The molecular mechanisms between metabolic syndrome and breast cancer.

Metabolic syndrome, which is extremely common in developed and some developing countries, is a clustering of at least three of five of the following medical conditions: abdominal obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein levels. It has been proved that there is a strong association between metabolic syndrome and breast cancer. Metabolic syndrome could increase the risk of breast cancer and influence the prognosis of the breast cancer patients. Some characteristic of metabolic syndrome such as obesity and lack of physical exercise are all risk factors for developing breast cancer. The metabolic syndrome mainly include obesity, type 2 diabetes, hypercholesterolemia and nonalcoholic fatty liver disease, and each of them impacts the risk of breast cancer and the prognosis of the breast cancer patients in different ways. In this Review, we focus on recently uncovered aspects of the immunological and molecular mechanisms that are responsible for the development of this highly prevalent and serious disease. These studies bring new insight into the complex associations between metabolic syndrome and breast cancer and have led to the development of novel therapeutic strategies that might enable a personalized approach in the management of this disease.

Surgical diagnosis and treatment of primary hyperparathyroidism: analysis of 19 cases.

This study was to discuss the surgical diagnosis and treatment experience of primary hyperparathyroidism. Clinical data of 19 primary hyperparathyroidism patients who were treated surgically in our department from Jan. 2005 to Jul. 2014 were retrospectively analyzed. Besides, general data, clinical manifestations, laboratory and imaging test results, surgical procedures and postoperative follow-up information were comprehensively analyzed. 15 of 19 patients had adenoma, among whom 1 case was complicated with goiter, 3 cases with parathyroid hyperplasia, and 1 case with parathyroid carcinoma. One case of bilateral parathyroid adenoma was explored bilaterally, and the bilateral parathyroid adenoma was excised. 14 cases of unilateral parathyroid adenoma were explored unilaterally and the unilateral parathyroid adenoma was excised. 3 cases of parathyroid hyperplasia were explored bilaterally, and parathyroid glands were removed subtotally, and only half gland was reserved. 1 case of parathyroid carcinoma experienced excision of thyroid gland and parathyroid at the affected side and isthmus excision, subtotal excision of thyroid gland at the healthy side and functional cervical lymphonode dissection at the affected side. All the 19 cases recovered well after operation, and symptoms of hyperparathyroidism were controlled. No relapse was found after follow-up of 3 months to 5 years. In conclusion, local parathyroid excision with small wounds after pre-operative locative image test and qualitative laboratory test is effective. Timely surgical treatment could reduce joint and urinary damage. Post-operative follow-up should be emphasized for early detection of the patients with hypoparathyroidism and recurrence.

Apoptotic Effect of Koumine on Human Breast Cancer Cells and the Mechanism Involved.

Koumine is an alkaloid separated from traditional Chinese herb Gelsemium elegans. In this study, anticancer activity and underlying mechanisms were investigated with an extract using human breast cancer cells. The survival rate was reduced in a concentration- and time-dependent manner as assessed by MTT assay. After incubation for 48 h, typical apoptotic morphological changes were observed by Hoechst 33258 dye assay. Flow cytometry result revealed that the treatment obviously induced G2/M arrest and apoptosis in MCF-7 cells. Furthermore, Western blotting demonstrated the down-regulation of protein expression of Bcl-2, whereas Bax and caspase-3 expressions were up-regulated. Therefore, we propose that koumine has the potential to be a future breast cancer chemotherapeutic agent.

Correlation between PON1 gene polymorphisms and breast cancer risk: a Meta-analysis.

OBJECTIVE: A number of studies have investigated the relationship between the PON1 gene polymorphisms and breast cancer risk, but the conclusions are not consistent. In this paper, a meta-analysis was conducted to explore the possible reasons for these inconsistencies, expecting to further clarify the correlation between PON1 gene polymorphisms and breast cancer risk. METHODS: After searches in the database such as MEDLINE, EBSCO, ProQuest, Google Scholar, High-Wire, SID (Scientific Information Database) and PubMed, 7 literatures were collected. RevMan 5.2 software was used to perform the meta-analysis. Random-effects or fixed-effects model was used to analyze the odds ratio (OR) and 95% confidence intervals. RESULTS: The analysis of L55M single nucleotide polymorphisms (SNPs) showed that M allele frequency was positively correlated with the incidence risk of breast cancer (OR=1.34, 95% CI: 1.03-1.74). While we did not found Q192R polymorphism associated with the risk of breast cancer (OR=1.0, 95% CI: 0.71-1.42). CONCLUSION: For PON1 gene, the frequencies of M allele were associated with the incidence risk of breast cancer.

Association between RECQL5 genetic polymorphisms and susceptibility to breast cancer.

