A highly sensitive sandwich-type electrochemical immunosensor was developed for the quantitative detection of breast cancer susceptibility protein 1 (BRCA1), leveraging the synergistic amplification of zeolitic imidazolate framework-8 decorated with gold nanoparticles (AuNPs@ZIF-8) and nitrogen-doped graphene quantum dots (N-GQDs). The AuNPs@ZIF-8 nanocomposite provided a high specific surface area and enhanced electron transfer, enabling dense immobilization of capture antibodies, while N-GQDs acted as signal labels for secondary antibody conjugation. Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) confirmed the stepwise assembly of the sensing interface. Differential pulse voltammetry revealed a linear response between 1.0 pg/mL and 50 ng/mL (ΔI (µA) = 3.58 log C + 7.21, R 2 = 0.9985), with a detection limit of 0.3 pg/mL. The immunosensor exhibited excellent selectivity against potential interferents, with non-specific responses below 5%, and demonstrated good reproducibility (RSD = 3.8%) and long-term stability (92.5% signal retention after 30 days). Recovery rates in spiked human serum ranged from 96.8% to 104.2%, confirming the robustness of the platform in complex biological matrices. Compared with conventional methods, the sensor achieved superior sensitivity and operational simplicity. This work highlights a versatile nanocomposite-based amplification strategy for ultrasensitive protein detection and provides a promising analytical tool for clinical screening of breast cancer biomarkers and other disease-related proteins.

Breast cancer (BC) is a malignant tumor with the highest incidence rate in women. This work explored the function of CXCL12 in tumor metastasis. CXCL12 protein expression levels were assessed by IHC in breast cancer tissues. Protein–protein interaction analysis (STRING) indicated that CXCL12 interacts with CXCL10 protein molecules. Correlation analysis in GEPIA2 showed that CXCL12 was negatively correlated with CXCL10. The effects of CXCL12 on invasion and migration were detected by scratch and transwell experiments in breast cancer cells. CD4 + T and CD8 + T cells in the inflammatory microenvironment of breast cancer patients were evaluated with the NGDC database and verified by IF. CXCL12 knockdown efficiency was 55.4

OBJECTIVE:This study investigated the function of the Bloom syndrome RecQ helicase-like gene (BLM) in triple-negative breast cancer (TNBC). METHODS:The expression levels of BLM in breast cancer cells were assessed using quantitative reverse transcription polymerase chain reaction (qRT-PCR), Western blotting, and immunohistochemical analysis. Cell proliferation, apoptosis, migration, and invasion were evaluated using the CCK-8 assay, clonogenic assay, flow cytometry, wound healing assay, and Transwell assay, respectively. Autophagosomes were observed via transmission electron microscopy (TEM). The expression levels of LC3B, Beclin1, and p62 were also measured. A murine xenograft model was employed to examine the impact of BLM on TNBC tumor growth, with tumor weight and volume recorded. Hematoxylin and eosin (H&E) staining and immunohistochemistry were utilized to assess pathological changes and Ki67 expression in tumor tissues. Additionally, Western blotting analysis was conducted to determine the expression of p53, AMPK, phosphorylated AMPK (p-AMPK), mTOR, and phosphorylated mTOR (p-mTOR). RESULTS:The expression of BLM was elevated in BT549 cells compared to normal cells. Following BLM knockdown, BT549 cell proliferation was significantly reduced, while apoptosis was enhanced. The migration rate of cells in the siBLM group was markedly decreased, as were the invasion and metastasis rates. TEM results indicated an increased presence of autophagosomes in the siBLM group, with significantly elevated expression levels of LC3B and Beclin1, and a decreased expression level of p62. Tumor volume and weight in the shBLM group were significantly lower than those in the shCtrl group. The number of intratumoral cells decreased, with most exhibiting nucleolysis or disintegration. Ki67 expression in the tumor tissue was also notably reduced. Additionally, the expression levels of p-mTOR, p-AMPK, and P53 proteins in the shBLM group were decreased. CONCLUSION:The knockdown of BLM significantly inhibited cell proliferation, migration, and invasion, while promoting apoptosis. This effect may be mediated through the regulation of the p53-AMPK-mTOR pathway.

