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Objective To analyze the immune function and shoulder function of sentinel lymph node biopsy combined with mastectomy in patients with early breast cancer.Methods A total of 80 patients with breast fibroadenoma were selected ,and they were randomly divided into surround -mammary areola incision group ( n=40 ) and conven-tional radial incision group(n=40) according to the digital table.The bleeding volume,operation time,hospital stay, satisfaction and curative effect were compared between the two groups .Results The markedly effective rate of surround-mammary areola incision group was 87.50％,which was significantly higher than that of the radial incision group(62.50％),and the difference was statistically significant (χ2 =10.400,P=0.001).The total effective rate was 100.00％in the surround -mammary areola incision group ,which was significantly higher than that in the radical incision group(χ2 =6.500,P=0.010).The time of operation,the amount of bleeding and the length of hospital stay in the surround-mammary areola incision group were (56.7 ±3.2) min,(62.1 ±1.8) mL and(8.3 ±0.8) d, respectively,which were lower than those in the radial incision group [(69.8 ±4.3)min,(71.1 ±2.4)min,(11.2 ± 1.3)d],there were statistically significant differences between the two groups (t=15.262,P=0.000;t=18.735, P=0.000;t=11.864,P=0.000).The incidence rates of breast milk symmetry,scar acceptance and adverse reaction in surround-mammary areola incision group were 87.50％,87.50％ and 2.50％,respectively,which were significantly better than those in the radial incision group(67.50％,65.00％ and 15.00％),there were statistically significant differences between the two groups (χ2 =5.032,P=0.024;χ2 =7.862,P=0.005;χ2 =3.923,P=0.047).The total satisfaction rate was 87.50％in the surround-mammary areola incision group ,which was higher than 62.50％in the radial incision group (χ2 =7.222,P=0.007).Conclusion The use of surround -mammary areola incision in the treatment of patients with breast fibroadenoma has obvious effect ,can reduce the degree of breast injury ,improve the physical appearance of the breast ,with high satisfaction .
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Objective To investigate the clinical significance of tumor related gene gankyrin expression in pancreatic cancer.Methods The immunohistochemical staining was performed to study the gankyrin expression in 62 pairs of pancreatic cancer and matched non-tumor tissues.The correlations ofgankyrin expression with pathological parameters and the influences on the prognosis were analyzed.Results Ggankyrin positivity in pancreatic cancer and matched non tumor tissue was 2.5％ (45/62)and 19.4％ (12/62),respectively.The positivity of gankyrin was significantly higher in pancreatic cancer compared with matched non-tumor tissues,and the differences were statistical significant (P ＜ 0.01).Gankyrin expression in pancreatic cancer tissues were significantly correlated with TNM stage,differentiation and metastasis (P ＜ 0.05),but not with age,gender or tumor location (P ＞ 0.05).The 3-year survival rates of patients with positive and negative gankyrin expression were 17.8 ％ (8/45)and 41.2％ (7/17),respectively.Patients with positive gankyrin expression had a significantly shorter survival period compared with these with negative expression in pancreatic cancer tissues (P =0.034).Conclusions Gankyrin was overexpressed in pancreatic cancer,which was correlated with poor prognosis.
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Objective To investigate the clinical charactors and treatment of IgM nephropathy with nephrotic syndrome(NS) in children.Methods Thirty-six IgM nephropathy patients hospitalized in Hunan Children's Hospital as research group(group A),from June 2005 to June 2012.One hundred and six patients with minimal change disease (MCD) as control group (group B),followed up for 1 ～ 8 years.Results (1) Hematuria at presentation of the two groups respectly 3.8％ vs 30.6％ (x2 =20.403,P ＜ 0.05).(2) Renal pathology revealed that there were 26 (72.2％)patients with minimal change disease,9 cases (72.2 ％)with moderate membranoproliferative glomerulonephritis,1 cases with focal segmental glomerulosclerosis.(3) According to renal pathology,group A patients were divided into two sub groups:mild group and moderate group.To compared with group B,the steroid-resistant incidence of the 3 group were respectly 12.3％,19.2％,77.8％ (x2 =24.369,P ＜ 0.05).There was no significant difference between control group and mild group.(4)The remission rate of proteinuria in steroid-resistant patients who combined to use mycophenolate mofetil (MMF) with the two groups were respectively 50％ and 85.7 ％ (x2 =3.60,P ＞ 0.05).Conclusion Incidence of hematuria is higher in IgM nephropathy patients and patients with renal pathology for moderate lesions have a high steroid-resistant,and need use immunosuppressive early.MMF may be a good immunosuppressive for theses patients.
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Objective To summarize the clinical features of pancreatic injury in children,and to explore the suitable methods for its diagnosis and treatment.Methods A retrospective analysis of children with pancreatic injury within the 15 years was carried out.Clinical injury severity and following-up data were collected.Correlationship between injury severity,treatment method and successful rate was analyzed.Results Eleven children aged 4 to 14 years old were diagnosed as pancreatic injury:two had GradeⅠinjury,three GradeⅡ,five GradeⅢ,and one GradeⅣ.CT scan was used in 7 children,and 5 had positive sign.Patients with GradeⅠand GradeⅡinjuries were successfully cured without surgery.Three children with GradeⅢinjury were initially treated without operation,but two developed a large symptomatic pseudocyst and were cared through operation,and another one died.The other two children with GradeⅢwho underwent a distal pancreatectomy cured without complications.A patient with GradeⅣinjury was treated by Berne operation and died. Conclusion The management of pancreatic injury in children should be individualized depending on diagnosis time and injury type.A repetitive CT scan was helpful within 24h after injury.Distal pancreatectomy was a safe and effective for those with GradeⅢinjury.