Objective To explore the effect of carbon nanoparticles dyeing on axillary lymph node dissection in modified radical mastectomy for breast cancer. Methods Eighty-eight patients with breast cancer who received modified radical mastectomy in Mianyang Central Hospital between Mar. 2012 and May. 2013 were recruited in the study, and they were equally divided into areola group and peripheral tumor group. After induction of anesthesia before operation, carbon nanoparticles were injected around the areolar in the areola group, and carbon nanoparticles were injected around the tumor in the peripheral tumor group. The number of dissected lymph nodes(be dyed or not be dyed), metastatic lymph nodes, and black dyed lymph nodes, as well as value of operation related indexes were recorded and compared. Results In the areola group, lymph nodes were detected in 1 453, in which 1 396 lymph nodes were stained black(96.1%); the average number of dissected lymph nodes were 33.0±7.1 per case; and 19 patients (43.2%, in total of 220 metastatic lymph nodes) of them were suffered from lymph node metastasis with the average number of metastatic lymph nodes of 5±2 per case. in addition, in the areola group, operative time were(122.1±10.2) min, blood loss were(83.8±10.1) mL, postoperative hospital stay were(7±1) d, and postoperative complications occurred in 3 patients. In the peripheral tumor group, lymph nodes were detected in 909, in which 594 lymph nodes were stained black (65.3%); the average number of dissected lymph nodes were 20.7±3.2 per case; 20 patients (45.5%, in total of 88 metastatic lymph nodes) of them were suffered from lymph nodes metastasis, with the average number of metastatic lymph nodes of 2±1 per case. In addition, in the peripheral tumor group, operative time were (121.6±11.4) min, blood loss were (84.2±11.3) mL, postoperative hospital stay were (7±2) d, postoperative complications occurred in 3 patients. The black staining rate of lymph nodes, the number of lymph nodes retrieved, and the number of metastatic lymph nodes in areola group were significantly higher than those of peripheral tumor group(P < 0.01). Operative time, blood loss, postoperative hospital stay, and postoperative complication rate did not significantly differ between the 2 groups (P > 0.05). Conclusion The dyeing effect of carbon nanoparticles suspension, which was injected at areola area after induction of anesthesia, is better than that of injected around the tumor, without increasing the incidence of complication.
ObjectiveTo systematically evaluate the efficacy and safety of epidermal growth factor receptortyrosine kinase inhibitors (EGFR-TKIs) as the first-line treatment for patients with advanced non-small cell lung cancer (NSCLC). MethodDatabases including PubMed, EMbase, The Cochrane Library (Issue 1, 2015) , CBM, CNKI, VIP and WanFang Data were electronically searched from inception to March 2015, to collect randomized controlled trials (RCTs) about EGFR-TKIs versus chemotherapy for advanced NSCLC patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.2 software. ResultsA total of 9 RCTs involving 3 841 patients were included. The results of meta-analysis showed that: for patients with EGFR mutation-positive, the rate of progression-free survival (PFS) (HR=0.41, 95%CI 0.31 to 0.54, P<0.000 01) , objective response rate (ORR) (RR=2.23, 95% CI 1.73 to 2.87, P<0.000 01) and quality of life (QoL) in the EGFR-TKI group were superior to the chemotherapy group; There was no statistical difference between two groups in rate of overall survival (OS) (HR=1.04, 95% CI 0.88 to 1.24, P=0.62) . The incidences of diarrhea (RR=3.81, 95% CI 2.15 to 6.76, P<0.001) and rash (RR=8.14, 95% CI 3.55 to 18.68, P<0.001) were significantly higher, but the incidence of blood toxicity was lower in the EGFR-TKI group that those in the chemotherapy group. ConclusionsCurrent evidence shows EGFR-TKI is superior to chemotherapy for advanced NSCLC patients with EGFR mutation-positive. However, due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.