Background Ongoing research has underlined the significant biological dimensions of anoikis in carcinogenicity and progression of multiple tumors. However, there is no definitive role for anoikis in the prognosis of lung adenocarcinoma (LUAD) and the tumor microenvironment (TME). Methods In this study, we employed ssGSEA to construct anoikis scores for 273 anoikis genes and screened 184 anoikis-associated genes by WGCNA and single-cell sequencing. The LASSO algorithm configured the LUAD prognostic risk cohort, and the CIBERSORT algorithm assessed differences in the infiltration abundance of 22 immune cells. The TIDE algorithm calculated discrimination based on anoikis risk cohort for immune therapy variation. Finally, the prognostic value of the two models was evaluated separately by machine learning algorithms. Results ssGSEA calculated the anoikis-related gene score (ARGS), which was classified into high ARGS and low ARGS based on the prognosis of LUAD patients. Single-cell sequencing verified the distribution of ARGS on different cellular taxa and constructed a set of models to predict LUAD based on the differential genes of high and low ARGS. Single-cell sequencing was performed to validate the distribution of ARGS in different cell populations and to construct a set of predictive models for LUAD based on the differential genes of high and low ARGS, Risk was developed based on LOX, MSX1, FSTL3, STEAP1, PMEPA1, SNAI1, ABCA6, PLOD2, SEMA3A, FRMD6. Further validation was performed in the Gene Expression Omnibus score (GEO) dataset. The immune and mesenchymal scores were generated by an estimation algorithm for LUAD patients from The Cancer Genome Atlas (TCGA) database and assessed the relationship between higher and lower-risk groups of the model. Higher risk was also negatively associated with the abundance of B cells, CD4 + T cells, and other stromal or immune cells. Mutations in genes occurred more frequently in the high-risk group. These mutations may be associated with changes in TME and suggest the patient's response to immunotherapy. For the drug sensitivity analysis, the high-risk group had a lower IC50 in some chemotherapeutic agents and targeted agents, suggesting that the high-risk group is more sensitive to these agents. Conclusion This study reinforces that anoikis patterns are significantly associated with the diversity and complexity of TME. Quantitative assessment of anoikis modification patterns in LUAD will reinforce our insights into TME characteristics and catalyze more effective immunotherapeutic strategies.

BACKGROUND Occult breast cancer (OBC) is diagnosed when regional or distant metastases are found without evidence of a primary tumor. The low overall incidence is a great challenge for the management strategy of OBC. Aggressive diagnosis and personalized treatment are feasible treatment strategies for OBC. We report the case of an OBC patient who achieved pathological complete response (pCR) after neoadjuvant chemotherapy. CASE REPORT A 43-year-old woman was admitted to the hospital 6 months after detecting a lump in her left axilla, about the size of a quail egg, but not red or swollen, and the lump gradually grew. Mammography, ultrasound, and magnetic resonance imaging showed a visible left axilla lesion but no nodules in bilateral breasts. A core-needle biopsy of the axilla lesion revealed an invasive carcinoma of breast origin. The tumor cells were estrogen receptors (ER)-negative, progesterone receptor (PR)-negative, and HER2-positive (3+) by immunohistochemistry. The patient was finally diagnosed with HER2-positive, hormone receptor-negative occult breast cancer of the left breast, cT0N2M0, stage IIIA. The TCbHP regimen (docetaxel, carboplatin, trastuzumab, and pertuzumab) as neoadjuvant chemotherapy was given. She underwent a modified radical mastectomy, showing a pCR. Subsequent radiotherapy and HER2-targeted therapy were administrated. CONCLUSIONS This case highlights that even aggressive HER2-positive breast cancer can present as an occult primary tumor. Our clinical experience suggests that neoadjuvant chemotherapy followed by modified radical mastectomy can be effective for treating such rare cases. The patient achieved pCR, which can provide a therapeutic strategy for effective treatment of similar OBCs.

