In the recent study, we have developed novel tumor targetable and pH-sensitive PLGA nanoparticles co-loaded with camptothecin (CPT) and metformin (Metf) to simultaneously improve the Type 2 Diabetes Mellitus (T2DM) and malignant breast cancer. To improve the drug loading efficiency, the hydrophobic CPT was conjugated with PLGA polymer by the pH-sensitive hydrazone bonds (hyd). Then, the Metf was physically loaded into the hydrophobicity inner core of CPT-conjugated PLGA nanocomplex to form the dual drugs-loaded nanoparticles (NP/CPT-Metf). Furthermore, on the surface of NP/CPT-Metf was modified with tumor-homing CGKRK peptides to obtain the tumor targetable and pH-sensitive polymer nanoparticles (CNP/CPT-Metf). It was demonstrated that the developed CNP/CPT-Metf displayed sufficient sensitivity to the weak acidic tumor microenvironment. Besides, excellent ability of CNP/CPT-Metf to mediate accumulation of drugs in cells and tumor tissues finally in turn resulted in a signal enhanced anti-tumor effect. Furthermore, it was demonstrated as well that CNP/CPT-Metf was able of significantly alleviating the type 2 diabetes mellitus in diabetic mice. In summary, the developed multifunctional polymer nanoparticles might represent a promising strategy for simultaneously improve the T2DM and treat malignant breast cancer.

目的:评估并分析乳头溢液患者的乳管镜诊断价值.方法:择取本院2019年7月～2021年4月300例仅为单侧乳头溢液患者,均接受乳管镜检查,分析术后病理结果.结果:300例患者经乳管镜检查发现乳管内非占位性病变201例、乳管内占位病变99例;99例患者接受病变乳管解剖切除手术,乳管镜诊断结果与术后病理诊断结果相符者76例,符合率为76.77％.其中乳头状瘤、乳腺癌诊断符合率均为100.00％;对比术后病理诊断结果,乳管镜诊断敏感度95.08％、特异度86.84％.结论:在乳头溢液诊断中乳管镜具有显著的诊断价值,诊断效能较高,可获取清晰图像,及时诊断乳腺导管内肿瘤性病变,为后期疾病治疗提供有效参考.

目的:分析非哺乳期乳腺炎患者应用病灶区段切除术与任意皮瓣转移成形术联合治疗的治疗效果.方法:选择东莞市妇幼保健院2019年1月至2020年12月收治的非哺乳期乳腺炎患者40例,用随机数字表法划分为对照组和观察组两组,各20例.对照组行病灶区段切除术治疗,观察组在实施病灶区段切除术的同时联合任意皮瓣转移成形术治疗,评估两组患者的手术效果,记录两组患者术后并发症发生情况.结果:观察组患者治疗总有效率明显高于对照组,差异具有统计学意义(P＜ 0.05);观察组患者术后并发症发生率明显低于对照组,差异具有统计学意义(P＜0.05).结论:非哺乳期乳腺炎患者接受病灶区段切除术与任意皮瓣转移成形术联合治疗,临床疗效确切,可降低术后并发症发生率.

目的 探讨伴有乳头溢液的乳管内占位性病变临床诊断中应用纤维乳管镜与乳腺超声的诊断效果.方法 58例乳头溢液患者作为研究对象,均接受纤维乳管镜与乳腺超声检查,以术后病理诊断结果为金标准,对比纤维乳管镜、乳腺超声对乳管内占位性病变的诊断准确率及灵敏度.结果 术后病理诊断证实,58例患者中乳管内占位性病变(导管内癌、导管内乳头状瘤、导管内不典型乳头样增生)51例,非乳管内占位性病变(乳腺囊肿、乳腺增生、乳腺导管炎)7例.乳腺超声的诊断准确率为58.62％(34/58),灵敏度为58.82％(30/51);纤维乳管镜的诊断准确率为91.38％(53/58),灵敏度为96.08％(49/51).纤维乳管镜的诊断准确率、灵敏度均高于乳腺超声,差异具有统计学意义(χ2=16.598、20.265,P<0.05).结论 相比于乳腺超声,纤维乳管镜在临床乳管内占位性病变诊断中的优势较为明显,可作为常规检查项目.

