Objective:To explore the efficacy of the oncoplastic round block technique in surgical management of idiopathic granulomatous mastitis (IGM).Methods:From January 2014 to December 2019, a total of 18 patients (24 to 38 years old, 32.2 years in average) with IGM underwent excision of the inflammatory breast mass with oncoplastic round block technique, the postoperative clinical efficacy was summarized and analyzed.Results:All 18 patients with IGM underwent excision of the inflammatory breast mass with oncoplastic round block technique, among them 2 patients underwent round-block reduction surgery of contralateral breast at the same time. The median follow-up duration was 16.1 months (from 6 to 36 months). Incision poor healing occurred in two cases which was cured after dressing change. Recurrence occurred in one case at 6 months after operation, and then cured with conservative measures. No other severe complications occurred. All patients were satisfacted with the results.Conclusions:Application of oncoplastic round block technique in surgical management of IGM may remove more tissue in order to reduce the recurrent rate, and get a better cosmetic results.

Triple-negative breast cancer (TNBC) is a highly invasive subtype of breast cancer. This study explored the molecular mechanism and influences of metallothionein 1 J, pseudogene (MT1JP), microRNA-138 (miR-138), and hypoxia-inducible factor-1α (HIF-1α) on TNBC cell proliferation and migration. We confirmed TNBC cases by immunohistochemistry (IHC) staining. The expression of MT1JP in two types of tissue collected from 78 TNBC patients was detected by performing real-time quantitative fluorescence PCR (RT-qPCR). To further evaluate the relationship among MT1JP, miR-138 and HIF-1α, expression vectors of MT1JP and HIF-1α, as well as miR-138 mimic and inhibitor, were delivered into BT-549 cells. We observed that MT1JP was downregulated in TNBC. MT1JP was positively correlated with miR-138 but negatively correlated with HIF-1α in TNBC tissues. In TNBC cells, upregulation of miR-138 and downregulation of HIF-1α were observed after overexpression of MT1JP. In addition, overexpression of miR-138 resulted in downregulation of HIF-1α but did not affect the expression of MT1JP. Decreased proliferation rate of TNBC cells was observed after overexpression of MT1JP and miR-138. HIF-1α increased cell proliferation and migration. HIF-1α also suppressed the role of MT1JP and miR-138 in TNBC cell proliferation and migration. In conclusion, our findings demonstrated that MT1JP inhibited TNBC by regulating the miR-138/HIF-1α axis, indicating that MT1JP might serve as a biomarker or target for TNBC treatment.

Objective:To study the expression of 5-fold transmembrane protein (CD133) and POU3 homobox gene 3-related long non-coding RNA (PANTR1) in breast cancer and their relationship with cell proliferation and invasion ability in vitro. Methods:A total of 50 breast cancer patients admitted to the Department of Breast Cancer, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from February 2019 to February 2021 were enrolled in this study. The expression of CD133 and PANTR1 in breast cancer tissues and adjacent normal tissues was detected by reverse transcription polymerase chain reaction (PCR). In addition, McF-7 cells were divided into control group, CD133 overexpression group, PANTR1 overexpression group, CD133 inhibition group and PANTR1 inhibition group. The CD133 overexpression group was given Lipofectamine 2000 and CD133 sequence, and the PANTR1 overexpression group was given Lipofectamine 2000 and PANTR1 sequence. Lipofectamine 2000 and si-cd133 were given in CD133 inhibition group, and si-pantr1 inhibition group were given Lipofectamine 2000 and si-pantr1. The differences in proliferation and invasion ability, Pum1 and E2F3 protein expression levels in each group were analyzed. The SPSS 22.0 software was used to carry out t test. Results:The relative expression levels of CD133 and PANTR1 mRNA in breast cancer tissues were higher than those in adjacent normal tissues (0.021±0.001 vs. 0.006±0.001, 0.016±0.002 vs. 0.005±0.001, t=75.000, 74.785, P<0.01). After transfection for 24, 48 and 72 h, the proliferation rate of CD133 overexpression group was higher than that of control group (3.05±0.26, 5.40±0.47 and 10.74±1.27 vs. 2.17±0.25, 4.38±0.42, 6.97±0.84, t=4.226, 2.783, 4.298, all P<0.05), and the number of invasive cells at 24 h after transfection was greater than that of the control group (75.29±7.19 vs. 54.01±6.27, t=3.865, P<0.05). After transfection for 24, 48 and 72 h, the proliferation rate of PANTR1 overexpression group was higher than that of the control group (3.11±0.28, 5.45±0.51 and 10.05±1.24 vs. 2.17±0.25, 4.38±0.42, 6.97±0.84, t=4.372, 3.003, 3.570, all P<0.05), and the number of invasive cells at 24 h after transfection was greater than that of the control group (76.03±7.26 vs. 54.01±6.27, t=3.977, P<0.01). The expression levels of Pum1 and E2F3 protein in CD133 overexpression group were higher than those in control group (4.52±0.75, 3.38±0.56 vs. 1.00±0.04, 1.00±0.03, t=8.118, 7.351, P<0.05). The expression levels of Pum1 and E2F3 protein in PANTR1 overexpression group were higher than those in control group (4.55±0.76, 3.41±0.59 vs. 1.00±0.04, 1.00±0.03, t=8.079, 7.066, P<0.01). The expression levels of Pum1 and E2F3 protein in CD133 inhibition group were lower than those in control group (0.45±0.02, 0.37±0.03 vs. 1.00±0.04, 1.00±0.03, t=21.301, 25.720, P<0.01). Pum1 and E2F3 protein expression levels in panTR1-inhibition group were lower than those in control group (0.47±0.03, 0.38±0.02 vs. 1.00±0.04, 1.00±0.03, t=18.360, 29.784, P<0.01). Conclusion:Both CD133 and PANTR1 are significantly overexpressed in breast cancer, and can enhance cell proliferation and invasion ability in vitro, which deserves clinical attention.

