Abstract:Objective: To observe the adverse reactions and quality of life (QOL) in early breast cancer patients undergoing adjuvant chemotherapy with AX regimen (pirarubicin/capecitabine). Methods: The adverse reactions in the early breast cancer patients that included 60 cases undergoing AX regimen and another 60 cases undergoing AC regimen (pirarubicin/cyclophosphamide) were recorded, and QOL surveys were conducted using the breast cancer-specific QOL scale. The results between the patients of the two regimens were compared. Results: The incidence of vomiting and severe vomiting (grade III/IV) in the AX regimen patients were significantly lower than those in the AC regimen patients (53.3% vs. 75.0%, P=0.013; 10.0% vs. 25.0%, P=0.031). The incidence of hand-foot syndrome in the AX regimen patients was significantly higher than that in the AC regimen patients (45.0% vs. 11.7%, P=0.001), but no significant difference was noted between the two regimen groups in incidence of severe hand-foot syndrome (3.3% vs. 0, P=0.154). There were no significant differences between the two regimen groups in the incidence of bone marrow suppression, nausea, diarrhea, hair loss or heart discomfort. The QOL questionnaire survey of functioning domains demonstrated that the patients with AX regimen had significant higher scores in the domain of personal and social functioning than those with AC regimen (78.40 vs. 70.92, P=0.042; 81.00 vs. 75.33, P=0.035), but there were no significant differences between the two regimen groups in the domain of physical, emotional and cognitive functioning (all P>0.05). Conclusion: Compared with the traditional AC regimen, AX regimen is easy to administer and shows less incidence of vomiting and severe vomiting as well as better overall QOL for patients.

Abstract:Objective: To evaluate the clinical efficacy of neoadjuvant chemotherapy combined with trastuzumab for HER-2 positive breast cancer. Methods: Thirty-nine patients with HER-2 positive breast cancer were treated with six cycles of docetaxel plus carboplatin based neoadjuvant chemotherapy combined with trastuzumab, and then the overall clinical efficacy was observed and univariate analysis was performed between the estrogen receptor (ER) expression status of the cancer tissues and pathologic complete response (pCR) rate. Results: The overall response (OR) rate of the 39 patients was 94.9% (37/39). Of the patients, clinical complete response (cCR) was achieved in 26 cases, partial response (PR) in 11 cases, stable disease in 2 cases and no case of progressive disease (PD). The pCR was seen in 27 cases (69.2%). The univariate analysis showed that the pCR rate of the ER-negative and ER-positive patients was 82.4% and 59.1% respectively. Conclusion: The docetaxel plus carboplatin based neoadjuvant chemotherapy combined with trastuzumab has demonstrable efficacy for HER-2 positive breast cancer, and the ER-negative patients can obtain a higher response rate.

Abstract:Objective: To investigate the incidence of breast cancer among women aged 35–69 years in Guilin urban area. Methods: A total of 1 1167 Guilin area women, aged 35–69 years, underwent breast cancer screening by the modalities that included clinical breast examination, selective color ultrasound, selective molybdenum target mammography and pathological section examination. Results: Seven cases of breast cancer were detected from the whole group, so the detection rate was 62.68/100 000 (7/11 167). The detection rates in age group of 60–69, 50–54, 40–44, and 35–39 were 322.23/100 000, 57.87/100 000, 41.46/100 000, 76.80/100 000, respectively. No cancer was detected in the age group of 45–49 and 55–59. Conclusion: The incidence of breast cancer among women in Guilin is relatively high. The screening mode of this study can probably cause misdetection of no-lump breast cancer. In our opinion, the suitable screening mode for breast cancer in China still needs to be further explored and we suggest that the B-type ultrasound-based screening could be the mainstream for further development.