Triple-negative breast cancer (TNBC) is characterized by a grim prognosis and numerous challenges. The objective of our study was to examine the role of thymidylate synthase (TYMS) in TNBC and its impact on ferroptosis. The expression of TYMS was analyzed in databases, along with its prognostic correlation. TYMS positive expression was identified through immunohistochemistry (IHC), while real-time quantitative PCR (qRTPCR) was employed to measure TYMS mRNA levels in various cell lines. Western blotting was utilized to assess protein expression. Cell proliferation, mobility, apoptosis, and reactive oxygen species (ROS) levels were evaluated using CCK8, wound scratch healing assay, transwell assay, and flow cytometry, respectively. Additionally, a tumor xenograft model was established in BALB/c nude mice for further investigation. Tumor volume and weight were measured, and histopathological analysis using hematoxylin and eosin (H E) staining was conducted to assess tumor tissue changes. IHC staining was employed to detect the expression of Ki67 in tumor tissues. High expression of TYMS was observed in TNBC and was found to be correlated with poor prognosis in patients. Among various cell lines, TYMS expression was highest in BT549 cells. Knockdown of TYMS resulted in suppression of cell proliferation and mobility, as well as promotion of apoptosis. Furthermore, knockdown of TYMS led to increased accumulation of ROS and Fe2+ levels, along with upregulation of ACLS4 expression and downregulation of glutathione peroxidase 4 (GPX4) expression. In vivo studies showed that knockdown of TYMS inhibited tumor growth. Additionally, knockdown of TYMS was associated with inhibition of mTOR, p-PI3K, and p-Akt expression. Our research showed that the knockdown of TYMS suppressed the TNBC progression by inhibited cells proliferation via ferroptosis. Its underlying mechanism is related to the PI3K /Akt pathway. Our study provides a novel sight for the suppression effect of TYMS on TNBC.

LncRNA MIR31HG is involved in many types of cancers, while its roles in breast cancer are still unknown. The current study aimed to explore the function of lncRNA MIR31HG in breast cancer and the underlying mechanisms. Stable expression cell lines were constructed by using lentivirus particles. MTT assay was used to determine cell viability. Wound healing and Transwell assay were used to determine cell migration and invasion, respectively. The changes in biomarkers were determined by using qPR-PCT and Western blotting, respectively. BALB/c nude mice were used to generate a xenograft mouse model. MIR31HG regulated cell proliferation, migration and invasion in MCF7 cells. Besides, MIR31HG regulated N-Cadherin, Vimentin, and E-Cadherin. MIR31HG positively regulated receptor-interacting serine-threonine kinase 4 (RIPK4), as supported by the fact that knockdown of MIR31HG suppressed RIPK4, and the knockdown of RIPK4 did not affect MIR31HG. Additionally, we found that RIPK4 regulated cell proliferation, migration and invasion in MCF7 cells. The changes in RIPK4 regulated N-Cadherin, Vimentin, and E-Cadherin. Consistently, in vivo studies showed that the knockdown of MIR31HG or RIPK4 reduced tumor size in xenograft animal models. The roles of lncRNA MIR31HG in breast cancer were associated with its regulatory effects against RIPK4.

Objective To find out the risk factors of lymph node metastasis of primary gastric cancer and construct a new target prediction model.Methods Retrospective cohort study was adopted.The clinical data of 514 patients with primary gastric cancer who underwent radical gastrectomy in the general surgery department and tumor surgery department of the first affiliated hospital of Bengbu Medical College from December 2019 to June 2022 were collected.All patients were randomly divided into the target model group（347 patients, 67.5%） and the comparison validation group（167 patients, 32.5%）.Single factor Logistic analysis method was used to conduct retrospective analysis on all case samples to screen variables affecting lymph node metastasis, then determine the variable items of the target prediction model input node, and then use multi-layer perceptron to train the target model.The target model was composed of the input layer of variables screened by single factor logistic analysis.AI analyzes patients’ lymph node metastasis status based on input data and compares it with the real value.The accuracy of the model was evaluated by drawing the ROC curve and obtaining the area under the curve（AUC）.Results There was no significant difference in the clinical data between the target model group and the contrast validation group（P＞0.05）.Multivariate analysis showed that the neutrophils to lymphocytes ratio（NLR）,tumor location, tumor shape, tumor length, differentiation, and tumor stage were related to lymph node metastasis.According to the ROC curve analysis drawn by the target prediction model, the AUC of the target model group was 0.841（95% CI:0.795-0.863）,and the AUC of the comparison verification group was 0.707（95% CI:0.679-0.852）,suggesting that the target prediction model has a higher ability to diagnose lymph node metastasis.Conclusions Lymph node metastasis of primary gastric cancer is related to the neutrophils to lymphocytes ratio, tumor location, tumor shape, tumor length, tumor differentiation and tumor stage.The novel target prediction model constructed in this study can accurately predict lymph node metastasis in patients with primary gastric cancer, and has clinical diagnosis, treatment and prognosis evaluation value.

