Objective To investigate the protection of renal function and the prevention of acute renal failure （ARF） in patients with malignant obstructive jaundice in perioperative period of radical resection. Methods A series of clinical interventions had been taken since 2004 in our treatment team, including control of endotoxemia, depression of biliary tract before operation, maintenance of adequate effective blood volume, nutritive support, administration of mannitol and low dose of furosemide, and avoidance of disseminated intravascular coagulation. The incidence of perioperative ARF in 206 patients with malignant obstructive jaundice who had been radically resected from 2000 to 2007 was retrospectively studied, and the RIFLE criteria was used for ARF classification. This study was progressed in two periods. The first one was from Jan. 2000 to Dec. 2003, and the second one was from Jan. 2004 to Dec. 2007. Results After 2003, the proportion of radical resection rose from 44.8% to 57.1% （P＜0.05), and the rate of perioperative ARF dropped from 15.1% to 6.7%（P＜0.05), among which the proportion in the RIFLE-R (Risk) stage had no significant change, while in the RIFLE-F (Failure) stage it dropped from 10.5% to 2.5% (P＜0.05). Finally, perioperative mortality rate dropped from 16.3% to 5.8% (P＜0.05). Therefore, the reduction of ARF was mainly attributed to the reduction in RIFLE-F stage. Conclusion By using the latest RIFLE criteria to classify ARF, it illustrates that our perioperative interventions have effectively decreased ARF, limited ARF in its early and reversible stage, and prevented advancing.
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 biological function of extracellular matrix metalloproteinase inducer (EMMPRIN) in tumor progression, and its roles in clinical diagnosis and treatment in recent years. MethodsLiteratures about the recent studies on molecular structure of EMMPRIN and biological function in tumor progression were reviewed according to the results searched from PubMed database. ResultsEMMPRIN play important roles in the tumor progression, involved in inducing the degradation of extracellula matrix, promoting angiogenesis, inhibiting apoptosis, enhancing chemoresistance and so on. ConclusionEMMPRIN could be a potential therapeutic target in turmor.
ObjectiveTo investigate the relationship between female estrogen metabolism and breast cancer.MethodBy searching the contents of Chinese Knowledge Network, Wanfang Database, PubMed and other databases, the relationship between breast cancer hormone receptor status, menstrual status and estrogen metabolism and breast cancer, estrogen metabolism pathway and signal in vivo a review of the transduction aspects.ResultsEstrogen and its metabolites was closely related to the occurrence and development of breast cancer. Among the main metabolic pathways of estrogen, 2-methoxyestradiol in the 2-hydroxy metabolic pathway had a potential protective effect on breast cancer; 4-hydroxyestradiol, 16α-hydroxyestrone might induce breast cancer; the ratio of 4-hydroxyestradiol to 2-hydroxyestradiol might be used as a biomarker for predicting malignant breast tumors. However, the estrogen metabolism patterns before and after menopause were different, and the effects on hormone receptor status were also different. Different hormone receptor status might affect the treatment and prognosis of breast cancer.ConclusionsThe relationship between estrogen and its metabolites and breast cancer in different receptor states is not completely clear. More large-scale prospective studies are needed to help us find out the rules to promote early diagnosis and early prevention of breast cancer.
ObjectiveTo understand the application of vacuum assisted rotary cutting technique in benign and malignant breast diseases.MethodThe related literatures about the application of vacuum assisted rotary cutting technique in the breast benign and malignant diseases were reviewed.ResultsThe technique of vacuum assisted rotary cutting had been applied to the treatment of intraductal and phyllodes tumors. The non-lactation mastitis lesions could all be removed by this technique, and as a minimally invasive treatment for gynecomastia. It could guided by the color Doppler ultrasound, mammography and MRI, which could obtain enough tissue specimens for the screening and biopsy of early breast cancer. The indication of vacuum assisted rotary cutting technique should be further discussed in the breast conserving treatment of breast cancer.ConclusionsVacuum assisted rotary cutting technique has been widely used in treatment of various benign diseases of the breast and diagnosis and treatment of breast cancer. The best indication for operation should be determined based on clinical manifestations and auxiliary examination results.