Abstract:Objective: To investigate the safety and surgical techniques of immediate breast reconstruction using an extended latissimus dorsi myocutaneous (LDM) flap following modified radical mastectomy with nipple-areolar complex (NAC) preservation. Methods: Twenty-eight patients with early-stage breast cancer underwent the modified radical mastectomy with NAC preservation, and then immediate breast reconstruction using an extended LDM flap was performed. Some technical modifications were adopted during surgery, including the protection of the sensory nerves of breast skin, preservation of the thoracodorsal nerve and its second branches, turnover flap for breast restoration, filling of the axillary defect, reconstitution of the anterior axillary fold, and ample bulk of the flap (equal to more than 20–50 percent of the glandular mass resected). Results: The immediate breast reconstruction was successfully performed in all of the 28 patients. All patients were alive and with no local recurrence during the follow-up period of 12–36 months. One patient had bone metastasis 10 months after operation and another case experienced bone metastasis 2 years later. The cosmetic results were excellent in 18 cases, good in 6 cases, fair in 2 cases and poor in 2 cases, respectively. The reconstructed breasts showed the presence of skin sensation and nipple erection function, with natural ptosis, symmetrical appearance with the contralateral breast and well-filled axillary space. In addition, this procedure conferred an obviously larger range of movement in the ipsilateral arm compared to that after conventional modified radical mastectomy. Conclusion: For appropriately selected patients, it is safe and effective to perform immediate breast reconstruction with extended LDM flap after modified NAC-sparing radical mastectomy. Some rational technical modifications of the procedure can improve the quality and aesthetics of the reconstructed breast.

Abstract:Objective: To investigate the feasibility and clinical efficacy of endoscopic axillary lymph node dissection in breast-conserving surgery for early-stage breast cancer. Methods: The clinical data of 98 patients with early-stage breast cancer who underwent breast-conserving therapy were retrospectively analyzed. Of the patients, 41 cases underwent endoscopic axillary lymph node dissection (endscopic group) and 57 cases underwent conventional axillary lymph node dissection (conventional group). The operative time, blood loss, number of the lymph node dissected, complications and prognosis of the patients between the two groups were compared. Results: Operations were performed in all patients of the two groups. In the observation group and conventional group, the average operative time was 99.5 and 61.5 min (P<0.05), average number of axillary lymph nodes dissected was 17.6 and 18.6 (P>0.05), average number of positive lymph nodes was 2.1 and 2.4 (P>0.05), average intraoperative blood loss was 35.4 and 61.5 mL (P<0.05), respectively. Follow-up was conducted for 1–4 years. No recurrence or metastasis and no postoperative complications were noted in the endscopic group. There was one case each of arm edema on the affected side, poor wound healing of breast incision, local recurrence, lung metastases and tibia metastases in the conventional group. No death occurred in either of the groups. Conclusion: Endoscopic axillary lymph node dissection can achieve an axillary node clearance as complete as that obtained by conventional open dissections. In addition, the endoscopic procedure has the advantages of fewer complications and better cosmetic results.

Abstract:Objective: To investigate the influence of preemptive analgesia with flurbiprofen axetil on postoperative pain and agitation during the emergence from general anesthesia of the patients undergoing radical masterctomy. Methods: One hundred and twenty patients who were scheduled to undergo radical masterctomy under general anesthesia (ASA I-II) were included. The patients were randomly designated to group A (a dose of 50 mg of flurbiprofen axetil was given immediately after the induction of general anesthesia and another dose of 50 mg was given on completion of incision closure), group B (flurbiprofen axetil 100 mg was given immediately after the induction of general anesthesia), group C (flurbiprofen axetil 100 mg was given on completion of incision closure) and group D (served as the control group, and the same volume of saline was given on completion of incision closure), with 30 patients in each group. Among the groups, the visual analogue scale (VAS) scores at 1, 3, 6, 12 and 24 h after surgery, cardiovascular responses at the end of surgery and after extubation, and incidences of emergence agitation were compared. Results: The VAS scores of the three observation groups were all significantly lower than those of the control group at each time point within 12 h after surgery (all P<0.05), in which, the VAS scores of group A were lower than those of the group C (all P<0.05) at each time points within 12 h and lower than those of group B at 1 and 3 h time points (both P<0.05), while the VAS scores of group B were significantly lower than those of the group C at 1 and 3 h time points (both P<0.05). However, the VAS scores had no significant differences among the four groups at 24 h after surgery (all P>0.05). The alterations of mean arterial pressures (MAP) and heart rates (HR) had no significant differences among the four group at the end of surgery (all P>0.05), but at the time of extubation, the alterations of both parameters of the three observation groups were all less evident than those of the control group (all P<0.05), in which group A showed the minimum changes and followed by group B and group C (all P<0.05). The incidences of emergence agitation were 13.3% in group A, 23.3% in group B, 33.3% in group C and 43.3% in group D, respectively, and all the differences among them had statistical significances (all P<0.05). Conclusion: Preemptive analgesia by flurbiprofen axetil for patients undergoing radical masterctomy can effectively reduce the early postoperative pain and cardiovascular responses as well as the incidence of emergence agitation.

