Objective To summarize the techniques for reconstruction of partial breast defects after breast-conserving surgery in breast cancer. Methods The relevant literatures were reviewed and the oncoplastic techniques and their surgical indications, incision selection, advantages， and disadvantages were summarized. Results Kinds of poor aesthetic outcomes still exist in some patients after breast-conserving surgery due to the breast deformity. How to choose the surgical incision and repair breast defects after tumor resection so as to obtain better cosmetic outcomes is still a focus of breast-conserving surgery. Oncoplastic techniques can not only achieve safe cancer treatments but also have satisfactory aesthetic outcomes. Conclusions Oncoplastic techniques in the breast conservative therapy for early stage breast cancer is a safe and effective procedure， with highly satisfactory cosmetic outcomes in the majority of patients..
Objective To systematically review the effects of fenofibrate on kidney function in various populations, so as to provide references for selecting the methods of treating hyperuricemia. Methods Such databases as PubMed (1966-2013), EMbase (1984-2013), The Cochrane Library (Issue 1, 2012), CBM (1978-2013), and CNKI (1989-2013) were electronically searched for relevant randomized controlled trials or non-randomized controlled trials on fenofibrate for treating hyperuricemia. According to the Cochrane methods, two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.0 software. Results A total of 16 studies involving 346 patients were included in total. The results of meta-analysis showed that: a) compared with the control group, the fenofibrate group had the lower serum uric acid level (WMD=48.68, 95%CI 10.02 to 87.34, Plt;0.000 01), lower Ccr (endogenous creatinine clearance) level (WMD=8.88, 95%CI 1.29 to 16.47, P=0.002), and similar serum creatinine level (WMD=1.78, 95%CI –2.86 to 6.42, P=0.45); and b) adverse reaction included gastrointestinal discomforts, skin rashes and transient increase of GPT and transaminase, most of which were mild. Conclusion Fenofibrate has good effects. Due to the low quality of the included studies, the exact effectiveness and adverse reaction need to be rigorously verified based on more multi-center, double-blind, randomized controlled trials with large sample size.
Objective To analyze the reason of tumor treatment-related premature ovarian failure, and to review the progress of ovarian functional reconstruction. Methods The l iterature about the effects of radiotherapy and chemotherapy on ovarian function and reconstruct ovarian function was reviewed, analysed and summarized. Results Radiotherapy and chemotherapy can both affect ovarian function. The ovarian function reconstruction included fresh ovarian transplantation and ovarian cryopreservation and transplantation. Frequent ovarian cryopreservation was procedure slow-freezing protocols and vitrification protocols. Some laboratory and animal models of ovarian function reconstruction have come to gratifying results. Conclusion Ovarian function reconstruction has a potential cl inical value and provides a promising future.
Objective To review the latest development of the research on the selfrenwal signaling pathway and culture system in vitro of the embryonic stem cells(ESCs). Methods The recent articlesabout the selfrenewal signaling pathway and culture system in vitro of the ESCs were extensively reviewed. Results Understanding of the molecular mechanism of the selfrenewalin vitro and pluripotency of the ESCs was considered important for developing improved methods of deriving, culturing and differentiating these cells into the cells that could be successfully used in the clinical practice. Conclusion A further research is needed to elucidate the selfrenewal signaling pathway and the pluripotency of the ESCs and the culture systemin vitro forthe human ESCs remains to be further improved and developed.
ObjectiveTo evaluate the clinical and cosmetic outcome of patients with early breast cancer underwent oncoplastic techniques in breast conserving surgery. MethodsClinical data of 59 patients with early stage breast cancer who underwent oncoplastic techniques in the breast conserving surgery were analyzed retrospectively from January 2007 to March 2011. Cosmetic outcome score and patient satisfaction questionnaire were also assessed. ResultsThe age of the patients was (53.5±9.8) years (range, 32 to 77 years). The diameter of tumors was (1.6±0.7) cm (range, 0.5 to 4.0 cm). The foci located at upper quadrant in 38, lower quadrant in 17, central area in 4. During operation, single incision approach was used in 25 patients, two incisions approach in 34 patients. A variety of methods were used to repair breast defects including mammary gland direct suture in 9 patients, mammary gland pedicle flaps in 35, local flaps or adipofascial flap in 9, latissimus dorsi myocutaneous flaps in 2, and reduction mammaplasty with “J” or double ring incision in 4. The mean followup period was 30 months (range, 3 to 53 months), no local recurrence was detected. However, bone metastases was found in one patient on 14 months after operation. Fifty-three patients (89.8%) had good to excellent aesthetic results with cosmetic outcome score ≥26. Patient satisfaction questionnaire showed that 40 patients (67.8%) were excellent, 14 (23.7%) good, 3 (5.1%) fair, and 2 (3.4%) poor. ConclusionOncoplastic techniques in the breast conservative therapy for early stage breast cancer is a safe and effective procedure, with highly satisfactory cosmetic outcomes in the majority of patients.
