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Objective To compare different blood purification techniques on serum fibroblast growth factor 23(FGF -23)scavenging effect in patients undergoing maintenance hemodialysis (MHD),in order to choose the best blood purification method for clinical maintenance hemodialysis patients.Methods 60 MHD patients were randomly divided into hemodialysis group (HD),hemodiafiltration group (HDF)and HD +HP group,20 cases in each group. Three groups of patients in the observation 1st start of treatment and observation at the end of the last treatment were detected cacium,phosphorus,FGF -23,intact parathyroid hormone(iPTH).Results After treatment,HD group and HDF group,Ca:t =0.29,P =0.77;P:t =1.65,P =0.11;iPTH:t =16.85,P =0.00;HD group and HD +HP group:Ca:t =0.20,P =0.84;P:t =2.62,P =0.01;iPTH:t =42.64,P =0.00;HDF group and HD +HP group:Ca:t =0.09,P =0.92;P:t =2.18,P =0.04;iPTH:t =31.41,P =0.00.After treatment,FGF -23 in the three groups were decreased significantly than before treatment,and the HD +HP group decreased most significantly(HD group and HDF group,t =4.47,P =0.00;HD group and HD +HP group:t =8.06,P =0.00;HDF group and HD +HP group:t =3.20,P =0.00).Conclusion HD +HP treatment can effectively remove phosphorus maintenance dialysis patients and FGF -23.
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<p><b>OBJECTIVE</b>To study the relationship between pathological features and classification criteria of the breast Phyllodes tumor.</p><p><b>METHODS</b>203 cases of breast phyllodes tumor diagnosed in 22 hospitals since 1956 were analyzed and reappraised by a retrospective study.</p><p><b>RESULTS</b>133 cases were benign, 42 cases were borderline and 28 were malignant. The follow-up (6 to 372 months) showed that 28/133 benign, 19/42 borderline and 18/28 malignant cases recurred, and 17 patients (2 borderline and 15 malignant) died. The statistic cluster analysis demonstrated that stromal cellar atypia, margin involvement, mitotic activity and tumor necrosis were retained in the variable group, and no error distinguish were showed.</p><p><b>CONCLUSIONS</b>The breast phyllodes tumor can be classified as the following three types: benign, borderline and malignant. It is important to diagnose and classify the breast phyllodes tumor according to the involvement of tumor margin, stromal cellar atypia, mitotic activity, stromal overgrowth and tumor necrosis. There are significant differences of 5 years survival rates, recurrent rates and death rates between the benign, borderline and malignant breast phyllodes tumor. With wide excision the recurrence of the tumor decreased suggesting that broad excision is preferred for the benign phyllodes tumor and mastectomy is indicated for recurred borderline and malignant tumors.</p>
Subject(s)
Humans , Breast , Breast Neoplasms , Mastectomy , Neoplasm Recurrence, Local , General Surgery , Phyllodes Tumor , Retrospective StudiesABSTRACT
ObjectiveTo study the treatment and prognosis of the breast phyllodes tumors.MethodsKG1Clinical data, and the results of follow-up in 203 cases of breast phyllodes tumors were analyzed using Logistic analysis and Cox regression in SPSS statistic software.ResultWT5”BZLocal recurrence and tumor mortality were in direct proportion to the pathologic grade of the tumor. There was a direct proportion between local recurrence and tumor infiltration; and between tumor caused-mortality and tumor mitosis and necrosis.Mitotic activity and tumor necrosis were the independent prognostic factors. After surgical resection 21 1% of patients with benign tumor, 45 2% of patients with borderline tumor, 64 3% of patients with malignant tumor suffered recurrence. The 5-year survival rate was 100% in patients with benign phyllodes tumor, 92 0% with borderline tumor, and 33 3% with malignance.KG2Conclusion Local excision is not the appropriate treatment for phyllodes tumor. Patients with benign or borderline phyllodes tumor should undergo wide local excision including a margin of uninvolved tissue, and that with local recurrent borderline and malignant phyllodes tumor receive mastectomy.
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Objective To study the epidemiology of breast diseases based on a vast amount of data collected from a number of hospitals. Methods The pathological data of breast diseases collected from 14 hospitals were statistically analyzed. Grouping was made according to the patients′ age, i.e. every 10 years from 0 to 69 as a group, and the patients aged 70 and over as another group. A database was established using software SPSS (10.0). A statistical analysis was made on the types of breast diseases, the incidence was calculated, and curves were plotted up based on the types of disease and the contribution of patients′ age in different hospitals. Results A total of 35948 cases, including 46 diseases of breast diseases, were analyzed. The common diseases were fibroadenoma, carcinoma, adenosis, hyperplasia of male breast, cystic hyperplasia and accessory-breast, which made up 37.99%, 21.49%, 20.60%, 4.54%, 3.60% and 2.80%, respectively, of the total cases analyzed. Conclusion The number of patients suffering from breast diseases is proportional to the size of the hospital. It has been found that different pathology of the breast had its peak preponderant age of discovery. In all the cases analyzed, tumors were found in 23 167 cases, accounting for 64.45% of all patients, among which benign and malignant lesions constituted 66.13% and 33.74%, respectively. Fibroadenoma was the predominant tumor among benign tumors (89.14%), while the breast cancer constituted 98.82% of malignant tumors. The incidences of the both types of tumor, were similar in different hospitals. No significant difference was found on the peak ages of different breast diseases among the hospitals. 12 781 cases of nontumorous lesions accounting for 35.55% for all the cases showed marked differences in age distribution among hospitals, implying that there were different diagnostic criteria for such lesions.