Reflection on the Cultivation of Humanistic Practice Ability of Obstetricians and Gynecologists / 中国医学伦理学

Obstetrics and gynecology is concerned with the gestation,birth and healthy development of human life and related to the happiness and joy of all families.Physicians need to have good medical humanistic practice ability.This paper analyzed the connotation of the physician's humanistic practice ability,investigated the current status of humanistic practice ability of obstetricians and gynecologists through in-depth interviews,and put forward the countermeasures of cultivating the humanistic practice ability of obstetricians and gynecologists,including strengthening the foundation of medical humanistic knowledge,carrying out the training of the humanities skills of obstetricians and gynecologists,integrating the evaluation of humanistic practice ability into the work of medical ethics,and integrating the new medical humanistic view into the construction of hospital culture.

Significance of MEK-ERK cascade in the development of human breast carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the MEK and ERK expression and their relationship with clinicopathological parameters in human breast carcinoma, and the effect of preoperative chemotherapy on MEK and ERK protein expression.</p><p><b>METHODS</b>Samples were obtained from 56 patients with breast carcinoma and 8 patients with benign tumors. Sixteen of the 56 patients received preoperative chemotherapy. Western blot and immunohistochemistry were used to measure the expression of MEK1, MEK2 and ERK1, ERK2 protein.</p><p><b>RESULTS</b>MEK2 and ERK1, ERK2 protein levels were increased in breast carcinoma tissue compared with those in adjacent normal tissues (t = 7.244, 5.959, 3.735, P < 0.01) and benign tumors (t = 2.206, P < 0.05). The levels of MEK1 were decreased. The expression of MEK2 protein in ER negative patients was higher than that in ER positive ones. MEK2 protein levels were lower in patients who received preoperative chemotherapy than in those who did not.</p><p><b>CONCLUSION</b>Overexpression of MEK-ERK may play an important role in the development of human breast carcinoma. MEK and ERK protein expressions are inhibited by preoperative chemotherapy.</p>

Expression of extracellular signal-regulated kinase and its relationship with clinicopathological characteristics of breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of extracellular signal-regulated kinase (ERK) and its relationship with clinicopathological characteristics of breast cancer as well as the effect of preoperative chemotherapy on ERK expression.</p><p><b>METHODS</b>Expression of ERK-1 and ERK-2 protein was examined by Western blot in the breast cancer and normal breast (control) tissue of 48 patients, of whom 8 had received preoperative chemotherapy of 5'-deoxy-5-fluorouridine (5'-DFUR), with distribution of ERKs protein detected by immunohistochemical method.</p><p><b>RESULTS</b>Expression of ERK-1 and ERK-2 protein was increased in tumor specimen as compared with control tissue (P < 0.01). A positive correlation was observed between ERK-1 and ERK-2 (r = 0.457, P < 0.01). Protein level of ERK-1 and ERK-2 was higher in stage III patients than in stage I and stage II patients (P < 0.05). Expression of both ERK-1 and ERK-2 in the carcinoma tissue was decreased in patients who had received preoperative chemotherapy of 5'-DFUR. ERK-1 and ERK-2 proteins were mainly located in the cytoplasm.</p><p><b>CONCLUSION</b>The hyperexpression of ERK may play an important role in the initiation and development of human breast cancer. Preoperative chemotherapy of 5'-DFUR is able to partially inhibit ERK expression.</p>

