To compare the clinical outcomes and learning curve characteristics of the traditional bilateral areolar approach (BAA) and the modified areolar approach (MAA) in endoscopic thyroidectomy and to assess the advantages and potential for clinical dissemination of the modified technique. We retrospectively reviewed 79 female patients who underwent endoscopic radical thyroidectomy for thyroid cancer. Patients were assigned to the BAA group or the MAA group according to the incision placement. Perioperative parameters were compared between groups, such as operative time, intraoperative blood loss, number of lymph nodes harvested, incidence of postoperative complications, and patient satisfaction. A cumulative sum analysis (CUSUM) was performed to construct learning curves and evaluate the progression of surgical proficiency. Compared with the BAA group, the MAA group demonstrated a significantly shorter operative time (P < 0.001), reduced intraoperative blood loss (P = 0.029), and a lower rate of short-term postoperative complications (P = 0.05). The CUSUM learning curve inflection point occurred earlier in the MAA group (20th case vs. 26th case), indicating more rapid acquisition of the technique. By optimizing incision placement and instrument alignment, the modified areolar approach shortens operative time, minimizes intraoperative trauma, and decreases complication rates. Its shorter learning curve and greater procedural stability facilitate faster mastery of endoscopic thyroidectomy, supporting its wider clinical adoption.

IntroductionBlood perfusion insufficiency and hypoxia are the main causes of drug resistance to chemotherapy in breast cancer. Increasing blood perfusion can improve drug delivery. This study aimed to investigate the effects of ultrasound-stimulated microbubbles (USMBs) on hemoperfusion in invasive breast cancer (IBC).MethodsIn this prospective clinical trial, 36 patients diagnosed with IBC were enrolled sequentially. The treatment group (n = 18, enrolled from June 2022 to April 2025) were treated with SonoVue® microbubbles (MBs) stimulated by ultrasound, with a mechanical index (MI) of 0.2-0.3: 1 mL of SonoVue® MBs was injected at 3.5-min intervals three times for a USMB treatment lasting 10 min. The control group (n = 18, enrolled from May to November 2025) received identical MB injections without ultrasound stimulation. Contrast-enhanced ultrasound (CEUS) was used to evaluate the changes in blood perfusion.ResultsIn the treatment group, in comparison with the pre-treatment findings, the tumor perfusion area expanded (P < .001) and the time to peak (TTP) increased (P < .05) after USMB treatment. For regions exhibiting low enhancement inside the lesion on CEUS before USMB treatment, the area under the curve (AUC) (P < .001) and mean transit time (MTT) (P < .05) both increased following therapy. In the control group, none of the parameters showed statistically significant differences after the MB injections.ConclusionUSMB treatment can improve blood perfusion in IBC, especially by enhancing the AUC and MTT in hypoperfused regions. These findings highlight the potential of USMB treatment as a noninvasive technique to enhance intratumoral drug delivery, although further validation of this approach is required.Clinical trial registration number: NCT06158217.

Objective To characterize the risk-adjusted learning curve of transareolar endoscopic thyroidectomy in patients with Hashimoto’s thyroiditis (HT) and differentiated thyroid carcinoma (DTC).To analyze their perioperative, pathological, and immunological features, thereby informing preoperative risk stratification and case selection. Methods This single-center retrospective study included 100 consecutive female patients who underwent endoscopic thyroidectomy performed by the same doctor, including 32 with HT and 68 without HT. We collected perioperative variables, complications, extent of lymph node dissection and nodal metastasis, aggressive pathological features, and TPOAb/TgAb indices. The primary endpoint was operative time. A risk-adjustment model was constructed, and the learning-curve breakpoint was estimated using risk-adjusted Cumulative Sum (CUSUM) and segmented regression. Spline fitting and multiple sensitivity analyses were performed to assess robustness. Perioperative and pathological outcomes were compared between groups, factors associated with central lymph node metastasis (CLNM) were analyzed using logistic regression. Associations of antibody status and titers with surgical and pathological parameters were also assessed. Results Operative time decreased markedly with accumulating experience and entered a relatively stable phase at approximately case 50. Compared with the non-HT group, the HT group had longer operative time and a higher lymph node yield. After risk adjustment, We find that HT did not alter the shape of the learning curve; this finding was consistently supported by multiple sensitivity analyses. Central lymph node metastasis was associated with capsular invasion and age, but not independently with HT. Antibody titers in the HT group also showed no consistent association with operative difficulty or aggressive pathological features. Conclusion HT does not materially alter the learning pattern of transareolar endoscopic thyroidectomy and should not be used as a basis for exclusion. With standardized technique and careful protection of critical structures, this procedure remains safe and feasible in patients with DTC and coexisting HT.

