OBJECTIVES:To compare the diagnostic efficacy of 3 imaging modalities-conventional ultrasound (US), contrast-enhanced ultrasound (CEUS), and their combination (US + CEUS)-among physicians with varying experience levels in diagnosing breast intraductal lesions and to elucidate the adjunctive value of CEUS. METHODS:This study included patients who underwent both US and CEUS for breast lesions and were subsequently pathologically confirmed to have intraductal breast lesions between January 2022 and September 2025. Using pathological findings as the gold standard, the efficacy of senior, mid-career, and junior physicians in differentiating benign from malignant intraductal lesions was calculated and compared across the 3 diagnostic modalities. RESULTS:A total of 205 cases were included, comprising 117 benign and 88 malignant lesions. The combined US + CEUS approach demonstrated significantly superior diagnostic efficacy and higher diagnostic confidence scores compared to either CEUS or US alone among physicians at all experience levels. The combined modality yielded optimal efficacy in the senior physician group (p < .001), while the magnitude of improvement was greatest among junior physicians (p < .001), particularly for easily missed lesions like atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). For any given examination protocol, diagnostic efficacy exhibited a declining trend with decreasing physician experience (p < .05). CONCLUSION:CEUS serves as a valuable adjunctive tool for diagnosing breast intraductal lesions and is particularly beneficial for junior and mid-career physicians. The combined diagnostic approach enhances overall diagnostic performance.

Objectives To compare the diagnostic efficacy of 3 imaging modalities—conventional ultrasound (US), contrast‐enhanced ultrasound (CEUS), and their combination (US + CEUS)—among physicians with varying experience levels in diagnosing breast intraductal lesions and to elucidate the adjunctive value of CEUS. Methods This study included patients who underwent both US and CEUS for breast lesions and were subsequently pathologically confirmed to have intraductal breast lesions between January 2022 and September 2025. Using pathological findings as the gold standard, the efficacy of senior, mid‐career, and junior physicians in differentiating benign from malignant intraductal lesions was calculated and compared across the 3 diagnostic modalities. Results A total of 205 cases were included, comprising 117 benign and 88 malignant lesions. The combined US + CEUS approach demonstrated significantly superior diagnostic efficacy and higher diagnostic confidence scores compared to either CEUS or US alone among physicians at all experience levels. The combined modality yielded optimal efficacy in the senior physician group ( p < .001), while the magnitude of improvement was greatest among junior physicians ( p < .001), particularly for easily missed lesions like atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). For any given examination protocol, diagnostic efficacy exhibited a declining trend with decreasing physician experience ( p < .05). Conclusion CEUS serves as a valuable adjunctive tool for diagnosing breast intraductal lesions and is particularly beneficial for junior and mid‐career physicians. The combined diagnostic approach enhances overall diagnostic performance.

Photoacoustic Imaging (PAI) synergizes light's optical contrast with ultrasound's penetration depth via the photoacoustic effect. Breast cancer remains a global challenge, particular demanding precise intraoperative tumor demarcation during breast-conserving surgery (BCS). PAI has the potential to address this need by enabling boundary delineation, promoting complete resection and healthy tissue preservation. This review summarizes breast cancer epidemiology and BCS's clinical demands, highlighting PAI's unique advantages for intraoperative use. PAI can dynamically monitor cellular/tissue morphology, blood oxygen saturation, vasculature, and tumor-associated calcifications, generating high-contrast tumor margin information. This real-time feedback enhances surgical precision, reduces recurrence rates, and improves breast aesthetics and patient quality of life. Despite translational challenges, PAI is poised to become a revolutionary tool for optimizing BCS outcomes.