目的 探讨麦默通旋切术(Mammotome,MMT)用于乳腺癌病灶切除的临床价值.方法 接受超声引导下MMT,术后病理检查确诊为乳腺癌,并接受再次开放手术病人75例,根据MMT后有无肿瘤残留分为肿瘤残留组和肿瘤无残留两组,肿瘤残留组39例,肿瘤无残留组36例.分析乳腺癌肿瘤病灶残留与临床、病理因素间的关系.结果 乳腺癌MMT后肿瘤病灶残留率为52.0％.年龄、组织学类型、Ki-67表达与乳腺癌肿瘤病灶残留相关(P<0.05);年龄是乳腺癌肿瘤病灶残留的独立危险因素,P<0.05.结论 乳腺癌经超声引导下MMT切除肿瘤病灶,肿瘤残留率偏高.不建议应用MMT治疗乳腺癌.

Platelet-rich fibrin (PRF) was prepared from the blood of BALB/C inbred mice to explore potential effects on postoperative intestinal adhesion. A murine model of intestinal adhesion characterized by abdominal wall defect/and cecum damage was established by scraping caecum serosa and cutting peritoneum and muscles in the abdominal wall. The wound was covered with PRF (group A), sodium hyaluronate (group B), or left alone (blank control; group C). All animals were monitored for 28 days. The incidence of adhesion was 35.0, 66.7, and 73.7% in groups A, B, and C, respectively. The incidence of adhesion in group A was significantly lower than that in group C (p < .05). Histopathologically, severity of fibrosis and the number of fibroblasts or inflammatory cells in group A were lower than those in groups B and C (p < .05), whereas the number of mesothelial cells was higher (p = .001). Furthermore, the severity of fibrosis and number of fibroblasts or inflammatory cells were lower in low grade than those in high grade of adhesion (p < .05), whereas the number of mesothelial cells was higher (p < .05). Collectively, PRF applied to abdominal surgery may reduce the incidence of intestinal adhesion by promoting proliferation of mesothelial cells whereas inhibiting proliferation of fibroblasts and infiltration of inflammatory cells.