OBJECTIVE:To integrate multiscale embedded gene co-expression network analysis (MEGENA) and Mendelian randomisation (MR) to identify new pathogenic factors associated with breast cancer (BC). STUDY DESIGN:A descriptive study. Place and Duration of the Study: Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China, from January to December 2024. METHODOLOGY:The raw mRNA expression data were downloaded from the Cancer Genome Atlas (TCGA) database, and differentially expressed genes were used for MEGENA analysis. MR analysis was applied to explore causal relationships. A sensitivity analysis using leave-one-out tests ensured robust results. Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA) were used to examine the functions and mechanisms of the newly identified targets. RESULTS:MEGENA analysis identified 257 targets. The MR analysis demonstrated that ALOX15B (0.874; 0.809-0.943; p = 0.001) and TLE3 (0.807; 0.667-0.976; p = 0.027) were associated with a low risk of the disease; while the genes FAAH (1.064; 1.003-1.129; p = 0.038), HDGF (1.158; 1.012- 1.326; p = 0.032), KLF5 (1.110; 1.020-1.208; p = 0.015), LSM4 (1.071; 1.001-1.145; p = 0.046), and TNS1 (1.073; 1.015-1.135; p = 0.013) were associated with a high risk of BC. Six (ALOX15B, FAAH, HDGF, KLF5, TLE3, and TNS1) of these seven genes have been further validated for their reliability through sensitivity analysis. These six genes are closely correlated with immune cell infiltration and multiple tumour-related pathways. CONCLUSION:This study demonstrated the causal effect of six key genes on BC and provided a potential molecular link between these genes and BC. KEY WORDS:Breast cancer, Mendelian randomisation, MEGENA, Biomarker, Immune infiltration.

ObjectiveTo identify risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC) and to establish clinical prediction models.MethodsWe retrospectively collected clinical data from 249 patients with PTC and suspected LLNM, 222 patients met the inclusion criteria. Based on postoperative pathology of the lateral compartment, 145 patients without metastasis were classified as the non-metastasis group, 77 patients with metastasis were classified as the metastasis group. All included patients were randomly assigned to training set and validation set. Univariate and multivariate logistic regression analyses were performed to screen predictors of LLNM and construct nomogram models for preoperative and postoperative prediction. Model performance was evaluated using the Hosmer-Lemeshow goodness-of-fit test, calibration curves with bootstrap resampling, receiver operating characteristic (ROC) curves and the area under the curve (AUC), as well as decision curve analysis (DCA).ResultsIn preoperative analyses, age, maximum tumor diameter ≥1 cm on ultrasound, hyperechoic area in the lateral cervical lymph node, and lateral cervical lymph nodes perinodal vascularity were independent predictors of LLNM. In postoperative analyses, age, multifocality, pathological maximum tumor diameter ≥1 cm, and concomitant central lymph node metastasis were independent predictors. The AUCs for the preoperative model were 0.805 (training set) and 0.719 (validation set), and for the postoperative model were 0.885 (training set) and 0.762 (validation set). After 1,000 bootstrap resamples, the mean absolute errors (MAE) of the calibration curves were 0.047 and 0.066 for the preoperative model (training set and validation set), and 0.021 and 0.046 for the postoperative model.ConclusionDCA showed a higher net clinical benefit of both models than the treat-all or treat-none strategies, indicating good predictive accuracy and clinical utility.

