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Cell epidermal growth factor receptor (EGFR) mutation is one of the causes of non-small cell lung cancer (NSCLC). The emergence of targeted drugs for EGFR gene mutation provides a new direction for NSCLC treatment. The common EGFR-targeted drugs like the first-generation gefitinib and erlotinib, the second-generation afatinib and the third-generation osimertinib have shown their good efficacies in a number of large international clinical trials. EGFR gene mutation in Chinese NSCLC patients is different from that in European and American NSCLC patients. This paper briefly reviews the characteristics of EGFR gene mutation and the current status and progress of EGFR-targeted drugs in Chinese NSCLC patients to investigate the mutation characteristics of EGFR in Chinese NSCLC patients and the response as well as prognosis of Chinese patients to EGFR-TKI therapy.
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Objective:To investigate the risk factors for intrahepatic cholangiocarcinoma (ICC) after hepatectomy for hepatolithiasis.Methods:The retrospective case-control study was conducted.The clinico-pathological data of 1 071 patients who underwent hepatectomy for hepatolithiasis at the Eastern Hepatobiliary Surgery Hospital of Navy Medical University between January 2010 and December 2011 were collected. There were 379 males and 692 females, aged (53±12)years, with the range of 12-86 years. Patients completed preoperative examinations. For regional hepatolithiasis, the anatomical hepatectomy was performed. For diffused hepatolithiasis, regional damaged lesions which confined to liver segment or lobe were resected. Hepaticolithotomy or cholangio-lithotomy was performed if necessary. When severe stricture of hilar bile duct affects biliary drainage, cholangiojejunostomy or biliary stricture plasty was performed. Observation indicators: (1) preoperative examination, surgical and postoperative situations; (2) follow-up; (3) risk factors analysis of ICC within the 5 years after hepatectomy for hepatolithiasis. Follow-up using outpatient examination and telephone interview was performed to detect the incidence of ICC after hepatectomy up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were described as M (range). Count data were described as absolute numbers or percentages. Continuous variables were converted into categorical variables according to the common clinical values or the best cut-off value of receiver operating characteristic curve. Binary logistic regression model was used for risk factors analysis. The factors with P<0.10 in univariate analysis were included for the multivariate analysis. Results:(1) Preoperative examination, surgical and postoperative situations. Results of preoperative examination: duration of hepatolithiasis-related symptoms of the 1 071 patients was 8.2 years(range, 0-27.0 years), the levels of CA19-9 and CEA were (163±87)U/mL and (5.0±2.1)μg/L, and stones located at left liver, right liver, bilateral sides, common hepatic duct or common bile duct were detected in 545, 245, 228, 53 patients. There were 226 patients complicated with biliary stricture and 172 with segmental atrophy. Of the 1 071 patients, 595 underwent anatomical hepatectomy, 272 underwent regional non-anatomical hepatectomy, 143 underwent cholangiolithotomy, and 61 underwent cholangiojejunostomy. Results of postoperative imaging examination showed residual biliary stricture in 26 patients and residual biliary stones in 74 patients. (2) Follow-up: 1 071 patients were followed up for (8.6±1.5)years. Of the 1 071 patients, 92 developed ICC, with an incidence of 8.590%(92/1 071). There were 32, 66, 90 patients developing ICC within 3, 5, 8 years after hepatectomy, with the incidence of 2.988%(32/1 071), 6.162%(66/1 071), 8.403%(90/1 071). (3) Risk factors analysis of ICC within the 5 years after hepatectomy for hepatolithiasis. The receiver operating characteristic curve of duration of hepatolithiasis-related symptoms for ICC within the 5 years after hepatectomy was constructed, and duration of hepatolithiasis-related symptoms was converted into categorical variable for following analysis using 7 years as the cut-off value based on Youden index. Results of univariate analysis showed that duration of hepatolithiasis-related symptoms>7 years, complication with metabolic diseases, segmental atrophy, postoperative residual stones were related factors for ICC within the 5 years after hepatectomy ( odds ratio=2.939, 2.654, 1.903, 2.361, 95% confidence interval: 1.582-5.460, 1.145-6.154, 1.068-3.390, 1.118-4.987, P<0.05). Results of multivariate analysis based on factors with P<0.10 in the univariate analysis showed that duration of hepatolithiasis-related symptoms>7 years, complication with metabolic diseases, segmental atrophy, postoperative residual stones were independent risk factors for ICC within the 5 years after hepatectomy ( odds ratio=2.843, 2.469, 1.922, 2.202, 95% confidence interval: 1.523-5.309, 1.042-5.851, 1.064-3.472, 1.021-4.747, P<0.05). Conclusions:There was risk of developing ICC after hepatectomy for cholelithiasis. The duration of hepatolithiasis-related symptoms >7 years, complication with metabolic diseases, segmental atrophy and postoperative residual stones are independent risk factors for ICC development within 5 years after hepatectomy.
