Risk factors analysis of breast cancer-related lymphedema based on the proportion of the arm lymph flow above and below the axillary vein / 中华普通外科杂志

Objective:To develop and validate an clinical prediction model for the risk of breast cancer-related lymphedema (BCRL).Methods:Breast cancer patients who were prepared to undergo axillary lymph node dissection were propsectively enrolled, indocyanine green combined with Photodynamic Eye (PDE) was applied to reveal the arm lymphatic flow . The arm lymphatic fluorescence images were collected to calculate the proportion of arm lymph flow above and below the axilla vein. Volumetric measurements of both arms and subjective questionnaire were performed to evaluate the occurrence of lymphedema. A difference in volume between the arms >10% was defined as lymphedema. Univariate logistic regression analysis was used to analyze the relationship between each factor and BCRL. The stepwise forward method was used to include multiple factors in the logistic regression analysis to establish the prediction model.Results:Three hundred and twelve patients were enrolled. Fourty-five (14.4%) patients developed BCRL. Using the coefficients obtained from multivariate analysis, BMI ( OR 95% CI: 1.34 (1.25-1.77), P<0.05), chemotherapy ( OR 95% CI: 2.26 (1.97-2.63), P<0.05), regional lymph node radiotherapy ( OR 95% CI: 1.59 (1.05-2.41), P<0.05) and the proportion of arm lymph flow above the level of the axillary vein ( OR 95% CI: 0.70 (0.68-0.81), P<0.05) were identified as independent predictive factors for BCRL, and the following prediction equation was derived: Y=0.369×(BMI at surgery)+0.713×(taxane-based chemotherapy)+0.862×(radiotherapy)-9.058×(proportion of the arm lymph above the axillary vein)-6.859 8. The ROC curve was screened to the optimal boundary value of 0.118 6 by the Youden's index. The sensitivity, specificity, positive predictive value and negative predictive value of prediction of this model were 93.3%, 79.4%, 73.3%, 98.6%, respectively. Conclusion:With the guidance of the predictive model, particular patients who need the preservation of axillary lymphatic system can be identified, and timely intervention can be carried out.

Diagnosis and treatment of patients with granulomatous lobular mastitis / 中华普通外科杂志

Objective:To observe the effect of local excision under ultrasonography with immediate mammoplasty in granulomatous lobular mastitis.Methods:Fifty-three patients with granulomatous lobular mastitis admitted from Jan 2017 to Jul 2020 were retrospectively analyzed. Combined with sonographic findings and clinical manifestations, patients were divided into four types: type Ⅰ, single mass; Type Ⅱ, single mass located in one quadrant with one or no skin lesion; Type Ⅲ, multi-quadrant involved with one or no skin lesion; Type Ⅳ, multiple abscesses with multiple lesions in the skin. Twenty-five patients underwent wide local excision (control group); Twenty-eight patients underwent local excision under ultrasonography with immediate mammoplasty (experiment group). Patients with erythema nodosum or in type Ⅳ were given antibiotics and corticosteroid therapy preoperatively for 1 week and postoperatively for 5 days. The others went straight to surgery.Results:All patients were followed up for 1 year. In the experiment group, 28 patients had primary wound healing, and 3 patients had poor wound healing after operation (all were of type Ⅳ). The control group had 6 cases of recurrence(were of type Ⅲ and type Ⅳ). There was significant difference of the recurrence rate between the two groups (0 vs. 24%, χ 2=6.033, P=0.014), and the aesthetic effect of local excision under ultrasonography with immediate mammoplasty was better than that of wide local excision(93% vs. 68%, χ 2=5.330, P=0.020). Conclusion:The recurrence rate of local excision under ultrasonography with immediate mammoplasty is low, and with a satisfactory cosmetic effect.

