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Objective To evaluate the hemostasis effect of balloon urinary catheter after vacuum-assisted breast biopsy (VABB).Methods From May.2016 to May.2017,270 patients undergoing VABB were randomized into study group (135 cases) and control group (135cases).Patients in the study group received VABB postoperative indwelling catheter balloon hemostasis,while patients in the control group received VABB postoperative conventional thoracic pressure bandage to stop bleeding.Postoperative bleeding and hematoma were recorded and compared between the two groups.Results The rates of postoperative bleeding and hematoma in the study group were significantly lower than that in the control group (6.7％ vs 16.3％,P＜0.05;8.9％ vs 24.4％,P＜0.05).Among patients with lesions ≤ 1.5 cm,the rates of postoperative bleeding and hematoma were 1.6％ and 4.7％ in the study group,and 6.5％ and 8.1％ in the control group.There was no significant difference between the two group (P＞0.05).Among patients with lesions ＞1.5 cm,the rates of postoperative bleeding and hematoma in the study group were significantly lower than those in the control group (11.3％ vs 24.7％,P＜0.05;12.7％ vs 32.9％,P＜0.05).Conclusion Hemostasis with balloon urinary catheter is a safe and effective method for postoperative bleeding and hematoma control after VABB.
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Objective To assess the accuracy of histological type and molecular subtype observed in preoperative 11-gauge vacuum-assisted core needle biopsy(VACNB) specimens in breast cancer.Methods Patients diagnosed by preoperative 1 l-gauge VACNB and received subsequent open excisional biopsy (OEB) from Mar 1 st 2014 to Mar 31 st 2015 were included.Kappa testing was used to test the concordance rate of histological type,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor 2(Her-2),Ki-67 and molecular subgroups between VACNB and paired OEB specimens.ER,PgR,Her-2,and Ki-67 were determined by immunohistochemistry (IHC).Patients with Her-2 IHC (+ +) were further examined by FISH.Molecular subtypes were classified as follows:LuminalA,LuminalB,Triple Negative,and Her-2 positive.Results There were 36 patients analyzed(32 of them had invasive breast cancer).Between VACNB and paired OEB specimens,concordance rate of histological type,ER,PR,Her-2,Ki-67 and molecular group were 94.4％ (κ =0.934),96.9％ (κ =0.904),87.5％ (κ =0.710),100％ (κ =1.000),84.4％ (κ =0.570),78.1％ (κ =0.621).No significant difference was detected in the expression of ER,PR and Ki-67 between VACNB and OEB specimens according to paired t-test results.Concordance rate of each molecular subtype between VACNB and OEB specimens were 100％ for Her-2 positive subtype,94.1％ for LuminalB subtype,50％ for LuminalA,and 33.3％ for TNBC.When the threshold for ER/PR positivity was upgraded from ≥1％ to ≥10％ and Ki-67 cutoff value to≥20％,the concordance rate for ER,PR,Ki-67 and molecular subtype reached to 100％,93.8％,87.5％,81.3％.Conclusions 11 G vacuum-assisted core needle biopsy was accurate in determining histological type and molecular subtype in breast cancer.
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Objective To investigate the role of the predictive prognostic value of BRCA1 screened by whole genome expression profiling in ductal carcinoma in situ.Methods Collected 4 cases of breast ductal carcinoma and 4 cases of breast invasive ductal carcinoma fresh samples from January 2014 to June 2014,and the difference of BRCA1 expression on whole genone expression profiling was analyzed by microarray comparative genomic hybridization.The expression of BRCA1 was detected by immunohistochemistry in 70 cases of ductal carcinoma in situ of the breast,and the prognosis of intraductal carcinoma was evaluated.Results BRCA1 gene differentially expressed in invasive ductal carcinoma and ductal carcinoma in situ by screening.The positive rate of BRCA1 protein in breast ductal carcinoma in 14.3％ (10/70),its expression had no significant relationship with age (P =0.959),menopause (P =0.959),tumor size (P =0.627),axillary lymph node status (P =1.000),HR status (P =0.958),HER-2 status (P =1.000),P53 expression (P =0.460).ductal carcinoma with micro-infiltration ratio in BRCA1 negative group was higher than BRCA1-positive group (P =0.043).The median follow-up of 47 months,Disease-free survival rate of all was 97.1％.Disease-free survival of BRCA1 negative group and BRCA1-positive group had no significant difference (96.7％ vs 100％,P =0.569),over all survival of BRCA1 negative and positive groups was 100％.Conclusions BRCA1 expression may not predict the prognosis of intraductal carcinoma,but ductal carcinoma in situ with microinvasion group ratio in BRCA1 negative was higher than ductal carcinoma in situ group,BRCA1 may take affect within ductal carcinoma infiltration process work.
