Trends in survival of ovarian clear cell carcinoma patients from 2000 to 2015.

Purpose: To analyze changes in survival outcomes in patients with ovarian clear cell carcinoma (OCCC) treated consecutively over a 16-year period using a population-based cohort. Methods: We conducted a retrospective analysis of OCCC from 2000 to 2015 using data from the Surveillance, Epidemiology, and End Results (SEER) program. The ovarian cancer-specific survival (OCSS) and overall survival (OS) were analyzed according to the year of diagnosis. Joinpoint Regression Program, Kaplan-Meier analysis, and multivariate Cox regression analyses were used for statistical analysis. Results: We included 4257 patients in the analysis. The analysis of annual percentage change in OCSS (P=0.014) and OS (P=0.006) showed that patients diagnosed in later years had significantly better outcomes compared to those diagnosed in early years. The results of the multivariate Cox regression analyses showed that the year of diagnosis was the independent prognostic factor associated with OCSS (P=0.004) and had a borderline effect on OS (P=0.060). Regarding the SEER staging, the OCSS (P=0.017) and OS (P=0.004) of patients with distant stage showed a significant trend toward increased, while no significant trends were found in the survival of patients with localized or regional stage diseases. Similar trends were found in those aged <65 years or those treated with surgery and chemotherapy. However, no statistically significant changes in the survival rate were found in those aged ≥65 years or those receiving surgery alone regardless of SEER stage during the study period. Conclusions: Our study observed a significant increase in the survival outcomes in OCCC from 2000 to 2015, and patients aged <65 years and those with distant stage experienced a greater improvement in survival.

A Co(II) compound: photocatalytic activity and application value in trigeminal neuralgia with minimally invasive interventional therapy guided by CT.

A new thermostable Co(II)-based compound, namely [Co3(L)2(HTEA)2]n (1, HL = isonicotinic acid, H3TEA = triethanolamine), has been successfully synthesized by the isomicotinic acid ligand and HTEA anion. The photocatalytic property of 1 was also investigated, indicating that it shows excellent photocatalytic activity for the degradation of Rhodamine B (MB) solution under the UV light irradiation. For the treatment of trigeminal neuralgia, the content of the inflammatory cytokines released into the trigeminal ganglion tissue fluid was measured with enzyme-linked immunosorbent assay (ELISA) assay. Then, the real-time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was conducted and the activation of the nuclear factor kappa-B (NF-κB) inflammatory signaling pathway was measured.

HLA-G-ILT2 interaction contributes to suppression of bone marrow B cell proliferation in acquired aplastic anemia.

Acquired aplastic anemia (AA) is an autoimmune disease characterized by hematopoietic stem and progenitor cell destruction in bone marrow. The non-classic human leukocyte class I antigen (HLA-) G interacts with multiple cell subsets, such as T cells and B cells. HLA-G exerts powerful immune suppression by binding with its receptors, immunoglobulin-like transcripts (ILTs). Here, we compared 46 AA patients and 28 healthy controls. Soluble HLA-G levels in bone marrow supernatants from AA patients were higher than controls. The proportion of bone marrow B cells was decreased and the ILT2-expressing cells among CD19+ cells were increased in AA patients. In addition, the percentage of mature B cells among marrow B cells was increased in AA patient, while the percentage of pro-B plus pre-B cells was decreased. More immature B cells and pro-B plus pre-B cells expressed ILT2 in AA patients than in controls, while mature B cells expressing ILT2 did not differ significantly. Functional studies demonstrated that high-level soluble HLA-G inhibited bone marrow B cell proliferation by interacting with ILT2 in AA, and was blocked by anti-HLA-G and anti-ILT2 monoclonal antibodies. Together, these results suggest that the abnormal decrease of pro-B plus pre-B cells in AA patients was related to the enhanced suppression by the excess HLA-G and ILT2 proteins. Therapeutic blockade of the HLA-G-ILT2 interaction may help to normalize bone marrow B cell proliferation.