Previous studies indicated that the RECQL5 gene polymorphism was associated with human cancers. However, the association of RECQL5 gene polymorphism with breast cancer remains unclear. In the present study, we investigated the association between polymorphisms of the RECQL gene and breast cancer in a Chinese population. We selected four polymorphisms of the RECQL5 gene (rs820186, rs820196, rs820200, and rs4789223) for the present study. The genotyping was performed using the TaqMan method in 510 patients with breast cancer and 510 age- and sex-matched non-cancer controls. We found that rs820196 and rs828200 polymorphisms of RECQL5 were associated with breast cancer. For rs820196, the CC genotype (16.7 vs 9.4 %, P < 0.001) and C allele (42.5 vs 34.3 %, P < 0.001) were common in the breast cancer patients than in the control subjects, respectively. For rs828200, the GG genotype (23.7 vs 18.0 %, P < 0.001) and G allele (52.7 vs 43.8 %, P < 0.001) were common in the breast cancer patients than in the control subjects, respectively. Haplotype analysis showed that C-G (odds ratio (OR) = 2.247, 95 % confidence interval (CI) 1.854∼2.722; P < 0.001) was associated with increased risk for breast cancer. However, the C-T (OR = 0.175, 95 % CI 0.110∼0.278; P < 0.001) and T-G (OR = 0.544; 95 % CI 0.428∼0.692; P < 0.001) were associated with decreased risk for breast cancer, respectively. The present study indicated that the RECQL5 genetic polymorphism and haplotypes were associated with breast cancer in a Chinese population.

Primary malignant melanoma of the breast: A case report and review of the literature.

Malignant melanoma predominantly occurs in the skin and mucous membranes, thus, malignant melanoma of the breast is particularly rare. In the current study, a case of a 26-year-old female with a malignant melanoma of the breast is presented. On diagnosis of the patient, extensive metastasis had occurred. The patient refused any treatment and succumbed two months after the initial diagnosis. The prognosis for patients with this rare tumour of the breast is somewhat poor. Early diagnosis, correct surgical resection and comprehensive adjuvant therapy are the key procedures that may improve the patient survival rate. The current case report aims to increase the awareness of uncommon tumours of the breast.

Surgical treatment of large substernal thyroid goiter: analysis of 12 patients.

This study was carried out to evaluate the clinical presentation, surgical treatment, complications, and risk of malignancy for large substernal goiter. From March 2010 to December 2012, 12 patients with large substernal thyroid goiter who underwent surgery in our Department were enrolled in the study. Their medical records were retrospectively analyzed. Collar-shaped incision was adequate for resection of the lesions in 10 (83%) patients, while two (17%) patients required combined cervical-thoracic incision. In addition, one case was subjected to postoperative tracheotomy. Transient hypocalcaemia occurred in one case. The incidence of transient hoarseness, tracheomalacia and hypothyroidism was 8.3%. There was no perioperative bleeding, thyroid storm as well as other serious complications. All patients were clinically cured. Therefore, cervical collar incision is nearly always adequate for most cases of larger substernal goiter, and sternotomy can be avoided. Furthermore, the application of intraoperative ultrasonic knife can effectively reduce intraoperative and postoperative complications. Aggressive perioperative management is crucial for the successful removal of large substernal goiter.

Outcome of transvaginal excision of large rectal adenomas.

PURPOSE: The purpose is to recommend a new approach-transvaginal excision-for large rectal adenomas and audit its results after being performed by dedicated surgeons at a specialized colorectal unit. METHODS: The surgical outcome of 11 patients undergoing transvaginal excision between July 1995 and March 2000 was reviewed. Data were collected retrospectively and no patients were lost to follow-up. RESULTS: Eleven patients underwent the procedure during the study period. Follow-up ranged from 7 to 75 months. There were complications in two patients. One had urinary retention, the other developed a rectal stenosis, which was resolved with multiple balloon dilatations. There was only one recurrence detected. None of the patients died. CONCLUSIONS: Transvaginal local excision is an alternative and feasible technique for the treatment of selected large sessile rectal adenomas that carries low mortality and complication rates.

[Long-term clinical results after highly selective vagotomy plus pylorus-preserved mucosal antrectomy].

OBJECTIVE: To study the long-term clinical results of 34 chronic duodenal ulcer patients treated with high selective vagotomy plus pylorus-preserved mucosal antrectomy (HSV + PPMA). METHODS: Clinical follow-up results of the patients from 8 approximately 14 years were analyzed. RESULTS: Thirty-tow patients (94.1%) followed-up for 8 approximately 14 years after operation achieved Visick grades I-II. No patient died. Gastric acid secretion and infection rate of Helicobacter pylori in the antral mucosa were significantly reduced after operation. No significant difference was found in bile acids, total bacterial counts in gastric juice, and the level of serum gastrin after operation. Gastric emptying was normal. No ulcer recurrence was found by barium meal and endoscopy. CONCLUSIONS: HSV + PPMA is a better operative treatment for duodenal ulcer, which not only can decrease acid secretion and ulcer recurrence rate but also can preserve the function of antrum and pylorus and prevent post-operation bile reflux and intragastric bacterial overgrowth.