Biomarkers are not only of significant importance for cancer diagnosis and selection of treatment plans but also recently increasingly used for the evaluation of malignancy development and tumor heterogeneity. Large-size tumors from clinical patients can be unique and valuable sources for the study of cancer progression, particularly to the extent of intratumoral heterogeneity. In the present study, we obtained a series of post-surgery puncture samples from a breast cancer patient with a 4 × 3.5 × 2 cm tumor in its original size. Immunohistochemistry for Ki-67, COX-2, and CA IX was performed and the expression levels within the breast cancer tumor mass were evaluated in the reconstructed 3D models. To further evaluate the intratumoral heterogeneity, we performed high throughput whole transcriptome sequencing of 12 samples from different spatial positions within the tumor tissue. Comparing the reconstructed 3D distribution of biomarkers with projected tumor growth models, asymmetric and heterogeneous expansion of tumor mass was found to be possibly influenced by factors such as blood supply, inflammation and/or hypoxia stimulations, as suggested from the correlation between the results of Ki-67 and CA IX or COX-2 staining. Furthermore, high-throughput RNA sequencing data provided additional information for profiling the intratumoral heterogeneity and expanded the understanding of cancer progression. Digital technology for medical imaging once properly integrated with molecular pathology examinations will become particularly helpful in dissecting out in-depth information for precision medicine. We prospect that this approach, facilitated by rapidly advancing artificial intelligence, could provide new insights for clinical decision-making in the future. Strategies for the continuous development from the present study for better performance and application were discussed.

A novel doxorubicin hydrochloride liposome injection was prepared to reduce toxicity and side effects, as well as extend plasma half-life in the treatment of breast cancer. In this study, a rapid and sensitive bioanalytical method was developed and validated to characterize the pharmacokinetic profile of total and free doxorubicin in plasma of 3 Chinese patients after intravenous infusion of this injection. Plasma samples were prepared by protein precipitation for the determination of total doxorubicin, while solid phase extraction was used to determine free doxorubicin. After plasma sample pre-treatment, total and free concentrations were quantified individually using a validated LC-MS/MS method. The calibration curves were found to be linear in the range of 0.20-500.0 ng mL(-1) for total doxorubicin and in the range of 1.00-1,000 ng mL(-1) for free doxorubicin. The free concentrations in plasma were only one sixth to one quarter of the total levels. Liposomal doxorubicin had a longer apparent half-life (>50 h) than the non-targeted drug (<10 h) reported in the reference. and a lower volume of distribution. This novel injectable formulation steadily released free doxorubicin from liposomes over a long period of time to reduce cardiac toxicity and side effects, while ensuring a clinical curative effect.

Background: The purpose of this study was to observe the effectiveness of minimally invasive video-assisted thyroidectomy (MIVAT) in treating papillary thyroid microcarcinoma (PTMC). Methods: A total of 224 patients with PTMC who met the inclusion and exclusion criteria were selected from the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, between January 2017 and December 2019. They were randomized into the MIVAT group or traditional open operation group. For both groups, we observed the number of lymph node dissections, amount of intraoperative blood loss, duration of the operation, length of the incision, and number of injuries to the recurrent laryngeal nerve. Results: The average operation time (132.8±29.4 min) in the MIVAT group was significantly higher than that in the open surgery group (83.8±14.29 min) ( P =0.026). The length of incision (2.8±0.6 cm) in patients in the MIVAT group was significantly shorter than that in patients in the open group (7.4±1.1 cm) ( P =0.000). No significant differences were observed in the number of lymph node dissections ( P =0.712), the amount of intraoperative bleeding ( P =0.581), and the number of recurrent laryngeal nerve injuries ( P =0.634). The average follow-up was 5 years, and both groups had no recurrence. Conclusions: In the treatment of PTMC, MIVAT had similar outcomes as traditional open operations, although the operation time was longer. However, the length of the incision was significantly shorter and thus provided cosmetic advantages for patients.

目的 探讨甲状腺手术相关的非返喉神经(NRLN)的临床特征与预判策略.方法 回顾性分析首都医科大学附属北京友谊医院医疗保健中心综合外科(以下简称"我科")2009年8月至2022年2月因甲状腺良、恶性肿瘤行甲状腺手术的175例患者的临床资料;另外以"非返喉神经""喉不返神经""非返性喉下神经""喉返神经""喉下神经""non-recurrent laryngeal nerve""non recurrent laryngeal nerve""non-recurrent inferior laryngeal nerve""recurrent laryngeal nerve""inferior laryngeal nerve""NRLN""NRILN"为检索词在中国知网、万方、PubMed 及 Web of Science数据库检索研究对象为中国人的文献,检索时间为2012年1月至2022年2月,统计NRLN总发生率、右侧发生率、Stewart分型、损伤率,以及术前应用影像学预判NRLN的结果.结果 我科术中发现1条右侧NRLN,Stewart Ⅰ型,NRLN总发生率为0.32％,右侧发生率为0.63％,所有患者术中无损伤.meta分析显示,NRLN总发生率为 0.46％(95％CI:0.26％～0.66％);右侧发生率为 0.45％(95％CI:0.22％～0.68％);Stewart Ⅰ 型发生率为 76.47％(95％CI:58.61％～94.33％),Ⅱ型发生率为 23.53％(95％CI:5.67％～41.39％);损伤率为 10.20％(95％CI:2.93％～17.47％).影像学预判结果显示,90％(81/90)存在异形右侧锁骨下动脉;CT预测NRLN的漏诊率为19.23％,胸部X线预测NRLN误诊率为56.67％,超声预测NRLN漏诊率为7.25％.结论 NRLN为少见变异,术中损伤率高,术前可通过影像学预判,CT及超声预测NRLN准确性较高.

