Conclusion Miccoli improved surgical incision and under direct vision thyroid bilateral subtotal resection both have similar clinical effects for Graves disease,Miccoli surgery has smaller trauma,more satisfaction incision,but under direct vision small incisions has lower treatment costs.