Flavonoids from the leaves of Astragalus membranaceus / 中成药

AIM To study the flavonoids from the leaves of Astragalus membranaceus (Fish.) Bge..METHODS The ethyl acetate and n-butyl alcohol fractions of 75％ ethanol extract from A.membranaceus leaves were isolated and purified by silica,ODS and preparative HPLC column,then the structures of obtained compounds were identified by spectral data.RESULTS Thirteen compounds were isolated and identified as quercetin (1),quercetin-3-O-β-D-glucopyranoside (2),rhamnocitrin-3-O-β-D-glucopyranoside (3),rhamnocitrin-3-O-β-neohesperidoside (4),rhamnocitrin-3-O-3-D-glucopyranoside (1'''→2'')-β-D-apiofuranosyl (5),complanatuside (6),glycitein (7),4',7-dihydroxy-3-methoxy isoflavone (8),genistein (9),calycosin-7-O-β-D-glucopyranoside (10),genistin (11),glycitin (12),tiliroside (13).CONCLUSION Compounds 5,8,13 are isolated from genus Astragalus for the first time,and compound 2 is first isolated from this plant.

Diagnosis and treatment of primary hyperparathyroidism: 115 cases / 中华内分泌外科杂志

Objective To analyze clinical features of primary hyperparathyroidism(PHPT)and to evaluate the diagnosis and treatment for PHPT.Methods 115 patients with PHPT undergoing surgery and confirmed by pathology from Jan.2006 to Mar.2014 were retrospectively analyzed.Results The clinical manifestations of PHPT were various.The rate of misdiagnosis was 70.0％(77/115).The positive rate of ultrasonography was 61.0％ (64/105),99Tcm-MIBI 88.3％(68/77)and CT 75.4％(46/61),respectively.The difference among the 3 tested methods had statistical significance (P＜0.05).89 cases with parathyroidoma underwent unilateral neck exploration,6 cases of parathyroid hyperplasia underwent bilateral neck exploration,3 cases with parathyroid carcinoma underwent carcinoma resection,ipsilateral thyroid lobe resection and ipsilateral central lymph node dissection,and 21 cases with thyroid benign or malignant lesions underwent suitable operations.97 cases developed hypocalcaemia of various degrees after operation,and the symptoms were relieved after use of calcium gluconate.Conclusions PHPT can be diagnosed according to the lever of serum calcium and PTH.Ultrasonography and 99Tcm-MIBI should be the first choice for preoperative localization.Unilateral neck exploration can be used for parathyroidoma with accurate localization.

Isolation and Identification of Triterpenoids from Acanthopanax Sessiliflorus Fruits / 中国药师

Objective: To isolate and identify the structures of triterpenoids from the extract of Acanthopanax sessiliflorus fruits. Methods:The chemical constituents were systematically isolated by column chromatography and liquid chromatography, and their struc-tures were determined by spectral data including 1 H-NMR, 13 C-NMR, HSQC and HMBC combined with ESI-MS. Results:Totally 8 trit-erpenoids compounds were isolated and identified from Acanthopanax sessiliflorus fruits, 22-α-hydroxychiisanogenin (1), chiisanogenin (2), 3-oxo-24-methylenecycloartan (3), mangiferonic acid (4), isomangiferolic acid (5), oleanolic acid (6), betulin (7) and betulin-ic acid (8). Conclusion:Compound 3, 4 and 5 are obtained from Acanthopanax genus for the first time.

Value of serum SDF-1a half-life in predicting postoperative recurrence and metastasis in patients of breast cancer / 中华普通外科杂志

Objective To investigate the plasma level of SDF-1a in patients with breast cancer after modified radical mastectomy and chemotherapy, and to evaluate the value of serum SDF-1a half-life for predicting breast cancer recurrence and metastasis. The correlation of SDF-1 a half-life and breast cancer recurrence and metastasis after treatment were retrospectively analyzed. Methods Serum chemokine SDF-1a of 112 cases of breast cancer were detected before and after modified radical surgery, and 1 day beforeeach chemotherapy session. SDF-1a levels and the dynamic changes in the process were observed and calculated. Results In 85 cases with no recurrence and metastasis the plasma level of SDF-1 a decreased rapidly to normal level ,while that in 27 cases with recurrence and metastasis was on high level with the halflife of SDF-1a being longer than that in no recurrence group(P ＜0. 01 ). Taking SDF-1a half-life ≥14 d as cut off point to predict breast cancer recurrence and metastasis after treatment, the sensitivity is 81.5%,specificity is 70. 6 %, and accuracy is 73.2%. Conclusions Serum SDF-1a half-life is a valuable marker in predicting postoperative breast cancer recurrence and metastasis.

