目的 探讨直肠癌根治性切除后用臀大肌瓣与弹性金属环行肛门成形的疗效及其在肿瘤局部治疗中的意义。方法 对34例中下段直肠癌在根治性切除后，利用自体臀大肌瓣加弹性金属环行会阴肛门成形，以代替切除的括约肌，使患者仍保持术后由会阴部排便。结果 手术成功30例，失败4例。按患者术后排便感觉、排便次数及排便预感等主观感觉划分，术后效果优者10例（33．3%），良者16例（53.3%），差者4例（13.3%）。术后随访6个月～6年，其控制大便优良率为76.7%（23/30），术后1年生存率为100%，3年为82.4%（28／34），5年为58.8%（20／34）。结论 臀大肌瓣加弹性金属环行肛门成形术术式对部分患者，特别是不愿意行腹壁人工肛门的直肠癌患者具有一定实用价值，值得推广应用。
Objective To explore the interaction of postmastectomy radiotherapy （PMRT） and breast reconstruction， and elucidate how to choose the type and timing of breast reconstruction. Method Literatures about PMRT and breast reconstruction were reviewed. Results PMRT might increase the incidence of complications and impair the cosmetic satisfaction of breast reconstruction. Breast reconstruction might also compromise the effect of PMRT. Conclusions In patients who will receive or have already received PMRT， the optimal approach is delayed autologous tissue reconstruction after PMRT. If PMRT appears likely but may not be required at the time of mastectomy，delayed-immediate reconstruction may be considered， or immediate autologous tissue reconstruction may be considered in case of patients awareness of the increased complications and impaired cosmetic outcomes from PMRT.
ObjectiveTo summarize the mechanism of CD147 in breast cancer invasion and metastasis, treatment, and drug resistance so as to provide reference for clinical decision-making.MethodThe relevant literatures about studies of CD147 in breast cancer in recent years were reviewed.ResultsCD147 was widely distributed in vivo and highly expressed in malignant tumor tissues. CD147 promoted matrix metalloproteinases and vascular endothelial growth factor productions and tumor microenvironment generation by extracellular matrix in breast cancer through different mechanisms. It degraded extracellular matrix and stimulated neovascularization to promote tumor invasion and metastasis. Related studies had shown that CD147 was highly expressed in the breast cancer tissues and which was associated with tumor grade and prognosis in patients with breast cancer, and it was a biological marker for diagnosis of breast cancer. However, a large of drugs targeted for CD147 and its involved pathways didn’t well benefit patient with breast cancer due to the failure of clinical trials and chemotherapy resistance.ConclusionsCD147 plays a key role in development, invasion and metastasis, diagnosis and treatment, and drug resistance of breast cancer, as well as guiding the treatment and prognosis of patients. However, benefits are poor, and relevant molecular mechanisms of action are limited.
目的 通过测定纳米活性碳吸附的表阿霉素经脱吸附后，脱吸附出来的表阿霉素的结构是否发生改变，来推测纳米活性碳吸附表阿霉素的稳定性，进而为临床使用纳米活性碳吸附表阿霉素行局部淋巴化疗寻找实验依据。方法 通过物理脱吸附方法使表阿霉素-纳米活性碳混悬液中纳米活性碳吸附的表阿霉素释放出来，再通过超高效液相色谱质谱联用法（LC-MS法）测定脱吸附后的表阿霉素结构是否发生改变。结果 表阿霉素-纳米活性碳混悬液经过脱吸附后提取的表阿霉素行LC-MS法检测提示：脱吸附后提取的表阿霉素样品液与表阿霉素标准液的LC-MS图基本一致。结论 被纳米活性碳吸附的表阿霉素，经脱吸附后其结构并未发生改变。
Objective To analyze the influence factors of amenorrhea in premenopausal breast cancer women treated with neoadjuvant chemotherapy and the relationship of neoadjuvant chemotherapy-related amenorrhea （NCRA） to down-staging of tumor. Methods Two hundred and twenty-four premenopausal breast cancer patients undergoing neoadjuvant chemotherapy from March 2006 to March 2011 in this hospital were investigated retrospectively. The effects of age， chemotherapy regiment， ER/PR status， Her-2 status， and tamoxifen （TAM） on NCRA and recovery of menstru-ation were assessed. The average age of the patients who had accepted different chemotherapy cycles when NCRA occurred was described， and the effect of different chemotherapy cycles on recovery of menstruation was evaluated. Tumor volume change was estimated to analysis the relation between NCRA and tumor response to chemotherapy. Results One hundred and sixty-six （74.11%） cases occurred NCRA， 40 （26.49%） cases returned to normal menstruation apart from 15 cases who had accepted oophorectomy or the luteinizing hormone-releasing hormone analog goserelin before menstrual status change. The results of univariate analysis and multivariate analysis indicated that the NCRA and menstruation recovery were both related to age at diagnosis （P＜0.001，P=0.001）， and only menstruation recovery was related to chemotherapy regiments （P＜0.001）. However， the NCRA and menstruation recovery were not related to ER/PR status， Her-2 status，and TAM （P＞0.05）. Chemotherapy cycles when NCRA occurred decreased with the increase of age， and wasn’t assoc-iated with menstruation recovery （P＞0.05）. There was no correlation between NCRA and downstage of tumor after neoadjuvant chemotherapy （P＞0.05）. Conclusions Amenorrhea resulted from neoadjuvant chemotherapy in most of breast cancer patients， which occurs more commonly in elder ones with less chemotherapy cycles. Quite a few patients resume menses after NCRA， which is associated with age and chemotherapy regiments. NCRA doesn’t influence tumor response to chemotherapy.
Objective To determine the best matching concentration of carbon nanoparticles suspension injection adsorb epirubicin by measuring the combination ratio of carbon nanoparticles suspension injection combined with epirubicin under different matching conditions. And then, to prove the adsorbability of carbon nanoparticles suspension injection adsorb epirubicin in vitro. Methods Firstly, epirubicin-carbon suspension of different concentrations will be prepared. The second, high performance liquid chromatography mass spectrometry（LC-MS） was used to assay the concentration of free epirubicin, and calculate the content of epirubicin that was combinated with carbon nanoparticles suspension injection. The difference of the ratio of carbon nanoparticles suspension injection combined with epirubicin under different matching conditions will be compared in the end. Results The combination ratio of carbon nanoparticles suspension injection combined with epirubicin solution of 5, 10, and 15 mg/ml were 85.6%, 85.7%, and 31.8%, respectively. Conclusions The adsorbability of carbon nanoparticles suspension injection adsorb epirubicin is favourable in vitro. Best matching concentration of carbon nanoparticles suspension injection adsorb epirubicin may be epirubicin solution of 5-10 mg/ml.