ABSTRACT
Objective To analysis the correlation factors which influence the prognosis and relationship of molecular subtypes on young patients.Methods Clinical data of 108 cases young breast cancer patients (≤ 35 years old) who were treat in the Third Affiliated Hospital of Zhengzhou University from January 2007 to October 2014 were retrospective analyzed.According to immunohistochemistry such as estrogen receptor (ER),progesterone receptor(PR),human epidermal growth factor receptor-2 (Her-2/neu),Ki-67 index,patients were divided into molecular subtypes and follow up.Results LuminalA subtype,LuminalB subtype,human epidermal growth factor receptor-2 overexpression subtype and basal-like accounted for 22％ (24/108),33％ (36/108),20％ (21/108) and 25％ (27/108) respectively,and there's 5-year disease-free survival rate were74.1％,62.8％,.56.8％,58.5％ respectively.Kaplan-Meier method was used to draw the disease-free survival curves through.There was no significant difference in the 5-year disease-free survival rate of each subtype (x2 =0.318,0.802,0.876,0.277,0.239,0.074,P＞0.05).Univariate analysis of prognostic factors of Log-rank showed that there were significant differences between recurrence with tumor size,age,lymph node metastasis and surgical methods in young patients with breast cancer(x2 =9.612,12.099,51.345,5.928,P＞0.05),while no significant difference with adjuvant chemotherapy,radiotherapy,endocrine therapy and molecular typing(x2 =2.381,1.958,0.027,2.612,P＞0.05).Multivariate Cox proportional hazards regression model analysis showed that tumor size (RR =5.487,95％ CI 1.519-19.822,P =0.009) and lymph node metastasis (RR =5.655,95％ CI 2.939 -10.884,P＜0.001) were independent risk factors for disease recurrence.Conclusion Tumor size and lymph node metastasis are important factors of prognosis on young patients.Young patients need the screening and therapy in the early time.
ABSTRACT
Objective To investigate the effect of dezocine combined with fentanyl in patients undergoing kidney transplantation on the quality of anesthesia and recover consciousness,as well as explore the preemptive analgesia effect of dezocine in renal transplantation.Methods Eighty patients undergoing allogeneic renal transplantation were randomly divided into control group (Ⅰ) and dezocine group (Ⅱ) (40 cases for each group).Patients in two groups were induced with midazolam 0.05 mg/kg,propofol 1-2 mg/kg,fentanyl 3 μg/kg,and cis-atracurium 2.5 mg/kg intravenously,and then they were incubated and given mechanical ventilation.Anesthesia was maintained with intravenous and inhalational anesthesia.1％-2％ sevoflurane had been inhaled until half an hour before the end of the surgery,while 1％ propofol 3-5 mg/kg/h and remifentanil 0.1-0.2 μg/kg/min had been pumped intravenously till the end of the surgery.2μg/kg fentanyl was infused in control group,while in dezocine group 0.1 mg/kg dezocine was intravenously infused before skin incision.The concentration of sevoflurane and the pump speed ofremifentanil were adjusted according to the depth of anesthesia.Changes of mean arterial pressure (MAP),heart rate (HR) and the pulse oximetry (SPO2) before anesthesia (T0),before skin incision (T1),5 minutes after incision (T2),5 minutes before extubation (T3) and 10 minutes after extubation(T4) were recorded.Extubation time,nausea,vomiting and the incidence of adverse reactions during recovery period were also recorded.Before leaving the operating room,VAS scale was used to assess the pain situation of patients.Results There were no significant differences in terms of MAP,HR and SPO2 at each time point between two groups (P ＞ 0.05).The VAS scores in fentanyl group was 1.76 ± 0.43,as same as that in dezocine group (1.84 ± 0.57,P =0.480 7).The incidence of adverse reactions including nausea,vomiting in fentanyl group and dezocine group were 22.5％ and 2.5％,and the difference was significant (x2 =7.314 3,P =0.007).The extubationtime after surgery in diesoline group [(12.21 ± 2.16) min] was significantly shortened than that in fentanyl group [(15.15 ± 2.25) min],P =0.000).Conclusion Dezocine preemptive analgesia is used in renal transplant patients in advance,and it can partly replace the same effect of fentanyl analgesia intensity,significantly shorten the extubation time,reduce the occurrence of awakening period adverse events such as of nausea,vomiting and restlessness.It is safe for renal transplant patients.