Celecoxib Inhibits Proliferation and Induces Apoptosis via Cyclooxygen-ase-2 Pathway in Human Pancreatic Carcinoma Cells / 华中科技大学学报（医学）（英德文版）

In order to evaluate the effects and mechanisms of celecoxib in inhibiting proliferation and inducing apoptosis on human pancreatic carcinoma cells, the anti-proliferative effect was measured by using methabenzthiazuron (MTT) assay. Cell cycle and apoptosis were analyzed by using flow cytometry (FCM), and the PGE2 levels in the supernatant of cultured pancreatic carcinoma cells were quantitated by enzyme-linked immunoabsordent assay (ELISA). Our results showed that celecoxib suppressed the production of PGE2 and inhibited the growth of JF-305 cells, and the anti-proliferative effect of celecoxib could be abolished by addition of PGE2. FCM revealed that celecoxib could inhibit proliferation and induce apoptosis by G1-S cell cycle arrest. It was concluded that cyclooxygenase-2 specific inhibitor celecoxib could inhibit proliferation and induced apoptosis of human pancreatic carcinoma cells via suppression of PGE2 production in vitro.

Effects of Bile from Patients with Cholecystolithiasis on the Growth of Human Gallbladder Carcinoma Cells / 中国普外基础与临床杂志

Objective To explore the effects of bile from patients with cholecystolithiasis on the growth of human gallbladder carcinoma cells GBC-SD and the potential correlation between cholecystolithiasis and gallbladder carcinoma. Methods Cholecystolithiasis bile (CB) and normal bile (NB) specimens were used for this study. The proliferative effects of bile were measured by methabenzthiazuron (MTT) assay and cell cycle and apoptosis were analyzed by flow cytometry. Results CB can significantly promote the proliferation of GBC-SD cells, GBC-SD proliferative index increased significantly after treated with 1% CB for 48 h (P

Proliferative activity for a cholangiocarcinoma cell line of bile from patients with choledocholithiasis / 中国普通外科杂志

Objective To explore the effects of bile from patients with choledocholithiasis on the growth of human cholangiocarcinoma cell line QBC939 and the potential relation between choledocholithiasis and cholangiocarcinoma. MethodsWT5”BZ Choledocholithiasis bile (CB) and normal bile (NB) specimen were used for this study. The proliferative effects of bile were measured by methabenzthiazuron (MTT) assay and cell cycle and apoptosis were analyzed by flow cytometry. KG2Results CB significantly promoted the proliferation of QBC939 cells, QBC939 proliferative index increased significantly after treated with 1% CB for 48 h ( P

Proliferative activity of bile of patients undergoing transduodenal sphincteroplasty / 中国普通外科杂志

Objective To explore the effects of bile in patients undergoing transduodenal sphincteroplasty (TSB) on the growth of human cholangiocarcinoma cell line QBC939 and the potential relation between transduodenal sphincteroplasty and cholangiocarcinoma. Methods TSB and normal bile (NB) sample were used for this study. The proliferative effect of bile was measured by using methabenzthiazuron (MTT) assay, and cell cycle and apoptosis were analyzed by using flow cytometry. Results Compared with NB,TSB significantly promote the proliferation of human cholangiocarcinoma QBC939 cells (P

Effect of octreotide on pancreatic cancer cells transfected with SST 2 gene / 中国普通外科杂志

Objective To observe the effect of octreotide on human pancreatic cancer cells (PC-3) apoptosis after PC-3 transfected with somatostatin receptor type 2 (SST 2) gene. Methods SST 2 was transfected into PC-3 by liposome,the result of transfection was detected by immunohistochemistry. The apoptosis of PC-3 induced by using different dosage of octreotide were detected by MTT assay and flow cytometry. Results The effects of killing PC-3 by different dosage (0.2,0.4 and 0.8?g/ml ) of octreotide in transfected groups were significantly stronger than those in non-transfected groups(P