Radiofrequency ablation (RFA) has emerged as a treatment modality for solid tumors. However, the feasibility of RFA in treating the tumor bed in breast surgery remains investigational. Herein, we have reported the preliminary results evaluating the effect of RFA in breast-conserving surgery (BCS), followed by neo-adjuvant chemotherapy (NAC), and the antibacterial effect of nanomaterials. From April 1, 2015 to March 31, 2017, 22 patients received NAC followed by BCS. After the lumpectomy was complete, suspicious tumor margins were ablated with radiofrequency electrodes. The clinicopathological features and follow-up results of these patients were collected. Furthermore, the Ag nanogel was prepared for the evaluation of antibacterial activity. RFA was successful in all 22 patients during BCS. Two patients (4.5%) got skin burns and six patients (27.3%) had solid nodules formed in situ . The median follow-up time was 22.5 months (range, 11–34 months). No patients presented local recurrences or metastasis. Moreover, 18 patients (81.8%) were satisfied with the cosmetic outcomes. The Ag nanogel has stable morphology and good bacteriostatic effect in Escherichia coli and Bovis aureus . The RFA techniques applied in BCS after NAC have high success rates with relatively low complication rates. RFA may improve cosmetic results after BCS and enhance local tumor control. Further applications of RFA in patients treated with BCS after NAC must be assessed in long-term studies. Nanomaterials have good antibacterial effect and can be used on the surface of medical instruments.

目的 探讨外周血循环肿瘤细胞(circulating tumor cells,CTCs)与非转移性乳腺癌临床病理因素的关联.方法回顾性收集2022年1月至2023年3月首都医科大学附属北京友谊医院普通外科收治的45例女性非转移性乳腺癌患者的临床数据,根据叶酸受体(folate receptor,FR)阳性循环肿瘤细胞检测(FR+CTCs)结果将研究对象分为CTCs阳性组(28例)和阴性组(17例),采用x2检验或Fisher确切概率法分析CTCs阳性组和阴性组患者绝经状态、雌激素受体(es-trogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人表皮生长因子受体 2(human epidermal growth factor receptor-2,HER-2)、Ki67、淋巴结转移以及TNM解剖学分期的组间差异.结果 非转移性乳腺癌患者外周血CTCs阳性率与绝经无明显相关性(P＞0.05),与ER、PR、HER-2、Ki67表达状态无明显相关性(均P＞0.05),与淋巴结转移、TNM解剖学分期有显著相关性(均P＜0.05),TNM解剖学分期1期CTCs阳性率分别较Ⅱ、Ⅲ期,差异有统计学意义(均P＜0.05),Ⅱ期CTCs阳性率与Ⅲ期比较,差异无统计学意义(P＞0.05).结论 非转移性乳腺癌患者外周血CTCs阳性率与淋巴结转移、TNM解剖学分期具有一定相关性,淋巴结转移者,CTCs阳性率较高;以及非转移性乳腺癌患者随着TNM解剖学分期的提高,CTCs阳性率逐渐升高.