Evaluation of two different regimens as neoadjuvant chemotherapy for breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the efficacy and toxicity of two different regimens as neoadjuvant chemotherapy for breast cancer.</p><p><b>METHODS</b>Forty-eight patients with stage II, III breast cancer as proved by cytology biopsy, were treated with either 5-Fu, epirubicin, cyclophosphamide (FEC) or epirubicin, paclitaxel (ET) regimens for 2 cycles every 3 - 4 weeks. Clinical responses in the breast and lymph nodes were assessed after 2 cycles of neoadjuvant chemotherapy. Patients in FEC arm received combination of 5-fluorouracil (5-Fu) 500 mg/m(2) by 4-hour continuous infusion on D1 and D8, epirubicin (EPI) 50 mg/m(2) by intravenous injection on D1, and cyclophosphamide (CTX) 500 mg/m(2) by intravenous injection on D1 and D8. Patients assigned to the ET arm received EPI 60 mg/m(2) by intravenous injection on D1, paclitaxel (TAX) 150 mg/m(2) by 3-hour continuous infusion on D2. All patients were treated by operation 2 weeks later and radiotherapy was added to some.</p><p><b>RESULTS</b>For primary tumor in the breast, the overall response rate (RR) was 50.0% (12/24) in FEC arm and 79.2% (19/24) in ET arm. One patient showed clinical complete response (cCR), 11 partial response (PR), 12 no change (NC) after the FEC therapy, while 1 patient showed CR, 18 PR, 5 NC after ET therapy. There was no pathologic complete response or progressive disease, though a higher proportion of RR was observed in stage II than stage III patients in these two groups. Clinically palpable axillary lymph nodes which had been found in all 48 patients before 2 cycles of treatment, 50.0% (12/24) in the FEC patients and 66.7% (16/24) in the ET patients became in-palpable. The major toxicity, including leukopenia, gastroenteric reactions, were similar in both groups, but alopecia was more severe and arthralgia, myalgia, neurotoxicity and flushing of face were the unique features of the ET regimen.</p><p><b>CONCLUSION</b>Neoadjuvant chemotherapy with two different regimens were effective to the primary tumor and axillary metastatic lymph nodes of breast cancer, and the side effects were tolerable. Higher efficacy and more side effects are observed in ET than in FEC regimen.</p>

Neoadjuvant chemotherapy with epirubicin plus paclitaxel in treatment of patients with breast cancer / 中国癌症杂志

Purpose: To study the short-term efficacy and toxicity of the neoajuvant chemotherapy with epirubicin (EPI) plus paclitaxel( TAX) in treatment of patients with breast cancer. Methods: 20 patients with stage Ⅱ,Ⅲ breast cancer were treated with paclitaxel plus epirubicin (TE) for 2 - 4 cycles every 3 weeks, their clinical response and the toxicity were assessed after 2-4 cycles of neoajuvant chemotherapy, and they are compared with those of the patients treated with vinorelbine plus epirubicin( VE) as neoadjuvant chemotherapy. Patients in TE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, paclitaxel 150 mg/m2 by 3-hour continuous infusion on d 2, 3 weeks was 1 cycle. Patients assigned to the VE arm received epirubicin 60 mg/m2 by intravenous injection on d 1, vinorelbine 30 mg/m by intravenous injection on d 1 and d 8, 4 weeks was 1 cycle. All patients were treated by modified radical operation after neoajuvant chemotherapy. Results: The overall response rate( RR) was 80% (16/20) both in TE arm and VE arm. There were 3(15%) clinical complete response( cCR) and 2(10%) pathologic complete response ( pCR) in every arm. No patient showed progressive disease. A higher proportion of RR and pCR was observed in patients with 4 cycles of neoajuvant chemotherapy than those with 2 cycles in the two groups. The major toxicity, including leukopenia, gastroenteric reaction, flushing of face and phlebitis, were similar in both groups, but fatigue, alopecia and neurotoxicity were more severe in VE arm than in TE arm(P

Treatment of locally advanced breast cancer with breast-conserving therapy after neoadjuvant chemotherapy: Report of 31 cases / 中国微创外科杂志

12 months postoperatively,and excellent results were obtained in 16.0% of the patients((4/25)),good in 40.0%(10/25),and poor in 44.0%(11/25). Conclusions For patients with locally advanced breast cancer previously treated with downstaging neoadjuvant chemotherapy,breast-conserving therapy offers satisfactory results.Strict adherence to technique and use of postoperative irradiation and systemic therapy are crucial to breast-conserving therapy.