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Objective Resarech on the value of body mass index (BMI) predicting efficacy of neoadjuvant chemotherapy and prognostic in breast cancer.Methods Clinical data of 99 patients who received neoadjuvant chemotherapy Ⅱ B-Ⅲ C stage breast cancer patients was collected between January 2007 and December 2013 in Women and Children Hospital of Guangdong Province.Anaslysing the relation of BMI and efficacy of neoadjuvant chemotherapy and prognosis.Results In the study, Clinaical complete ressiom was 12.1％ (12/99), partal ressiom was 68.7％ (68/99), stable disease or disease progression was 19.2％ (19/99), respone rate was 80.8％ (80/99), pathlogic complete ression was 9.1％ (9/99).BMI was significantly associated with response rate(P =0.039), but not with pathlogic complete ression (P =0.454).Univariate and multivariate analysis showed that BMI was not significantly associated with disease free survival and overall survival(P ＞ 0.05).Conclusions BMI was significantly associated with response rate, overweight or obese patients would prodict poorly efficacy of neoadjuvant chemotherapy.The relationg of BMI and prognosis of breast cancer who accepted neoadjuvant chemotherapy is not clear, for further study.
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Objective To compare the sensitivity and diagnostic features of mammogram (MG) and magnetic resonance imaging (MRI) on diagnosis of breast ductal carcinoma in situ (DCIS) with or without microinvasion (DCIS-MI).Methods From Jan 2012 to Nov 2013,results of MG and MRI from 72 cases of DCIS or DCIS-MI were retrospectively analyzed.Results The sensitivity of MG was 52.8％ (38/72).The sensitivity of MRI was 87.5％ (63/72),among those 76.2％ (48/63)lesions presented as non-mass-like enhancement.Sensitivity of MRI was significantly higher in DCIS-MI than DCIS (84.6％ vs 100％,P =0.027).Logistic regression analysis showed calcifications was an independent factor influencing the sensitivity of MG (OR =23.785,P ＜ 0.001).Conclusions The sensitivity of MRI is higher than MG for the diagnosis of DCIS and DCIS-MI.
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Objective To explore the diagnostic value of MRI special use of breast and uhrasonography in axillary lymph node metastasis of early breast cancer.Methods Clinical data of 136 Ⅰ-Ⅲ A breast cancer patients accepted MRI examination before surgery had been retrospectively studied,analysing diagnostic value of MRI and ultrasonography in axillary lymph node metastasis of early breast cancer.Results The sensitivity,specificity,and accuracy obtained by MRI were 83.3％,88.6％ and 86.3％.And these data of ultrasonography were 73.1％,76.7％ and 75.0％.The sensitivity,specificity,and accuracy obtained MRI were better than that of ultrasonography.The sensitivity,specificity,and accuracy of ≥ 50 years old patients were 70.0％,77.8％ and 75.0％.And ＜ 50 years old patients were 85.7％,92.3％ and 88.9％.The sensitivity,specificity,and accuracy of ＜ 50 years old patients were better than ≥ 50 years old patients.Conclusions The MRI special use of breast have an important value in axillary lymph node metastasis of early breast cancer,especially to gounger than 50 years old patients.It can provide a scientific basis of the clinical accurate treatment for early breast cancer patients.
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Objective To investigate the effects of methylthioadenosine phosphorylase (MTAP) on invasion and migration in breast cancer cells.Methods Human breast cancer cell line MCF-7 cells were treated with MTAPtargeted siRNA to diminish MTAP mRNA.MCF-7 cells proliferation was evaluated by cell counting kit-8,the analysis of cells invasion and migration was performed using Transwell chamber.The expressions of MTAP and matrix metalloproteinase 1 (MMP1) in cell extracts were detected by Western blotting.The experimental divided into blank contrd group,negative control group,MTAP-siRNA experimental group.Results The MCF-7 cells growth was promoted after knockdown the MTAP mRNA.MATP-siRNA experimental group 450 nm absorbance values at 24h,48 hand72 h of the control group were (112.3±11.9)％,(144.4±8.4)％,(169.3±9.4)％ respectively.Cell invasion analysis by Transwell chamber showed 570 nm absorbance values were 0.49 ± 0.06 (control),0.45 ± 0.07 (negative control) and 0.87 ± 0.07 (MTAP-siRNA) respectively.Cell migration analysis by Transwell chamber showed 570 nm absorbance values were 0.46 ± 0.06 (control),0.49 ± 0.08 (negative control)and 0.75 ± 0.07 (MTAP-siRNA) respectively.The expression of MMP1 in MCF-7 cells was upregulated after knockdown the MTAP mRNA.Conclusion The knockdown of MTAP in MCF-7 cell can increase the cells invasion and migration,and this may involve the the MMP1.