Abstract:Objective: To assess and compare the two procedures, total thyroidectomy (TT) and partial thyroidectomy (PT), for differentiated thyroid cancer in terms of associated injuries, survival and recurrence rate, so as to provide a reference and basis for surgical procedure option of this disease. Methods: Thirteen controlled clinical trials that met the inclusion criterion were collected from several domestic and global databases, and a Meta-analysis was performed on the data concerning associated injuries, survival and recurrence rate of the patients selected using fixed-effects and random-effects model, respectively. Results: The incidences of recurrent laryngneal nerve injury and parathyroid injury of TT group were both significantly higher than those of PT group [(OR=1.58, 95% CI=1.04–2.42, P=0.03), (OR=4.29, 95% CI=3.09–5.94, P<0.000)]. There was no difference in short- to mid-term survival (20 years or less) between the two groups, while the recurrence rate of the low-risk patients in TT group was significantly lower than that in PT group (OR=0.42, 95% CI=0.32–0.55, P<0.000). Conclusion: For patients with differentiated thyroid cancer at different risk levels, the principle of individualized treatment should be implemented, and the relatively conservative resection is appropriate for the low-risk patients.

Abstract:Objective: To investigate the indications, surgical techniques and efficacy of selective neck dissection (SND) for papillary thyroid cancer. Methods: The clinical data of 544 patients with early- and mid-stage papillary thyroid cancer (364 cases of stage I, 89 cases of stage II and 91 cases of stage III) undergoing thyroidectomy plus SND were retrospectively analyzed. Results: Of the 544 patients, 150 cases underwent central (level VI) neck dissection only and 325 cases (59.7%) of SND encompassed no more than three nodal levels. Operations of all the 544 patients were done through transverse neck incision. The overall positive lymph node rate was 67.4% (367/544) and separately, the positive rate of VI, IV, III, II and V level was 54.4% (296/544), 44.2% (174/394), 45.9% (181/394), 34.2% (68/199) and 9.0% (6/65), respectively. The positive rate of level VI had no significant difference compared with than that of level IV, III or II (all P>0.05). A single parathyroid gland that was resected by mistake was found in 39 cases (7.2%, 39/544) of specimens, and 86 cases (15.8%, 86/544) had transient hypocalcemia but no permanent hypocalcemia occurred. Twenty-six cases (4.8%, 26/544) had transient vocal cord paralysis but no permanent one was noted. No enlarged cervical lymph node was detected by ultrasound in the 544 patients during the follow-up period of more than 6 months after surgery. Conclusion: It is reasonable to perform SND in patients with early- and mid-stage papillary thyroid cancer. Moreover, SND is a standardized and individualized procedure with a high clinical value.

