Single stage immediate breast reconstruction with acellular dermal matrix and implant: Defining the risks and outcomes of post-mastectomy radiotherapy

IntroductionThe objective of this study is to evaluate outcomes and complications in patients with single-stage ADM-implant based immediate breast reconstruction with and without radiotherapy (RT), highlighting the effects of RT on the reconstruction.Materials and methodsThis prospective study recruited 91 consecutive patients who underwent skin-sparing, nipple-sparing or wise-pattern skin reduction mastectomy with direct-to-implant breast reconstruction with ADMs using sub-pectoral or pre-pectoral approach at the two breast units. Early and late complications like seroma, delayed wound healing, wound breakdown, infection, capsular contracture, implant loss and revision surgery were evaluated in the RT and non-RT groups.ResultsIn the total cohort of 91 patients, 29 received adjuvant RT and 62 did not need RT. In the RT group, 3–7% of them had early complications like seroma, wound infections and delayed healing. 20.7% had post-RT capsular contractures which either required revision surgery with autologous flap (6.9%) or capsulotomy with exchange of implant (6.9%). In the non-RT group, 7–9% cases had seroma & wound infections, 3.06% had delayed wound healing and 7.25% had capsular contracture. 13.04% required revision surgery due to infection, implant loss or failure to achieve expectations. The total loss of implants in the cohort was 7.14% (RT group 6.9% and non-RT group 7.25%). The need for PMRT could have been predicted pre-operatively in the RT group in 55.17% cases based on the extent of disease, multifocality, tumour grade and positive LN status on imaging.ConclusionADM based reconstruction in patients anticipated to receive adjuvant RT is always debatable. Though there is no significant difference in the revision surgeries in our study of the 2 groups, the rate of capsular contracture as expected, was higher in the RT group. Hence, pre-operative discussion on the need for RT highlighting the risks and complications will help patients make a better-informed choice.     

EGFR、PCNA、LN、IV型胶原在SACC中的表达及临床意义

目的：探讨表皮生长因子受体（EGFR）、增殖细胞核抗原（PCNA）、层黏连蛋白（LN）和IV型胶原蛋白在唾液腺腺样囊性癌（SACC）中的表达及临床意义。方法：选取临床病例资料齐全的SACC 78例,用荧光原位杂交技术检测EGFR基因表达,免疫组织化学技术检测 EGFR、PCNA、LN和Ⅳ型胶原蛋白的表达,分析其与临床病理参数的相关性。结果：SACC中EG-FR基因扩增率（69．2％）与蛋白的阳性表达率（71．8％）存在明显正相关（P＜0．05）,且EGFR、PCNA、LN、Ⅳ型胶原蛋白表达与临床病理参数密切相关。EGFR、PCNA表达水平间存在明显正相关（P＜0．05）;LN蛋白、Ⅳ型胶原表达水平间存在明显负相关（P＜0．05）。结论：EGFR基因在SACC中明显扩增,EGFR、PCNA、LN、Ⅳ型胶原蛋白共同参与SACC发生、发展。     

血清HA、LN、CPⅢ和Ⅳ-C测定在160例肝纤维化患者诊断过程中的应用

目的探讨慢性乙型病毒性肝炎血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)和Ⅳ型胶原(Ⅳ-C)在肝纤维化诊断中的应用价值。方法采用放射免疫分析法(R IA)检测160型慢性乙型病毒性患者血清HA、LN、PCⅢ和Ⅳ-C水平,并与肝组织活检纤维化程度进行相关性分析。结果各组慢性乙型病毒性肝炎患者血清HA、LN、PCⅢ和Ⅳ-C水平均高于正常对照组(p<0.05),与肝纤维化活动水平及程度呈密切正相关(p<0.01)。结论血清HA、LN、PCⅢ和Ⅳ-C水平能较好地反映乙型病毒性肝炎的慢性化程度和肝纤维化的活动水平及程度,联合检测可明显提高肝纤维化诊断的准确性和可靠性。     

Does loss of hormonal receptors influence the pathophysiological characteristics of the HER-2 breast cancer phenotype?