Gemcitabine-based chemotherapy is commonly applied for the treatment of breast cancer in a clinical setting. However, acquired resistance to chemotherapy primarily results in treatment failure and eventually culminates in patient mortality. Aberrant expression of microRNAs (miRNAs) has been demonstrated to be implicated in the development of chemoresistance; however, the role of miR-873 in the chemoresistance of breast cancer and its underlying mechanism have not been completely elucidated. Herein, using cell viability assays, the present study demonstrated that overexpression of miR-873 sensitized triple-negative breast cancer (TNBC) cells (MDA-MB-231 and BT549) towards gemcitabine treatment, while inhibition of miR-873 promoted resistance of TNBC cells to gemcitabine exposure. The 3 ' untranslated region of zinc finger E-box binding homeobox 1 (ZEB1) was predicted as a candidate target of miR-873, and the regulatory association between ZEB1 and miR-873 was validated with a dual luciferase assay. Reverse transcription-quantitative polymerase chain reaction and western blot analysis confirmed that miR-873 mimics reduced ZEB1 at mRNA and protein levels in MDA-MB-231 and BT549 cells. As ZEB1 was previously reported to interact with Yes associated protein (YAP) to promote cancer progression. The present study observed that miR-873 overexpression decreased the expression of YAP target genes AXL receptor tyrosine kinase, connective tissue growth factor and cysteine rich angiogenic inducer 61 at mRNA and protein levels. Additionally, elevation of the ZEB1 level and reduction of the miR-873 level were detected in gemcitabine-resistant MDA-MB-231 (MDA-MB-231GEMr) cells, which were accompanied with stronger proliferative ability, compared with parental cells. Overexpression of miR-873 or ZEB1 knockdown reversed chemoresistance of MDA-MB-231GEMr cells by inducing a notable cell growth arrest upon gemcitabine exposure. In conclusion, the data obtained by the present study demonstrated that the decrease of miR-873 promoted the development of gemcitabine resistance in TNBC via elevation of ZEB1 expression, which indicated that miR-873 may be a promising predictor for gemcitabine sensitivity in patients with TNBC.

Objectives: To investigate the relationship between the expression of ER, PR, HER-2 and Ki-67 and the effective rates of neoadjuvant chemotherapy (NAC), and to study the influence of NAC on the expression of ER, PR, HER-2 and Ki-67 in breast cancer patients.

目的 通过建立裸鼠胰腺癌模型,结合磁共振成像(magnetic resonance imaging,MRI),探讨同步辐射X线相衬成像技术对胰腺癌的早期诊断.方法 32只nu/nu雌鼠,采用数字表法随机分为A、B两组:A组(n=24)为人胰腺癌细胞PANC-1胰腺原位移植瘤组,即于胰腺被膜下注射108 ×2 μL单细胞悬浮液;B组(n=8)为空白对照组,即于胰腺被膜下注射2μL 0.9％(质量浓度)氯化钠注射液.再根据术后1、2、3、4周处理时间的不同,将A、B两组分为4个亚组,即A1、A2、A3、A4(n =6)和B1、B2、B3、B4(n=2).术后分别行MRI扫描、肿瘤标本相衬成像及病理学检查.结果 ①A组术后平均成瘤率73％ (16/22),术后4周成瘤率最高,达到100％,成瘤率随观察时间的延长而升高,二者之间存在线性趋势关系(x2线性趋势=4.718,P=0.030);病理组织学检查为胰腺低分化腺癌.②同步辐射X线相衬成像可显示直径为0.5mm的胰腺原位肿瘤,早期(两周)的灵敏度和特异度达到100％,明显高于MRI扫描(P =0.029).结论 PANC-1细胞原位移植是建立裸鼠胰腺癌模型的可靠方法;与MRI相比,同步辐射X线相衬成像能发现胰腺癌微小病变,有可能为胰腺癌的早期诊断提供了一种全新的技术手段.

The classic method for gene knockout （KO） is based on homologous recombination （HR） and embryonic stem cell technique （Gerlai,1996）.Actually,the procedure of homologous replacement is complicated and time consuming,although it has been popular during the past decades.Recent years,genome editing which can cause DNA sequence-specific mutations in the genomes of cellular

乳腺导管内乳头状瘤是一种多发于乳腺导管上皮细胞的良性肿瘤[1].发病症状主要体现为乳头呈现硬块,且乳头间歇性溢液或溢血,好发于产后、40～50岁绝经前的妇女,病因目前尚不明确[2].主要分为两大类型,分别是中央型和周围型,中央型常发于乳晕区输乳管壶腹部内的大导管,主要特征为乳头溢液.周围型则常发于乳腺周围末梢、小导管中,通常情况下为多发[3].该病症有一定的癌变概率,一般通过外科手术进行治疗,可采用传统开放性手术和超声引导下真空辅助微创旋切手术来进行治疗[4].本研究分析超声引导下真空辅助微创旋切乳腺导管内乳头状瘤的疗效,现将结果报告如下.