目的:探索对于乳腺良性肿物患者予以真空辅助旋切术的临床应用价值及术后复发率.方法:选取2016年6月-2018年12月于本院就诊的乳腺良性肿物患者,按照随机数字表法分为对照组和研究组,各300例.对照组予以传统乳晕旁手术切口,研究组予以真空辅助旋切术.对比两组患者手术情况、术后情况、疼痛程度,并采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估术后心理状态.结果:研究组患者手术切口长度、手术时间、术中出血量均低于对照组(P＜0.05);研究组患者术后并发症、术后畸形、术后复发率均低于对照组(P＜0.05);研究组患者术后疼痛评分、SDS、SAS评分显著低于对照组(P＜0.05).结论:真空辅助旋切术治疗乳腺良性肿物患者不仅能缩短手术时间、手术切口小、减轻疼痛、改善心理状态,还能降低并发症及复发率,具有较好的临床使用价值.

目的 探讨与分析麦默通微创旋切手术在良性乳腺肿物治疗中的应用效果及价值.方法 随机选取本院2016年6月～2017年6月期间内接收的良性乳腺肿物患者120例,按照人院顺序奇偶性分为观察组和对照组各60例.观察组患者受麦默通微创旋切手术治疗,对照组患者接受传统乳腺肿物切除术治疗.对比两组治疗效果及复发情况,观察两组患者手术相关指标、乳房美容评分.结果 两组治疗总有效率比较,无显著性差异(P＞0.05);观察组复发率、手术相关指标、乳房美容各项评分均优于对照组,差异有统计学意义(P＜0.05).结论 良性乳腺肿物患者接受麦默通微创旋切手术治疗,效果理想,能缩短手术时间短,患者术后康复快,复发几率低,且满足了患者对于乳房美观的需求,临床价值较高,值得推广使用.

Objective To explore the safety and reliability of ultrasound-guided Mammotome gland minimally invasive rotary cutting biopsy in diagnosis of breast cancer,provide a basis for researching replacement of radical mastectomy.Methods The clinical data of 31 cancerous lesions in 23 patients diagnosed as breast cancer by ultrasound-guided Mammotome gland minimally invasive rotary cutting biopsy was analyzed retrospectively.Results Among 31 lesions,19 lesions (61.29％) with invasive ductal carcinoma,2 lesions (6.45％) with invasive ductal carcinoma combined with intraductal papillary carcinoma,1 lesion (3.23％) with invasive lobular carcinoma,6 lesions (19.35％) with ductal carcinoma in situ,2 lesions (6.45％) with ductal carcinoma in situ combined with micro-infiltration,and 1 lesion (3.23％) with mucous carcinoma were included.No false negative and false positive result occurred.The accurate rate of diagnosis was 100.00％.Cancer residual was found in 10 lesions (32.26％).All the cases were followed up for 3-66 months.No recurrence and metastasis occurred.Conclusion Ultrasound-guided Mammotome gland minimally invasive rotary cutting biopsy is a safe and reliable method for diagnosis of breast cancer,but it cannot replace radical mastectomy because of the possibility of cancer residual.

目的:比较超声引导下麦默通旋切活检术与超声引导下导丝定位手术切除乳腺隐匿性肿块(NPBL)的效果,为临床手术方法的选择提供依据.方法:回顾性分析362例行手术治疗的NPBL患者临床资料,其中293例超声引导下麦默通旋切活检手术(旋切组),69例行超声引导下导丝定位开放活检术(开放组),比较两组的相关手术指标.结果:两组患者基本资料差异均无统计学意义(均P＞0.05).旋切组在手术时间、切口长度、术中出血量方面均优于开放组,手术费用明显多于开放组(均P＜0.05),旋切组术后并发症发生率低于开放组,但差异无统计学意义(P＞0.05).两组手术成功率均达到100％.两组随访1～12个月,均无肿瘤复发,开放组有长短不等的瘢痕,而旋切组瘢痕微小或不可见.结论:麦默通旋切活检术切除NPBL安全有效,较导丝定位开放活检术出血少、手术时间短、美容效果好,但手术费用较高.