Abstract Purpose It was demonstrated that contralateral prophylactic mastectomy (CPM) provides no survival benefit for patients with average risk breast cancer, but the application in patients with early-stage breast cancer has increased. This study aims to explore the application trend, survival benefits, decision-making factors, and satisfaction of CPM based on the patients undergoing CPM in a Chinese institution. Methods The 0-III stage unilateral breast cancer (UBC) patients who received breast surgery in the First Medical Center of the PLA General Hospital from 2005 to 2017 were selected. The surgical procedures include simple mastectomy (SM), nipple-sparing mastectomy (NSM) and breast conserving surgery (BCS). Those patients who underwent preventive breast surgery on the healthy side were defined as the CPM group. The Cochran Armitage trend test was used to compare the longitudinal application trend of the annual surgical number and proportion of the four surgical procedures. Cox proportional regression analysis and Kaplan-Meier curve were performed to compare the overall survival (OS) and disease free survival (DFS) rates between CPM group and unilateral mastectomy (UM) group. Proportional propensity score matching (PSM) with a 1:1 ratio was used to match the two groups and secondary survival analysis was performed. Logistic regression models were used to test predictive factors related to patients' CPM surgical decision-making. A self-made satisfaction rating scale were used to analyze the satisfaction of CPM procedure and the impact on quality of life. Results 4,276 patients were included in the study, with 73 (1.7%) patients receiving CPM, 3567 (83.4%) receiving SM, 151 (35.3%) receiving NSM, and 485 (11.3%) receiving BCS. CPM surgery was first used in 2007, with a peak application rate of 3.02% in 2016 and a decrease to 1.05% in 2017. 3,791 patients with CPM and UM were included in the survival analysis, with a median follow-up time of 66.60 months. Compared to UM patients, neither the KM survival curve nor Cox regression hazard analysis of CPM showed better OS (p = 0.963; p = 0.834). After PSM, CPM also did not exhibit significant survival benefits in OS (HR 0.876, 95% CI 0.253–3.034, p = 0.335) and DFS (HR 0.922, 95% CI 0.629–1.352, p = 0.409). The logistic regression analysis showed that NSM surgery and early TNM stage were independent factors to promote the CPM decision-making of patients. 73 patients in the CPM group showed high overall satisfaction (84.9%) and relatively low physical satisfaction (69.9%). And a significant percentage of patients expressed that the physical labor was affected. Conclusion Our study suggested CPM does not provide any OS and DFS survival benefits compared to UM. Although most patients with CPM were generally satisfied, many gave a low evaluation of cosmetic results. Therefore, clinicians should fully communicate with patients before surgery and be more cautious in giving CPM recommendations.

Background: Grading based on histopathologic indicators cannot accurately assess the prognosis of phyllodes tumor (PT) of the breast. This article aimed to investigate the correlation between PT prognosis and clinicopathological features, treatment, and surgical margin. Methods: The clinicopathological data of patients with pathologically confirmed PT at our institution were retrospectively collected. Univariate and multivariate Cox proportional risk models were employed to test the effects of different variables on the prognosis of PT. A nomogram to predict the 1-, 3-, 5-, and 10-year recurrence-free survival (RFS) of PT was proposed, and its discriminative ability and calibration were tested using the concordance index (C-index), area under the curve (AUC), and calibration plots. All statistical analyses were performed using R. Results: A total of 342 PT patients were included, including 242 benign (70.8%), 75 borderline (21.9%) and 25 malignant (7.3%) cases. The median follow-up period was 64.5 months (range, 3-179 months), 66 PT patients had local recurrence (LR), and four patients had distant metastasis. The 1-, 3-, 5-, and 10-year RFS of the PT patients were 90.8%, 81.8%, 78%, and 76.7%, respectively. Age, fibroadenoma (FA) surgery history, treatment, mitotic activity, and surgical margin were selected as the independent factors for PT prognosis. The nomogram showed good discriminative ability and calibration, as indicated by the C-index [0.78, 95% confidence interval (CI): 0.75-0.11]. Conclusions: Independent predictors related to PT prognosis were selected to establish a nomogram for predicting the RFS of PT. This nomogram was able to objectively stratify PT patients into prognostic groups and performed well in the internal validation.