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Objective To explore a salvaging and nursing pathway of gas gangrene following trauma during seismic disaster.Methods The contingency plan of prevention was invocated to physically and psychologically salvage and nurse 18 sufferers having gas gangrene following trauma. Results The illness state of 18 sufferers were all effectively controlled and straightened up.The psychic trauma were pacified and no cross infections took place.Condusions Contingency plan of prevention from gas gangrene directs medical staff how to salvage gas gangrene after disaster,ensure the unblock green life passage for salvaging of patients with gas gangrene.
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Objective To analyze the main causes of sources of stress for nurses in cardiovascular department. Methods We selected 110 nurses from three class-one hospitals in Chengdu and divided them into the nurses in cardiovascular department (the research group) and nurses in other departments (the control group). We compared the two groups in the following aspects: family, society, interpersonal relationship, work nature and work strength, continuing education and professional demand. In view of the high spirit stress existed in nurses in cardiovascular department, some corresponding stress-relief strategies were adopted. Results Two groups were statistically different in social, interpersonal relationship, work nature and work strength, continuing education and professional demand. While in the aspect of family, no difference was seen. Conclusions nurses in cardiovascular department had high spirit stress in social, interpersonal relationship, work nature and work strength, continuing education and professional demand. To analyze sources of stress and stress-relief strategy for them could improve physical and psychological health of them and thus enhance nursing quality.
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Objective To assess the value of fiberoptic ductoscopy (FDS) in the diagnosis of nipple discharge.Methods Clinical records of 800 patients with nipple discharge undergoing FDS from October 1998 to July 2003 were retrospectively reviewed. Results Diagnoses established by FDS were pathologically confirmed in 92 2% of patients with papilloma (202/219), in 86 7% of patients with papillomatosis (13/15), and in 95 2% of patients with breast cancer (40/42). The total diagnostic accordance rate was 92 0% (266/289). Conclusions FDS in the diagnosis of nipple discharge is sensitive and of great clinical significance.
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Objective To investigate the pathology of nonpalpable breast lesions(NPBL),and evaluate the diagnostic value of ultrasound-guided mammotome(MMT)biopsy.Methods Between January 2005 and December 2007,254 patients with NPBL(328 lesions)diagnosed by ultrasonography received ultrasound-guided MMT biopsy.Among the patients,176 were diagnosed as having no breast mass or calcification by mammography.Results Of the 328 lesions,269(82.0%)were fibroadenomas,34 were(10.4%)cysts,3(0.9%)were intraductal papillomas,19(5.8%)were adenosis,and 3(0.9%)were early breast cancers.Among the 254 cases,251(98.8%)were benign without positives findings during follow-up.These patients received simple MMT,and 239(95.2%)of them were satisfied with the cosmetic outcome.The other 3(1.2%)patients who had malignancies were treated with modified mastectomy;none of them had residual tumors.The underestimate rate for NPBL was 0 in our cases.Of the 251 benign patients who received only MMT biopsy,239(95.2%)have satisfactory cosmetic results.Conclusions As an effective,minimally invasive,and rapid diagnostic technique for NPBL,ultrasound-guided MMT biopsy is an optimal tool for "one-step" operation.By using the method,underestimate risk can be decreased.
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Objective To assess the diagnostic value of fiberoptic ductoscopy(FDS) on the nipple discharge. Methods The clinical data of fifty two consecutive patients with nipple discharge undergoing FDS from November 1998 to April 1999 were retrospectively analysed. Results A total of 62 ducts in 52 patients were successfully examined by FDS. Intraductal tumor of the breast was found in 14 cases(4 cancer and 10 papilloma). The diagnostic rate of FDS on intraductal tumor was 100%; and 85.7% of these patients were microlesions. Six cases were diagnosed as mastitis. Thirty two normal duct cavities presented just simple dilatation. In 73.7% of non tumor patients, the nipple discharge disappeared after irregation via FDS. Conclusions As a simple technique and a minimal traumatic endoscopy, FDS would be useful in detection of the microlesions of breast and might become a new diagnostic method of nipple discharge instead of ductography.
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Objective To study the clinical and pathological characteristics of breast ductal carcinoma in situ (DCIS) and with microinvasion (DCIS-MI). Methods From June 1999 to June 2003, a total of 41 patients with DCIS and DCIS-MI patients were retrospectively studied. Results Pathology varies between DCIS type Ⅰ, type Ⅱ and DCIS-MI patients. Mammographic calcification was the only presenting symptom in 9.76% of patients with DCIS accounting for 50% of these cases. The accordance rate of mammography with final diagnosis was 80%, and 33.3% of mammography in DCIS-MI type 2 showed mass or chaos of gland construction. The initial symptom in 57% of patients was nipple discharge. For fiberoptic ductoscopy, the accordance rate was 95.65%. There were two local recurrent cases in DCIS-MI type 2. Conclusion Breast ductal carcinoma in situ and with microinvasion had their own characteristics, including different prognosis.