目的 探讨丹鹿胶囊治疗乳腺增生症的临床疗效.方法 选取2018年10月至2019年5月本院收治的64例乳腺增生患者作为研究对象,均采用丹鹿胶囊治疗,比较治疗前后证候、临床疗效及不良反应.结果 主症:治疗后,乳房疼痛、乳房肿块质地、乳房肿块长径分值均低于治疗前,差异有统计学意义(P＜0.05).次症:治疗后,腰膝酸软、神疲乏力、胸胁胀痛、心烦易怒和月经不调发生率均低于治疗前,差异有统计学意义(P＜0.05).治疗后,治愈40例,显效13例,好转10例,无效1例,治疗总有效率为98.4％,不良反应发生率为6.3％.结论 丹鹿胶囊治疗乳腺增生患者疗效显著,能有效减轻临床症状,且不良反应少,值得临床推广应用.

Objective:To explore the effect of hyperbaric oxygen (HBO) therapy on the healing of the skin flap, the vascular endothelial growth factor (VEGF) and hypoxia inducing factor-1α (HIF-1α) after modified radical mastectomy.Methods:A total of 132 patients with breast cancer admitted in the Department of Breast Surgery of Heping Hospital Affiliated to Changzhi Medical College from January 2017 to June 2019 were selected as the research subjects and randomly divided into control group ( n=66) and observation group ( n=66). The control group was given the modified radical mastectomy, while the observation group was additionally given hyperbaric oxygen therapy. The postoperative healing condition of incision flap, including healing time, drainage volume, and pain score, was compared between two groups. And the serum VEGF and HIF-1α levels of patients in the two groups were compared before and after the treatment. Besides, postoperative complications were also observed. Results:The healing time of the skin flap in the observation group with HBO [(10.43±0.96) d] was significantly shorter than that in the control group [(13.81±1.15) d]. The drainage volume of the observation group was (274.01±13.10) ml, and the visual analogue scale (VAS) were (4.02±0.34) and (2.84±0.30) on the first and the third day after the operation respectively. The healing condition and VAS scores of the observation group were both better than those in the control group, and all the differences were statistically significant ( P<0.05). Serum VEGF and HIF-1α levels in the observation group were (809.67±40.22) pg/ml and (243.71±22.84) pg/ml respectively, which were significantly improved compared with those before the treatment and those of the control group, and all the differences were statistically significant ( P<0.05). The incidence of postoperative complications in the observation group (3.03%) was lower than that of the control group (10.61%). Conclusion:The hyperbaric oxygen therapy has a significant clinical effect on the patient after the modified radical mastectomy. It can accelerate skin flap healing, relieve patients’ pain, and promote prognosis by reducing HIF-1α level and increasing VEGF content.

Background: Many breast cancer clinical trials with PARPi have been completed or are currently carried out, either by monotherapy or combined with chemotherapy. We aim to assess the efficacy and safety of PARPi in breast cancer patients as compared to chemotherapy. Methods: A comprehensive literature search of PubMed, EMBASE, CENTRAL, conference meetings and clinical trial registry was performed. The primary outcomes were progression-free survival (PFS), overall survival (OS), overall response rate (ORR). The secondary outcome was safety profile. The comparative effects were measured using hazard ratio (HR) or relative risk (RR) with 95% confidence interval. Subgroup analyses were conducted based on types of intervention and baseline characteristics of patients. Results: Six RCTs (n = 1953) were included. Two RCTs were recognized as high risk. PARPi was associated with an improved PFS (HR, 0.65; 95% CI, 0.56–0.74), OS (HR, 0.86; 95% CI, 0.73–1.01), and a higher ORR (RR, 1.38; 95% CI, 1.05–1.82). PARPi, however, significantly increased risk of grade 3–4 thrombocytopenia (RR, 1.63; 95% CI, 1.06–2.52). Monotherapy was observed with lower risk of disease progression and higher ORR rate than combination therapy, 0.56 to 0.65 and 2.21 to 1.05, respectively. For patients without prior platinum treatment, PARPi significantly improved PFS (HR, 0.64; 95% CI, 0.52–0.79). Conclusions: PARPi was observed with a significantly improved efficacy in aspects of PFS and ORR, but also higher risk of grade 3–4 thrombocytopenia as compared to chemotherapy. PARPi was a better choice for patients who had not received previous platinum treatment.