Background: Due to differences in socioeconomic and cultural backgrounds, the characteristics and prognosis of Asian female patients choosing contralateral prophylactic mastectomy (CPM) are likely to be different from Western patients. To fill the research gap of CPM in Asian populations, this study aims to explore the application trend, survival benefits, decision-making factors, and satisfaction of CPM based on the Chinese patients undergoing CPM. Methods: The 0-III stage unilateral breast cancer (UBC) patients who received breast surgery in the Chinese PLA General Hospital from 2005 to 2017 were selected. The surgical procedures included simple mastectomy (SM), nipple-sparing mastectomy (NSM), breast conserving surgery (BCS), and CPM. Cox proportional regression analyses and Kaplan-Meier (KM) curve were performed to compare the overall survival (OS) and disease-free survival (DFS) rates between CPM group and unilateral mastectomy (UM) group. Proportional propensity score matching (PSM) with a 1:1 ratio was used to match the two groups and secondary survival analysis was performed. Logistic regression models were used to test predictive factors related to patients' CPM surgical decision-making. Results: Four thousand two hundred and seventy-six patients were included in the study, with 73 patients receiving CPM, 3,567 receiving SM, 151 receiving NSM, and 485 receiving BCS. CPM surgery was first used in 2007, with a peak application rate of 3.02% in 2016. Three thousand seven hundred and ninety-one patients were included in the survival analysis, with a median follow-up time of 66.60 months. Compared to UM patients, neither the KM survival curve nor Cox regression hazard analyses of CPM showed better OS (P=0.963; P=0.834). After PSM, CPM also did not exhibit significant survival benefits in OS (P=0.335) and DFS (P=0.409). The logistic regression analyses showed that NSM surgery and lower tumor-node-metastasis (TNM) stage were independent factors to promote the CPM decision-making of patients. The CPM group showed high overall satisfaction (84.9%) and relatively low appearance satisfaction (69.9%). Conclusions: CPM was practiced for the first time since 2007 in our hospital. CPM does not provide any OS and DFS benefits compared to UM and the appearance satisfaction procedure was relatively low. Therefore, clinicians should fully communicate with patients before surgery and be more cautious in giving CPM recommendations.

Background The breast imaging reporting and data system (BI-RADS) lexicon provides a standardized terminology for describing leision characteristics but does not provide defined rules for converting specific imaging features into diagnostic categories. The inter-reader agreement of the BI-RADS is moderate. In this study, we explored the use of a simplified protocol and scoring system for BI-RADS categorization which integrates the morphologic features (MF), kinetic time-intensity curve (TIC), and apparent diffusion coefficient (ADC) values with equal weights, with a view to providing a convenient and practical method for breast magnetic resonance imaging (MRI) and improving the inter-reader agreement and diagnostic performance of BI-RADS. Methods This cross-sectional, retrospective, single-center study included 879 patients with 898 histopathologically verified lesions who underwent an MRI scan on a 3.0 Tesla GE Discovery 750 MRI scanner between January 1, 2017, and June 30, 2020. The BI-RADS categorization of the studied lesions was assessed according to the sum of the assigned scores (the presence of malignant MF, lower ADC, and suspicious TIC each warranted a score of +1). Total scores of +2 and +3 were classified as category 5, scores of +1 were classified as category 4, and scores of +0 but with other lesions of interest were classified as category 3. The receiver operating characteristic (ROC) curves were plotted, and the sensitivity, specificity, and accuracy of this categorization were investigated to assess its efficacy and its consistency with pathology. Results There were 472 malignant, 104 risk, and 322 benign lesions. Our simplified scoring protocol had high diagnostic accuracy, with an area under curve (AUC) value of 0.896. In terms of the borderline effect of pathological risk and category 4 lesions, our results showed that when risk lesions were classified together with malignant ones, the AUC value improved (0.876 vs. 0.844 and 0.909 vs. 0.900). When category 4 and 5 lesions were classified as malignant, the specificity, accuracy, and AUC value decreased (82.3% vs. 93.2%, 89.3% vs. 90.2%, and 0.876 vs. 0.909, respectively). Therefore, to improve the diagnostic accuracy of the protocol for BI-RADS categorization, only category 5 lesions should be considered to be malignant. Conclusions Our simplified scoring protocol that integrates MF, TIC, and ADC values with equal weights for BI-RADS categorization could improve both the diagnostic performance of the protocol for BI-RADS categorization in clinical practice and the understanding of the benign-risk-malignant breast diseases.

