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Objective:To explore the clinical application of lateral thoracic artery perforator flap in repairing local defect after breast conserving surgery.Methods:The clinical data of 48 breast cancer patients planned to finish breast conserving surgery were retrospectively analyzed. The patients were divided into plastic breast-conserving group and routine breast conserving group. In the plastic breast-conserving group, 24 patients local defect repaired with the lateral thoracic artery perforator flap. In the routine breast conserving group, 24 patients local defect repaired with the fascial flap around the cutting edge. The operation related indexes and cosmetic effect from two groups were compared.Results:Both groups of patients successfully completed breast conserving surgery. The plastic breast-conserving group patients had significantly increased in operation time, operative blood loss, incision length and drainage tube indwelling time compared with the routine breast conserving group; the differences were statistically significant ( t=6.99, 9.37, 21.74, 8.80, P<0.05). The rate of secondary surgery enlarged was lower than fhat in the routine breast conserving group, and the difference was statistically significant (χ 2=4.76, P<0.05). There were 3 cases in the plastic breast conserving group and 1 case in the conventional breast conserving group. The skin at the edge of the flap was ischemic necrosis in the 4 cases, which healed after dressing change and drainage, and there was no significant difference ( P>0.05). The evaluation of postoperative cosmetic effect showed that the excellent and good rate of the observation group was 91.7%, compared with the routine breast conserving group (58.3%); the difference was statistically significant (χ 2=7.11, P<0.05). All patients were followed up for average 24 months, and local recurrence and distant metastasis were not observed. Conclusions:The lateral thoracic artery perforator flap for filling local defects in the lateral quadrant or central region of breast cancer is feasible, easy to operate, hides incision scar, better cosmetic effect and worthy of clinical promotion.
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Objective To investigate the etiology and novel treatment of plasma cell mastitis (PCM).Methods 145 cases of PCM undergoing massage dredge,ductal lavage and local amalgesic injection from Jan.2011 to Dec.2012 were retrospectively analyzed.Results 145 cases of PCM underwent conservative treatment for 2 to 8 weeks,among whom 128 cases were cured and the other 17 cases underwent surgical treatment for poor outcome.Among the 128 cases undergoing conservative treatment,9 cases had relapse during the follow-up of 12 to 36 months.Conclusions The combined treatment of massage dredge,ductal lavage and partial closed treatment is effective for patients with PCM,and it can keep patients from having mastectomy and reduce the recurrent rate.
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Objective To investigate the correlated factors of pulmonary metastasis of hepatocellular carcinoma (HCC),so as to provide theoretical evidences for the prevention and treatment.Methods The clinical data of 862 patients with HCC who were admitted to the First Affiliated Hospital of Fujian Medical University from January 2008 to March 2012 were retrospectively analyzed.There were 107 patients with pulmonary metastasis.Factors including serum alpha fetoprotein (AFP) level,serum gamma-glutamyl transpeptidase (GGT) level,hepatitis B virus (HBV) infection,presence and treatment of intrahepatic tumor were analyzed to screen out relevant factors of pulmonary infection of HCC.Univariate and multivariate COX regression model analysis were performed for data analysis.Results The results of univariate analysis showed that high level of AFP (≥400 μg/L),ultra-high level of GGT (≥ 150 U/L),presence of HBV infection,the number of intrahepatic tumors ≥2,no radical resection (or radiofrequency ablation) for intrahepatic tumors,combining with tumor thrombi in the vessels,lymph node metastasis were risk factors of pulmonary metastasis of HCC (RR =1.986,3.653,0.365,3.675,0.252,0.379,0.352,P ＜ 0.05).The results of multivariate analysis showed that high level of AFP (≥400 μg/L),HBV infection,the number of intrahepatic tumors ≥2,no radical resection (or radiofrequency ablation) for intrahepatic tumors,combining with tumor thrombi in the vessels were risk factors of pulmonary metastasis of HCC (RR =2.391,3.462,3.425,3.396,2.418,0.638,P ＜ 0.05).Conclusions AFP ≥400 μg/L,HBV infection,the number of intrahepatic tumors ≥ 2,no radical resection (or radiofrequency ablation),tumor thrombi in the vessels and lymph node metastasis are risk factors of pulmonary metastasis of HCC.Anti-hepatitis virus treatment and early treatment are helpful for the prevention and treatment.
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Objective To investigate the value of high frequency 2-Dimensional and color Doppler flow imaging combined with mammography on the diagnosis of breast cancer. Methods 90 patients with breast cancer and benign breast lesions in 22 cases, respectively, separate by color Doppler ultrasound and mammography and their combination were compared. Results The blood flow signals were Ⅱ～Ⅲ grade(76.32% ) in breast cancer and benign breast lesions less blood flow to 0 ～Ⅰ grade ( 87.10% ); The detection rate of blood flow 89.48% in breast cancer were significantly higher than 38.71% in benign breast lesions ( x2 = 4.57, P ＜ 0. 05 ); 68 cases (75.5 % ) were diagnosed by mammography 38 cases(55.8% ) in diameter≤2. 0em were significantly higher than 30 cases(44.4% ) in ≤ 1.0 cm( x2 = 3.97, P ＜ 0. 05 ); The corresponding rate of Joint Inspection 85.7 % (96/112) was higher than the r 72.3% (81/112) in color Doppler ultrasound and 75.8% (85/112) in mammography ( x2 = 3.87, x2 = 3.85, all P ＜0. 05 ). Conclusion Color ultrasonography combined with mammography could raise diagnostic rate of breast cancer.Their combination is the best one of breast imaging examinations.
