ABSTRACT
The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.
ABSTRACT
Objective:To characterize the knee gait maps of ordinary people, athletes and patients with anterior cruciate ligament (ACL) injury when walking on a level ground in order to identify potential kinematic indicators for early identification of ACL injury.Methods:From December 2021 to March 2022, 39 ordinary college students (normal group) and 39 college athletes (athlete group) were recruited in Southern Medical University, and 26 patients with ACL injury (patient group) were recruited at the Department of Orthopedics, Guangdong Provincial People＇s Hospital. The normal group consisted of 20 males and 19 females with a median age of 19 (18, 21) years; the athlete group consisted of 22 males and 17 females with a median age of 19 (18, 20) years; the patient group consisted of 23 males and 3 females with a median age of 20 (19, 20) years. A portable knee joint motion capture system was used to collect the knee gait maps of the subjects walking at a speed of 3 km/h on a treadmill. The knee varus and valgus angles, internal and external rotation angles, flexion and extension angles during the movement, and anteroposterior, medial-lateral superior-inferior displacements of the tibia relative to the femur were compared between the 3 groups.Results:There was no significant difference in the general data among the 3 groups except for gender, showing they were comparable ( P>0.05). There were significant differences in the varus and valgus angles during the whole gait cycle (1% to 100%), internal and external rotation angles during the weight-bearing response period (9% to 10%), flexion and extension angles during the stance phase and swing phase (1% to 27%, 29% to 100%), anteroposterior displacements during the weight-bearing reaction phase (1% to 3%) and at the end of the swing phase (96% to 98%), superior-inferior displacements at the middle support phase (15% to 19%), the end of the support phase (29% to 33%, 36% to 43%) and the swing phase (68% to 94%), and medial-lateral displacements at the middle stance phase and the middle swing phase (12% to 82%) among the 3 groups ( P<0.05). The maximum varus and valgus angles (-10.89°±4.55°, -12.20°±4.38°) of the subjects in the normal group and the athlete group were significantly greater than those in the patient group (-5.44°±3.72°) ( P<0.05). The medial-lateral displacement at the middle support phase [3.69 (0.13, 7.25) mm] of the subjects in the normal group was significantly larger than those in the athlete group and the patient group [-0.59 (-6.65, 5.24) mm, 0.96 (-1.54, 3.89) mm] ( P<0.05). Conclusions:The gait of college athletes is significantly different from that of ordinary college students and that of patients with ACL injury. Indexes like the varus and valgus angles and the medial-lateral displacement may be used as potential indictors for early identification of ACL injury.
ABSTRACT
Objective:To explore the clinical effectiveness of arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors.Methods:A retrospective analysis was performed of the 58 patients with tibial eminence avulsion fracture who had been treated by the same group of surgeons using four-point fixation technique with suture anchors under arthroscopy at Department of Sports Medicine, The Affiliated Hospital to Qingdao University from January 2015 to December 2018. They were 33 males and 25 females, with an average age of 18.4 years (from 14 to 32 years). By the modified Meyers-McKeever classification, 15 fractures were type Ⅱ, 19 type Ⅲ and 24 type Ⅳ. Recorded and compared were knee Lysholm scores, International Knee Documentation Committee (IKDC) scores and tibial eminence height between preoperation and one year postoperation; recorded at the last follow-up were range of knee motion and results of Lachman and pivot-shift tests.Results:The 58 patients were followed up for a mean of 20.7 months (from 12 to 33 months). Bony union was achieved in all patients within 12 weeks after operation. In this cohort, the Lysholm score (85.2±4.9) and IKDC score (86.2±4.3) at one year postoperation were significantly higher than the preoperative values (43.2±5.2 and 51.2±4.9), and the post-operative tibial eminence height [(9.1±1.2) mm] was significantly lower than the preoperative value [(12.6±1.2) mm] (all P<0.05). The correlation coefficients between the tibial eminence height and the Lysholm & IKDC scores at one year postoperation were -0.16 and -0.17, respectively. The last follow-up showed a 132°±5° range of knee motion for all patients, a positive result of pivot-shift test (grade Ⅱ) for 3 and a positive result of Lachman test (grade Ⅰ) for 2. Conclusion:Arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors can lead to satisfactory effectiveness, showing advantages of minimal invasion, anatomic reduction, reliable fixation, and little impact on the epiphysis plate.