Background Accurately predicting outcomes for patients with breast cancer receiving neoadjuvant chemotherapy (NAC) is critical for clinical decisions. Prognostic models applicable to the Chinese population remain limited. The Neo-Bioscore staging system has been utilized as a predictive model for survival of breast cancer patients after NAC. This study aimed to validate the applicability of Neo-Bioscore in a Chinese population and develop an improved staging system based on it to predict prognosis of Chinese patients more accurately. Methods This study retrospectively collected clinicopathological and survival data in patients receiving NAC from February 2005 to August 2018 in PLA General Hospital. Discrimination, calibration and clinical usefulness were used to assess model performance. Univariate and multivariate analyses assessed relationships between clinicopathological factors and disease-specific survival. For model modification, postoperative pathological staging in the Neo-Bioscore was substituted with the posttreatment pathological tumor (ypT) stage and posttreatment pathological lymph node (ypN) stage. Neo-Bioscore and Modified Neo-Bioscore were compared with the American Joint Committee on Cancer (AJCC) staging system. Results A total of 436 patients with a median follow-up of 67 months were included. Five-year disease-specific survival (DSS), overall survival, and disease-free survival rates were 88.0%, 87.9%, and 76.8%, respectively. The concordance index (C-index) of the Neo-Bioscore staging system, posttreatment pathological stage (PS), and pretreatment clinical stage (CS) for DSS were 0.78 [95% confidence interval (CI): 0.72–0.83], 0.75 (95% CI: 0.69–0.82), and 0.68 (95% CI: 0.62–0.74), respectively. No significant difference between the Neo-Bioscore and PS was observed in the C-index (P=0.399). ypT and ypN were included in Neo-Bioscore to replace PS and create a modified staging system named MNeo-Bioscore. The C-index for DSS of the MNeo-Bioscore was 0.82 (95% CI: 0.78–0.87), and the calibration curve and decision curve analysis (DCA) curve performed well in internal validation. Conclusions The Neo-Bioscore staging system provided precise prognostic stratification for Chinese breast cancer patients receiving NAC; ypN and ypT stage may be substituted for PS to add significant prognostic value for Neo-Bioscore.

Background: The incidence of bilateral breast cancer (BBC) is low, accounting for 5% of patients with breast cancer. This study aimed to investigate the clinicopathological features and prognosis of synchronous bilateral breast cancer (SBBC) and metachronous bilateral breast cancer (MBBC) in the Chinese population. Methods: Patients with BBC, including SBBC and MBBC, were selected from 6,162 breast cancer patients who underwent surgery at the Chinese People's Liberation Army (PLA) General Hospital between January 2007 and December 2019. Furthermore, patients with unilateral breast cancer (UBC) who underwent surgery at the same time were randomly selected at a ratio of 1:2 as the control group. Clinicopathological features and prognosis were compared between the groups. Results: In all, 123 (2.0%) patients with BBC were enrolled in this study, including 98 (1.6%) SBBC and 25 (0.4%) MBBC patients. A total of 280 patients with UBC were selected for the control group. Compared with patients with UBC, patients with SBBC were more likely to be older and have a family history of breast cancer, non-infiltrative carcinoma, lower pathological tumor-node-metastasis (pTNM) stage, and luminal A type breast cancer as their first tumor. Patients with MBBC were more likely to be postmenopausal and have hormone receptor [estrogen receptor (ER)/progesterone receptor (PR)] negativity, a higher pTNM stage, and a triple-negative first tumor. Patients with UBC with ER/PR (-) were more likely to develop contralateral breast cancer (CBC) than those with ER/PR (+). There was no significant difference in overall survival (OS) and disease-free survival (DFS) between patients with SBBC and patients with UBC. Patients with MBBC had worse DFS than those with UBC, but OS was similar for both types of patients. Patients with MBBC <55 years at first diagnosis had significantly shorter DFS compared to those with SBBC and UBC. A multivariate Cox proportional hazards model revealed that age >= 55 years and ER/PR negativity of the first tumor were independent risk factors for OS. Independent risk factors for DFS included MBBC, age <55 years, family history of other malignant tumors, ER/PR (-), lymphovascular invasion, and N stage >= 2 of the first tumor. Conclusions: The OS and DFS of patients with SBBC and UBC were similar. The MBBC patients, especially those <55 years old at first diagnosis, had shorter DFS than patients with UBC.