Implicit support differs across five groups in the U.S., Taiwan, and Mexico.

Objective: Prior research documents numerous psychological and physiological benefits of implicit support particularly for Asians/Asian Americans. However, potential variation in how two different kinds of collectivism-Harmony and Convivial-shape support has been overlooked. Additionally, implicit support has largely been studied using quantitative approaches, whereas qualitative methods may best illuminate how implicit support is used in everyday life. The present mixed-methods investigation aims to better understand implicit support "in practice" and to unpack previously overlooked nuances between different subsets of collectivism in implicit support processes. Method: We collected qualitative accounts of implicit support interactions from 216 female participants (U.S. Whites, U.S. Latinas, U.S. Asians, Mexican, Taiwanese) who were prompted to describe an implicit support experience and then quantitatively assess its helpfulness. Results: Qualitative analysis using a thematic analysis approach identified three subcategories of implicit support (traditional, semi-disclosure, non-verbal cues). Cultural patterns emerged in how implicit support was used across different groups that align with high-context and low-context communication theories and cultural values. Conclusions: The current research highlights the benefit of qualitative approaches to understanding nuanced support processes, and the need to study culture beyond the individualism-collectivism dichotomy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Different Chinese herbal medicine therapy for idiopathic thrombocytopenic purpura: A protocol for systematic review and Bayesian network meta-analysis.

BACKGROUND: Idiopathic thrombocytopenic purpura (ITP) is a common immune system and blood system disease in clinical practice, and it is a hemorrhagic disease caused by immune factors causing platelet destruction and decreasing number of platelets. There is currently no effective treatment plan for ITP. At this stage, glucocorticoid and gamma globulin are mostly used in the treatment of ITP, and some patients use splenectomy to achieve therapeutic purposes, but the various treatment methods are inadequate. At this stage, a large number of randomized controlled studies have reported that Chinese herbal medicine has achieved good curative effect in the treatment of ITP. However, due to the variety of Chinese herbal medicine, there has been no evidence of the effectiveness and safety of Chinese herbal medicine in the treatment of ITP. Because of the above reasons, this study uses the network meta-analysis method based on Bayesian method to compare the clinical efficacy and safety of different kinds of Chinese herbal medicine in the treatment of ITP through direct and indirect comparison, in order to provide evidence-based medical support for the treatment of ITP with Chinese herbal medicine. METHODS: This study uses the method of combining free words with theme words, and using computer to retrieve PubMed, EMbase, The Cochrane Library, WANFANG Database, CNKI, and VIP Database, etc, to collect the randomized control studies on Chinese herbal medicine in the treatment of ITP. The retrieval time is from the establishment of each database to January 2021, and the retrieval languages are Chinese and English. Two researchers independently read the title, abstract and full text of the article to determine whether it is included in the literature; In the event of a disagreement, a third researcher will join the discussion to resolve the disagreement; For the literature that lacks information, trying to contact the original author of the document to supplement it. The literature quality evaluation carried out by using the Stata 14.0 software to draw network and funnel plots, in accordance with the quality evaluation criteria of version 5.1.0 of the Cochrane System Evaluation Manual. Statistical analysis is performed by using ADDIS 1.16.8 software based on the Bayesian model. RESULTS: This study will compare the clinical efficacy and safety of different types of Chinese herbal medicine in the treatment of idiopathic thrombocytopenic purpura through the method of network meta-analysis, and rank the different types of Chinese herbal medicine according to their effectiveness, and the results will be published in a peer-reviewed, high-quality academic journal. CONCLUSION: This study will find effective and safe Chinese herbal medicine for clinical treatment of ITP from the perspective of evidence-based medicine, and benefit more ITP patients.

Systematical Engineering of Synthetic Yeast for Enhanced Production of Lycopene.

