Analysis of risk factors related to distant metastasis in patients with early breast cancer undergoing endoscopic nipple-areola-sparing subcutaneous gland resection / 国际外科学杂志

Objective:To analyze the risk factors related to distant metastasis in patients with early breast cancer who undergoing endoscopic nipple-areola-sparing subcutaneous gland resection.Methods:A retrospective analysis was used to select 402 patients with early breast cancer from January 2012 to January 2016. According to the breast cancer metastasis within 5 years after surgery, the patients were divided into the metastasis group ( n=37) and the control group ( n=365). Metastasis group refers to patients with breast cancer metastasis within 5 years after surgery, and control group refers to patients without breast cancer metastasis within 5 years after surgery. The age, family history of breast cancer, breast cancer stage, location of lesion, number of lesions, diameter of tumor, histopathological type, histological grade, molecular classification, lymph node metastasis, distant metastasis site, number of distant metastasis, operation time, intraoperative blood loss, axillary operation, carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 153 (CA153), cancer antigen 199 (CA199), postoperative extubation time, drainage amount, postoperative subcutaneous effusion, flap necrosis, incision infection, poor incision healing, dyskinesia of affected limbs, length of hospital stay were compared between the two groups. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups; Chi-square test was used for comparison of enumeration data between groups. Multivariate logistic regression analysis was used to analyze the independent risk factors of distant metastasis undergoing endoscopic nipple-areola-sparing subcutaneous gland resection in patients with early breast cancer. Using SPSS decision tree model to predict the intensity and hierarchical nodes of each risk factor. Receiver operating characteristic curve (ROC) were drawn using R 4.0.2 software, and the area under the ROC curve (AUC) was used to validate stratified nodes for continuous variables. Results:Multivariate Logisitic regression analysis showed that age < 40 years ( OR=2.715, 95% CI: 2.349-3.168, P=0.002), lymph node metastasis ( OR=2.604, 95% CI: 2.413-2.825, P=0.009), histological grade G3 ( OR=2.473, 95% CI: 2.331-2.701, P=0.007), CEA ≥ 4.10 ng/mL ( OR=2.481, 95% CI: 2.357-2.616, P=0.003) and CA153 ≥ 18.90 U/mL ( OR=2.467, 95% CI: 2.344-2.620, P=0.002) were independent risk factors for distant metastasis after endoscopic nipple-areola-sparing subcutaneous gland resection in patients with early breast cancer. The decision tree model showed that age < 40 years ( χ2=16.18, P<0.001), lymph node metastasis ( χ2=9.53, P=0.002), histological grade G3 ( χ2=11.73, P<0.001), CEA ≥ 4.10 ng/mL ( χ2=13.62, P=0.001) and CA153 ≥ 18.90 U/mL ( χ2=7.39, P=0.010) could predict distant metastasis after endoscopic nipple-areola-sparing subcutaneous gland resection in patients with early breast cancer.The AUC values of ROC curves of each node were 0.814, 0.789, 0.761, 0.696 and 0.745 respectively, the sensitivity were 84.35%, 74.96%, 79.35%, 71.59% and 73.10% respectively, and the specificity were 80.16%, 77.55%, 76.54%, 70.32% and 76.83%, respectively. The prediction performance of the model was good. Conclusion:Age < 40 years, lymph node metastasis, histological grade G3, CEA ≥ 4.10 ng/mL and CA153 ≥ 18.90 U/mL are independent risk factors for distant metastasis after endoscopic nipple-areola-sparing subcutaneous gland resection in early breast cancer patients.