Abstract:Objective: To investigate the clinical value of the combined detection of high-mobility group box-1 (HMGB-1) and tumor-specific growth factor (TSGF) for diagnosis of thyroid cancer. Methods: The serum levels of HMGB-1 and TSGF in 86 patients with pathologically confirmed thyroid cancer, 78 cases with nodular goiter and 69 healthy individuals as control were detected by using ELISA kits, and the correlations of the serum levels of HMGB-1 and TSGF with the clinicopathologic parameters were analyzed. Results: The differences in the levels of both HMGB-1 and TSGF among the three groups had statistical significances (both P<0.05), of which, both levels were the highest in thyroid cancer patients, followed by those in nodular goiter patients, and the lowest in the healthy subjects. The area under curve (AUC) of the combination of HMGB-1/TSGF was 0.912, which was significantly higher than that of HMGB-1 or TSGF alone (both P<0.05). In patients with thyroid cancer, the serum levels of HMGB-1 and TSGF were unrelated to sex, age, lymph node metastasis or clinical stage (all P>0.05). Conclusion: The combination detection of HMGB-1 and TSGF may have certain application value for the early diagnosis of thyroid cancer.

Abstract:Objective: To observe the influence of different doses of iodine intake on the expressions of thyroid-stimulating hormone receptor (TSHR) mRNA and sodium/iodide symporter (NIS) protein in thyroid tissue of rats. Methods: Thirty-six SD rats were equally randomized into low iodine group, normal iodine group and high iodine group. Half of the number of rats of each group were sacrificed at the end of 4 and 8 weeks, respectively. The expressions of TSHR mRNA and NIS protein in the rats’ thyroid tissues were determined by real-time PCR and immunohistochemical staining, respectively. Results: Compared with the normal iodine group at the end of 4 weeks of the experiment, the TSHR mRNA expression level in low iodine group significantly increased (P<0.05), and slightly decreased in high iodine group but the difference had no statistical significance (P>0.05); the NIS protein expression in low iodine group increased to some extend and somewhat decreased in high iodine group, but both differences reached no statistical significance (both P>0.05). Compared with the normal iodine group at the end of 8 weeks, the expressions of TSHR mRNA and NIS protein in both the low iodine and high iodine group were significantly reduced (both P<0.05), in which the NIS expression levels dropped to 44.03% and 56.12% of what they had reached at the end of 4 weeks, respectively (both P<0.05). Conclusion: In either iodine-excessive or iodine-deficient conditions, the long-term iodine disorder can decrease NIS expression, which is possibly mediated by the alterations of the TSH-TSHR signaling activity.

Abstract:Objective: To investigate the effect of Smad4 specific small interference RNA (siRNA) on the invasive ability and MMP-9 expression of the breast cancer MDA-MB-231 cells. Methods: After Smad4 siRNA construction, the breast cancer cells were divided into control group, Smad4 siRNA transfection group, TGF-β treatment group and Smad4 siRNA transfection plus TGF-β treatment group. The expression of Smad4 protein in the breast cancer cells transfected with Smad4 siRNA was tested by Western blot analysis, and the activity of 4xSBE (Smad4 binding element) of the cells after TGF-β treatment was detected by luciferase reporter gene assay. Subsequently, the cell invasive ability and MMP-9 expression of the cells of each group were determined by using Transwell chamber system and Western blot analysis, respectively. Results: The protein expression of Smad4 and the TGF-β-induced elevation of 4xSBE activity of the breast cancer cells were significantly inhibited by Smad4 siRNA transfection (both P<0.05). The invasive ability and MPP-9 expression level of the breast cells stimulated by TGF-β were significantly increased compared with the cells of control group (both P<0.05), but these effects of TGF-β were significantly inhibited in the cells previously transfected with Smad4 siRNA (both P<0.05). The Smad4 siRNA transfection alone had no obvious effects on the invasive ability and MMP-9 expression of the cells. Conclusion: Smad4 siRNA can effectively decrease the invasive ability of MDA-MB-231 cells promoted by TGF-β1, and this effect may be associated with its inhibition of MMP-9 expression.