This study aims to explore the vascularization of hydroxyapatite/tricalcium phosphate (HA/TCP) biomaterials implanted in mice during osteoinduction. The HA/TCP biomaterials were implanted in muscle of mice, and 2, 4, 6, 8, 10 and 12 weeks after the implantation, the materials were harvested to prepare serial sections and hematoxylin-eosin (HE) staining. The process of vascularization was dynamically described, and the area percentage of neovascularization was quantitatively analyzed. The results showed that neovascularization formation was a continuous and dynamic process. The neovascularization appeared largely in the first two weeks, with a rising trend in week 4, reached peak in week 6, and gradually reduced in week 8. The results provide ideas for improving the success rate of bone tissue engineering, and indicate the mechanism of osteoinduction.
ObjectiveTo discover the indicators and develop a model for predicting protracted hypoparathyroidism (HPT) after thyroid cancer surgery in order to guide the early therapy for patients with HPT.MethodsThe clinical and postoperative pathological data of patients with thyroid cancer who received surgical treatment in the Xuanwu Hospital and Beijing Pinggu Hospital from January 2019 to December 2020 were retrospectively analyzed. The potential indicators of postoperative HPT and protracted HPT were analyzed by logistic and LASSO regression analysis. A nomogram for predicting protracted HPT was constructed in the training set, and the discrimination and consistency of the nomogram were verified in the training set and the validation set respectively.ResultsAccording to the inclusion and exclusion criteria, a total of 464 patients diagnosed with thyroid cancer were finally included in the study. Among the 100 patients with postoperative HPT (except 1 case of incomplete data), 62 patients showed short-term HPT and 37 patients developed protracted HPT. Multivariate logistic regression analysis showed that the preoperative intact parathyroid hormone (iPTH) level [OR=0.953, 95%CI (0.931, 0.976), P<0.001], lobectomy with contralateral partial lobectomy [OR=3.247, 95%CI (1.112, 9.485), P=0.031], and total thyroidectomy [OR=11.096, 95%CI (5.432, 22.664), P<0.001] were related to postoperative HPT. The multivariant logistic regression analysis revealed that postoperative iPTH level was a predictive factor for protracted HPT [OR=0.719, 95%CI (0.588, 0.879), P=0.001]. The area under receiver operating characteristic curve (AUC) value of postoperative iPTH level in predicting protracted HPT was 0.848 [95%CI (0.755, 0.942)]; The cut-off value was 9.405 ng/L, and its specificity and sensitivity were 0.659 and 0.944, respectively. Moreover, the AUC value of the nomogram model including postoperative iPTH level and other clinicopathologic features (extraglandular invasion, cumulative maximum tumor diameter, and central lymph node dissection) for predicting protracted HPT was 0.900 [95%CI (0.817, 0.982)]; The cut-off score was 118.891, and its specificity and sensitivity were 0.772 and 0.944, respectively; The Hosmer-Lemeshow goodness of fit test indicated good fit of nomogram (χ2=8.605, P=0.377). The AUC value of the nomogram was 0.640 [95%CI (0.455, 0.826)] in the validation set (Pinggu Hospital data). The Hosmer-Lemeshow goodness of fit test also indicated good fit of nomogram (χ2=12.266, P=0.140).ConclusionsThe postoperative iPTH level is an important influencing factor of protracted HPT. The nomogram prediction model based on postoperative iPTH level and other clinicopathologic features has a favorable predictive value for protracted HPT.