Background

Some breast carcinomas (BC) of the HER-2 type respond poorly to endocrine therapy, indicating that hormonal receptor (HR) status possibly impacts the biological criteria of this tumor class. The aim of this study was to compare the clinicopathological characteristics of HR-positive and HR-negative tumors occurring in HER-2 and non-HER-2 BC.

lncRNA FAM95B1在胶质瘤中的表达及其影响LN382细胞增殖和迁移 的可能机制

目的：探讨lncRNA FAM95B1 对胶质瘤细胞增殖和迁移能力的影响并探究其相关作用机制。方法：选取2018年1月至2020年8月于合肥市第三人民医院行手术治疗的38例胶质瘤患者的胶质瘤组织及癌旁组织标本,利用qPCR检测胶质瘤组织与4种细胞系中FAM95B1的表达水平,以表达最低的胶质瘤LN382细胞为研究对象,转染空载质粒（对照组）或pcDNA3.1-FAM95B1质粒（实验组）。MTT法和划痕实验检测FAM95B1对LN382细胞增殖和迁移能力的影响。生物信息学分析技术和双荧光素酶基因报告实验预测并验证FAM95B1与miR-26a-5p及PTEN之间的相互作用机制,应用qPCR和WB法检测FAM95B1对miR-26a-5p和PTEN表达的影响。结果：FAM95B1在胶质瘤组织中的表达明显低于癌旁组织（P<0.01）。FAM95B1在多种胶质瘤细胞系中的表达均明显低于正常脑胶质细胞（均P<0.01）。过表达FAM95B1可以下调LN382细胞的增殖（P<0.05）和迁移能力（P<0.01）。FAM95B1 能够靶向结合 miR-26a-5p（P<0.01）,miR-26a-5p 能够靶向结合 PTEN mRNA（P<0.01）。过表达FAM95B1可下调LN382细胞中miR-26a-5p的表达（P<0.01）,促进PTEN mRNA的表达（P<0.01）。结论：在胶质瘤组织和细胞系中异常低表达的FAM95B1通过发挥竞争性内源RNA的功能抑制miR-26a-5p的表达而增强PTEN蛋白表达,抑制胶质瘤细胞系LN382的增殖和迁移。     

尿MCP-1、细胞免疫水平检测对狼疮性肾炎患者病情评估的价值及相关性研究

目的探讨尿单核细胞趋化蛋白-1(MCP-1)、细胞免疫水平检测对狼疮性肾炎(LN)患者病情评估的价值及相关性。方法回顾性分析2011年9月~2016年9月60例就诊于我院肾内科的LN患者临床资料,依据系统性红斑狼疮疾病活动指数(SLE-DAI)将60例患者分为活动组(SLE-DAI评分≥10分,n=37)和稳定组(SLE-DAI评分10分,n=23);以同时期30例健康志愿者作为健康组。比较三组受试者尿MCP-1水平和外周血T细胞亚群(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+)检测结果差异;经Pearson线性相关分析法分析尿MCP-1、T细胞亚群水平与LN患者病情严重程度的相关性。结果三组受试者尿MCP-1、外周血CD8~+检测结果显示:活动组稳定组健康组(P0.05);外周血CD4~+、CD4~+/CD8~+检测结果则显示:活动组稳定组健康组(P0.05);三组外周血CD3~+检测差异无统计学意义(P0.05)。Pearson线性相关分析结果显示:尿MCP-1水平、CD8~+水平与SLE-DAI评分呈正相关,CD4~+、CD4~+/CD8~+水平与SLE-DAI评分呈负相关(P0.05),CD3~+水平与SLE-DAI评分无明显相关性(P0.05)。结论尿MCP-1和T细胞亚群水平与LN患者病情严重程度关系密切,可作为LN诊断和病情评估的敏感指标。     

The Efficacy of Lymph Node Embolization Using N-Butyl Cyanoacrylate Compared to Ethanol Sclerotherapy in the Management of Symptomatic Lymphorrhea after Pelvic Surgery

Purpose

To compare the efficacy of lymph node (LN) embolization using N-butyl cyanoacrylate versus ethanol sclerotherapy in the management of symptomatic postoperative pelvic lymphorrhea.