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Objective: We aimed to investigate the clinicopathology and prognosis of invasive micropapillary carcinoma (IMPC) of the breast. Methods: This was a single-center retrospective study based on the clinicopathological and follow-up data of 246 patients with IMPC who were treated at the Tianjin Medical University Cancer Institute and Hospital between January 2011 and December 2015. The patients were divided into two groups: we included 143 patients with >50% IMPC in group A and the remaining 103 patients in group B. The cox proportional-hazard regression model, Log-rank test, and Kaplan-Meier method were used for analysis. Results: The 5-year disease-free survival (DFS; 76.5% vs. 83.6%, P=0.042) and overall survival (OS; 74.1% vs. 81.6%, P=0.029) of group A were lower than those of group B. The DFS (χ2=5.219, P=0.022) and OS (χ2=3.96, P=0.047) of patients who did not receive radiotherapy in group A were lower than those of patients who received radiotherapy. Multivariate Cox regression analysis showed that HER-2 expression (HR= 2.989, 95% CI 1.400-6.384, P=0.005), mammilla invasion (HR=2.388, 95% CI 1.263-4.518, P=0.007), and ≥4 lymph node metastasis (HR= 2.076, 95% CI 1.080-3.992, P=0.029) were independent risk factors for DFS. Mammilla invasion (HR=1.951, 95% CI 1.054-3.609, P= 0.033) was an independent risk factor for OS. The DFS (χ2=6.541, P=0.011) and OS (χ2=6.455, P=0.012) in patients with mammilla invasion who did not receive radiotherapy were significantly lower than those of patients who received radiotherapy. Conclusion: As a special type of breast cancer, mammilla invasion indicates a poor prognosis. The prognosis of patients with >50% IMPC was worse than that of patients with ≤50% IMPC. Postoperative adjuvant radiotherapy may provide survival benefit to patients with IMPC accounting for 50% or mammilla invasion.
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Objective To explore the clinicopathological characteristics,diagnosis,treatment and prognosis of accessory breast cancer.Methods Clinical and pathological data of 37 accessory breast cancer patients from Dec 2005 to Aug 2017 were reviewed.Results 12 patients underwent breast-conserving local wide excision plus axillary lymph node dissection.5 cases were treated by segmental resection and 19 patients by Auchincloss or Halsted mastectomy;One patient abandoned surgery.The most common histological type of accessory breast cancer was infiltrating ductal carcinoma (26 cases,70.3％) followed by adenocarcinoma (4 cases) and miscellaneous type (7 cases).The most common AJCC pathological stages were stage Ⅱ (n =24,65 ％),Ⅰ (n =8),Ⅲ(n =3) and Ⅳ (n =2).The median follow-up time was 6 (1-12) years,the followup rate was 100％.Until Dec 2017,7 patients died from metastasis and the others were alive.Conclusions Accessory breast cancer is rare and with poor prognosis.The diagnosis depends on clinical manifestations,imaging and pathology.Surgery is the mainstay therapy,adjuvant chemo therapy is recommanded.
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Breast cancer is the most common malignant tumor in women. With the development of cell biology and molecular bio-technology, great progress has been made in the study of the pathogenesis of breast cancer. Familial breast cancer is closely related to the mutation of susceptible genes. Selected susceptible genes of breast cancer can be grouped into three categories: high-, medium-, and low-penetrance susceptible genes. The means of identifying the high-risk sites of pathogenic mutation and genetic polymorphism is the focus of research on the genetic predisposition of breast cancer.