Synthetic biology allows the re-engineering of biological systems and promotes the development of bioengineering to a whole new level, showing great potential in biomanufacturing. Here, in order to make the heterologous lycopene biosynthesis pathway compatible with the host strain YSy 200, we evolved YSy200 using a unique Synthetic Chromosome Rearrangement and Modification by LoxP-mediated Evolution (SCRaMbLE) system that is built in the Sc2.0 synthetic yeast. By inducing SCRaMbLE, we successfully identified a host strain YSy201 that can be served as a suitable host to maintain the heterologous lycopene biosynthesis pathway. Then, we optimized the lycopene biosynthesis pathway and further integrated into the rDNA arrays of YSy201 to increase its copy number. In combination with culturing condition optimization, we successfully screened out the final yeast strain YSy222, which showed a 129.5-fold increase of lycopene yield in comparison with its parental strain. Our work shows that, the strategy of combining the engineering efforts on both the lycopene biosynthesis pathway and the host strain can improve the compatibility between the heterologous pathway and the host strain, which can further effectively increase the yield of the target product.

Host BAG3 Is Degraded by Pseudorabies Virus pUL56 C-Terminal 181L-185L and Plays a Negative Regulation Role during Viral Lytic Infection.

Bcl2-associated athanogene (BAG) 3, which is a chaperone-mediated selective autophagy protein, plays a pivotal role in modulating the life cycle of a wide variety of viruses. Both positive and negative modulations of viruses by BAG3 were reported. However, the effects of BAG3 on pseudorabies virus (PRV) remain unknown. To investigate whether BAG3 could modulate the PRV life cycle during a lytic infection, we first identified PRV protein UL56 (pUL56) as a novel BAG3 interactor by co-immunoprecipitation and co-localization analyses. The overexpression of pUL56 induced a significant degradation of BAG3 at protein level via the lysosome pathway. The C-terminal mutations of 181L/A, 185L/A, or 181L/A-185L/A in pUL56 resulted in a deficiency in pUL56-induced BAG3 degradation. In addition, the pUL56 C-terminal mutants that lost Golgi retention abrogated pUL56-induced BAG3 degradation, which indicates a Golgi retention-dependent manner. Strikingly, BAG3 was not observed to be degraded in either wild-type or UL56-deleted PRV infected cells as compared to mock infected ones, whereas the additional two adjacent BAG3 cleaved products were found in the infected cells in a species-specific manner. Overexpression of BAG3 significantly suppressed PRV proliferation, while knockdown of BAG3 resulted in increased viral yields in HEK293T cells. Thus, these data indicated a negative regulation role of BAG3 during PRV lytic infection. Collectively, our findings revealed a novel molecular mechanism on host protein degradation induced by PRV pUL56. Moreover, we identified BAG3 as a host restricted protein during PRV lytic infection in cells.

The complexity of cultural mismatch in higher education: Norms affecting first-generation college students' coping and help-seeking behaviors.

OBJECTIVES: First-generation college students commonly experience financial, academic, and personal challenges that are exacerbated by a cultural mismatch between independent university settings and interdependent family environments. There is a paucity of research on the influence of cultural norms, including cultural mismatch, on first-generation college students' coping and help-seeking behaviors. The present research explored how cultural norms affect coping and help seeking for academic, financial, and psychological problems among diverse first-generation college students. METHOD: Eleven individual interviews were conducted to obtain pilot data, and 8 group interviews (n = 60) were conducted to examine cultural norms, relational concerns, coping, and social support. These same 71 participants (51% Ethnic Minority; 49% White; 70% female) completed a background survey (e.g., demographics, use of resources, coping, and family obligation). RESULTS: Most students were self-reliant and underutilized social support because of concerns about negatively affecting close relationships; these relational concerns included burdening others, being judged by others, and making matters worse. Concerns about face loss and group harmony were heightened among ethnic minority students. Despite limited quantitative evidence for White-Ethnic Minority differences in coping and psychological and academic functioning, minority students reported higher levels of family obligation. CONCLUSIONS: Results revealed a mismatch between hard independence (being self-reliant, resilient, and emotionally tough) and soft independence (being self-expressive, pursuing personal interests, and gaining a sense of freedom) and illuminate how relational concerns hinder help seeking among first-generation college students. These findings support culturally tailoring outreach efforts to address norms that promote self-reliance and the underutilization of services. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

[Expression of CD44, CD87 and CD123 in Acute Leukemia and Its Correlation with Cellular Immunity].