Abstract:Objective: To investigate the expressions of tight junction protein claudin-1 (Cldn-1) and E-cadherin (E-cad) in breast cancer tissue and their relations with invasion and metastasis of this cancer. Methods: The expressions of Cldn-1 and E-cad in the breast cancer samples (n=77) were detected by using tissue chip technology and immunohitochemisty. The relations of Cldn-1 and E-cad with lymph node metastases, TNM stage, maximum lump diameter and histological classification of breast cancer were analyzed. Results: The expression intensities of Cldn-1 and E-cad were associated with lymph node metastases and clinical stage of breast cancer. The results showed that the expression intensities of Cldn-1 and E-cad in the breast cancer tissues with nodal metastases were significantly lower than those without lymph node metastases (P=0.0009, P=0.014), the expression intensity of Cldn-1 in stage III breast cancer was significantly lower than that in stage I and stage II (P=0.046, P=0.047), and the expression intensities of E-cad in both stage II and stage III breast cancer were significantly lower than that in stage I (P=0.021, P=0.001). The expression intensities of Cldn-1 and E-cad were unrelated to the maximum lump diameter and histological classification of the tumor (P=0.967, P=0.150 and P=0.188, P=0.164). There was no significant difference between the expression intensities of Cldn-1 and E-cad in breast cancer (P=0.747). Conclusion: Both Cldn-1 and E-cad expressions show a decreasing trend in development and metastases of breast cancer, but both may be independent factors. Combination measurement of Cldn-1 and E-cad is of value for the screening of breast cancer with high risk of recurrence, and they may be potential indicators for metastases, recurrence and prognostic estimation of breast cancer.

Abstract:Objective: To investigate the expression and clinical significance of L-selectin in sentinel lymph node (SLN) of human breast cancer, so as to clarify the relation of SLN status with the expression of L-selectin. Methods: Sixty-eight patients with T1-2N0M0 breast cancer were selected. SLN biopsy (SLNB) was performed using 1% methylene blue dye, and then the L-selectin expressions in the SLNs, tissues of primary lesions and tumor adjacent tissues along with the tissues from 20 cases of stage III atypical hyperplasia were detected by immunohistochemical staining methods. Results: The SLNs were successfully identified in 62 of the 68 patients, so the detection rate was 91.17% (62/68). There were 3 false negative cases. The L-selectin expression level in the positive SLNs was significantly higher than that in the primary tumor tissues and adjacent tissues (both P<0.05); in the primary tumor tissues of the SLN positive cases it was significantly higher than in those of the negative ones (P<0.05), and in the primary tumor tissues of both SLN and non-SLN positive cases it was significantly higher than in those of both SLN and non-SLN negative ones (P<0.05). Conclusion: The L-selectin expression level increases in SLN positive breast cancer, which suggests that L-selectin plays an important role in lymphatic chemotactic metastasis of breast cancer. SLN status was closely related with the L-selectin expression in breast cancer, and the combination analysis of both can more comprehensively reflect the metastastic pattern of breast cancer and status of the axillary lymph node.

Abstract:bjective: To investigate the expressions of breast cancer susceptibility gene 1 (BRCA1) protein and p120-catenin (p120ctn) in invasive ductal carcinoma (IDC) of the breast and their relations with the clinicopathologic characteristics of this tumor, so as to determine their roles in the occurrence and development of IDC and their clinical application values. Methods: The expression of BRCA1 protein and p120ctn in the specimens of IDC, breast adenosis and tumor adjacent breast tissue were detected by immunohistochemical method. The relations of both expressions with the various clinicopathologic characteristics of IDC and correlation between the both were analyzed. Results: Among the 60 cases of IDC specimens, the positive expression rates of BRCA1 protein and P120ctn were 60.0% (36/60) and 35.0% (21/60), and both expressions were significantly lower than those in the breast adenosis and tumor adjacent breast tissues, respectively (all P<0.05). The expression status of BRCA1 protein was related to high incidence age, clinical stage, presence of axillary lymph node metastases and histological grade of the patients (all P<0.05), but unrelated to their tumor size (P>0.05). The expression status of p120ctn was relevant to the clinical stage, presence of axillary lymph node metastases and histological grade of the patients (all P<0.05), but irrelevant to their age at onset of disease and tumor size (both P>0.05). There was a positive correlation between the expression of BRCA1 protein and p120ctn in IDC tissues (r=0.314, P<0.05). Conclusion: The combination detection of BRCA1 protein and p120ctn can be used for diagnosis and determination of the degree of malignancy and prognosis of IDC, and provide a basis for the individualized treatment of IDC patients.

