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.

目的 探讨术中神经监测(IONM)信号异常在判断甲状腺癌手术喉返神经(RLN)损伤的类型与转归中的作用.方法 回顾性分析2018年1月至2020年12月在首都医科大学附属北京友谊医院普外科确诊行甲状腺癌根治术并应用IONM的705例甲状腺癌病人临床资料.根据IONM结果、手术记录、术后症状,以及喉镜检查结果,分析IONM信号异常原因、RLN损伤及类型,研究IONM信号异常在判断RLN损伤的类型与转归中的作用.结果 705例病人中,63例(8.9％)IONM信号异常,包括RLN真性损伤42例(5.9％),短暂性损伤11例(1.6％),假损伤10例(1.4％).与RLN短暂性损伤和假损伤相比,肿瘤侵犯或粘连(21.4％,9/42)是RLN真性损伤的重要原因(P＜0.05),后者均出现术后喉镜结果异常,64.3％出现术后声音嘶哑或饮水呛咳症状.此外,RLN显性损伤9例(1.3％),RLN非显性损伤44例(6.2％).RLN显性损伤均为真性损伤;非显性损伤者中,33例为真性损伤(4.6％)、11例为短暂性损伤(1.6％).此外,IONM 一过性信号异常占RLN真性损伤者21.4％,短暂性损伤者90.9％,假损伤者40.0％,差异有统计学意义(P＜0.05);IONM信号异常部位,信号衰减幅度与RLN损伤类型差异无统计学意义(P＞0.05).结论 甲状腺癌术中IONM信号异常可能源于RLN真性损伤、短暂性损伤或假损伤.即使RLN外观正常,术者应重视一过性IONM信号异常,如不及时终止操作,对RLN加以保护,短暂性损伤可能成为真性损伤.在未使用IONM情况下,RLN短暂性损伤可能被忽视,真性损伤可能增加.

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.

Objective To explore the application effect of fine needle aspiration cytology and sentinel lymph nodes stain assisted by contrast-enhanced ultrasound in early breast cancer.Methods A patient with early breast cancer enrolled in Beijing Friendship Hospital,Capital Medical University received fine needle aspiration cytology assisted by contrast-enhanced ultrasonography and the sentinel lymph nodes were stained with blue dye before a standard sentinel lymph nodes biopsy traced with indocyanine green.The axillary status accessed by these two methods were compared.Results Three sentinel lymph nodes were found and aspirated assisted by contrast-enhanced ultrasonography.Seven sentinel lymph nodes were obtained in sentinel lymph nodes biopsy surgery.All of these sentinel lymph nodes were negative.The stained sentinel lymph nodes could be recognized and dissected in open lymph nodes biopsy surgery.Conclusions Fine needle aspiration cytology assisted by contrast-enhanced ultrasonography could be a substitute for open sentinel lymph nodes biopsy.More related researches should be carry out to further compare these two methods.

目的 探讨应用皮下负压引流器预防下消化道开腹手术切口愈合不良的价值.方法 回顾性分析2018年10月至2020年1月首都医科大学附属北京友谊医院普外科收治的113例下消化道开放手术病人的临床资料.根据腹壁缝合时是否放置皮下引流器,分为皮下引流组(78例)和对照组(35例).比较两组病人切口愈合情况,分析切口愈合不良与临床特征的关系以及开放手术切口愈合不良的影响因素.结果 113例病人中,切口愈合不良发生率为14.2％(16/113),其中皮下引流组切口愈合不良发生率为5.1％(4/78),对照组为34.3％(12/35),两组差异具有统计学意义(P＜0.05).多因素分析提示,影响切口愈合不良发生的独立危险因素为未放置皮下引流器(OR=14.510,95％CI 3.411～61.735,P=0.001)、糖尿病(OR=7.064,95％CI 1.286～38.789,P=0.024)及吻合口漏/残端漏(OR=15.004,95％CI 1.876～119.996,P=0.011).结论 下消化道开放手术切口愈合不良发生率较高,应用皮下负压引流器能有效减少其发生,且操作方便、价格低廉.

Objective:To explore the application of radiofrequency ablation in breast conserving surgery with breast carcinoma.Methods:With retrospective research methods, a total of 230 patients who were treated with radiofrequency ablation after breast conserving surgery in Beijing Friendship Hospital, Capital Medical University from January 2016 to September 2018 were selected, patients were all females, the median age was 56 yecers, ranged from 27 to 91 years, and the postoperative efficacy, patients′ satisfaction with their appearance and complications were outpatient follow-up.Results:Follow-up for 18 months showed that 2 (0.87%) patients had postoperative recurrence and metastasis, 217 (94.35%) patients were satisfied with the postoperative breast appearance, and 8 patients (3.48%) had skin burns and in- situ sclerosing. Conclusions:Radiofrequency ablation is used in breast conserving surgery, which is simple to operate and has a low incidence of complications. It can strengthen local tumor control and improve the cosmetic effect of breast after conserving surgery, worthy of clinical promotion.

Objective To evaluate the efficacy of radiofrequency ablation in breast-conserving surgery followed neoadjuvant chemotherapy.Methods Retrospective analysis of 30 cases of breast cancer patients admitted to Beijing Friendship Hospital,Capital Medical University from April 2015 to September 2018.The average age was 54.3 years and the range was 28 to 70 years.For breast invasive ductal cancer,patients underwent breast-conserving surgery after neoadjuvant chemotherapy,and then received radiofrequency ablation.The clinical and pathological characteristics,postoperative complications,recurrence and metastasis,and cosmetic effects were observed.Results All 30 patients with breast-conserving surgery successfully completed radiofrequency ablation.The average outpatient follow-up was 22.5 months,ranging from 2 to 43 months,without local recurrence or metastasis;skin burns occurred in 2 cases (6.67％),and solid nodules formed in situ in 6 cases (20.00％);cosmetic satisfaction rate was 86.67％ (26/30).Conclusions The radiofrequency ablation techniques applied in breast-conserving surgery have a high rate of technical success with relative low complication rates.And the radiofrequency ablation techniques may improve the cosmetic results after breast-conserving surgery and enhance local control.