Objective To analyze the diagnostic value of serum procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) in the detection of incision infection after breast cancer surgery. Methods A total of 152 breast cancer patients admitted to our hospital from June 2016 to April 2018 were enrolled. All patients were given surgery.According to whether the wound infection occurred after operation, the patients were divided into control group (not infected, n=114) and observation group (infected, n=38). The serum levels of PCT, CRP and IL-6 were measured in the two groups on the 2 nd postoperative day. Results The average operation time and hospital stay in the observation group were longer than those in the control group (P<0.05). The serum levels of PCT, CRP and IL-6 in the observation group were higher than those in the control group (P<0.05). The positive rate of the observation group was higher than that of the control group (P<0.05). Conclusion In patients with breast cancer surgery, serum PCT, CRP and IL-6 detection can provide a good reference for the prediction of postoperative incision infection.

OBJECTIVE To investigate the isolation and the drug resistance of Enterobacter cloacae strains from the orthopedics department between 2007 and 2011,and analyze the related factors so as to provide basis for the clinical treatment and prevention of E.cloacae infections.METHODS A total of 1218 wound secretion specimens were collected from hospitalized patients with limbs trauma from 2007 to 2011.All the specimens were sampled under the rigid aseptic operation,and the bacterial culture and drug susceptibility testing were performed in accordance with the standard procedure.RESULTS Of totally 1218 specimens collected,there were 154 specimens with the E.cloacae detected positive,the detection rate was 12.64%,and the detection rates were all higher than 10.00% in the four years except 2007.The drug resistance rates to imipenem and amikacin were less than 50.00% in 2011,and the strains were highly resistant to the commonly used penicillins and cephalosporins antibiotics.The study concluded that both the detection rate and the drug resistance rate were significantly increased during the past five years.CONCLUSION E.cloacae is the prevalent pathogen causing infections in the orthopedics department and is highly resistant to the commonly used penicillin and cephalosporin antibiotics,which is closely related to the unreasonable use of antibiotics in the hospital,thus,it is necessary for the clinicians to reasonably choose antibiotics on the basis of the drug susceptibility testing.

BACKGROUND: Icariin and simvastatin alone or in combination can promote the radial fracture healing of rabbits. But the best dosage ratio is still lack of basis. OBJECTIVE: To investigate the effect of icariin and simvastatin with different dosage ratios on rabbits’ radial fracture healing. METHODS: Forty-five healthy rabbits were enrolled to prepare bilateral radial fracture models, and then randomly divided into five groups: model group; bone morphogenetic protein-2 control group; and three experimental groups (ratio of icariin and simvastatin: 3:1, 1:1, 1:3). Model and bone morphogenetic protein-2 control groups were given normal saline by gastric perfusion. The three experimental groups were given icariin and simvastatin solution with dosage ratios of 3:1, 1:1, 1:3 by gastric perfusion. Model group and three experimental groups were injected normal saline at fracture site, while bone morphogenetic protein-2 control group was injected bone morphogenetic protein-2 solution. Gastric perfusion was performed for 6 consecutive weeks and local injection at fracture site lasted for 2 weeks. RESULTS AND CONCLUSION: Bone morphogenetic protein-2 control group and 1:1 experimental group were the best followed by the 3:1 and 1:3 experimental groups, and the model group was the worst in the following aspects: growth and alteration of callus, recanalization of bone marrow cavity, bone mineral density and morphology of the fracture site. Icariin and simvastatin with different dosage ratios all can promote the radial fracture healing of rabbits. When the dosage ratio is 1:1, the combination of icariin and simvastatin can further promote fracture healing.