Ehm2/1, an Ehm2 transcript variant, regulates the cytoskeleton by binding to plasma membrane proteins. However, the role of Ehm2/1 in breast cancer development remains poorly understood. This study shows that, the expression of Ehm2/1 was decreased in breast cancer and that patients with low Ehm2/1 expression had a significantly poorer prognosis than those with high expression of Ehm2/1. Overexpression of Ehm2/1 in MCF-7 breast cancer cells inhibited cell migration and invasion. Ehm2/1 markedly increased the stability and half-life of E-cadherin. Moreover, Ehm2/1 was collocated with E-cadherin in the plasma membrane of MCF-7 cells. Furthermore, downregulation of Ehm2/1 promoted ubiquitination of E-cadherin, whereas overexpression of Ehm2/1 inhibited ubiquitination of E-cadherin. These results suggest that Ehm2/1 could suppress the migration and invasion of breast cancer cells by increasing E-cadherin stability.

DLG1-AS1 and PBX3 have been identified as acting as an oncogene in cervical cancer. However, they have not been well explored in triple-negative breast cancer (TNBC). As TNBC is one of the malignancies causing increasing death throughout the world, this study aimed to probe into the regulatory relationship between DLG1-AS1 and PBX3 in TNBC cells. In this study, real-time quantitative PCR (qRT-PCR) and western blot experiments were conducted to investigate the RNA and protein levels of genes of interest in TNBC cells. Functional experiments were implemented, such as 5-ethynyl-2'-deoxyuridine (EdU), transwell, and wound healing assays, to assess the changes in TNBC cell phenotype. Chromatin immunoprecipitation, luciferase reporter, RNA binding protein immunoprecipitation, and RNA pull-down assays were conducted to investigate the binding relationships among subject genes. The results show that DLG1-AS1 and PBX3 displayed high expression in TNBC cells, and PBX3 worked as the transcriptional activator of DLG1-AS1. Also, DLG1-AS1 served as an oncogene in TNBC cells and as a sponge for miR-16-5p to up-regulate JARID2. Meanwhile, JARID2 and PBX3 exerted oncogenic effects on TNBC cell growth. In conclusion, PBX3-activated DLG1-AS1 can promote the proliferation, invasion, and migration of TNBC cells by sponging miR-16-5p and elevating JARID2 expression.

Introduction Breast cancer is the most prevalent cancer and the leading cause of cancer-related death in women. Conventional open mastectomy (C-OM) is one of the most common procedures for breast cancer, which involves the removal of the nipple-areola complex and a large proportion of the breast skin, leading to poor cosmetic effect and restriction of upper extremity function. Single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) could conceal the incision along the wrinkles in the axilla, preserve all the breast skin and nipple-areola complex and provide a better cosmetic outcome and quality of life. This trial aims to investigate the oncological safety between SIE-NSM and C-OM in early breast cancer patients. Methods and analysis This is a single centre, non-blinded, randomised controlled trial (RCT) and will be conducted at Beijing Friendship Hospital. Patients will be enrolled in the inpatient ward. Breast surgeons will notify patients who meet the inclusion and exclusion criteria with the instruction of this RCT. Patients will be randomly assigned to C-OM or SIE-NSM with a 3:1 allocation as per a computer-generated randomisation schedule. Patients will be followed-up for 12 months for analysing surgical outcomes. The primary outcome is the local recurrence rate at a 12-month follow-up. The secondary outcome is the distant metastasis rate, cosmetic satisfaction score and psychosocial well-being score after a 12-month follow-up. To ensure the accuracy of the cosmetic satisfaction score and psychosocial well-being score, the standard scale, Breast-Q score, will be applied. Ethics and dissemination This study will be conducted according to the medical ethics committee of the Beijing Friendship Hospital and according to the principles of the Declaration of Helsinki. All patients will receive clear instruction of their disease and treatment plan. Informed consent will be obtained from all patients when they agree to comply with our research plan. The results will be disseminated at academic presentations and publications in peer-reviewed journals. The raw data will be confidentially stored in our electronic data capture database. Data will not be shared unless an appropriate data request is submitted after the trial completion and peer-review journal publication. Trial registration number NCT04461847.