OBJECTIVE: To investigate the expression of CD44, CD87 and CD123 in acute leukemia and its correlation with cellular immune markers. METHODS: A total of 166 patients with acute leukemia (AL) admitted from May 2014 to February 2017 were enrolled in AL groups. Among these patients, 100 patients suffered from acute myeloid leukemia, 50 patients suffered from acute lymphoid leukemia, and 16 patients showed B/medullary phenotype. At the same time 50 patients with non-acute leukemia were enrolled in the control group. 5 ml of fasting venous blood collected from the patients in each group, and the percentage of CD44, CD87 and CD123 cells was determined by three-color flow cytometry. Symptomatic chemotherapy was given to the patients with confirmed acute leukemia, and the remission was evaluated after 2 treatmen courses. The Complete remission (CR) was recorded and the percentage of CD44, CD87 and CD123 cells under different curative efficacy were recorded. The correlation of the prognosis patients with CD44, CD87 and CD123 was analyzed by SPSS Pearson correlation analysis software. RESULTS: The positive rates of CD44, CD87 and CD123 in AL group were all higher than those in the control group (P＜0. 05). The positive rates of CD44 and CD123 in acute myeloid leukemia group were higher than those in acute lymphoblastic leukemia group and B/myeloid phenotype group (P＜0. 05). The positive rate of CD44 in acute lymphoid leukemia group was higher than that in B/medullary double phenotype group (P＜0.05). The treatment in the patients of AL group was successfully completed. 132 patients reachel to CR and 34 patients to PR+NR after 2 courses. The positive rates of CD44, CD87 and CD123 in CR patients were lower than those in PR+NR patients (P＜0.05). The results of SPSS Pearson correlation analysis showed that the prognosis of patients with acute leukemia negatively correlated with CD44 and CD87 (P＜0.05). CONCLUSION: The expression of CD44, CD87 and CD123 in different phenotype of acute leukemia are different, which correlateds with prognosis. The determination of CD44, CD87 and CD123 can be used to evaluate the prognosis of patients for the reference of clinical treatment.

Novel Murine Model of Immune Thrombocytopaenia through Immunized CD41 Knockout Mice.

Immune thrombocytopaenia (ITP) is the most common autoimmune bleeding disorder, where platelets are destroyed by auto-antibodies and/or cell-mediated mechanisms. To understand the pathogenesis of ITP and explore novel therapeutics, three types of animal models have been used: passive ITP, secondary ITP and platelet-induced ITP. However, the first two are not ideal for chronic ITP pathophysiology where both T cell and B cell play important roles in platelet destruction. The most efficient model to mimic chronic ITP is developed by Chow et al through transferring splenocytes from platelet-immune CD61-knockout (KO) mice into mice with severe combined immunodeficiency (SCID). However, placental defects are evident in 25% of CD61-KO females and post-natal haemorrhage does occur, reducing the survival rate of embryos and pups. Compared with CD61-KO mice, CD41-KO ones do not present such problems. In our study, we employ CD41-KO mice as another source of immunized spleen cells. We evaluated our model with existing standards. Transferred SCID mice presented typical features of ITP, such as reduced platelet counts in the peripheral blood, increased anti-platelet antibody levels in the serum and reduced mature megakaryocytes in the bone marrow. What is more, lymphocyte-depletion experiments showed the role of CD8+ T cells in mature megakaryocyte decrease and thrombocytopaenia. And we confirmed the antibody-mediated platelet destruction by phagocytosis in the spleen. Our study develops another efficient murine ITP model through immunized CD41-KO mice.