Background: The rapid development of early diagnostic methods and systematic treatment for breast cancer have shed lights on the insight of prognosis of breast-conserving therapy versus mastectomy. However, there are relatively few studies with long-term follow-up, large patient cohort and under the contemporary setting in China on the subject of survival of patients undergoing breast conserving therapy versus mastectomy. Methods: Data on the cases of breast-conserving therapy and mastectomy for breast cancer from October 1, 2005 to September 31, 2010 were retrieved from the breast cancer database of Chinese PLA General Hospital. The clinicopathological characteristics of patients were compared by chi-square test or Fisher’s exact test. Breast cancer-specific survival, disease-free survival, local recurrence-free survival, loco-regional recurrence-free survival, and distant metastasis-free survival were calculated and compared by Kaplan-Meier survival analysis and log-rank test firstly. And then Cox Proportional-Hazards model was used for multivariate analysis. Results: There were 296 patients in the breast-conserving surgery group and 675 patients in the mastectomy group. For patients with invasive breast cancer in the entire cohort, the 10-year breast cancer-specific survival rate of patients in the breast-conserving surgery group at stage I-II was significantly higher than that of the mastectomy group. However, surgical method was not an independent prognostic factor for breast cancer-specific survival, disease-free survival and local recurrence-free survival. Moreover, N stage and luminal B-like subtype were independent prognostic factors for the breast cancer-specific survival of invasive breast cancer in the entire cohort. Conclusions: This study suggests that there is no significant difference in breast cancer-specific survival between breast cancer patients undergoing breast-conserving surgery and mastectomy after adjusting for confounding factors. Lymph node staging is the major risk factor affecting patients’ survival. In this case, choosing patients with smaller tumor size, avoiding patients with stage N3, and removing a smaller volume of breast tissue including tumors while ensuring negative margins may reduce the patient’s risk of local recurrence and loco-regional recurrence.

OBJECTIVE:To provide a reference for clinical work and guide the decision-making of healthcare providers and end-users, we systematically reviewed the development, validation and classification of classical prognostic models for breast cancer.BACKGROUND:Patients suffering from breast cancer have different prognosis for its high heterogeneity. Accurate prognosis prediction and risk stratification for breast cancer are crucial for individualized treatment. There is a lack of systematic summary of breast cancer prognostic models.METHODS:We conducted a PubMed search with keywords "breast neoplasm", "prognostic model", "recurrence" and "metastasis", and screened the retrieved publications at three levels: title, abstract and full text. We identified the articles presented the development and/or validation of models based on clinicopathological factors, genomics, and machine learning (ML) methods to predict survival and/or benefits of adjuvant therapy in female breast cancer patients.CONCLUSIONS:Combining prognostic-related variables with long-term clinical outcomes, researchers have developed a series of prognostic models based on clinicopathological parameters, genomic assays, and medical figures. The discrimination, calibration, overall performance, and clinical usefulness were validated by internal and/or external verifications. Clinicopathological models integrated the clinical parameters, including tumor size, histological grade, lymph node status, hormone receptor status to provide prognostic information for patients and doctors. Gene-expression assays deeply revealed the molecular heterogeneity of breast cancer, some of which have been cited by AJCC and National Comprehensive Cancer Network (NCCN) guidelines. In addition, the models based on the ML methods provided more detailed information for prognosis prediction by increasing the data dimension. Combined models incorporating clinical variables and genomics information are still required to be developed as the focus of further researches.

Prolonged Post-Operative Ileus (PPOI) is an aberrant pattern of gastrointestinal motility, most frequently occurring after abdominal surgery.The clinical manifestations include abdominal pain, nausea, vomiting, moderate to severe sick, intolerable of a solid diet and a delayed passage of flatus and stool, which usually resolves spontaneously within 2 to 3 days [1,2].If the symptoms persist for more than 4 days, Prolonged Postoperative Ileus (PPOI) is defined [3].PPOI hampers the patients' recovery, increases postoperative morbidity and leads to longer length of hospital stay [4].Understanding the incidence and factors of PPOI can help clinicians take effective measures to reduce the incidence of PPOI, and ultimately achieve rapid recovery of patients.This study retrospectively collected the clinical information of gastric cancer patients who received surgical treatment in our department, analyzed the related factors of PPOI occurrence, in order to take targeted prevention and treatment measures. Materials and Methods Study PopulationA retrospective cohort study was carried out using a PPOI registry database consecutively collected between June 2016 and October 2016 in Chinese PLA General Hospital.Among them, 62 were male and 21 were female, the ratio of male to female was about 3:1, they were between 39 and 89 years old , and the average age was (60.1 ±

