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Breast cancer is the most common cancer in women and the second most common cancer overall. Although advancements in the early diagnosis and therapy of breast cancer have occurred in recent years, the prognosis of breast cancer bone metastasis remains poor and this type of cancer is rarely cured. The gut microbiota is indispensable for internal homeostasis and regulates various biological processes. Understanding the gut microbiota profiles in normal controls (NCs), breast cancer patients with no metastasis (BNs), and breast cancer patients with bone metastasis (BMs) may shed light on the development of diagnostic and therapeutic targets for breast cancer and bone metastasis. We comprehensively analyzed the gut microbiota from NCs, BNs, and BMs and found that the community diversity decreased in the order of NCs, BNs, and BMs. Streptococcus, Campylobacter and Moraxellaceae showed higher abundances in BNs and BMs than in NCs. The lack of Megamonas and Akkermansia in the BM compared with those in the NC and BN groups was considered related to bone metastasis. Additionally, based on the distinct gut microbiota profiles, we predicted that lipid transportation and metabolism, as well as folate biosynthesis, participate in breast cancer occurrence and that steroid hormone biosynthesis influences bone metastasis. Our study demonstrated that variations in gut microbiota are associated with breast cancer occurrence and bone metastasis, providing attractive targets to develop therapeutic and diagnostic methods.
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Objective To analyze the perioperative risk factors of postoperative complications after posterior lumbar fusion operation.Methods The clinical data of 654 patients with posterior lumbar fusion during 2010 and 2014 were retrospectively analyzed.Using x2 test and one-way ANOVA,the predicted risk factors were screened for further Logistic regression.Results The total complication rate was 11.6% among all 654 patients.The major complications included cardiac infarction,deep infection,sepsis,neurological impairment,and secondary operation.And the minor complications included wound dehiscence,urinary tract infection,pulmonary infection,gastrointestinal bleeding,CSF leakage and others.According to x2 test and one-way ANOVA,renal function insufficiency,preoperative neurological injury,ASA higher than Ⅲ level,intraoperative blood loss,long operation length,and usage of autogenous bone were screened as risk factors of complications.Renal function insufficiency,preoperative neurological injury,intraoperative blood loss,and long operation length were screened as risk factors of minor complications.And male,renal function insufficiency,preoperative neurological injury,intervertebral fusion,and posteriolateral fusion were screened as risk factors of major complications.However,according to Logistic regression,the independent risk factor of complications were preoperative neurological injury and long operation length;independent risk factors of minor complications were renal function insufficiency,preoperative neurological injury and long operation length;and independent risk factor of major complications was preoperative neurological injury.Conclusion Preoperative neurological injury,renal function insufficiency and long operation length are proved to be the risk factors of postoperative complication in lumbar fusion surgery.
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<p><b>OBJECTIVE</b>To evaluate the clinical outcomes of total en-bloc spondylectomy (TES) in recurrence spinal tumor.</p><p><b>METHODS</b>The study was a retrospective study of recurrence spinal tumor from January 2010 to October 2013. A total of 6 patients with recurrent spinal tumor underwent TES procedures, with 5 cases located in thoracic spine and 1 case located in L1. There were 3 male and 3 female patients, with a mean age of 33.2 years. Pathological diagnosis included giant cell tumor of bone in 3 cases, breast cancer, lung cancer and nasopharyngeal carcinoma with 1 case in each. The operation time, bleeding loss, resected segments, cutting edge, spinal cord function and complications was evaluated.</p><p><b>RESULTS</b>Single segment resected in 1 case, 2 segments resected in 2 cases and 3 segments resected in 3 cases. The average operation time was 8.9 hours (7.5 to 12.0 hours). The average blood loss was 3 116 ml (2 500 to 4 500 ml). The average follow-up period was 23.2 months (12 to 47 months) without recurrence. There was no spinal cord injury during operation. The neurologic function was significantly improved in 2 cases (American Spinal Injury Association (ASIA) grade C to grade D), unchanged in 1 cases (ASIA grade B) and no deteriorated case in 3 cases (ASIA grade E). There was no perioperative deaths case. Complications included 2 cases pleural rupture, 1 case dural tear and 1 case massive haemothorax. No peri-operation death case.</p><p><b>CONCLUSION</b>Some of the recurrent spinal tumors are still suitable for en-bloc resection and TES procedure with the extent of its applicability under strict control.</p>