High-throughput screening of high lactic acid-producing Bacillus coagulans by droplet microfluidic based flow cytometry with fluorescence activated cell sorting.

A high-throughput screening system based on droplet microfluidic sorting was developed and employed for screening of high lactic acid-producing Bacillus coagulans. In this system, water-in-oil-in-water (W/O/W) droplets, which were ∼12 pL in volume were used as picoliter-reactors for lactic acid fermentation. A fluorescent sensor was developed and used for monitoring pH which indicated the production of lactic acid. After fermentation, fluorescence activated cell sorting was performed with high sensitivity and speed. Using this microfluidic high-throughput screening system, we found a mutant with a yield of 76 g L-1 lactic acid which was 52% higher than its parent strain with a screening throughput exceeding 106 clones per h.

Ethnicity moderates the benefits of perceived support and emotional expressivity on stress reactivity for Asian Americans and Euro Americans.

OBJECTIVE: This study examined whether ethnicity moderated the benefits of perceived support and emotion expressivity on stress responses (cortisol, negative mood, task performance) during a lab stress task for Asian Americans and Euro Americans. We hypothesized that perceived support and emotion expressivity would be less beneficial for Asian Americans (relative to Euro Americans), for whom support seeking and emotional expressivity are less aligned with cultural values. METHOD: A majority female sample (72%) of 83 Asian American (first generation, n = 30; second generation, n = 53) and 50 Euro American college students completed the Trier Social Stress Test. Participants provided baseline and poststressor measures of salivary cortisol and negative mood, and their task performance was coded by researchers. RESULTS: Results showed evidence of ethnic group moderation such that perceived support and emotional expressivity did not buffer biological, psychological, or behavioral stress outcomes for Asian Americans, but did offer some benefits to Euro Americans. The two groups differed on interdependence and acculturation, yet there was limited evidence that cultural variables moderated those same associations. CONCLUSIONS: Results counter the notion that perceived support and emotion expressivity are universal psychosocial resources for managing stress. This study highlights the importance of considering ethnic group differences in these socioemotional processes that are relevant for better understanding adaptive coping and well-being. (PsycINFO Database Record

Effects of job stress on family relationships.

In the short-term, daily job stressors influence family interactions through their impact on the employed person's mood, thoughts, and coping behaviors. In the long-term, family relationships can be shaped by those experiences in both positive and negative ways. Some spouse 'cross-over' effects appear to represent accommodations of the employed partner under stress-for instance, a spouse's increased provision of social support and involvement with children-and are evidence of dynamics that go beyond a simple and direct transfer of stress from work to home.

Effect of image-guided hypofractionated stereotactic radiotherapy on peripheral non-small-cell lung cancer.

The objective of this study was to compare the effects of image-guided hypofractionated radiotherapy and conventional fractionated radiotherapy on non-small-cell lung cancer (NSCLC). Fifty stage- and age-matched cases with NSCLC were randomly divided into two groups (A and B). There were 23 cases in group A and 27 cases in group B. Image-guided radiotherapy (IGRT) and stereotactic radiotherapy were conjugately applied to the patients in group A. Group A patients underwent hypofractionated radiotherapy (6-8 Gy/time) three times per week, with a total dose of 64-66 Gy; group B received conventional fractionated radiotherapy, with a total dose of 68-70 Gy five times per week. In group A, 1-year and 2-year local failure survival rate and 1-year local failure-free survival rate were significantly higher than in group B (P<0.05). The local failure rate (P<0.05) and distant metastasis rate (P>0.05) were lower in group A than in group B. The overall survival rate of group A was significantly higher than that of group B (P=0.03), and the survival rate at 1 year was 87% vs 63%, (P<0.05). The median survival time of group A was longer than that of group B. There was no significant difference in the incidence of complications between the two groups (P>0.05). Compared with conventional fractionated radiation therapy, image-guided hypofractionated stereotactic radiotherapy in NSCLC received better treatment efficacy and showed good tolerability.