BACKGROUND:Vir like N6-methyladenosine (m6A) methyltransferase associated protein (VIRMA) is associated with various tumors, but the specific role of VIRMA in triple-negative breast cancer (TNBC) and the mechanisms are still unclear. Thus, in this study, in addition to the effect of VIRMA on TNBC, the underlying mechanisms were also explored. METHODS:In vitro, VIRMA expression was detected by quantitative real-time polymerase chain reaction (qRT-PCR) and western blot; VIRMA lentiviral overexpression vector (LV-VIRMA) and lentiviral vector connected with the shRNA targeting VIRMA (LV-shVIRMA) were constructed to explore the functional role of VIRMA; RNA immunoprecipitation and qRT-PCR were performed to assess the relationship between VIRMA and kinesin family 15 (KIF15). In vivo, female Balb/C mice (n = 6) were subcutaneously injected with TNBC cells transfected with LV-shRNA + LV-NC (negative control), LV-shVIRMA + LV-NC, and LV-shVIRMA + LV-KIF15, tumor volume, weight and immunohistochemistry staining of Ki-67 were employed to assess breast tumor growth; immunohistochemistry of VIRMA and KIF15 were performed to examine VIRMA and KIF15 expression in breast tumor tissues. RESULTS:Compared to normal breast epithelial cells, VIRMA was increased in TNBC cells (p < 0.01 and p < 0.001). LV-VIRMA elevated proliferation, metastasis and invasion of TNBC cells in comparison with LV-NC (p < 0.001), while VIRMA knockdown resulted in the opposite effects in comparison with LV-shRNA NC (p < 0.01 and p < 0.001). Also, compared to LV-shRNA NC, LV-shVIRMA downregulated KIF15 expression by reducing KIF15 mRNA stability (p < 0.05 and p < 0.001), which was dependent on m6A. Furthermore, compared to LV-shVIRMA + LV-NC, LV-shVIRMA + LV-KIF15 not only reversed the reduced proliferation, metastasis and invasion of TNBC cells (p < 0.05, p < 0.01, and p < 0.001), but also reversed the decreased tumor weight and volume (p < 0.05, p < 0.01, and p < 0.001). CONCLUSIONS:The above results indicated that VIRMA promoted TNBC progression by upregulating m6A-dependent KIF15 expression, providing a better understanding of the pathogenesis of TNBC.

Using a meta-analysis approach, we conducted a comprehensive evaluation of the effect of neoadjuvant chemotherapy (NACT) on the incidence of surgical site wound infection during immediate breast reconstruction (IBR) following breast cancer. The aim was to provide evidence-based support for the prevention of wound surgical site infection during IBR after breast cancer surgery. Relevant literature on the effects of NACT on IBR in patients with breast cancer published up until May 2023, was retrieved from various databases, including PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang databases, and China Biology Medicine Database. Two researchers performed the literature screening, data collection, and quality assessment of the included studies independently. The meta-analysis was conducted using Stata version 17.0. Fourteen studies involving 3401 patients (599 in the intervention group and 2802 in the control group) were included in the analysis. The incidence of surgical site infection in the NACT group was higher than that in the control group, but the difference between the two groups was not statistically significant (7.17% vs. 4.85%, odds ratio: 1.02, 95% confidence interval: 0.70-1.50, p = 0.902). These findings suggest that NACT does not increase the risk of surgical site infection during IBR. However, owing to the variation in sample size and literature quality among the included studies, randomised controlled trials are needed to confirm the safety of IBR in patients receiving neoadjuvant chemotherapy.