Sarcoidosis is a multisystem disease with unknown causes. The prevalence of sarcoidosis that occurs worldwide is highly variable. It is pathologically characterized by the formation of non-necrotizing epithelioid cell granuloma, mainly affecting the respiratory tract and involving extrapulmonary organs including the skin, heart, extrathoracic lymph nodes, central nerves and eyes. A correct diagnosis of sarcoidosis depends on the clinical symptoms, imaging observations, and characteristic histopathological findings. This study aims to review the recent contributions of pulmonary sarcoidosis. It is based on a search of a published article and review on pulmonary sarcoidosis. PubMed, Embase and CNKI were searched for latest developments from 1977. The most common clinical symptoms of sarcoidosis include dry cough, dyspnea, and chest discomfort. The imaging manifestations of sarcoidosis can be divided into typical and atypical findings. Lymphadenopathy is a typical imaging manifestation of sarcoidosis. Sarcoidosis is also a highly variable multisystem disease with an unpredictable clinical course. Clinically encountered cases cover a wide range from asymptomatic patients with incidental findings in radiographic images to chronic progressive diseases. Corticosteroids are the most widely recommended as the first-line treatment for symptomatic or organ-threatening disease in sarcoidosis, but they are associated with substantial toxic effects. Meanwhile, for sarcoidosis, the follow-up is also an important part of the diagnosis and treatment. Pulmonary sarcoidosis needs further recognition. In this paper, the clinical features, imaging observations, pathology, and treatment modalities for pulmonary sarcoidosis are presented and discussed vis-à-vis the current dilemma in diagnosis and therapy.

Breast cancer is one of the most common life-threatening cancers, mainly because of its aggressiveness and metastasis. Accumulating evidence indicates that long non-coding RNAs (lncRNAs) participate in the development and progression of breast cancer. Nevertheless, the function and expression level of lncRNAs in breast cancer are still not fully understood. Here, we demonstrated that lncRNA PCDHB17P was up-expressed in human breast cancer tissues and cell lines. Knockdown of PCDHB17P remarkably suppressed migration and invasion, as well as tube formation ability of breast cancer cells. MiR-145-3p was significantly decreased in breast cancer samples, which was negatively correlated to the expression of PCDHB17P. In addition, we identified that MELK was a direct target gene of miR-145-3p, which was higher expressed in breast cancer tissues than that in adjacent normal tissues. Mechanistic investigation indicated that PCDHB17P acted as a cancer-promoting competing endogenous RNA (ceRNA) by binding miR-145-3p and upregulating MELK. Interestingly, MELK could in turn increase the promoter activity and expression of PCDHB17P via NF-κB, thus forming a positive feedback loop that drives the metastasis and angiogenesis of breast cancer. Overall, the results demonstrated that the constitutive activation of PCDHB17P/miR-145-3p/MELK/NF-κB feedback loop promotes the metastasis and angiogenesis of breast cancer, suggesting that this lncRNA might be a promising prognostic biomarker and therapeutic target for breast cancer.

Background Electrosurgical technology is widely used in surgical dissection and hemostasis, but the generated heat creates thermal injury to adjacent tissues and delays wound healing. The plasma blade (PB) applies pulsed radiofrequency (RF) to generate electrical plasma along the edge of a thin, flat, insulated electrode, minimizing collateral tissue damage. This study aimed to evaluate wound healing in swine skin following incision with a new surgical system that applies low-temperature plasma (NTS-100), a foreign PB, conventional electrosurgery (ES), and a scalpel blade. Methods In vitro porcine skin and an in vivo porcine skin model were used in this study. Full-thickness skin incisions 3 cm in length were made on the dorsum of each animal for each of the 5 surgical procedures at 0, 21, 28, 35, and 42 days. The timing of the surgical procedures allowed for wound-healing data points at 1, 2, 3, and 6 weeks accordingly. Local operating temperature and blood loss were quantified. Wounds were harvested at designated time points, tested for wound tensile strength, and examined histologically for scar formation and tissue damage. Results Local operating temperature was reduced significantly with NTS-100 (cut mode 83.12±23.55 °C; coagulation mode 90.07±10.6 °C) compared with PB (cut mode 94.46±11.48 °C; coagulation mode 100.23±6.58 °C, P<0.05) and ES (cut mode 208.99±34.33 °C, P<0.01; coagulation mode 233.37±28.69 °C, P<0.01) in vitro. Acute thermal damage from NTS-100 was significantly less than ES incisions (cut mode: 247.345±42.274 versus 495.295±103.525 µm, P<0.01; coagulation mode: 351.419±127.948 versus 584.516±31.708 µm, P<0.05). Bleeding, histological scoring of injury, and wound strength were equivalent for the NTS-100 and PB incisions. Conclusions The local operating temperature of NTS-100 was lower than PB, and NTS-100 had similarly reliable safety and efficacy.