Who gives to whom? Testing the support gap hypothesis with naturalistic observations of couple interactions.

We examined sex differences in explicitly supportive behavior exchanges between husbands and wives using naturalistic video-recordings of everyday couple interactions inside the home. Thirty dual-earner, middle class, heterosexual couples with school-age children were recorded in their homes over 4 days. Specific instances of face-to-face explicit couple support in the video-recordings were identified, and the support role assumed by each partner (recipient vs. provider), the method of support initiation (solicitations vs. offers), and the type of support (instrumental vs. emotional) in each interaction were coded. Paired samples t tests examined sex differences in husbands' and wives' supportive behavior, and bivariate correlations tested the associations among spouses' support initiation behaviors. Findings counter prior research that has largely found a "support gap" favoring husbands as support recipients. Instead, results indicate that wives received significantly more support of an instrumental nature from husbands (than husbands did from wives), a finding driven by wives' active support-soliciting behavior. Among husbands, a tendency to be the solicitor of support was positively correlated with a tendency to offer support. Within couples, rates of offers of support by 1 spouse were correlated with offers by the partner. Naturalistic observations highlight processes that may not be detected by self-reports or laboratory data, in an ecologically valid context in which social behavior reflects the natural rhythms and pulls of everyday life. (PsycINFO Database Record

Psychological well-being and job stress predict marital support interactions: A naturalistic observational study of dual-earner couples in their homes.

Video recordings of couples in their everyday lives at home were used to study how supportive interactions relate to psychological well-being and experiences of job stress. Thirty dual-earner, middle-class, heterosexual couples with school-age children were videotaped in their homes over 4 days and completed self-report measures of depressive symptoms, trait neuroticism, and job stress. After isolating the specific instances of marital support in the video recordings, the support role assumed by each partner (recipient vs. provider) and the method of support initiation (solicitations vs. offers) in each interaction were coded. Actor-partner interdependence models (APIMs), which accounted for interdependence within couples, tested linkages between husbands' and wives' scores on the psychological well-being and job stress variables, and husbands' and wives' supportive behavior. Analyses suggested sex differences in the way that psychological well-being and job stress influence support transactions. Wives' depressive symptoms predicted more support received from husbands, due both to more support solicitations by wives as well as more support offers by husbands. However, for husbands, it was neuroticism that predicted support receipt-both more solicitations (by husbands) and more offers (by wives). In addition, men married to women under greater job stress appeared to increase their unprompted offers of support to their wives, whereas wives did not appear to be similarly responsive to husbands' job stress. This study provides unique insights into couple support processes as they spontaneously unfold in everyday settings, and highlights the utility of naturalistic observation for better understanding social behavior in close relationships.

Near-infrared light photocontrolled targeting, bioimaging, and chemotherapy with caged upconversion nanoparticles in vitro and in vivo.

The major challenge in current chemotherapy is to increase local effective therapeutic concentration of drugs as well as to minimize toxicity and side effects for patients. The targeted delivery of drugs to their desired site of action in a controlled manner plays an essential role in the development of drug formulations. A photocage refers to a caged molecule rendered biologically inert by a photolabile protecting group. Molecules are illuminated with light to liberate the caged group and then become active forms. In this study, we formulate upconversion nanoparticles (UCNPs) as the NIR-triggered targeting and drug delivery vehicles that successfully deliver in vitro and in vivo for near-infrared light photocontrolled targeting, bioimaging, and chemotherapy. It is noted that there has been no report on the systemic administration UCNP-based drug delivery agents for evaluation of bioimaging and chemotherapy. To achieve phototargeting, the tumor-homing agent (i.e., folic acid) has been constructed as a photoresponsive molecule. For the chemotherapeutic effect, the antitumor drug doxorubicin is thiolated on the surface of UCNPs, forming a disulfide bond that can be cleaved by lysosomal enzymes within the cells. The caged UNCPs can serve as a platform for the improvement of selective targeting and possible reduction of adverse side effects from chemotherapy.

