Résumé
Purpose To discuss the clinical,histopathological characteristics,diagnosis,differential diagnosis and prognosis of malignant intraductal papillary lesions of the breast.Methods 28 cases of malignant intraductal papillary lesions of the breast were analyzed by histology and immunobistochemistry.Clinical and follow-up information was obtained.The published relevant literatures were reviewed.Results All the patients were females with a mean age of 55.7 years.The clinical features were a palpable mass or nipple discharge.28 cases were diagnosed including 22 cases of intraductal papaillary carcinoma,2 cases of encapsulated papillary carcinoma and 4 cases of solid papillary carcinoma.Microscopically,the tumor showed solid and papillary area inside the capsule wall with fine delicate fibrovascular septa.The tumor cells usually displayed low-grade nuclear features.Immunohistochemistry,the tumor cells revealed diffusely strong positive ER and PR in almost all cases and HER-2,CK5/6 were negative positive.All cases were negatiive for CK5/6,p63 and SMA in the celluar nodules.CD56,Syn and CgA were found positively in some solid papillary carcinoma cases.The average positive rate of Ki-67 in tumor cells was 5.3 ％.27 patients were available for follow-up examination from 10 to 79 months and all the patients were alive.Conclusion Malignant intraductal papillary lesions of the breast most occurs in postmenopausal women.The diagnosis should be based on the clinical information,histopathological features and immunohistoehemistry stain due to its diverse histology.The main differential diagnosis is intraductal papilloma.This kind of lesion is a low grade malignant tumor with favorable prognosis.
Résumé
Objective To evaluate the synergistic effect of Baoxinkang on chronic heart failure ( CHF) rats by observing the effect of the combination of Baoxinkang and conventional medicine intervention on cardiac function and adenylate metabolism. Methods Sixty Sprague-Dawley rats were randomly divided into 6 groups, namely sham-operation group, model group, Baoxinkang group ( Baoxinkang 1 020 mg/kg) , conventional medicine intervention group (metoprolol 10 mg/kg, captopril 5 mg/kg, and digoxin 0.022 5 mg/kg), combination group 1 ( conventional medicine intervention + Baoxinkang 1 020 mg/kg) , and combination group 2 ( conventional medicine intervention + trimetazidine 10 mg/kg) . Abdominal aora was constricted to establish CHF rat model. The rats except for the sham-operation group and model group were given the corresponding medicine according to the experimental design for 6 weeks. Echocardiography ( ECHO) was performed to evaluate the cardiac function of rats. High performance liquid chromatography was utilized to investigate the contents of myocardiac adenylate of adenosine triphosphate ( ATP) , adenosine diphosphate ( ADP) , adenosine monophosphate (AMP) . Total adenylate nucleotide pool (TAN) was equal to ATP+ADP+AMP, energy charge (EC) was equal to ( ATP+0.5 ×ADP) /TAN. Results The results of ECHO showed that the heart size was reduced, left ejection fraction and cardiac output were increased in the combination group 1 compared with the model group and conventional medicine intervention group. The levels of ATP, TAN, and EC were significantly increased, whereas the levels of ADP and AMP were decreased in the combination group 1 (P0.05) . Conclusion Baoxinkang may have some synergistic effect on the improvement of CHF rat cardiac energy metabolism disorder treated by conventional medicine.