目的 探讨利用CT三维重建的方法在评估乳腺癌前哨淋巴结(SLN)状态及其引流通路中的应用价值.方法 对确诊为乳腺癌拟行前哨淋巴结活检(SLNB)或腋窝淋巴结清扫(ALND)的23例患者行CT淋巴管造影(CT-LG),图像经3D容积重建后显示SLN及其引流淋巴管,通过SLN的影像学特征如淋巴结的形态及充盈情况等来评估其转移情况,并与术后病理结果作对比;将CT-LG所显示的SLN及其相连的淋巴管与SLNB术中解剖的SLN及其连接的淋巴管进行对比分析,验证CT三维重建的临床应用价值.结果 20例(86.9％)患者的SLN被检出;SLNB检出SLN数量显著高于CT-LG(Z=3.568,P＜0.01).通过CT-LG在术前发现1枚非常规引流通路SLN,由乳晕处淋巴管丛发出,通过腺体层进入乳房后间隙;CT-LG所显示的34枚淋巴结中病理阴性26枚,其中有20枚淋巴结表现为均匀充盈,6枚表现为充盈缺损;病理阳性的8枚均表现为充盈缺损;在病理阳性SLN淋巴结充盈缺损比例高于病理阴性SLN(P＜0.01).结论 CT三维重建有助于SLN的精准定位,也可以发现非常规引流通路的SLN,对于影像学表现为充盈缺损的淋巴结应考虑有肿瘤细胞浸润.

目的:探讨经口腔前庭入路腔镜甲状腺切除术在甲状腺微小乳头状癌中应用的安全性、可行性及临床效果.方法:回顾性分析2016年1月至2020年1月蚌埠医学院第一附属医院肿瘤外科收治的45例经病理确诊的甲状腺微小乳头状癌患者的临床资料,所有患者均采用腔镜甲状腺切除术进行治疗,其中行经口腔前庭入路15例为经口组,经胸乳入路30例为经胸乳组,比较2组患者围术期资料及随访情况等.结果:2组患者在术中出血量、术后住院时间、中央区淋巴结清扫数目方面比较,差异无统计学意义(P>0.05);经口组患者术后第1天引流量、颈部VAS评分显著低于经胸乳组(P<0.05),但手术时间显著多于经胸乳组(P<0.05).2组患者术后并发症比较,差异无统计学意义(P>0.05).2组患者术后至少随访6个月,经口组患者美容满意度评分高于经胸乳组(P<0.05),且均未见肿瘤复发与转移.结论:经口腔前庭入路腔镜甲状腺切除术治疗甲状腺微小乳头状癌手术安全、可行及临床效果良好,且有较佳的美容效果.

目的 探讨经锁骨下切口无充气腔镜双侧甲状腺切除术的疗效和安全性.方法 回顾性分析蚌埠医学院第一附属医院甲乳外科2019年10月至2020年9月行双侧甲状腺手术治疗的39例患者,其中19例行锁骨下切口入路腔镜手术,20例行传统开放手术.比较两组手术总时间、术中出血量、恶性患者中央区淋巴结清扫数、术后疼痛视觉模拟量表(VAS)、术后住院时间、术后并发症和术后3个月美容满意度的差异.结果 腔镜组平均手术时间长于传统开放组(P<0.05),术后3 d疼痛评分高于传统开放组(P<0.05),术后美容满意度明显高于传统开放组(P<0.05).两组患者术中出血量、术后住院时间、恶性患者中央区淋巴结清扫数目、术后并发症及术后3个月疼痛评分的差异无统计学意义(均P>0.05).结论 经锁骨下切口腔镜甲状腺手术适用于有美容需求且需行双侧甲状腺切除的患者,术后患者切口美容满意度高.

