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Objective:To compare the complications between breast-conserving surgery with free dermal fat graft (FDFG) and traditional breast-conserving surgery (TBCS) in breast cancer patients, and to analyze the influencing factors for the incidence of complications of breast-conserving surgery with FDFG.Methods:The clinical data of 120 breast cancer patients who underwent breast-conserving surgery with FDFG (FDFG group, 50 cases) or TBCS (TBCS group, 70 cases) in Liuzhou People's Hospital from June 2015 to September 2020 were retrospectively analyzed. The incidence of overall complications and various complications between the two groups were compared, the influencing factors of complications in the FDFG group were analyzed, and the cosmetic outcome was evaluated.Results:There was no significant difference between the two groups in age, lymph node status, clinical TNM stage, etc (all P > 0.05). In the FDFG group, the proportions of patients with the longest tumor diameter > 3 cm and tumor in upper inner quadrant were significantly higher than those in the TBCS group [52.0% (26/50) vs. 27.1% (19/70), χ2 = 7.69, P = 0.006; 38.0% (19/50) vs. 15.7% (11/70), χ2 = 7.73, P = 0.005]. The operation time, intraoperative blood loss, postoperative hospital stay and weight of resected tissues in the FDFG group were higher than those in the TBCS group [(251±69) min vs. (213±41) min, (107±29) ml vs. (68±26) ml, (8.8±2.5) d vs. (6.1±1.6) d, (81±26) g vs. (56±20) g], and the differences were statistically significant ( t values were 10.14, 30.58, 22.20, and 14.54, respectively, all P < 0.001). There were no significant differences in the incidence of overall complications, bleeding, infection, or poor wound healing between the two groups (all P > 0.05). The incidence rate fat liquefaction in the FDFG group was higher than that in the TBCS group [14.0% (7/50) vs. 1.4% (1/70), χ2 = 5.53, P = 0.019]. Multivariate logistic regression analysis showed that the weight of FDFG ( OR = 14.056, 95.0% CI 1.764-111.985, P = 0.013) and the thickness of FDFG ( OR = 19.599, 95.0% CI 1.743-220.345, P = 0.016) were independent influencing factors for the incidence of complications in the FDFG group. The percentage of 'excellent' or 'good' cosmetic outcome in the FDFG group was 90% (45/50). Conclusions:Breast-conserving surgery with FDFG can extend the resected area for tumor without increasing the incidence of overall complications and could provide patients a superior cosmetic outcome, but the incidence of fat liquefaction is higher than that of TBCS. The weight and thickness of FDFG are the influencing factors for the incidence of complications of breast-conserving surgery with FDFG.
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Objective:To compare toally endoscopic thyroidectomy(TET) with open thyroidectomy(OT) in the treatment of differentiated thyroid cancer.Methods:Data of 190 patients at Liuzhou People's Hospital from Jul 2017 to Dec 2019 were analyzed. Patients were divided into endoscopic surgery group ( n=95) and open surgery group ( n=95). Results:The operation time and the hospital stay in endoscopic group were longer than that in open surgery group[(153±25) min vs. (116±17) min, (5.56±1.08) d vs.(5.08±1.04) d, t=11.827，3.083， both P<0.05)]. There was no significant difference in intraoperative blood loss [(33±14) ml vs. (37±16) ml, t=-1.851 P>0.05], recurrent laryngeal nerve paralysis, hypoparathyroidism and wound complications (4% vs. 9%, 9% vs. 15%,1% vs. 3%, all P>0.05). There was no significant difference in the number of central lymph node dissection between the two groups (6.12±3.54 vs. 6.35±4.75, t=-0.404, P<0.05). The length of scar in endoscopic group was shorter [(3.03±0.27) cm vs. (6.47±0.53) cm, t=-56.138, P<0.05), and the postoperative cosmetic score evaluated by the patients was higher (8.76±0.75 vs. 7.39±0.76, P<0.05), than those in open group. There were no tumor recurrence nor metastasis in neither group by short term follow-up. Conclusions:TET is similar to OT on clinical curative effectiveness for differentiated thyroid carcinoma while carries a better cosmetic result .
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DNA methylation is an important epigenetic modification. Evaluating the status of DNA methylation could be useful for diagnosis, prognostic evaluation and predicting the risk of cancer. Thyroid cancer is the most prevalent endocrine malignancy in humans. Growing evidence shows that epigenetic abnormalities participate with genetic alterations in carcinogenesis of thyroid cancer. This article reviewed the recent research progress of DNA methylation in thyroid cancer.
