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.
Objective To explore the outcome of hypopharynx reconstruction by using remaining laryngeal mucosa flap and pectoralis major myocutaneous flap in advanced pyriform sinus cancer.Methods Twelve patients with pyriform sinus cancers underwent hemilaryngectomy and partial pharyngectomy, two patients underwentcervical esophagectomy at the same time. The defects were reconstructed by remaining laryngeal mucosa flap. Four cases were involved in the bilateral larynx, received total laryngectomy and were repaired by pectoralis major myocutaneous flap. Results There was no operative fatal case and all flaps survived. Only one suffered from postoperative pharyngocutaneous fistulas, whose defect was reconstructed by remaining laryngeal mucosa flap and had radiotherapy. All patients could swallow ordinary food and had no benign esophagostenosis and pharyngostenosis after operation. Out of 16 pateints, 1 case died of general metastasis;3 cases died of local tumor relapse, tumor relapse of cervical lymphonode and lung metastasis respectively within 1 year after operation; the other 12 casessurvived over 2 years.Conclusion The advantage of hypopharynx reconstruction with remaining laryngeal mucosa flap is simple and convenient with less trauma and complication. The reconstruction should be completed by using the pectoralis major myocutaneous flap when the bilateral larynx are involved in.
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.