ObjectiveTo summarize the research progress on the impact of postoperative adjuvant chemotherapy on frailty, cognitive function, and quality of life in older patients with breast cancer.MethodCollected literatures about the impact of postoperative adjuvant chemotherapy on frailty, cognitive function, and quality of life in older patients with breast cancer to make an review.ResultsElderly breast cancer patients were likely to benefit from postoperative adjuvant chemotherapy without undergoing significant impairment of frailty, cognitive function, and quality of life. However, postoperative adjuvant chemotherapy might cause an aggravation of the frailty in patients who was already with it.ConclusionWe should develop personalized treatment plans for elderly breast cancer patients after multidisciplinary assessment.
ObjectiveTo summarize recent research on the surgical treatment of breast cancer after neoadjuvant chemotherapy (NAC) and to review the impact of NAC on the surgical treatment of breast cancer. MethodRelevant studies on NAC and surgical treatment of breast cancer from both domestic and international sources were reviewed. The literatures were analyzed, summarized, and discussed. ResultsFollowing NAC, the survival outcomes and risk of local recurrence in patients undergoing breast-conserving surgery were similar to those undergoing mastectomy. The using of image-guided minimally invasive biopsy accurately predicted pathological complete remission (pCR) of breast lesions after NAC, potentially allowed some breast cancer patients to undergo only radiation therapy after NAC, thus avoiding breast surgery. For patients with positive axillary lymph nodes, techniques such as dual-tracer, triple-tracer, and targeted axillary lymph node dissection had achieved clinical requirements in terms of detection rate and false-negative rate of sentinel lymph node biopsy, provided a safe alternative to axillary lymph node dissection. ConclusionsNAC is an important component of comprehensive breast cancer treatment. However, there is still controversy regarding the local treatment of the primary breast lesion and axillary lymph nodes after NAC. Currently, individualized treatment based on the specific circumstances of the patient remains the approach in clinical practice, aiming to achieve the optimal control of local recurrence and survival benefits for patients.
Objective To summarize the clinical outcome of combined operation for patients with Cockett syndrome complicated with acute symptomatic deep venous thrombosis （DVT）. Methods From October 2008 to March 2012， a total of 23 patients （male 8 cases and female 15 cases；mean age 59.3 years old， range 36-76 years old） with Cockett syndrome complicated with acute symptomatic DVT were underwent combined surgical venous thrombectomy and endovascular stenting in ipisilateral iliac vein in our hospital. All the patients were underwent duplex ultrasonography for diagnosis of DVT. The location of thrombosis in the left iliofemoral vein was 21 cases， right iliofemoral vein was 2 cases. The affected limb of all the patients were severely swell and pain. The mean time of symptomatic DVT occurring at operation was 2.53d. All the operations were performed under general anesthesia. The inferior vena cava filter was inserted before thrombectomy， iliac vein compression was diagnosed by angiography and treated with self-expandable stent after thrombectomy. Twenty-eight self-expandable stents were placed successfully. Results In all the cases， the procedural successful rate was 100%， the 30-day mortality rate was 0. One case suffered from hematoma at incision after operation. Median follow-up was 11.7 months （range 3-26 months）. There was no case of rethrombosis. Symptoms were disappeared in 21 cases， the leg slightly swelled in 2 patients. Conclusion Combined surgical thrombectomy and endovascular treatment for patients with Cockett syndrome complicated with acute symptomatic DVT is an effective and safe technique with low morbidity and good clinical results.
【摘要】 目的 探讨老年糖尿病患者合并脑梗死的临床特点及相关危险因素。 方法 回顾分析2008年7月-2009年7月收治的96例老年糖尿病合并脑梗死患者（A组）及116例老年非糖尿病脑梗死（B组）的临床资料，比较两组患者临床症状、体重指数（BMI）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、纤维蛋白原（FIB）水平及头颅CT结果等。 结果 A组与B组相比，BMI，TC、TG、LDL及FIB水平明显增高，而HDL降低，颅内病灶直径多较小，数目较多。 结论 老年糖尿病患者合并高BMI、TC、TG、LDL及低HDL脑梗死的危险性较高，且以多发腔隙性脑梗死多见。【Abstract】 Objective To investigate the clinical features and risk factors of the cerebral infarction in elder diabetic patients. Methods The clinical data of 96 (group A) and 116 (group B) elder patients with and without diabetes mellitus treated in our hospital due to cerebral infarction from July 2008 to July 2009 were retrospectively anlalyzed. The differences in clinical symptoms, body mass index (BMI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), fibrinogen (FIB) and the results of head CT between the two groups were compared. Results The levels of BMI, TC, TG, LDL, and FIB were obviously higher in group A than those in group B; HDL decreased, and the size and number of cerebral infarction was smaller and more in group A. Conclusion The elder diabetic patients with high BMI, TC, TG, and LDL and low HDL have a high risk of cerebral infarction, most commonly lacunar infarction.
Objective To summarize the description about the pure noninvasive breast carcinoman in guidelines. Methods The related guidelines and literatures about the pure noninvasive breast carcinoma were collected to make a review. Results Through reviewing the guidelines of breast carcinoma, including Chinese Anti Cancer Association (CACA), National Comprehensive Cancer Network (NCCN), St.Gallen, European Society for Medical Oncology Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up, as well as Japanese Breast Cancer Society Clinical Practice Guideline, we find that, the main treatment of noninvasive breast carcinoma is operation and the surgery for axillary is not recommended by most guidelines. The sentinel lymph node biopsy (SLNB) should be performed only when the invasive ductal carcinoma (IDC) is suspected or location of lesion would decrease the success of SLNB in the future. The radiotherapy should be advised to patients following conservation surgery. The patients with estrogen receptor (ER)-positive should undergo endocrine therapy. However, the using of endocrine therapy should be discussed with patient. Conclusions Although the prognosis of pure noninvasive breast carcinoma is better than invasive cancer, the research about it is still less, and the treatments recommended by guidelines are different. The more attention should be paid to the research about the pure noninvasive carcinoma.