ABSTRACT
Objective:To compare the therapeutic outcomes of anterior cruciate ligament (ACL) reconstruction between small-sized and normal-sized patients using grafts of different diameters.Methods:The data of 63 patients were selected who had undergone ACL reconstruction at Department of Joint/Sports Medicine, The Third Affiliated Hospital to Southern Medical University from January 2018 to December 2018. They were divided into 2 groups according to body size. In the observation group of 26 small-sized patients who were shorter and lighter, there were 18 males and 8 females with an age of (29.4±8.5) years and a graft of 7.5 mm in diameter was used. In the control group of 37 normal-sized patients, there were 26 males and 11 females with an age of (28.8±8.2) years and a graft of 8.0 mm in diameter was used. The 2 groups were compared in terms of failure rate, kinematic changes in the affected knee joint (taking the 63 normal knee joints in the 2 groups as controls), isokinetic muscle strength and Lysholm knee score.Results:There was no significant difference in the general data or follow-up time between the 2 groups other than height and weight ( P>0.05), indicating comparability between the 2 groups. In the control and observation groups, the failure rates were 2.7% (1/37) and 3.8% (1/26), and the Lysholm knee scores 2 years after surgery (86.6±10.1) points and (90.2±6.9) points, respectively, showing no statistical significance ( P>0.05). The range of flexion and extension was 56.30° (51.10°, 58.10°) in the observation group, significantly smaller than that in the control group [60.15°(58.95°, 63.08°)] and that for a normal knee joint [59.00° (56.45°, 63.00°]; the internal and external displacement in the observation group [7.30 (5.30, 8.30) mm] was significantly smaller than that for a normal knee joint [9.00 (7.00, 12.00) mm]; the external rotation in the observation group [0.97°(-1.59°, 3.01°)] was significantly larger than that for a normal knee joint [-1.54°(-5.30°, 2.28°)]; the knee extension muscle strength at 60°/s in the observation group was (65%±19%), significantly smaller than that in the control group (78%±18%) (all P<0.05). Conclusion:When small-sized and normal-sized patients use a 7.5 mm graft and a 8.0 mm graft respectively in ACL reconstruction, similar therapeutic outcomes can be expected.
ABSTRACT
There are abundant cancer stem cells (CSCs) in triple-negative breast cancer TNBC).CSCs can maintain their phenotype by unique molecular mechanism and tumor microenvironment,and can promote the chemotherapy resistance and recurrence of TNBC.Blocking these key molecules or altering tumor microenvironment can reduce CSCs,and then inhibited cancer growth and reverse chemotherapy resistance of TNBC.
ABSTRACT
Objective To compare a novel mirror-overlap method with the traditional manual measurement and the subjective assessment in assessing breast symmetry after oncoplastic surgery.Methods 59 patients with breast cancer who underwent conservation/reconstruction surgery were recruited.The post-operative assessment for breast symmetry was conducted using manual measurement,subjective assessment by the patient,their family member and a nurse,and the mirror-overlap method respectively.The latter method involved using the Photoshop to assess the area differences in breast outlines and shadows created by a flashlight when bilateral images were overlapped in the axis of midline.Results The distance differences between bilateral breasts measured using manual method were negatively correlated with symmetric coefficients in the mirror-overlap method (P＜0.05).There was a positive correlation between the average scores in the subjective assessment and symmetric coefficients of mirror-overlap method (P＜0.05).Conclusion The mirror-overlap method is an easy,feasible and cheap method which collects 3D breast information and provides an effective approach to assess breast symmetry after oncoplastic surgery.