Abstract:Objective: To investigate the expressions of miR-23a and runt-related transcription factor 1 (RUNX1) in gastric cancer and their significances. Methods: The binding affinity between the miR-23a and 3' untranslated region (3'UTR) of RUNX1 was evaluated by luciferase reporter gene activity assay. The resection specimens (gastric cancer tissues and their adjacent tissues) from 87 gastric cancer patients were collected, and then the expressions of miR-23a and RUNX1 were detected by in situ hybridization and immunohistochemical staining, respectively. Results: The uciferase reporter gene activity assay suggested that RUNX1 was the target gene of miR-23a. The positive expression rates of miR-23a and RUNX1 in the 87 cases of gastric cancer tissues were 82.76% and 14.94% respectively, and both were significantly higher than those (25.29% and 80.46%) in the adjacent tissues (both P<0.01). The expression of miR-23a in the cases with lymph node metastasis was significantly higher than that in the cases without lymph node involvement (P<0.01), and the miR-23a expression increased with the development of the clinical stage and infiltration depth (P<0.01). The expression of RUNX1 in the cases with lymph node metastasis was significantly lower than that those without lymph node involvement (P<0.01), and the RUNX1 expression decreased with the development of the clinical stage and infiltration depth (P<0.01). There was a significant negative correlation between the expression of miR-23a and RUNX1 in gastric cancer (r=–0.474, P=0.004). Conclusion: RUNX1 is the target gene directly regulated by miR-23a. The high miR-23a expression and lower RUNX1 protein expression may be important biological markers for malignant transformation of the gastric mucosa, and invasion or metastasis of gastric cancer.

Abstract:Objective: To investigate the influence of antibiotics, bowel preparation, and food intake on gut bacteria of rats. Methods: Sixty SD rats were randomly divided into the control group, single factor treatment group (containing 3 subgroups: antibiotics group, bowel preparation group and fasting group), two factors treatment group (containing 3 subgroups: antibiotics + bowel preparation group, bowel preparation + fasting group and antibiotics + fasting group), three factors treatment group (antibiotics + bowel preparation + fasting group) and surgical treatment group (containing 2 subgroups: bowel preparation + antibiotics + operation + free diet group and bowel preparation + antibiotics + operation + postoperative fasting group). All groups were treated according to their predefined protocols for 4 days, and on the 5th day, all rats were killed by cervical dislocation and the stools taken from ileocecal junction under sterile conditions were used for bacterial culture and count. Results: The colibacillus number markedly increased, bifidobacterium and lactobacillus number, and bifidobactirium/colibacillus ratio markedly decreased, when the single factor treatment group was compared with the control group, the two factors treatment group was compared with the single factor treatment group, or the three factors treatment group was compared with the two factors treatment group respectively, and all the differences had statistical significances (all P<0.05). Furthermore, the above changes of gut flora in subgroups with antibiotics treatment were more evident than those in the subgroups of the same group without antibiotics treatment (all P<0.05). The colibacillus number was moderately reduced, and bifidobacterium and lactobacillus number in the free diet group was moderately increased compared to the postoperative fasting group, and the difference was statistically significant (P<0.05). Conclusion: Antibiotics, bowel preparation and fasting can all cause intestinal dysbacteriosis in rats, among which antibiotics have the greatest impact. Furthermore, the more numerous the treatment factors, the greater the influence. Early resumption of food intake has less influence on intestinal flora than postoperative fasting.