Objective:To compare the diagnostic efficiency of colloidal gold dipstick method (PTH dipstick method) with that of doctors’ experience method based on nano-carbon method for rapid identification of parathyroid gland in thyroidectomy of thyroid cancer.Methods:From March to July 2020, 90 patients underwent thyroid surgery in the Friendship Hospital, Capital Medical University participated in the experimental study, and 155 samples underwent empirical judgment, parathyroid dipstick and pathological examination. All operations were performed by senior specialists. SPSS statistics 17.0 software was used for statistical analysis.Results:Seventy-four cases of parathyroid gland confirmed by both pathology and empirical judgment, and 81 cases of non-parathyroid gland confirmed by pathology; 130 cases of parathyroid glands confirmed by both PTH dipstick method and pathology, and 22 cases of non-parathyroid glands confirmed by pathology. The accuracy rate of PTH dipstick method was 85.53% which was much higher than that of empirical judgment method (47.74%). The data were statistically significant ( χ2=49.14, P<0.05). The sensitivity of PTH method was 95.89%, the specificity of PTH method was 75.94%, and the Youden index was 0.7183. The sensitivity of empirical judgment method was 81.3%, the specificity of empirical judgment method was 47.74%, and the Youden index was 0.2904. Conclusions:The diagnostic efficiency of the PTH method is higher than that of empirical judgment method to identify parathyroid gland in thyroid surgery. The two methods can be used together to increase the protection of parathyroid gland during operation.

Purpose The combination of taxanes and anthracyclines is still the mainstay of chemotherapy for early breast cancer. Capecitabine is an active drug with a favorable toxicity profile, showing strong anti-tumor activity against metastatic breast cancer. This trial assessed the efficacy and safety of the TX regimen (docetaxel and capecitabine) and compared it with the TE (docetaxel and epirubicin) regimen in locally advanced or high risk early HER2-negative breast cancer. Patients and methods This randomized clinical trial was conducted at five academic centers in China. Eligible female patients were randomly assigned (1:1) to the TX (docetaxel 75 mg/m 2 d1 plus capecitabine 1000 mg/m 2 twice d1–14, q3w) or TE (docetaxel 75 mg/m 2 d1 plus epirubicin 75 mg/m 2 d1, q3w) groups for four cycles. The primary endpoint was a pathological complete response in the breast (pCR). Secondary endpoints included pCR in the breast and axilla, invasive disease-free survival (iDFS), overall survival (OS), and safety. Results Between September 1, 2012, and December 31, 2018, 113 HER2-negative patients were randomly assigned to the study groups (TX: n = 54; TE: n = 59). In the primary endpoint analysis, 14 patients in the TX group achieved a pCR, and nine patients in the TE group achieved a pCR (25.9% vs. 15.3%), with a not significant difference of 10.6% (95% CI -6.0–27.3%; P = 0.241). In a subgroup with high Ki-67 score, TX increased the pCR rate by 24.2% (95% CI 2.2–46.1%; P = 0.029). At the end of the 69-month median follow-up period, both groups had equivalent iDFS and OS rates. TX was associated with a higher incidence of hand-foot syndrome and less alopecia, with a manageable toxicity profile. Conclusion The anthracycline-free TX regimen yielded comparable pCR and long-term survival rates to the TE regimen. Thus, this anthracycline-free regimen could be considered in selected patients. Trial Registration ACTRN12613000206729 on 21/02/2013, retrospectively registered.

BackgroundWe sought to explore the impact of changing treatment strategy based on circulating tumor cells (CTC) on postoperative survival of breast cancer.MethodsWe retrospectively analyzed records of patients who underwent surgery for early-stage breast cancer at Beijing Friendship Hospital from January 2016 to January 2018 and regularly underwent CTC examination after surgery. During the regular examination and CTC monitoring, the patients with positive CTC results and without distant metastasis had their treatment regimen changed.ResultsOf 109 patients who received CTC examination regularly after surgery, 61 (56.0%) were CTC-positive during postoperative follow-up, including 33 ER or PR-positive, and 28 ER and PR-negative patients. Of the 33 ER or PR-positive patients, 20 changed endocrine therapy drugs. Compared with those without replacement, those with changed endocrine therapy strategy had higher CTC clearance rates (90.0% vs. 53.8%, p=0.04) and significantly lower CTC-positive values (1.70 ± 1.72 vs. 0.62 ± 0.65, p = 0.04). Among the 28 patients who were CTC positive and ER and PR-negative, 11 used capecitabine. Compared with non-users, the capecitabine users had higher CTC clearance rates (100.0% vs. 52.9%, p=0.01) and more significant decrease in CTC-positive values (2.09 ± 1.14 vs. 0.82 ± 1.67, p=0.04). Disease-free survival (DFS) at 1, 3, and 5 years was significantly longer in those who changed treatment than in those who did not (respectively, 96.6% vs. 89.6%, 92.8% vs. 56.9%, 69.0% vs. 47.8%, p<0.01). By changing the treatment strategy, CTC-positive patients achieved DFS that was not significantly different from CTC-negative patients (95.0% vs. 97.7%, 77.5% vs. 82.9%, 57.6% vs. 59.9%, p=0.20).ConclusionTimely change of treatment strategy for breast cancer patients with positive CTC results after surgery may improve CTC clearance rate and DFS.