(E)-6-(4-Chloro-phen-yl)-4-[(2-cyano-3-phenyl-all-yl)sulfan-yl]-2,2-difluoro-3-phenyl-1,3,2-oxaza-borinin-3-ium-2-uide.

In the title compound, C25H18BClF2N2OS, the characteristic B-N and B-O bond lengths are 1.571 (3) and 1.458 (3) Å, respectively. The phenyl rings form dihedral angles of 83.1 (1) and 64.6 (1)° with the chloro-phenyl ring. In the crystal, weak C-H⋯N, C-H⋯F, C-H⋯π and π-π inter-actions [centroid-centroid distances 3.877 (6) Šbetween the chloro-phenyl rings of neighbouring mol-ecules] held mol-ecules together, forming ladders along the b axis.

Positive and negative emotion in the daily life of dual-earner couples with children.

What is the emotional valence of family life and what factors contribute to this valence? Research indicates that most people are mildly happy but also that the years devoted to raising children are associated with diminished happiness and well-being, particularly for mothers. Public discourse is increasingly concerned that parenthood does not make us happy, but little empirical work has actually studied the emotional valence of family life. We addressed this gap in the literature with an intensive examination of the emotional valence of dual-earner family life. Specifically, we examined positive and negative emotional tone and expressivity throughout two weekday afternoons and evenings to test whether it was more positive or negative, explored gender differences in valence patterns, and qualitatively identified dinner food-related talk as a factor in mothers' evening emotion valence. Our sample was 30 dual-earner couples with young children who took part in a naturalistic observation study that involved continuous videotaping from the time that mothers and fathers left work until family members went to bed. Analyses revealed the following: (a) mild positive emotion was generally characteristic of both mothers and fathers, (b) mothers were more emotionally expressive than fathers, but (c) only mothers' positive emotion dropped during the evening period (5-8 p.m.) where the most salient feature of dinner was children's vocal expressions of distaste for dinner food. The implications of these findings for understanding the concurrent rewards and strains of everyday family life are discussed.

High-intensity focused ultrasound compared with irradiation for ovarian castration in premenopausal females with hormone receptor-positive breast cancer after radical mastectomy.

The aim of the current study was to determine the feasibility, efficacy and safety of ovarian castration by high-intensity focused ultrasound (HIFU) in premenopausal patients with estrogen receptor (ER)(+)/progesterone receptor (PR)(+) breast cancer subsequent to radical mastectomy. A total of 88 premenopausal females with pathologically confirmed ER(+)/PR(+) breast cancer following radical mastectomy were randomly and equally divided into two groups that received HIFU therapy or radiation treatment. HIFU therapy was applied twice at an interval of three days and radiotherapy was administered to a total prescribed dose of D(T) 18 Gy in nine fractions over 11 days. Outcome measures included serum levels of estradiol and estrone, the Kupperman index and the incidence of secondary amenorrhea. Adverse events were monitored and recorded. All patients were followed up for 12 months. Serum levels of estradiol and estrone were comparable prior to treatment between the HIFU and radiation treatment groups. One month following treatment, serum levels of estradiol and estrone were significantly decreased in the two groups, but a greater decline was observed in the HIFU treatment group (P<0.01 and 0.05, respectively). In addition, more patients developed severe menopausal symptoms and amenorrhea in the HIFU therapy group compared with the radiotherapy group (P<0.01 for the two groups). A total of 3 months following treatment, serum levels of estradiol and estrone and the distribution of patients with severe, moderate and mild menopausal symptoms were comparable between the two groups. Following nine menstrual cycles, the incidence of amenorrhea reached 100% in the two groups. HIFU therapy is superior to radiotherapy for ovarian castration in premenopausal females with ER(+)/PR(+) breast cancer subsequent to radical mastectomy in terms of its minimal invasiveness and faster efficacy. HIFU represents a feasible non-surgical approach for ovarian castration.