目的 探讨腹腔镜胆总管探查取石术(LCBDE)及胆囊切除(LC)治疗老年急性胆管炎合并胆总管结石(CBDS)患者相关并发症的预防.方法 将近年收治的部分老年CBDS患者72例根据有无非重度急性胆管炎分为胆管炎组(37例)及非胆管炎组(35例),并比较两组特点.结合围术期综合治疗.四孔法完成经胆总管切开的LCBDE、T管引流及LC.结果 两组胆总管直径、结石数目、手术时间及住院天数相当;无中转开腹、胆道损伤、手术死亡及伤口感染.术后胆管炎、胆漏组4例,非胆管炎组3例,均经保守治疗治愈.术后胆管炎组、胆道残余结石4例,非胆管炎组2例,经T管窦道胆道镜取净结石,两组比较差异无统计学意义(P>0.05).胆管炎组术后胆管炎症状及体征明显缓解.结论 LCBDE及T管引流术治疗非重度急性胆管炎安全、有效;把握好胆管炎LCBDE的指征、有效的围术期综合治疗、熟练的腹腔镜及胆道镜技术有助于并发症的预防及减少.

Objective:To observe and analyze expression of adiponectin (ADPN) and adiponectin receptors (adipoR) in breast cancer and its correlation with clinicopathological features.Methods:60 cases of patients with breast cancer were selected as the case group.30 cases of patients with benign breast diseases were selected as the control group.The serum level of ADPN of the patients in the two groups were detected and compared.The expressions ofADPN,adipoR1,adipoR2 in the tumor tissue of the patient in the case group and in the lesions of the patients in the control group were detected and compared.The primary tumor site,the tumor nodule number,the pathological type,the tumor infiltration,the lymph node metastasis,T staging,TNM staging of the patients in the case group and their correlation with the levels ofADPN,adipoR1,adipoR2 were observed and analyzed.Results:The serum ADPN level and the expressions ofADPN,adipoR1,adipoR2 in the tumor tissue of the patient in the case group were significantly lower than those in the control group.The differences between the two groups were statistically significant (P＜0.05).The serum ADPN level and the expressions of ADPN in the tumor tissue of the patient with breast cancer were related with the tumor infiltration,the lymph node metastasis,T staging,TNM staging (P＜0.05).The expressions of adipoR1 and adipoR2 in the tumor tissue of patients with breast cancer were related with the pathological type,the tumor infiltration,the lymph node metastasis,T staging and TNM staging (P＜0.05).Conclusions:The ADPN and its receptors in tumor tissues and peripheral blood of patients with breast cancer show low expressions,and have relevance with the pathological type,invasion and metastasis and clinical staging of the tumor and,which are expected to become new type of target for diagnosis and treatment of breast cancer.

目的 探讨3.0 T TX磁共振成像(MRI)对7,12-二甲基苯并蒽(DMBA)诱导的大鼠胰腺病损的诊断价值.方法 将DMBA 2 mg/100 g植入60只雄性SD大鼠胰腺,术后2、4、6个月对存活的55只行腹部MRI(3.0 T TX)冠状位、横断位平扫及增强扫描,并与术前10只正常大鼠的MRI比较,随后取胰腺组织行病理检查.结果术后2个月,MRI显示大鼠均出现胰腺形态不规则、腹水、肠管扩张现象;19只行病理检查呈现急、慢性胰腺炎改变.术后4个月,MRI显示33.3%(6/18)的大鼠出现胰腺囊肿,病理检查为胰腺假性囊肿,直径0.3~1.0 cm.术后6个月,38.9%(7/18)的大鼠出现胰腺假性囊肿,MRI表现为较长T1、长T2信号,结节中心低信号,增强扫描后不明显.1只可见胰腺部位肿瘤,直径约0.3 cm;MRI特点为稍长T1、长T2信号,病变信号不均匀,中心呈更长T1信号,增强扫描后病变边缘可见较明显强化,病变内部无明显强化;病理及免疫组化诊断为胰腺平滑肌肉瘤.结论使用3.0 T TX MRI可发现DMBA诱导的大鼠胰腺病损,可分辨直径≤0.5 cm的胰腺部囊肿及肿瘤.