Conservative surgery for the treatment of breast cancer:Analysis of 148 cases / 中国微创外科杂志

Objective To investigate the therapeutic procedures,indications and efficacy of breast-conserving therapy (BCT). Methods BCT was carried out in 148 patients with breast carcinoma in this hospital from January 1996 to October 2003.There were 5 patients in stage 0,85 patients in stage Ⅰ,55 patients in stage Ⅱ,and 3 patients in stage Ⅲ.The surgical treatment was quadrantectomy or local wide excision of tumor,combined with axillary lymph node dissection.Routine adjuvant irradiation,chemotherapy and hormone therapy were given postoperatively. Results Pathological examinations of breast specimens found no positive margins.Follow-up observations for a median of 54 months (range,2 ～ 84 months) revealed a local recurrence rate of 2 7% ( 4/148 ;3 patients in breast and 1 patient in axillary fossa).Distant metastasis occurred in 5 patients (3 4%) and 3 of them died.Sites of metastasis included lung,liver,meninges and bone.The duration from surgery to distant metastasis was 6 ～ 43 months.Evaluation of cosmetic results in 108 patients who had received BCT for at least 12 months showed that good outcomes were achieved in 32 4% of the patients (35/108),fair outcomes,in 49 1% of the patients (53/108),and poor,in 18 5% (20/108). Conclusions For patients with early stage breast carcinoma,and part of those with local advanced breast cancer who have received neoadjuvant chemotherapy and gotten downstaging effects,the effects of BCT is satisfactory.Standard excision,postoperative irradiation and systemic combination treatment are crucial to BCT.Most patients receiving BCT have good cosmetic results.

Prognostic significance of serum CA15-3 detection in patients with breast carcinoma / 中国普通外科杂志

Objective This study is to investigate the prognostic significance of serum CA15 3 detection in patients with breast carcinoma Methods Blood samples were obtained from 145 breast carcinoma patients, ECL(electrochemiluminescence) technology was used to measure CA15 3 levels Results CA15 3 levels were elevated in breast carcinoma patients with recurrence or metastasis ( ? 2=27 865, P

Evaluation of neo-adjuvant chemotherapy with different cycles for locally advanced breast cancer / 中国普通外科杂志

Objective To compare the efficacy and toxicity of different cycles of neo-adjuvant chemotherapy for locally advanced breast cancer. Methods Seventy-five patients with locally advanced breast cancer were treated with epirubicin (Epi) plus paclitaxel (TAX, ET regimen). Two cycles were used in 39 patients (2 cycles group) and 4 cycles were used in 36 patients (4 cycles group). Results The overall response rate (RR) was 74% (29/39) in 2 cycles group and 94% (34/36) in 4 cycles group. One patient got clinically complete response (CR), 28 cases had partial response (PR),10 with no change (NC) in 2 cycles group, while 21 patients showed CR including 11 patients with pathologically complete response, 13 with PR, and 2 with NC in 4 cycles group. There was no progression to advanced stage in either groups. Axillary lymph nodes were palpable in all 75 patients before ET regimen, lymph nodes became non-palpable in 46% (18/39) cases in 2 cycles group and in 75% (27/36) cases in 4 cycles group. Toxicities including leukopenia, gastroenteric reactions were similar in the 2 groups, though arthralgia, myalgia, and neurotoxicity were more common in 4 cycles group than 2 cycles group. Conclusion Neo-adjuvant chemotherapy with ET regimen for 4 cycles were more effective than 2 cycles to down staging locally advanced breast cancer. Toxicities including arthralgia, myalgia, and neurotoxicity were more common in 4 cycles group than 2 cycles group.

The role of oncogene Stat3 in carcinogenesis and progression of human breast cancer / 中国普通外科杂志

Objective The aim of this study is to investigate STAT3 expression and the relationship between protein levels of STAT3 and clinicopathological parameters together with preoperative chemotherapy in human breast cancer. Methods Samples were obtained from 51 patients with breast carcinoma in which 7 patients had received preoperative chemotherapy. Western blot was used to measure the protein expression in tissue and SK-BR-3 cell line. MTT method was used to evaluate the proliferation. Cell-cycle and apoptosis were quantified by flow cytometry. Results STAT3 protein levels increased in breast cancer tissues compared with adjacent normal tissues(t=5.540,P

The effect of HO-1 activated via P38? pathway in the genesis and chemotherapy resistance of breast carcinoma / 中国普通外科杂志

Objective To investigate the role of p38? pathway and HO-1 in the genesis and chemotherapy resistance of breast cancer. Methods The proliferation and apoptosis of human breast cancer cells were examined by MTT assay. The expression of p38? and HO-1 mRNA were examined by RT-PCR. Results The p38? mRNA level in 78% of samples was significantly greater than that in the normal tissue and the p38? mRNA level in patients with lymph node metastasis was higher than that without lymph node metastasis (P