ABSTRACT
Objective To explore the safe bone channels for transverse placement of sacroiliac screws via the second sacral vertebra in the fixation of longitudinal fracture of the sacrum by digital analysis and clinical observation.Methods Firstly,abdomen CT scanning was performed in 50 healthy adult volunteers.They were 30 males and 20 females,aged from 18 to 56 years (mean,34.6 years).After their CT images were transformed by software Materialise Mimics Innovation Suite 15.0,three-dimensional (3D) models of the pelvis were generated,stored in stereolithography format,and transferred into software Imageware 12.0.In the standard antero-posterior position,the sacrum was segmented and the points of 2D image coordinate geometric boundary were extracted to generate an optimal channel for transverse placement of sacroiliac screws via the second sacral vertebra.Secondly,we admitted 10 patients with longitudinal fracture of the sacrum.They were 7 men and 3 women,aged from 20 to 51 years (average,38.3 years).By Tile classification,4 cases were type B2 and 6 type C1.All the fractures were Denis region Ⅱ ones.Pubic ramus fracture was complicated in 3 cases.After traction reduction of the tibial tubercle was conducted for patients with obvious displacement,the optimal channel was calculated on the basis of the CT data.On the lateral images of the sacrum acquired before operation by C-arm fluoroscopy,the optimal channel for transverse placement of sacroiliac screws via the second sacral vertebra was located.After the skin was marked,2.5 mm Kirschner wire was drilled and the 6.0 mm hollow screws were fixated along the Kirschner wire.Postoperative CT scanning images and 3D reconstructed models were analyzed to validate the accuracy of screw placement.Results The projection of safety bone channel on the sagittal fluoroscopy of S2 vertebral body displayed an irregular water drop shape;the projection area in males (213.9 ± 52.4 mm2) was significantly larger than that in the females (171.6 ±49.6 mm2) (P ＜ 0.05).The average length of the channel in men (135.2 ± 12.9 mm) was significantly longer than that in women (121.1 ± 10.1 mm);the average diameter of the screw in men (10.2 ± 0.9 mm) was also significantly larger than that in women (9.1 ±0.8 mm) (P ＜ 0.05).The postoperative X-ray and CT scanning images showed satisfactory positions and lengths of the screws.The screw lengths averaged 98.2 mm;the operation time averaged 25.6 min.No nerve or vascular injury,loosening or breakage of the sacroiliac screws occurred in the patients.Follow-ups for 12 to 24 months revealed no other complications.Conclusion The safety channel for transverse placement of sacroiliac screws via the second sacral vertebra can be determined using the lateral 3D reconstruction images of the sacrum in preoperative planning,which facilitates the percutaneous transverse fixation of longitudinal fracture of the sacrum.
ABSTRACT
Objective To compare the effect of thin-sliced enhanced CT scanning and 3D-DSA data sources in the 3 D printing data reconstruction of intracranial arteriovenous malformation (AVM ). Methods Five patients with AVM were selected prospectively,3 were Spetzler-Martin grade II and 2 were grade III. Two of them used 256-slice spiral CT thin slice enhanced scanning. Three used the 3D-DSA rotating imaging,and the DICOM raw data of the examination results were extracted. Digital processing was performed by using the Mimics software,and the 3 D printing was performed according to the ratio of 1∶1 obtaining the solid model and the effects were compared. Results Using the data source 3 D printing of 256 slice spiral CT thin-slice enhanced scan could obtained skull and blood vessel image information and could reveal the smallest diameter of 0. 9 mm vessel,however,the fine branch structures of the vessel were difficult to distinguish. The 3D printing based on 3D-DSA data,although the digital subtraction did not have the skull data information,the vascular branches showed more abundant. It could reveal the smallest diameter of 0. 9 mm vessel. Conclusions Using the CT thin-slice enhanced scan or 3D-DSA data source can obtain reconstruction images of AVM nidus,and 3D-DSA shows that the better effect for spatial structure of AVM nidus. It is helpful to the design of preoperative treatment scheme and the development of corresponding auxiliary tools.
ABSTRACT
Objective Less than a decade ago, ER-positive and PgR-positive diagnostic criteria decrease from 10%to 1%. Up to 20%of current immunohistochemical determinations of ER and PgR worldwide may be inaccu-rate. It is necessary to study patients whose tumors are between luminal A (LABC) and triple-negative (TNBC) breast cancer. Methods Survival analysis grouping by the level of positive hormone receptor, CK5/6 and EGFR, and en-docrine therapy was carried out in 206 patients whose tumors were junction zone between LABC and TNBC. Re-sults There were no significant differences between the low-positive (1%-9%) HR group and positive HR (10%-19%) group in overall survival (OS) and disease-free survival (DFS). There was an apparent difference between the nor-mal-like group and basal-like group in OS and DFS, and between the patients with and without endocrine therapy. There were significant differences between death and tumor progression for EGFR and CK5/6, chemotherapy, and endocrine therapy. Conclusions We conclude that EGFR and CK5/6 are better prognostic indicators than the lev-el of positive HR in patients whose tumors are junction zone at the junction zone between LABC and TNBC. En-docrine therapy can be highly beneficial to these patients regardless of the positive HR level.
