Objective To review the latest progress in the major biological properties of adipose-derived stem cells (ADSCs) and ADSCs assisted autologous lipotransfer in breast repair and reconstruction. Methods Recent literature about ADSCs assisted autologous lipotransfer in breast repair and reconstruction was reviewed. Results ADSCs have multipotential differentiation capacity, and they could promote angiogenesis and regulate immune reactions. ADSCs assisted autologous lipotransfer can obtain satisfactory effectiveness in breast repair and reconstruction with few complications, but more studies are needed to confirm the long-term safety. Conclusion ADSCs assisted autologous lipotransfer has good effectiveness in breast repaired and reconstruction. But further clinical trials are needed to confirm the long-term safety.
【摘要】 目的 比較在乳腺癌Auchincloss改良根治術中使用超聲刀及電刀手術的優、缺點。 方法 2009年6月－2010年7月將176例乳腺癌患者通過信封法隨機分為超聲刀組和電刀組，每組88例，分別比較兩組患者手術時間、術中出血量、淋巴結檢出數目、術后引流量、皮下積液及術后出血量的差異。 結果 手術時間:超聲刀組為（145.72±50.76） min，電刀組為（171.27±66.68） min，兩組差異有統計學意義（P=0.005）；術中出血量:超聲刀組為（71.56±31.34） mL，電刀組為（84.99±36.39） mL，兩組差異有統計學意義（P=0.009）；清掃出的淋巴結個數:超聲刀組為（20.92±9.09）個，電刀組為（17.90±6.74）個，兩組差異有統計學意義（P=0.013）。而在術后平均引流量和術后積液例數方面兩組的差異無統計學意義（Pgt;0.05）。兩組均無術后出血的情況。 結論 在乳腺癌Auchincloss改良根治術中使用超聲刀，較單獨使用電刀能縮短手術時間，減少出血量，并增加淋巴結檢出的數量。【Abstract】 Objective To compare the disadvantages and advantages between modified radical mastectomy with harmonic scalpel (HS) and conventional electro-scalpel (ES) for patients with breast cancer. Methods Between June 2009 and July 2010, 176 patients with breast cancer were randomly divided into two groups including the HS group and the ES group. The operation time, intra-operative bleeding volume, the number of lymph nodes detected, postoperative drainage volume, subcutaneous hydrops, and postoperative hemorrhage volume between the two groups of patients were compared. Results There were significant differences between the HS and ES groups in terms of operation time [(145.72±50.76) minutes vs. (171.27±66.68) minutes, P=0.005], intra-operative bleeding volume [(71.56±31.34) mL vs. (84.99±36.39) mL, P=0.009], and number of lymph nodes detected (20.92±9.09 vs. 17.90±6.74, Plt;0.05). The postoperative drainage volume and subcutaneous hydrops were not significantly different between the two groups (Pgt;0.05). No postoperative hemorrhage occurred in both groups. Conclusion Compared with ES, the use of HS can reduce operation time and intra-operative bleeding volume, and increase the number of lymph nodes detected during modified radical mastectomy.
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.
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 Extracellular matrix is one of the focus researches of the adi pose tissue engineering. To investigate the appropriate method to prepare the porcine skeletal muscle acellular matrix and to evaluate the biocompatibility of the matrix. Methods The fresh skeletal muscle tissues were harvested from healthy adult porcine and were sl iced into2-3 mm thick sheets, which were treated by hypotonic-detergent method to remove the cells from the tissue. The matrix was then examined by histology, immunohistochemistry, and scanning electron microscopy. The toxic effects of the matrix were tested by MTT. Human adi pose-derived stem cells (hADSCs) were isolated from adi pose tissue donated by patients with breast cancer, and identified by morphology, flow cytometry, and differentiation abil ity. Then, hADSCs of passage 3 were seeded into the skeletal muscle acellular matrix, and cultured in the medium. The cellular behavior was assessed by calcein-AM (CA) and propidium iodide (PI) staining at 1st, 3rd, 5th, and 7th days after culturing. Results Histology, immunohistochemistry, and scanning electron microscopy showed that the muscle fibers were removed completely with the basement membrane structure; a large number of collagenous matrix presented as regular network, porous-like structure. The cytotoxicity score of the matrix was grade 1, which meant that the matrix had good cytocompatibil ity. The CA and PI staining showed the seeded hADSCs had the potential of spread and prol iferation on the matrix. Conclusion Porcine skeletal muscle acellular matrix has good biocompatibility and a potential to be used as an ideal biomaterial scaffold for adi pose tissue engineering.
Objective To explore the clinical application of combination of radiolabeled colloid （99Tcm-sulphur colloid） and blue dye in sentinel lymph node biopsy （SLNB） for early-stage breast cancer. Methods SLNB was performed with the guidance of blue dye, radiolabeled colloid, and the combination method in all patients enrolled, and clinical and pathological data were recorded respectively for analysis. Results Two hundred and one patients were enrolled in this study and the SLN were successfully detected in 200 cases. The identification rate of radiolabeled colloid method and combination method was 99.5% （200/201） and 99.5% （198/199） respectively, which significantly higher than blue dye method （85.4%, P＜0.001）. There were no differences of accuracy rate 〔95.3% （162/170） vs. 94.5% （189/200） vs. 98.0% （194/198）, P=0.185〕 and false negative rate 〔11.3% （8/71） vs. 13.9% （11/79） vs. 5.1% （4/79）, P=0.165） between blue dye method, radiolabeled colloid method, and combination method. The combination method could detect more SLN than radiolabeled colloid method or blue dye method only （P＜0.001）. Compared to combination method, there were 12 and 7 patients miss diagnosed in blue dye method and radiolabeled colloid method, and the miss diagnosed rate was 16.0% （12/75） and 9.3% （7/75）, respectively. Conclusions Compared to radiolabeled colloid and blue dye method, combination method has higher identification rate, and could identify more SLNs. It is recommended that the combination of radiolabeled colloid and blue dye should be adapted for procedure of SLNB in clinical practice.