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Objective To summarize the epidemiological characteristics of ankle fractures and clinical outcome of open reduction and fixation for the treatment of posterior Pilon fracture with supporting plate. Methods From January 1st,2013 to December 31st,2016,the data of three hundred and twelve patients with ankle fracture in Jinshan Hospital of Fudan University were collected, and 21 cases of posterior Pilon fracture were treated with open reduction and fixation using supporting plate and were followed up,the ankle function was assessed by American Orthopaedic Foot and Ankle Society ankle hindfoot scale. Results There were 312 patients with ankle fractures,180 males,132 females. The age distribution of patients was as follows:1. 28%,12. 82%,14. 42%,24. 04%,28. 53%,11. 54%,6. 09% and 1. 28% in the following age group:≥18 and≤20 years of age,>20 and ≤30 years of age,>30 and ≤40 years of age,40> and ≤50 years of age,>50 and≤60 years of age,>60 and ≤70 years of age,>70 and ≤80 years of age and >80years of age. Traffic accidents (49%),sprains(31%),falling injury (11%),heavy pound(6%) were the main causes of ankle fractures. In terms of fracture types,238 (76. 2%) cases with lateral malleolus,235 (75. 3%) cases with medial malleolus fractures,161 (51. 6%) cases with posterior malleolus,and 105 (33. 7%) cases with trimalleolar fracture,21 (6. 8%)cases with posterior Pilon fracture. 21 patients with posterior Pilon fracture were followed up for 13. 0 to 56. 0 months,with an average of (31. 7±12. 6) months. Postoperative incision infection occurred in 3 patients,of which 1 cases had mild external leakage,and all wounds healed after dressing change. No fracture and screw prolapse occurred in all follow-up patients. The average score of AOFAS was (87. 2± 7. 1) points,of which 9 cases were excellent,10 cases were good,and 2 cases were fair. Conclusion Patients with ankle fractures were more common in males aged 60 and below,while in patients above 60 years old,the majority patients were females. In addition,patients aged 40 to 60 years old accounts for more than half of the population and the most common age group were between 50 and 60 years old. Traffic accidents and sprains are the common causes. The incidence of different fracture types in descending order were as follows: lateral malleolus fractures, medial malleolus fractures,posterior malleolus fractures and trimalleolar fractures. Pilon fracture was a common type of ankle fracture. Clinical outcome of open reduction and fixation for the treatment of posterior Pilon fracture with supporting plate was satisfied.
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Nitrogen-doped carbon nanoparticles (N-CNPs) with a fluorescence quantum yield of 15.1％ were prepared from sucrose and urea in oleic acid medium by a one-pot solvothermal method.A new approach for quick,sensitive,and selective determination of free chlorine in water was developed based on fluorescence quenching of N-CNPs.There existed a good linear correlation between the fluorescence quenching and the concentration of ClO-in the range of 0.05-25.00 μmol/L.The limit of detection (LOD,S/N =3) was estimated to be 23 nmol/L.This method can be applied to the determination of free chlorine in real water samples.
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Objective To know the basic hygienic condition of the drinking water safety project in the countryside of Ya'an. Methods The water samples were collected in 2008 and were analyzed complying with the standard protocol of drinking water quality test(GB/T 5750-2006),the basic condition of the water supply was investigated in the same time. Results The main water sources of the researched 133 water supply projects were brook and spring,accounted for 64.66%. The central water supply projects with complete water treatment accounted for 36.84% ,the projects with partial water treatment accounted for 56.39% ,the projects without water treatment accounted for 6.77%. In the projects with partial water treatment, 84% of them had no disinfection facilities. In low flow and ample flow period,the eligible rates of water quality were 26.32%(70/266)and 37.98%(98/258)respectively. The bacteriological indexes were the main influencing factors. Conclusion The centralized water supply projects in the countryside in Ya'an have a high eligible rate in the items,but the bacteria contamination is still a main influencing factor in the rural area drinking water safety.