目的:探讨乳腺浸润性导管癌(BIDC)组织胰岛素受体底物1(IRS1)蛋白、丝氨酸蛋白酶3(PRSS3)蛋白表达与磷酸化蛋白激酶B(p-AKT)表达以及预后的关系.方法:选择2017年1月至2018年12月我院收治的363例BIDC患者,采用免疫组化法检测经手术切除的BIDC癌组织和癌旁组织中IRS1蛋白、PRSS3蛋白以及p-AKT表达,比较BIDC不同病理特征IRS1蛋白、PRSS3蛋白表达差异.Spearman秩相关分析IRS1蛋白、PRSS3蛋白表达与p-AKT表达的相关性.术后定期随访,采用Ka-plan-Meier生存分析、Cox风险比例回归分析IRS1蛋白、PRSS3蛋白表达与BIDC患者预后的关系.结果:BIDC组织中IRS1蛋白、PRSS3蛋白、p-AKT阳性表达率分别为68.87％、58.13％、68.04％,均高于对照组的46.56％、40.50％、41.60％(P＜0.05).IRS1蛋白表达、PRSS3蛋白表达与p-AKT表达均呈正相关(rs=0.805、0.796,P＜0.05).肿瘤直径＞2 cm、低中度分化、AJCC分期为Ⅱ期的患者IRS1蛋白阳性表达率高于肿瘤直径≤ 2cm、高度分化、AJCC分期为Ⅰ期的患者(P＜0.05),AJCC分期为Ⅱ期、HER-2阳性表达、Ki-67阳性表达的患者PRSS3蛋白阳性表达率高于AJCC分期为Ⅰ期、HER-2阴性表达、Ki-67阴性表达的患者(P＜0.05).Kaplan-Meier生存分析显示IRS1蛋白、PRSS3蛋白阳性表达者PFS生存率、OS生存率低于IRS1蛋白、PRSS3蛋白阴性表达者(P＜0.05).多因素COX风险比例回归结果显示AJCC分期Ⅲ期、IRS1蛋白阳性表达、PRSS3蛋白阳性表达是BIDC患者预后不良的危险因素(P＜0.05).结论:BIDC癌组织中IRS1蛋白、PRSS3蛋白阳性表达率增高,IRS1蛋白、PRSS3蛋白可能通过调节p-AKT参与BIDC癌症进展过程.

Background: Breast ptosis is directly caused by Cooper's ligament laxity, with the decline of nipple areola complex (NAC) and mammary parenchyma. Breast cancer with ptosis is always a knotty problem that can hardly be repaired by classic breast conservation surgery (BCS) ending up with a pleasing appearance. We analyzed our 12 years' experience of performing inverted-T pattern techniques to treat bilateral breast ptosis, with or without breast cancer. Methods: One hundred forty-eight breasts in 74 patients undergoing inverted-T pattern reduction mammoplasty were included in this study. Information about patients' clinical and surgical characteristics, complications, NAC sensitivity, cosmetic and oncological outcomes were collected and retrospectively analyzed. Results: In the cohort of 57 patients with pure breast ptosis, the mean body mass index (BMI) was 25.2 kg/m2, and the mean weight of resected tissue from the left and right breast reductions were 744.9 and 756.7 g. In the cohort of 17 patients diagnosed as breast cancer with ptosis, the mean BMI was 25.1 kg/m2, and the mean weight of resected tissue were 504.1 g for left and 535.6 g for right side. The majority of repairs were performed for tumors located in the upper outer (58.8%), mostly with inferior or superomedial pedicles (90%). All the upper inner tumors were repaired with inferior pedicles. Minor complications such as seroma (8.1%), NAC epidermolysis (8.1%), delayed wound healing (4.1%) were detected postoperatively. Partial NAC necrosis occurred in one patient (1.4%). 82.4% of all the patients rated "very satisfied" or "satisfied" as the final cosmetic outcomes. NAC sensitivity was "very high" and "high" in 82.4% patients. No local occurrence, distant metastasis and mortality occurred in tumor patients. Conclusions: The inverted-T pattern reduction mammoplasty is a reliable technique to treat bilateral breast ptosis with a low complication rate. For cases with breast cancer, this technique can achieve both satisfying cosmetic outcomes and oncological safety.