Abstract:Objective: To evaluate the application value of ductoscopy for diagnosis of pathologic nipple discharge. Methods: The clinical data of 1606 patients with pathologic nipple discharge undergoing ductoscopic examination and resection were retrospectively analyzed. Results: Although the results of the ductoscopy were not entirely consistent with those of the final pathology, there was a relatively high consistency between the two diagnostic methods (Κ=0.828). The sensitivity and specificity of ductoscopic diagnosis was 95.5% and 88.6% respectively, and its consistency rate with pathological diagnosis was 94.0%. Conclusion: Ductoscopy has considerably good sensitivity and specificity in diagnosis of nipple discharge and has a high consistency with the pathology findings, thus it can be used as an important approach for clinical diagnosis of mammary gland disease.

Abstract:Objective: To investigate the expression of transforming growth factor-β1 (TGF-β1) in the splenic tissues from patients with hypersplenism induced by portal hypertension (PH), idiopathic thrombocytopenic purpura (ITP) and hemolytic anemia (HA) respectively and its role in splenic fibrosis. Methods: According to the etiopathogenisis, the splenectomy specimens were divided into group A (PH or cirrhosis induced hypersplenism), group B (ITP induced hypersplenism), group C (HA induced hypersplenism) and group D (traumatic rupture of the spleen as the control), with 20 cases in each group. The morphological features of the specimens were observed through HE and Mason staining, and their TGF-β1 expressions were detected by Western blot analysis. Results: The HE and Mason staining showed that the splenic tissues of group A, B and C all presented different degrees of fibrosis, and that in group A had the most severe fibrosis, but no fibrotic change was noted in the specimens of group D. Western blot showed that the TGF-β1 expressions of the group A, B and C were all significantly higher than that of the group D (all P<0.05), but these had no statistical differences among the group A, B and C (P>0.05). Conclusion: There is overexpression of TGF-β1 in splenic tissue of the patients with hypersplenism, and it may be one of the mechanisms for the severe splenic fibrosis in these patients.

Abstract:The application of neoadjuvant chemotherapy in locally advanced breast cancer (LABC) has made it possible for LABC patients to receive breast conservation therapy (BCT). This paper overviews the current understanding in BCT for LABC patients, including its feasibility, indications and contraindications, and the relevant research progress in imaging assessment, existing problems and their solving strategies as well as postoperative radiotherapy and overall efficacy.

Abstract:This paper reviews the recent advances in the clinical research on breast cancer brain metastases. The main contents include the morbidity, risk factors, prognosis and treatment of this condition, among which the prognosis assessment system for breast cancer brain metastases is highlighted.

Abstract:Beclin1, an autophagy gene, has aroused great interest among investigators in recent years. This paper addresses the basic role of autophagy in cancer along with its regulatory mechanisms, the mechanisms of deletion or down-regulation of Beclin1 in breast cancer, and the relevance of autophagy to breast cancer as well as the treatment strategies by taking advantage of autophagy.

Abstract:Papillary thyroid microcarcinoma (PTMC) has become a special clinical concern with the increased preoperative detection of this disease. This paper reviews the current investigation status associatated with PTMC that included the onset characteristics, clinical signs, diagnostic approaches, pathological examination and treatment as well as the prognosis of this disease.

Abstract:MicroRNA (miRNA) dysfunction contributes critically to the occurrence and development of cancer. This paper reviews the synthesis and biological function of miRNA, as well as the contributions of miRNA dysfunction to the malignant phenotypes of tumor cells involving the cell cycle, apoptosis, invasion, and metastasis, so as to help understand its significances in the early detection and recurrence surveillance of cancer.

Abstract:The causes of biliary obstruction are diverse, but the subsequent series of pathophysiological alterations are quite similar after its onset. Inflammatory response as the main reaction plays a very important role in the hepatic and systemic injury secondary to biliary obstruction. To understand and clarify the role and impact of the inflammatory response in the pathophysiological alterations following biliary obstruction is of special significance for dealing with this disease. This paper reviews the process of the inflammatory response to biliary obstruction and its underlying mechanism.