目的:探讨三阳性乳腺癌(triple-positive breast cancer,TPBC)患者的临床病理特征及预后.方法:收集2010年9月至2015年9月我院收治的TPBC患者130例,对其临床病理资料进行回顾性分析.结果:研究中,TPBC患者共130例,占所有乳腺癌患者的13.10％.其中,63.08％为超重/肥胖患者(BMI≥24),52.31％的患者合并有慢性病.患者最常见的首诊症状为发现乳房肿块(80例,占61.54％),而非疼痛(10例,占7.69％).病灶的位置以右侧多见(75例,占57.69％),最常见的部位为外上象限(58例,占44.62％).最常见病理学类型为浸润性导管癌(104例,占80.00％).随访结果表明,局部复发率为9.23％(12例),远处转移率为26.92％(35例).最常见的转移部位为骨(24例,占68.57％),其次为肺(18例,占51.43％).结论:TPBC患者的预后较差,容易发生远处转移,且有早期转移倾向,因此迫切需要对TPBC进行全面的研究,更深入的了解TPBC的异质性.

目的:探讨免充气经腋窝入路治疗甲状腺微小乳头状癌的手术经验及疗效.方法:选取80例甲状腺微小乳头状癌病人,其中行腔镜手术35例(腔镜组),开放手术45例(开放组),比较2组病人围手术期资料、并发症及随访情况等资料.结果:腔镜组平均年龄较开放组年轻(P<0.05);腔镜组平均手术时间及术后第1天引流液量均较开放组多(P<0.01);腔镜组术中出血量比开放组少(P<0.01);术后第3天颈部VAS评分腔镜组较开放组低(P<0.05);中央区清扫后平均淋巴结数目腔镜组与开放组比较差异无统计学意义(P>0.05);2组病人术后住院时间、术后并发症比较差异无统计学意义(P>0.05);腔镜组术后美容满意度较高(P<0.01);随访3个月以上,均未见复发与转移.结论:免充气经腋窝入路腔镜下甲状腺微小乳头状癌手术安全可行,与开放手术相当,并具有较佳的美容效果.

目的 探讨无充气经锁骨下入路完全腔镜双侧甲状腺腺叶切除术的可行性及安全性.方法 回顾性分析43例双侧甲状腺全切术患者的临床资料.其中13例行无充气经锁骨下入路完全腔镜双侧甲状腺腺叶切除手术(腔镜组),30例行传统开放手术(开放组).记录2组手术时间、术中出血量、术后引流量、术后第1天甲状旁腺素(PTH)、术后住院时间、手术并发症及美容满意度等.结果 腔镜组患者年龄(46.2±10.1)岁小于开放组(57.4±7.9)岁(P<0.05);而2组间性别比例、肿块直径、肿瘤性质差异无统计学意义(P>0.05).腔镜组手术时间[(124.2±15.8)min vs.(92.9±9.7)min]及术后引流量[(147.1±42.9)mL vs.(103.7±16.5)mL]均较开放组增多(P<0.01);但术中出血量[(26.1±8.5)mL vs.(37.0±10.9)mL]较开放组减少.2组患者术后第1天PTH、住院时间比较差异无统计学意义(P>0.05);腔镜组术后美容满意度高于开放组(P<0.05).结论 无充气经锁骨下入路完全腔镜双侧甲状腺腺叶切除手术安全、可行,美容效果较佳,值得推广.

目的 分析乳腺癌术后上肢淋巴水肿(breast cancer related lymphedema,BCRL)发生的危险因素.方法 随访2008年7月-2019年11月蚌埠医学院第一附属医院甲乳外科收住的62例乳腺癌患者,采用5点周径测量法结合Norman问卷评估上肢淋巴水肿发生情况,结合患者临床资料分析BCRL发生的危险因素.结果 62例患者中发生上肢淋巴水肿22例(35.5％),轻度水肿20例,中度水肿2例;单因素分析结果提示BCRL与患者的年龄、体重指数(body mass index,BMI)、腋窝淋巴结清扫数量、腋窝第Ⅲ组淋巴结清扫及手术时间有关(均有P＜0.05);多因素多分类Logistic回归分析模型分析结果提示患者的年龄、BMI及手术时间是BCRL发生的独立危险因素(均有P＜0.05).结论 乳腺癌患者术后早期即可发生上肢淋巴水肿,尤其是对于年龄≥53岁、BMI≥27 kg/m2及术后时间≥6月的患者,应积极采取预防性干预措施,以预防和减少BCRL的发生.