目的:比较一次性可吸收钉皮内吻合器与合成可吸收外科缝线在甲状腺和乳腺手术切口闭合中的应用及愈合情况.方法:选取医院收治的152例行甲状腺和乳腺手术患者,使用中央随机系统随机化分为观察组和对照组,每组76例,观察组采用一次性可吸收钉皮内吻合器行甲状腺和乳腺手术切口闭合;对照组采用传统可吸收缝线行甲状腺和乳腺手术切口闭合.分析比较两组患者术后第8 d切口甲级愈合率,以及单位长度切口缝合时间、切口愈合效果、缝合部位疼痛程度和缝合线和(或)缝合钉吸收等疗效情况,评价一次性可吸收钉皮内吻合器的临床安全有效性.结果:两组患者术中单位长度切口缝合时间观察组短于对照组,两组比较差异有统计学意义(t=9.735,P<0.001);两组患者术后1 d和3 d缝合部位疼痛程度视觉模拟量表(VAS)评分比较,差异无统计学意义(t=0.773,t=0.605;P>0.05);两组患者术后8 d切口甲级愈合率、术后8 d、(42±3)d以及28周(+10 d)缝合线和(或)缝合钉吸收情况进行比较,差异均无统计学意义.结论:一次性可吸收钉皮内吻合器与合成可吸收外科缝线相比具有缝合速度快、实现临床手术切口快速闭合、缩短手术时间和降低医疗成本的优势.

目的 探讨两步法单孔腔镜乳房重建手术在早期乳腺癌治疗中的临床应用价值.方法 21例早期乳腺癌患者于乳房皮下腺体切除术即刻行两步法单孔腔镜乳房重建手术;记录手术情况、术后并发症及美容效果;术后6个月,应用BREAST Q乳腺癌患者结局量表评价患者对外观满意度和生活质量.结果 21例均顺利完成两步法单孔腔镜乳房重建手术,无中转开放手术病例;术后无假体取出、包膜挛缩发生,2例发生乳头、乳晕缺血坏死,发生率为9.5％.术后6个月,BREAST Q量表评分乳房满意度为(75.3±2.2)分,胸壁状态评分为(90.4±1.5)分,社会心理状态评分为(86.1±2.0)分,性健康程度评分为(71.4±2.6)分.结论 两步法单孔腔镜乳房重建手术在早期乳腺癌治疗中应用效果良好,患者可获较好的外观满意度和生活质量.

To explore the effect of circRHOT1 on breast cancer progression and the underlying mechanism. Significantly, our data revealed that the depletion of circRHOT1 was able to repress the proliferation and induce the apoptosis of breast cancer cells. CircRHOT1 knockdown could remarkably inhibit the invasion and migration in the breast cancer cells. Meanwhile, the depletion of circRHOT1 enhanced the erastin-induced inhibition effect on cell growth of breast cancer cells. The circRHOT1 knockdown notably increased the levels of reactive oxygen species (ROS), iron, and Fe2+ in breast cancer cells. Mechanically, circRHOT1 was able to sponge microRNA-106a-5p (miR-106a-5p) and inhibited ferroptosis by down-regulating miR-106a-5p in breast cancer cells. Besides, miR-106a-5p induced ferroptosis by targeting signal transducer and activator of transcription 3 (STAT3) in the system. Moreover, the overexpression of STAT3 and miR-106a-5p inhibitor could reverse circRHOT1 knockdown-mediated breast cancer progression. Functionally, circRHOT1 promoted the tumor growth of breast cancer in vivo. In conclusion, we discovered that circRHOT1 contributed to malignant progression and attenuated ferroptosis in breast cancer by the miR-106a-5p/STAT3 axis. Our finding provides new insights into the mechanism by which circRHOT1 promotes the development of breast cancer. CircRHOT1 and miR-106a-5p may serve as potential targets for breast cancer therapy.