ABSTRACT
Objective To investigate the extent of axillary lymph node dissection which can not only ef-fectively evaluate the axillary status but also reduce the complications to the minimum in early stage breast can-cer. Methods 331 patients with early breast cancer surgically treated from Jan. 2011 to Dec. 2013 were retro-spectively analyzed. Their preoperative axillary state was evaluated. They undertook sentinel lymph node biopsy (SLNB) by pure methylene blue dye method and frozen section examination during surgery. According to the ex-tent of axillary lymph nodes dissection, patients were divided into SLNB group (98 cases) and intercostobrachial nerve level lymph node dissection (ILND) group (233 cases). The pros and cons of the operation were compared. Results The sentinel lymph nodes (SLN) labeled by methylene blue were located under the intercostobrachial nerve level. The average number of SLN and intercostobrachial nerve level lymph nodes were 5.64+1.68 and 13.34+3.61 respectively. The detection rate and the false negative rate of SLNB was 97.42% and 2.58% respec-tively. The medium follow-up was 27.5 months. There was no significant difference in postoperative complications including upper limb paresthesia, swelling or limitation of shoulder activity between the two groups. Conclusion ILND is an effective and suitable surgical method in early breast cancer patients with failed intraoperative SLN labeling or with one SLN metastasis.
ABSTRACT
<p><b>OBJECTIVE</b>To study the value of three-dimensional (3D) visualization, 3D printing and 3D laparoscopy (3-3D techniques) in the diagnosis and surgical treatment of hepatic tumors.</p><p><b>METHODS</b>From November 2013 to January 2015, 22 patients with hepatic tumors admitted in our department underwent abdominal thin-slice CT scanning. The CT images were imported into Medical Image three Dimensional Visualization System (MI-3DVS) for 3D reconstruction. Standard Template Library (STL) files were exported for 3D printing. The hepatic vascular classification and predicted liver resection were performed with the aid of MI-3DVS system. The 3D models were then printed and virtual liver resections were executed accordingly. Based on these preoperative surgical planning data, we performed anatomical hepatectomy using 3D laparoscopy, and the intraoperative blood loss, volume of virtual and actual liver resection and postoperative hospital stay were recorded.</p><p><b>RESULTS</b>According to Michels's classifications, 19 patients had type I, 2 had type II, and 1 had type VIII hepatic arteries; based on Cheng classifications, the portal vein was classified into type I in 17 cases, type II in 2 cases, and type III in 2 cases, and type IV in 1 case; according to Nakamura classifications, the right hemiliver hepatic vein was classified into type I in 10 cases, type II in 7 cases, and type III in 5 cases. In the virtual operations, the mean volume of liver resected was 490 ± 228 ml and the mean remnant liver volume was 885 ± 139 ml, with a remnant to functional liver volume ratio of (71 ± 11)%. The 3D printed models stereoscopically displayed the location of the liver tumors and adjacent liver vascular structure clearly. Laparoscopic hepatectomy was performed successfully in 20 patients guided by the 3-3D techniques, and the other 2 patients required convertion to open hepatectomy. The mean operation time was 186 ± 92 min, the intraoperative blood loss was 284 ± 286 ml, the mean actual liver resection volume was 491 ± 192 ml, and the mean postoperative hospital stay of the patients was 8.6 ± 3.7 days.</p><p><b>CONCLUSIONS</b>The 3-3D technique can facilitate the evaluation of preoperative risk and critical anatomical structures and navigate the surgical procedure in real time in anatomical hepatectomy for hepatic tumors.</p>
Subject(s)
Humans , Blood Loss, Surgical , Hepatectomy , Hepatic Artery , Hepatic Veins , Imaging, Three-Dimensional , Laparoscopy , Liver Neoplasms , Diagnosis , General Surgery , Portal Vein , Printing, Three-Dimensional , Tomography, X-Ray ComputedABSTRACT
Objective To evaluate diagnostic value of the combined examination of ultrasound , contrast-enhanced CT and physical examination in axillary lymph node status in breast cancer .Methods 316 cases of breast cancer were studied from Jan .2012 to Dec.2013.The axillary lymph nodes were divided into negative group, suspicious negative group , suspicious positive group and positive group by physical examination , axillary ultrasound , and contrast-enhanced breast CT imaging .ROC curve was used to evaluate diagnostic value and the sensitivity,specificity,and accuracy were analyzed .Results The evaluation model presented the AUC of 0.859. The accuracy, sensitivity, specificity, positive and negative predictive value was 91.3%, 93.8%, 92.5%, 94.0%and 90.9%in negative group and positive group .Conclusion This evaluation method can accurately predict the axillary lymph node status and may be instructive to clinical operation mode selection .