Objective To investigate the effects of ovarian tissue cryopreservation by needle immersed vitrification (NIV) method and subsequently orthotopic transplantation on ovarian function reconstruction in chemotherapy-induced ovary damage rat model. Methods A total of 52 matured virginal female Wistar rats at age of 8-9 weeks housed in specific-pathogen-free facilities, weighing 250-300 g. Vaginal smears were obtained daily, 50 rats having at least 2 consecutive normal estrous cycles were included in the experiment. Ten rats were selected as donors randomly, and NIV method was used for cryopreserving ovarian tissues. The remaining 40 rats were divided into 3 groups according to different treatments: cyclophosphamide group (C group, n=14), cyclophosphamide/transplantation group (C/T group, n=12), and control group (NS group, n=14). In C group and C/T group, the rats received peritoneal injection of cyclophosphamide every day for 21 days to establish the chemotherapy-induced ovary damage models; and then the frozen-thawed ovarian tissues orthotopically transplanted into the left ovarian bursae in C/ T group. The rats received peritoneal injections of 0.9% saline solution every day for 21 days in NS group. Estrous cycle recovery time, ovary weight, morphology change of ovarian tissues, and follicle count were compared among 3 groups. Results One rat died at 2 days after transplantation in C/T group; the other rats survived to the completion of the experiment. At 4 weeks after the end of injection, no significant difference in body weight was found among 3 groups (P gt; 0.05). The rats of NS group had regular estrous cycle, but cyclic changes in vaginal smears were observed in C group and C/T group during cyclophosphamide treatment. The median estrous cycle recovery was 9 days (95%CI: 7.9-10.1 days) in C group, and was 6 days (95%CI: 4.9-7.1 days) in C/ T group, showing significant difference (χ2=6.571, P=0.010). The ovarian weight showed an obvious downtrend in C group at 4 weeks after cyclophosphamide treatment, and an upward trend was observed in C/T group. The ovarian grafts survived and grew well in C/T group. Primordium follicles and primary follicles in C/T group and NS group were significantly more than those in C group (P lt; 0.05), but no significant difference was found between NS group and C/T group (P gt; 0.05). There was no significant difference in secondary follicles and antral follicles among the 3 groups (P gt; 0.05). Conclusion The method of ovarian tissue cryopreservation by NIV and subsequently orthotopic transplantation can significantly shorten the estrous cycle recovery time in chemotherapy-induced ovary damage rat model. Ovarian grafts grow well, follicle count is similar to normal level. So it has the potential ability of ovarian endocrine and fertility reconstruction after chemotherapy.
Objective To explore the learning curve and evaluate the safety of uniportal complete video-assisted thoracoscopic surgery (VATS) lobectomy. Methods We reviewed retrospectively the clinical data of 133 patients, who underwent uniportal VATS between March 2015 and October 2016 in Sichuan Provincial Cancer Hospital. There were 79 males and 54 females at age of 52.21±10.77 years. Results All the 127 patients completed uniportal VATS, 4.51% (6/133) converted to open surgery. There were 78 patients with lobectomy, 6 patients with segmentectomy, 37 patients with wedge resection, 6 patients with pleural, mediastinal lymph node biopsy or mediastinal tumor resection. In the lobectomy group, mean surgical time was 148.75±34.12 min, mean blood loss was 118.87±59.96 ml, mean number of lymph nodes was 11.25±6.15, the mean duration of chest-tube placement was 2.17±1.35 days, and mean length of stay was 7.58±2.59 days. Conclusion Based on skillful performance of the conventional thoracoscopic lobectomy, the learning curve for single port thoracoscopic lobectomy comprises at least 20 patients. The uniportal VATS lobectomy is a safe and operable method of minimally invasive technique, and it is worthy to be applied in thoracic surgery.
Objective To compare the effect of uniportal and multiportal thoracoscopic lobectomy, and to explore the advantages and applications of uniportal thoracoscopic lobectomy in enhanced recovery after surgery. Methods Totally 169 patients with video-assisted thoracoscopic lobectomy in Department of Thoracic Surgery of Sichuan Cancer Hospital from January to December 2016 were enrolled. There were 99 males and 70 females with age of 60.83±7.24 years. Patients were divided into two groups: a uniportal group (78 patients) and a multiportal group (91 patients) . Patients’ clinical and pathological materials were collected. Postoperative pain, complications and hospital stay, etc of the two groups were compared. Results All patients were successfully discharged without serious postoperative complication or death. Patients in the multiportal group had smaller surgical incisions than that in the uniportal group (3.12±0.73 cm vs. 6.38±1.50 cm, P=0.016). Pain scores at postoperative 24 and 48 hours of the uniportal group were less than those of multiportal group (4.18±1.67 vs. 6.54±1.83, 3.05±1.47 vs. 4.68±1.64, P<0.05). Operation data, postoperative complications and hospital stay were similar in both groups. Conclusion Uniportal video-assisted thoracoscopic lobectomy makes smaller incisions and can further reduce postoperative pain and dosage of morphine. The operation is safe and worthy of wide application in enhanced recoveryafter surgery.