Objective To explore the possibility of pancreatic carcinogenesis induced by small dose 7,12-dimethylbenzanthracene ( DMBA) implantation in Sprague-Dawley( SD) rats.Methods Totally 70 male SD rats were randomly divided into two groups:DMBA (2 mg/100 g) was implanted into the parenchyma of rats pancreas in experimental group( n=60); No drugs were implanted into the parenchyma of pancreas in control group.Rats were killed after surgery operation(2, 4 and 6 months).Finally, the pancreases of rats were fixed in formalin for HE staining and immunohistochemical analysis.Results ①No significant differences were observed with the weight of rats between experimental and control groups(P=0.680);②The incidence of pancreatic cyst was 33.3%in the experimental group 4 months after surgery.The incidence of pancreatic cyst was 38.9% and that of leiomyosarcoma was 5.6% in the experimental group 6 months after surgery.Conclusion Small dose of DMBA(2 mg/100 g) implanted into SD rats can cause acute pancreatitis, chronic pancreatitis, pancreatic cyst, and pancreatic leiomyosarcoma.The incidence of pancreatic leiomyosarcoma is very low.But no pancreatic ductal cell carcinoma was found.Further reaserch is needed.

It is undetermined when and how laparoscopic common bile duct exploration (LCBDE) should be used in patients with common bile duct (CBD) stone-related nonsevere acute cholangitis. We aimed to evaluate the effect of LCBDE on the clinical outcome of those patients within (early) or beyond (delayed) 72 hours of emergent admission. Surgery-related complications, length of hospital stay (LOS) and total cost, as well as demographic and clinical parameters were compared between the two groups. Finally, 3 and 5 patients in early and delayed LCBDE group, respectively, had retained stones, which were removed by choledochoscopy before T-tube was removed. Each group had 3 patients who developed biliary leak, which was conservatively cured by the drainage. Shorter LOS and less total cost were observed in early group compared to the late one (13.34 ± 4.48 vs. 18.32 ± 9.13, p < 0.05; 17712 ± 5446.63 vs. 21776 ± 7230.41 ¥RMB, p < 0.05). Improvement of cholangitis was achieved in all patients with LCBDE. None of the patients developed stricture of the CBD after LCBDE. To conclude, both early and delayed LCBDE are safe and effective for the treatment of CBD stone-related nonsevere acute cholangitis during emergent admissions. Early LCBDE may be superior to delayed procedure due to the shorter LOS and less cost.

Background: Laparoscopic common bile duct exploration (LCBDE) has already been established for the treatment of patients with common bile duct stones (CBDS) in elective situations. However, the effect of emergent LCBDE on those patients with nonsevere acute cholangitis has not been assessed. The aim of this study was to evaluate the effect of emergent LCBDE on patients with nonsevere acute cholangitis complicated with CBDS.Methods: Seventy-two patients with CBDS admitted from January 2009 to December 2012 were included for this retrospective study. LCBDE of transductal approach for CBDS was performed to all patients. Thirty-seven patients underwent emergent LCBDE for nonsevere acute cholangitis and 35 patients underwent elective LCBDE. Duration of the procedure, complications, retained stone of bile duct, hospital stay, and total charges were compared between the two groups. In addition, the characteristics of patients underwent emergent LCBDE were also compared before and after surgery.Results: There was no significant difference with regard to the diameter of common bile duct and number of CBDS from imaging and/or operative findings between the two groups. There was no conversion to open common bile duct exploration, no major bile duct injuries, and no mortality in both the group of patients. There was no significant difference in patients with or without acute or chronic cholecystitis, duration of surgery, overall hospital stay (16.41 +/- 1.03 versus 14.54 +/- 0.94, P > 0.05), and total charges (18,603 +/- 1774.64 versus 14,951 +/- 1257.09 Yuan in renminbi, P > 0.05) between the two groups. Four cases with retained stones were found in patients with emergent LCBDE and two in elective LCBDE patients. There were four cases of biliary leak in patients with emergent LCBDE and three cases in elective LCBDE group, respectively. However, there was no statistical difference between the two groups. The biliary leak was cured postoperatively after drainage. Control of septic symptoms was achieved in all patients after emergent LCBDE.Conclusions: Our data indicated that emergent LCBDE is as safe and effective as elective LCBDE for the treatment of patients with nonsevere acute cholangitis complicated with CBDS. (C) 2014 Elsevier Inc. All rights reserved.

<正>胆囊结石合并胆总管结石(common bile ductstones,CBDS)是胆道外科的常见病、多发病,文献报道因胆囊结石行胆囊切除术的患者,3%～14.7%合并CBDS[1]。随着腹腔镜胆囊切除术