ABSTRACT
Objective By using digital three-dimensional (3D) model of abdominal and pelvic vessels to investigate the relationship between the angle/position of the bifurcation of bilateral common iliac arteries and the length of the common iliac artery, thus to guide the endovascular interventional catheterization manipulation. Methods A total of 439 patients, who received abdominal and pelvic CTA at authors’ department during the period from Sep. 2011 to May 2013, were included in this study. By using digital 3D reformation technique, the 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae was established in all patients. With the help of mimics and geomagic software the angles between the left and right common iliac arteries and the lengths of common iliac arteries were determined, and the lumbar vertebra corresponding to the bifurcation of common iliac arteries was recorded. Using statistical software, the relationship between the bifurcation angle of bilateral common iliac arteries and the corresponding lumbar vertebra as well as the length of common iliac arteries was analyzed. Results The digital 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae was successfully reconstructed in all 439 patients. Both the angle between the left and right common iliac arteries and the corresponding lumbosacral level of bifurcation angle were clearly demonstrated on the model. The average angle was 49.1° ± 12.4°. The bifurcation was located at L3 -L4 level in 38 cases, at upper one-third level of L4 in 63 cases, at middle one third level of L4 in 89 cases, at lower one-third level of L4 in 135 cases and at L4 -L5 level in 114 cases. The average length of the left and right common iliac artery was (45.6 ± 15.6) mm and (43.3 ± 15.4) mm respectively. Pearson correlation analysis indicated that a negative correlation existed between the angle and the position level of the left and the right common iliac artery (r = -0.172, P< 0.05), and a negative correlation also existed between the angle and the length of the common iliac artery (left: r = -0.171, P<0.05; right: r = -0.164, P < 0.05). Conclusion The lower the opening position of the left and right common iliac artery is, and the bigger the intersection angle is, the shorter the length of corresponding common iliac artery will be. In this case, catheterization via femoral artery to contralateral iliac artery is a short path, and the catheterization procedure is easy to manipulate with higher success rate. On the contrary, the catheterization will be difficult, and the use of loop-technique will be needed. The digital 3D model of the abdominal and pelvic vessels as well as the lumbosacral vertebrae can help select the optimal catheterization path.
ABSTRACT
<p><b>OBJECTIVE</b>To construct a three-dimensional (3D) liver model of Wuzhishan mini-pig for virtual liver surgeries.</p><p><b>METHODS</b>The biliary tree and hepatic arteries of Wuzhishan mini-pig were perfused with perchloroethylene and ethyl acetate along mixed with lead oxide, and the hepatic vein and portal vein were perfused with a mixture of dental base acrylic resin and lead oxide. The sectional images were acquired using a 64-slice spiral CT, and the 3D models of the portal vein, hepatic vein, biliary tree, hepatic arteries, and liver parenchyma were reconstructed using Mimics software; the resection image of the liver was also designed. The intrahepatic vascular cast was prepared by corroding the soft tissue with hydrochloric acid.</p><p><b>RESULTS AND CONCLUSION</b>The intrahepatic vascular cast obtained fully retained the vascular architecture and displayed the fifth- and sixth-level branches of the hepatic vein and portal vein and the third- and fourth-level branches of the artery and bile duct. The 3D model of liver allowed stereoscopic and accurate display of the third- and fourth-level branches of the hepatic vein and portal vein and the second- and third-level branches of the artery and bile duct. The 3D model showed fewer branches but represented the structural distribution identical to the cast. The 3D model could clearly display the spatial relationship between the vasculature and the soft tissue in virtual resection of the liver tissues, and thus provides a useful model for training of laparoscopic liver resection.</p>
Subject(s)
Animals , Bile Ducts , Hepatic Artery , Hepatic Veins , Imaging, Three-Dimensional , Liver , Models, Anatomic , Portal Vein , Swine , Swine, Miniature , Tomography, Spiral ComputedABSTRACT
Objective To explore the application of 3D printing technology in individual pelvic structure of female and its value in obstetrics and gynecology based on the CT datasets of the pelvic structure and digital three-dimensional reconstruction. Methods CTA image dataset of a patient from gynecology department was obtained for constructing three-dimensional models of each organ using the digital three-dimensional reconstruction technology , then the digital 3D model with the same size as the model displayed was printed with Z510 3D printer. Results 3D models of patient′s lumbosacral vertebrae, aorta artery, common iliac artery, internal and external iliac artery , postcava , common iliac vein , internal and external iliac vein , pelvis ureter , uterus and uterine artery were printed out in the same size replica of the virtual reality model. Conclusion 3D printed model has all the features of 3D vision and can be touched and felt by people , which can provide new insights for medical education, clinical and medical research.
