Clinical analysis in 45 cases of extensive intraductal carcinoma treated by breast shape reserving surgery with vertical double-pedicle bridge / 中国实用外科杂志

OBJECTIVE: To investigate the clinical effect of breast shape reserving surgery with vertical double dermal pedicle bridge in the treatment of extensive intraductal breast cancer.METHODS: During March 2015 to August 2017,the clinical and follow-up data of 45 patients with extensive intraductal cancer accepting breast shape reserving surgery with vertical double-pedicle bridge in Shengjing Hospital of China Medical University were analyzed retrospectively.RESULTS: Among the 45 cases,35 were treated with the modified McKissock mammaplasty technique and 10 combined prosthesis.The median follow-up time was 40(24-48) months.The disease-free survival rate was 100%.Two patients with nipple necrosis after combined prosthesis implantation recovered within 6 months after treatment.CONCLUSION: In the treatment of extensive intraductal breast cancer,the use of vertical double-pedicle dermal bridge for breast shape reserving(with or without prosthesis) has a satisfied efficacy.

A retrospective study on the relationship between LMR and preterm delivery in pregnant women / 中国实用妇科与产科杂志

OBJECTIVE: To study a potential relationship between preterm labor and lymphocyte to monocyte ratio(LMR).METHODS: This retrospective cohort study was conducted in Second Affiliated Hospital of Chongqing Medical University from August 2016 to November 2017. Totally 100 pregnant women who delivered between 28 th to 37 th gestational week were included as the study group,and 116 pregnant women who delivered after 37 th gestational week were as the control group. The data of routine blood test from 11 th to 13 th gestational week and 28 th to 30 th gestational week were observed and compared.RESULTS: The LMR value of preterm women was significantly higher than that of those who delivered at term(early pregnancy 4.90±1.40 vs. 4.31±1.30,P<0.01;middle and advanced stage of pregnancy 3.54±0.93 vs. 2.95±0.64,P<0.01). A negative correlation was observed between the level of LMR and the gestational weeks of termination of pregnancy(r=-0.350,P<0.01).CONCLUSION: The value of LMR in pregnancy is associated with the occurrence of preterm labor. Therefore,it is necessary to make further study.

Pharmacokinetic and Pharmacodynamic Efficacies of Continuous versus Intermittent Administration of Meropenem in Patients with Severe Sepsis and Septic Shock: A Prospective Randomized Pilot Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The antibiotic meropenem is commonly administered in patients with severe sepsis and septic shock. We compared the pharmacokinetic, clinical, and bacteriological efficacies of continuous infusion of meropenem versus intermittent administration in such patients.</p><p><b>METHODS</b>Patients admitted to the Intensive Care Unit (ICU) with severe sepsis or septic shock who received meropenem were randomly assigned to either the continuous (n = 25) or intermittent groups (n = 25). The continuous group received a loading dose of 0.5 g of meropenem followed by a continuous infusion of 3 g/day; the intermittent group received an initial dose of 1.5 g followed by 1 g for every 8 h. Clinical success, microbiological eradication, superinfection, ICU mortality, length of ICU stay, and duration of meropenem treatment were assessed. Serial plasma meropenem concentrations for the first and third dosing periods (steady state) were also measured.</p><p><b>RESULTS</b>Clinical success was similar in both the continuous (64%) and intermittent (56%) groups (P = 0.564); the rates of microbiological eradication and superinfection (81.8% vs. 66.7% [ P = 0.255] and 4% vs. 16% [ P = 0.157], respectively) showed improvement in the continuous group. The duration of meropenem treatment was significantly shorter in the continuous group (7.6 vs. 9.4 days; P= 0.035), where a better steady-state concentration was also achieved. Peak and trough concentrations were significantly different between the continuous and intermittent groups both in the first (Cmax: 19.8 mg/L vs. 51.8 mg/L, P= 0.000; Cmin: 11.2 mg/L vs. 0.5 mg/L, P= 0.000) and third dosing periods (Cmax: 12.5 mg/L vs. 46.4 mg/L, P= 0.000; Cmin: 11.4 mg/L vs. 0.6 mg/L, P= 0.000). For medium-susceptibility pathogens, continuous infusion concentrations above the minimal inhibitory concentration were 100%, which was better than that in the intermittent group.</p><p><b>CONCLUSIONS</b>Continuous infusion of meropenem provides significantly shorter treatment duration and a tendency for superior bacteriological efficacy than intermittent administration. Continuous infusion may be more optimal against intermediate-susceptibility pathogens.</p>