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Objective To probe the effect of perioperative therapeutic regime on breast reconstruction after surgery in breast cancer patients.Methods We retrospectively reviewed the clinical data of 145 consecutive breast cancer patients with 162 reconstructions.Results 127 of 145 patients got an excellent or good appearance (87.6％),and 42 cases had complications occurring in 162 operations (25.9％).After a median follow-up of 38.4 months,recurrences were found in 9 patients,3 cases died,and the disease free survival rate was 93.1％.Multivariate analysis showed that radiation therapy,without nipple-sparing and one-stage prosthesis implant were independent risk factors for negative postoperative aesthetic outcome;Delayed reconstruction and implant reconstruction were found to be protective factors for the postoperative complications.Conclusions Although the survival rate appears to be scarcely affected,different treatment modalities in reconstruction strategy bring different clinical results and outcomes.The perioperative decision-making of reconstruction strategy should be based on oncological safety,postoperative complications,aesthetic outcomes and subsequent therapies.
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Objective To evaluate the effectives of high-frequency oscillatory ventilation (HFOV)in the treatment of severe NRDS.Methods The severe NRDS who failed to response to conventional mechanical ventilation (CMV) were changed to HFOV treatment.Ventilator parameters and blood gas analysis were compared before and after treatment.Results Among thirty patients,19 cases were significantly improved and 11 cases were failed,the success rate was 63％.Nineteen patients with HFOV,the main ventilator parameters and blood gas results such as FiO2 ( 0 h:0.87 ± 0.09 vs 3 h:0.67 ± 0.10,6 h:0.54 ±0.08,12h:0.44 ±0.08),MAP[0 h:(14.47 ±1.17) mbar vs 3 h:(13.79 ± 1.03) mbar,6 h:(13.26 ±1.05) mbar,12 h:( 12.37 ±0.83) mbar],f[0 h:(7.26 ±0.56) Hz vs 3 h:(7.89 ±0.57) Hz,6 h:(8.42±0.51 ) Hz,12 h:(9.26 ±0.45) Hz] and PaCO2 [0 h:(9.69 ±0.86) kPa vs 3 h:(6.00 ±0.55) kPa,6 h:(5.62 ± 1.03)kPa,12 h:(5.47 ±0.55)kPa] were decreased while pH(0 h:7.21 ±0.06 vs 3 h:7.35 ±0.07,6 h:7.39 ±0.07,12 h:7.40 ±0.06) and PaO2[0 h:(5.46 ±0.82)kPa vs 3 h:(7.92 ± 1.13)kPa,6 h:(9.25 ± 0.99)kPa,12 h:(9.20 ± 0.96)kPa] were significantly increased compared with before treatment ( P ＜ 0.05).Conclusions The patients of severe NRDS who failed to response to CMV were treated with HFOV,some patients received a significant effect with HFOV treatment.
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BACKGROUND:The incorporating of zeolites or porous fillers into polymer membranes can improve the pervaporation separation properties of membranes.But the effect mechanism of zeolites or porous fillers on membrane properties needs to be further studied.OBJECTIVE:The study was designed to prepare ZSM-5 zeolite incorporated chitosan membrane by solution blending method to investigate the effecIs of zeolite on membrane pervaporation properties.DESIGN:A controlled observation.SETTING:Dalian Institute of Chemical Physics,Chinese Academy of Sciences.MATERIALS:This study was performed at the Laboratory of New Type Membrane Separation Technology,Dalian Institute of Chemical Physics,Chinese Academy of Sciences in May 2006.Chitosan,with deacetylation degree of 75%-85%,was obtained from Sigma-Aldrich Chemical Company,USA;Dimethyl carbonate(DMC),with purity of 99%,was purchased from Fluka Chemical Company,USA:ZSM-5 zeolite was kindly supplied by Dalian Institute of Chemical Physics,Chinese Academy of Sciences,China;Methanol,with purity＞99.5%,were purchased from Shenyang Lianbang Chemical Company,China.METHODS:ZSM-5 zeolite incorporated chitosan membranes were prepared by solution blending method.MAIN OUTCOME MEASURES:①Swelling and sorption of ZSM-5 zeolite-incorporated chitosan membranes in the DMC/methanol mixture.②Effects of zeolite content in the membrane and operating temperature on pervaporation properties.RESULTS:Scanning electron mieroscope demonstrated that zeolite was uniformly distributed in the membrane matrix and the membranes were free from possible defects.The separation selectivity of dimethyl carbonate(DMC)/methanol mixtures was dominated by solubility selectivity rathcr than diffusivity selectivity.Swelling degree increased and the permeation flux of the membranes increased significantly with the zeolite content increasing.From the temperature-dependent permcation values,the Arrhenius activation parameten were estimated.CONCLUSION:The pervaporation results indicated that the membranes incorporated with the ZSM-5 zeolite exhibited better separation properties for DMC/methanol mixtures comparing with homogeneous chitosan membranes.