ABSTRACT
Vasculogenic mimicry (VM) is one of the blood supply patterns in malignant tumor,and the molecular mechanism of breast malignant tumor VM is complicated.The plasticity of tumor cells and variety of molecules regulation play important roles in the mechanism of VM.At the same time,the hypoxic microenvironment and microRNA (miRNA) are associated with the occurrence and development of VM,especially in breast malignant tumor,and they are expected to become important diagnostic and prognostic indicators in breast cancer.
ABSTRACT
Objective To explore the correlation between the incidence of abdominal and pelvic artery distortion and age using dig-ital three-dimensional reconstruction,in order to assess risk in uterine artery embolization surgical approach.Methods Collecting the CTA datasets of 475 patients,group A aged 11-27 (n=40),group B aged 28-44(n=218),group C aged 45-61(n=197), group D aged 62-78(n=20).The 3D model of pelvic arteries was reconstructed by mimics software,and the arterial distortion was recorded by rotating and observing the 3D model,which was further classified into three categories.One was the distortion of the aorta only,the second was the distortion of iliac artery,and the third being distortion of both sturctures.the number of cases appeared arterial distortion in every age group was calculated and the ratio of the total cases to each age group was counted.Results There were 128(26.9%)cases appeared arterial distortion,the last 347(73.1%)were not found distortion in any artery.Of the 128 cases,the occurrence rates of arterial distortion in each age group were 2.5%、11.9%、44.7%、65% for group A,B,C and D respec-tively.Pearson linear correlation analysis showed that the incidence of arterial distortion positively correlated with age (r=0.404,help of three-dimensional reconstruction.The occurrence rate of artery distortion is increased with age and the iliac artery distortion occurrence is higher than that of the aorta artery.
ABSTRACT
Objective To discuss the role of miRNA-374a in invasion and metastasis of breast cancer.Methods Breast tissues from 48 patients(32 patients with breast cancer)were classified into high invasive and metastatic group(HIMG,group A),low invasive and metastatic group(LIMG,group B),and normal group (group C).Each group contained 16 specimens.6 samples were selected randomly from each group and were detected by microRNA array.Key microRNA (miRNA-374a)was selected and its target protein(BMP-2) was predicted by bioinformatics software.The rest 10 specimens of each group were detected by real-time qRT-PCR and Western blot to test the content of miRNA-374a,mRNA and protein of BMP-2.Correlation analysis was performed between miRNA and the target protein.SPSS 18.0 was used to make statistical analysis.Results The relative content of miRNA-374a was higher in group C than in group B,higher in group B than in group A(P ＜ 0.05).BMP-2 mRNA level was higher in group A and group B than in group C (P ＜ 0.05).The expression level of BMP-2 protein was lower in group C than in group B,lower in group B than in group A(P ＜0.05).Correlation analysis showed that miRNA-374a was negatively correlated with BMP-2 protein(P =-0.412 8).Conclusion miRNA-374a inhibits the invasion and metastasis by regulating BMP-2 in human breast cancer.