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Objective To study the curative effect of breast-conserving therapy in patients with breast cancer.Methods 100 cases with breast cancer were divided into breast-conserving therapy 50 cases and radical therapy 50 Cases.The primary manner was wide excision of tumor and dissection of axillary lymph node.Adjuvant radiotherapy,chemotherapy and incretion treatment were given postoperatively.Results In 100 cases of breast cancer,the surviral of 83 cases(83.0%),17 patients(17.0%)died,30 cases(30.0%)of metastasis,local recurrence in 13 cases (13.0%);ER,PR-positive are 62 cases(62.0%),both wholly negative in 18 cases(18.0%),ER-positive only 12cases(12.0%),only 8 cases(8.0%)of PR positive;comparing two groups,survival and recurrent rate had no significant difference(X2=3.503,X2=4.284,P＞0.05),metastasis rate was significant different(X2=6.789,P＜0.05);satisfaction degree was 99.0% more than 12 months,and got ideal appearance was over 90%.Conclusion Breastconserving therapy can get long-term effect like Auchineol's.Breast-conserving therapy can gain good cosmetic resuits.
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Objective To assess the value of the resection of mammary intraductal tumors under ultra-fine fiberoptic ductoscopy.Methods Ductoscopic examinauions were performed in 312 patients with nipple discharge,and those with positive findings of intraductal tumors were given further surgical treatment.The location of lesions was determined according to the position of skin projection of the cold light source,the passage of the mammary ducts was determined depending on the direction of intraductal dilatator,and the distribution of the distal ends of mammary ducts was determined with methylene blue staining.Results Intraductal tumors were found in 78 cases,including solitary papilloma in 68 cases,papillomatosis in 5 cases,and intraductal carcinoma in 5 cases.The lesions were located at the major mammary ducts in 22 cases(28.2%,22/78),at the first branches of segmental ducts in 38 cases(48.7%,38/78),at the second branches in 14 cases(17.9%,14/78),at the third branches in 3 cases(3.8%,3/78),and at the fourth branches in 1 case(1.3%,1/78).The distance between the lesions and the lacteal outlet was 1~5 cm(mean,2.5 cm).All the 78 cases were surgically treated.Postoperative pathological findings revealed 65 cases of papilloma,8 cases of papillomatosis,and 5 cases of intraductal carcinoma.The diagnostic accordance rate of ductoscopy was 96%(65/68) for papilloma and 100% for papillomatosis(5/5) and intraductal carcinoma(5/5).There were 65 cases of ductectomy,8 cases of segmentectomy,3 cases of breast-conserving radical resection,and 2 cases of modified radical resection.Conclusions On the basis of the position of skin projection of the cold light source,the direction of intraductal dilatator,and the methylene blue staining,the location of lesion can be accurately identified for precise resection,which carries out a minimally invasive treatment for mammary intraductal tumors.
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Objective To evaluate the clinical application of high-frequency ultrasound-guided Mammotome Breast Biopsy System in the biopsy of breast microcalcification.Methods The sterotactic biopsy of microcalcification in breast was performed under the guidance of high-frequency ultrasonography in 24 patients.Results The location of the lesion was accurately determined in all the 24 patients.Pathological findings showed malignant breast tumors in 3 patients(12.5%) and benign breast diseases in 21 patients(87.5%).The malignant tumors included ductal carcinoma in situ in 2 patients and invasive ductal carcinoma in 1 patient.The benign diseases included cystic lobular hyperplasia in 9 patients,ductal hyperplasia and dilation in 6 patients,galactophore cirrhosis in 5 patients,and intraductal papilloma in 1 patient. Conclusions Use of the Mammotome Breast Biopsy System under the guidance of high-frequency ultrasonography is a safe and effective option for the diagnosis of impalpable breast lesions.
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Objective To study the application value of steelwire perforation and cerclage in treatment of comminuted clavicular fracture. Methods 32 patients with comminuted clavicular fracture were treated with steelwire perforation and cerclage. Two holes were made at the lateral margin at the ends of fractured clavicle, then a steel wire of 0.6mm in diameter passed through them and fixed the fracture. The bone fragments were fixed either with perforation or with cerclage according to their size and shape. Results The mean follow up time was 59 months. All the 32 cases of fracture healed within expected time. The function of the shoulder joints recovered well, with the excellent and good rate being 90.6% . Conclusion The steelwire perforation and cerclage bears advantages of being less traumatic, providing stable fixation, promoting fracture healing and making the secondary operation easy.
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Objective To study the value of BCSG1 on evaluating the curative effect of neoadjuvant chemotherapy(NC) for breast cancer.Methods The expression of BCSG1 in cancer tissue was assayed by immunohistochemistry and RT-PCR in 36 cases of breast cancer patients before and after receiving NC of CEF(cyclophosphamide,epirubicin and fluorouracil) regimen.The therapeutic response of NC was evaluated by morphological and pathological observation.The relationship between expression of BCSG1 and morphological response to NC was analyzed.Results Among the studied cases,the diameter of tumor significantly decreased(P
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ObjectiveTo investigate the feasibility and isolation efficiency of percutaneous selective isolated hepatic perfusion chemotherapy(PSIHP). MethodsSix pigs underwent the procedure of routine transhepatic arterial infusion(HAI) and 6 underwent PSIHP.5-FU was used in this study. The drug(5-FU) (concentration) of blood from hepatic and systemic veins of both groups was observed. Liver tissue was (investigated) for pathologic changes. ResultsThe peak level of 5-FU concentration in blood from right (hepatic) vein and systemic vein in HAI group was(4082.530415.213)mg/L and (1682.230216.834)mg/L respectively.In PSIHP group, the peak level(5-FU) was(5321.711517.318)mg/L and(510.83452.518)mg/L, respectively.There was a statistically significant difference between HAI group an PSIHP group(P