Purpose: To identify risk factors for lymph node metastasis in central zone of papillary thyroid microcarcinoma (PTMC) in patients so as to provide a clinical basis for selective lymph node dissection surgery in central zone. Methods: Clinical data of 210 PTMC patients with surgical treatment in he First Affiliated Hospital of Bengbu Medical College from March, 2012 to December, 2017 were analyzed retrospectively for independent risk factors for lymph node metastasis in central zone. Results: Total metastasis of PTMC in central zone was 37.62 % (79/210). Single factors analysis showed that tumor size, envelope invasion, and clinical typing cN1 patients had close relations with lymph node metastasis in central zone (p < 0.05). Multiple factors analysis showed that size of tumor (OR = 2.418, 95 % CI = 1.186 - 4.731, p = 0.008); envelope invasion (OR = 1.981 95 % CI = 1.976 - 3.307, p = 0.006); and clinical typing (OR = 2.961 95 % CI= 1.163 - 3.162, p = 0.001) were independent risk factors of lymph node metastasis in central zone. Lymph node metastasis in central zone of patients without the three independent factors was 18.03 % (11/61), which was significantly lower than metastasis in patients with any of the risk factors (45.64 %, 681149; chi(2) = 14.054, p < 0.001). Conclusion: Tumor size, tumor envelope invasion and clinical typing cN1 are independent risk factors for lymph node metastasis in central zone. Patients who present with these risk factors should be given lymph node dissection in central zone.

目的 探讨综合护理在减少乳腺癌腋窝淋巴结清扫术后并发症中的应用效果.方法 选择2017年5月—2019年5月在本院行腋窝淋巴结清扫术的60例乳腺癌患者作为研究对象,根据随机数字表法均分为观察组和对照组两组,每组各30例:观察组给予综合护理,对照组给予常规护理,护理干预前后,采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评价患者焦虑抑郁情况,采用乳腺癌患者生命质量测定表(FACT-B)评价患者生存质量,并记录患者护理满意度和并发症发生情况.结果与护理前相比,两组护理后的HAMD评分和HAMA评分均显著降低,且观察组下降更为明显,差异均具有统计学意义(P<0.05);与护理前相比,两组护理干预后的各项FACT-B评分均显著升高(P<0.05),且观察组上升幅度较对照组更大,差异均具有统计学意义(P<0.05);观察组并发症发生率与对照组相比显著降低(6.67％vs 16.67％),差异具有统计学意义(P<0.05);观察组的护理满意度与对照组相比显著提高(93.33％vs 76.67％),差异具有统计学意义(P<0.05).结论 综合护理在腋窝淋巴结清扫术患者中的应用,可显著改善患者焦虑、抑郁情绪,减少术后并发症发生率,从而提高患者护理满意度及患者生存质量.

目的:探讨环乳晕切口及放射状切口术对乳腺纤维瘤的疗效及乳晕区感觉神经功能的影响.方法:80例乳腺纤维瘤患者,根据手术方式均分为环乳晕切口组(环乳晕切口术)和放射状切口组(放射状切口术);比较两组患者的手术时间、术中出血、手术瘢痕长度及住院时间,比较两组患者术后瘢痕愈合评分、乳腺外形满意度评分、并发症、哺乳率及术后1d、6个月时乳晕区感觉功能变化,术后6个月评价两组患者的治疗效果.结果:环乳晕切口组的手术时间显著长于放射状切口组、术中出血量显著多于放射状切口组,而手术瘢痕长度显著短于放射状切口组(P＜0.05);环乳晕切口组患者术后瘢痕愈合评分显著低于放射状切口组、乳腺外形满意度评分显著高于放射状切口组(P＜0.05);环乳晕切口组术后1d及6个月时的晕区感觉功能正常占比均显著高于放射状切口组(P＜0.05),两组患者术后哺乳率比较,差异无统计学意义(P＞0.05),环乳晕切口组的手术治疗总有效率(95.00％)显著高于放射状切口组(75.00％,P＜0.05),环乳晕切口组患者术后并发症总发生率(7.50％)显著低于放射状切口组(30.00％,P＜0.05).结论:环乳晕切口手术治疗乳腺纤维瘤的疗效优于放射状切口手术,对乳晕区感觉神经功能损伤较小、术后美观性更好.