ABSTRACT
Objective To find out the factors which would be likely to affect the occurrence of lactation mastitis.Methods 216 patients with lactation mastitis,who met our grouping criteria,were chosen for survey and clinical data collection.Their age,time of onset,mode of delivery,post-partum colostrum time,mastering of breast-feeding skills,feeding habits,occurring site of their mastitis and other data were input into SPSS 17.0 software,respectively,to perform retrospective analysis.Results Patients' average age and their age of first breast-feeding were all 30 years old ; the average age of their first pregnancy were 27 years old.Their initial post-natal breast-feeding was about 2 to 4 days.The onset of incidence of mastitis was about 28 days post-natal.First,second and third pregnancy patients represented 1/3 of the total patients respectively.63.4％ patients had cesarean delivery and only 36.6％ patients had vaginal delivery; 91.7％ were outpatients and 8.3％ patients were inpatients.10.6％ patients had abscess and 89.4％ patients hadn't.The distribution ratio of inflammation in the upper outer,lower outer,lower inner and upper inner quadrants of the breast was 30.6％,48.1％,19％,2.3％ respectively.If the mode of delivery is considered as a factor to investigate incidence time of mastitis and postpartum colostrums time,no significant difference between the two groups was found (P ＞ 0.05).Our survey indicated that 79.2％ patients did not have any knowledge of breastfeeding,8.8％ patients got the breast-feeding knowledge from their mothers,11.6％ patients got the breastfeeding knowledge from books or web resources,only 0.5％ of the patients participated in the training of breast-feeding.76.9％ patients never had breast massage,19％ of patients had a few times of massage,2.8％ of patients had occasional massage,and only 1.4％ of patients had regular breast massage with the help of their family.85.6％ patients didn't have their breasts emptied from breast-feeding to incidence of mastitis,11.6％ patients occasionally emptied their breasts,and only 2.8％ of patients can ensure one side of the breasts emptied daily.56.5％ patients used lying position with the lower breast as the most common breastfeeding posture,37％ patients used sitting position,only 6.5％ of patients used lying position with the upper breast.The correlation analysis of breeding posture and occurring site of lactation mastitis revealed that the Spearman coefficient was-0.14,P value was 0.04,which is statistically significant,suggesting there is correlation between occurring sites of lactation mastitis and breeding posture.Conclusions Mothers need to master breast-feeding skills including breast massage,breast milk emptying and breast-feeding postures to prevent the occurrence of mastitis.Furthermore,gravity probably affects the occurring sites of mastitis through its impact on patients' preferred breast-feeding postures.
ABSTRACT
Objective To study the assessment value of enhanced CT for axillary lymph node in breast cancer.Methods 71 patients meeting the inclusion criteria in our hospital were reviewed.They had level Ⅲ lymph nodes pathologically confirmed for almost 2 years.CT scan by a 64-detector row scanner were performed from the lower edge of breast to neck.CT images were analyzed from these aspects:with or without lymph node enlargement; the size and shape of the lymph nodes; lymph node with or without enhancement.Through the determination of CT net increase value,the metastasizing lymph node signs were explored.Diagnostic index of axillary lymph nodes imaged by breast sonography and enhanced CT were calculated separately.The size of level Ⅲ lymph node and CT net increase value were statistically analyzed.The correlation of metastasizing level Ⅲ lymph node and tumor location was analyzed.Results The accuracy,sensitivity,specificity,and positive predictive value of diagnosed axillary lymph node was 70.4％,85.7％,64.0％,and 50.0％ by three-dimensional ultrasound and 88.7％,90.6％,83.3％,and 94.1％ by enhanced CT.The accuracy,sensitivity,specificity,and positive predictive value of diagnosed level Ⅲ lymph node was 95.8％,90.5％,98.0％,and 95.0％ by enhanced CT.The maximal diameter of level Ⅲ lymph node was ＞ (8.7 ± 1.3) mm and the short diameter was ＞ (5.3 ±0.5) mm.CT net increase value was ＞ (50.0 ±9.0) HU.The shape of lymph nodes was mainly round or oval solid.Conclusions The diagnosis rate for level Ⅲ lymph node is obviously higher by enhanced CT than by three-dimensional ultrasound.There is no obvious correlation between level Ⅲ lymph node and tumor location.