预防性乳腺切除术是近年来兴起的一种针对乳腺癌高危女性的降低发病风险的手段,美国女性在过去20多年接受该手术的比例大幅增加,且单侧乳腺癌患者选择对侧乳房预防性切除比高风险健康女性选择双侧乳房预防性切除的接受度更高.高危人群选择手术多基于对癌症的恐惧、对乳房对称性的担忧、随访筛查的负担等多重因素.对于健康高危女性,行双侧预防性乳腺切除术可显著降低患乳腺癌的风险,降低死亡率,延长预期寿命,显示出生存获益;对于单侧乳腺癌患者,行对侧预防性乳腺切除术明显降低对侧乳腺癌的发生风险.预防性乳腺切除术结合乳房重建具有良好的美容学效果且显著缓解高危女性心理压力,术后女性的整体满意度高;但术后组织坏死、感染、出血等并发症的风险增加,并可能影响未达预期女性的生活质量.临床上外科医生需充分平衡高危人群的获益与风险,采用多学科、个体化的方法辅助女性决策.

Background: Breast cancer is one of the most common life-threatening cancers, mainly due to its aggressiveness and metastasis. Accumulating evidence indicates that long non-coding RNAs (lncRNAs) participate in the development and progression of breast cancer. Nevertheless, the function and expression level of lncRNAs in breast cancer are still not fully understood.Methods: TCGA data was utilized to screen out lncRNAs dysregulated in breast cancer. The expression level of genes were analyzed and measured by RT-qPCR. The effects of PCDHB17P in breast cancer were determined in vitro and in vivo. Bioinformatics analysis was applied to predict the target between genes in breast cancer and verified via luciferase reporter assays, RNA Immunoprecipitation (RIP) and Chromatin immunoprecipitation (ChIP).Results: LncRNA PCDHB17P was up-expressed in human breast cancer tissues and cell lines. Knockdown of PCDHB17P remarkably suppressed migration and invasion as well as tube formation ability of breast cancer cells. MiR-145-3p was significantly decree ased in breast cancer samples, which was negatively correlated to the expression of PCDHB17P. In addition, we identified MELK was a direct target gene of miR-145-3p, which was higher expressed in breast cancer tissues than that in adjacent normal tissues. Mechanistic investigation indicated that PCDHB17P acted as a cancer-promoting competing endogenous RNA (ceRNA) by binding miR-145-3p and upregulating MELK. Interestingly, MELK could in turn increase the promoter activity and expression of PCDHB17P via NF-κB, thus forming a positive feedback loop that drives the metastasis and angiogenesis of breast cancer.Conclusions: Our research demonstrated that the constitutive activation of PCDHB17P/miR-145-3p/MELK /NF-κB feedback loop promotes the metastasis and angiogenesis of breast cancer, suggested that this lncRNA might be a promising prognostic biomarker and therapeutic target for breast cancer.

目的 对解放军总医院第一医学中心乳腺癌病理报告进行文本结构化信息提取,以支持临床分析研究.方法 通过总结解放军总医院第一医学中心2005-2017年共计1万余份乳腺癌病理报告结构及特点,结合临床科研需求和专家经验,整理结构化字段词典和抽取规则,利用基于规则的模式匹配抽取方法 对病理报告进行信息抽取.结果 利用该方法 得到临床科研所需乳腺病理文本结构化指标及其值,并对随机抽样的200条病理报告进行效果评估,结构化字段的召回率和准确率均高于90％.结论 基于规则的模式匹配信息提取方法 在乳腺癌病理报告中具有一定适用性,可快速、有效地实现对文本信息的结构化提取.