Preliminary results of multicenter studies on ABO-incompatible kidney transplantation / 中华器官移植杂志

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Preparation of the polyclonal antibodies of CDPK 5 gene from toxoplasma gondii and the identification of its functions / 重庆医学

Objective Screening the immune polypeptide sequence of toxoplasma (Tg) CDPK5 gene ,which were synthesized and then immunized the New Zealand white rabbit to prepare antiserum ,and identification its function .Methods Bioinformatics a‐nalysis was used to determine the immune peptide of Tg CDPK5 sequence ,which were artificially synthesized to immune white rab‐bit to prepare antiserum .The titers of antibodies were determined by ELISA and the polyclonal antibodies were verified with CD‐KP5 antigen by Western blot .The sub‐cellular localization of Tg CDPK 5 were obtained by immunofluorescence assay .Results 17 bp peptide sequence from the Tg CDPK5 N‐terminal were chosen as immune polypeptide by bioinformatics analysis .Synthetic pep‐tide were used to immune rabbit to obtain polyclonal antiserum .The result showed that the titer of the obtained ployantibody were 1∶640 000 ;Western blot demonstrated that the antiserum could specifically recognize Tg CDPK 5(75 .4 × 103 );Immunofluores‐cence assay revealed this antibody could specifically recognize the endogenous Tg CDPK 5 of Toxoplasma gondii .Conclusion Ac‐cording to the analysis of Tg CDPK5 sequence information ,this study successful obtained Tg CDPK5 polyclonal antibody .

Mutation analysis of 16 mutation spots related to children patients with non-syndromic sensorineural hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical signification of screening 16 target deafness mutations in GJB2, GJB3, SLC26A4, WFS1 and mitochondrial DNA 12S rRNA in 135 children patients with non-syndromic sensorineural hearing loss (NSHL) in Zibo City, Shandong province.@*METHOD@#Peripheral blood samples of 135 subjects in the study diagnosed as NSHL were collected; Polymerase chain reaction (PCR) and direct sequencing were used to analyze the 16 mutation spots.@*RESULT@#Sixty-two cases of 135 patients (45.9%, 62/135) were found out to be carries of at least one pathogenic gene mutation. Among them, 24 cases (17.8%, 24/135) had two mutated alleles (homozygote and compound heterozygote), and 38 cases (28.1%, 38/135) were single mutant carriers. Among all the children patients, 30 cases (22. 2%, 30/135) had SLC26A4 mutations, and 19 cases (14.1%, 19/135) had GJB2 mutations. In the study 86 Mutant alleles were detected, and the allele frequency of SLC26A4 c. 766_2A > G and GJB2 c. 235delC was 11.11% (30/270) and 8.5% (23/270) respectively. The allele frequency of SLC26A4 c. 2168A > G and WFS1 c. 2158A > G is 2.6% (7/270).@*CONCLUSION@#SLC26A4 mutation is the primary cause of the patients with NSHL in this study, and GJB2 mutation is the secondary. The most common mutant form is c. 766_2A of SLC26A4, and the second is c. 235delC of GJB2. GJB3 and WFS1 mutations were detected, whereas mtDNA mutations were not found out in this study.

Comparative study on drug resistance of pseudomonas aeruginosa isolated from different sites of patients / 国际检验医学杂志

Objective To analyze the infection sites of pseudomonas aeruginosa (PAE) isolated from patients in hospital ,and in‐vestigate their drug resistance situation ,in order to provide reference information for clinical use of antibiotics rationally .Methods The sample distribution of PAE between January 2012 and December 2013 were retrospectively analyzed .And the resistance rates of PAE to antibacterial drugs from different sites of patients were statistically compared .Results The isolation rate of PAE in re‐spiratory tract was the highest ,accounting for 74 .1% ,closely followed by isolation rate in urine and wound secretion .The resist‐ance rate of PAE to antibacterial drugs in these three kinds of specimen is statistically different (P<0 .05) .The resistance rate of PAE is high in respiratory tract ,and low in wound secretion .Conclusion The pseudomonas aeruginosa infection is mostly common‐ly found in respiratory tract ,and has the highest drug resistance rate .The choice of antibacterial drug should be made according to the infection sites of patients ,because the resistance rate of PAE in different sites of patients is significantly different .