Fabrication of Ultrafine Cu2 O Nanoparticles on W18 O49 Ultra-Thin Nanowires by In-Situ Reduction for Highly Efficient Photocatalytic Nitrogen Fixation.

Photocatalytic ammonia synthesis technology is one of the important methods to achieve green ammonia synthesis. Herein, two samples of Cu ion-doped W18 O49 with different morphologies, ultra-thin nanowires (Cu-W18 O49 -x UTNW) and sea urchin-like microspheres (Cu-W18 O49 -x SUMS), are synthesized by a simple solvothermal method. Subsequently, Cu2 O-W18 O49 -x UTNW/SUMS is synthesized by in situ reduction, where the NH3 production rate of Cu2 O-W18 O49 -30 UTNW is 252.4 µmol g-1  h-1 without sacrificial reagents, which is 11.8 times higher than that of the pristine W18 O49 UTNW. The Cu2 O-W18 O49 -30 UTNW sample is rich in oxygen vacancies, which promotes the chemisorption and activation of N2 molecules and makes the N≡N bond easier to dissociate by proton coupling. In addition, the in situ reduction-generated Cu2 O nanoparticles exhibit ideal S-scheme heterojunctions with W18 O49 UTNW, which enhances the internal electric field strength and improves the separation and transfer efficiency of the photogenerated carriers. Therefore, this study provides a new idea for the design of efficient nitrogen fixation photocatalysis.

Construction of an Endogenously Activated Signal Amplification Assay for In Situ Imaging of MicroRNA and Guided Precise Photodynamic Therapy for Cancer Cells.

The construction of a sensitive strategy for in situ visualizing and dynamic tracing intracellular microRNA is of great importance. Via the toehold-mediated strand displacement process, the catalytic hairpin assembly (CHA) could offer several hundreds-fold signal amplifications. However, the CHA may produce certain background interferences since microRNA may exist in normal cells. In this work, we constructed an endogenously and sequentially activated signal amplification strategy to provide the amplified dual-color fluorescence imaging of microRNA in living cancer cells, which was comprised of two successive reaction processes: the activation of the preprotective catalytic probe by the endogenous glutathione (GSH) and the subsequent catalytic hairpin assembly on the surface of the upconversion nanoprobe triggered by the specific microRNA. Since the concentration of GSH in cancer cells was much higher than that in normal cells and the extracellular environment, the activation of the designed nanoprobe could be controlled at the desirable site. With the merits of the endogenous initiation and selective activation, the designed nanoprobe could achieve the bioimaging of microRNA in living cancer cells with high precision and reliability. Furthermore, via the introduction of a photosensitizer molecule into the DNA strand, the designed nanoplatform could achieve the precise photodynamic therapy (PDT) for cancer cells and malignant tumors under the irradiation of the NIR laser. This work provided a new avenue to achieve the accurate imaging of intracellular microRNA and guided precise PDT, which would offer powerful hints to the early diagnosis and therapy of malignant tumors.

Construction of Co3O4 nanopolyhedra with rich oxygen vacancies from ZIF-67 for efficient photocatalytic nitrogen fixation.

Photocatalytic nitrogen fixation has attracted much attention due to the fact that it is a way of using solar energy to achieve clean and sustainable conversion of nitrogen to ammonia under mild conditions. In this paper, different proportions of Zn-doped Co3O4 nanopolyhedrons were synthesized using bimetallic ZIFs containing Co2+ and Zn2+ as precursors for the construction of photocatalytic nitrogen fixation semiconductor materials for the first time. The synthesized Co3O4 nano-polyhedron still retains the rhombic dodecahedron shape of ZIF-67 and exhibits a large specific surface area. Moreover, Zn doping results in abundant oxygen vacancies on the surface of Co3O4 polyhedron. These oxygen vacancies not only provide active sites for nitrogen adsorption and activation, but also enhance the separation ability of photocarriers, which can significantly improve the efficiency of photocatalytic nitrogen fixation of the material. When Zn-Co3O4-30 is utilized as the catalyst for photocatalytic nitrogen fixation, the nitrogen fixation rate is 96.8 µmol g-1 h-1, which is much higher than that of pure-Co3O4. In this study, heteroatom-doped Co3O4 polyhedron with rich oxygen vacancy was synthesized by low-temperature oxidation method, which provides a new idea for the design and synthesis of skeleton-based photocatalytic nitrogen fixation materials.

Limitation of WO3 in Zn-Co3O4 Nanopolyhedra by the Pyrolysis of H3PW12O40@BMZIF: Synergistic Effect of Heterostructure and Oxygen Vacancies for Enhanced Nitrogen Fixation.

The photocatalytic nitrogen fixation process is a crucial step toward carbon neutrality and sustainable development. The combination of polyoxometalates and metal-organic frameworks is a viable method to achieve high-efficiency photocatalytic nitrogen fixation. In this work, we employed bimetallic ZIF (BMZIF) composed of Co2+ and Zn2+ encapsulated with H3PW12O40 (PW12) as the precursor to synthesize Zn-doped Co3O4 nanopolyhedra loaded with WO3 nanoparticles. The NH3 yield of WO3/Zn-Co3O4-2 with the best photocatalytic performance can reach 231.9 µmol g-1 h-1 under visible light, about 2.4 and 6.4 times those of pure Zn-Co3O4 and WO3, respectively. The rhombic dodecahedral geometry of BMZIF is still maintained in the synthesized WO3/Zn-Co3O4 nanopolyhedra, with the significant increase in the specific surface area after calcination showing better catalytic performance. At the same time, Zn doping and the formation of WO3 nanoparticles result in abundant oxygen vacancies in WO3/Zn-Co3O4 heterostructures. Oxygen vacancies can supply nitrogen with active sites for adsorption and activation and improve photocarriers' capacity for separation, which can greatly increase the effectiveness of the photocatalytic synthesis of ammonia. This work can easily synthesize the heterostructure based on n-type WO3 nanoparticles and p-type Zn-doped Co3O4 nanopolyhedra, and the beneficial combination of POMs and metal-organic framework provides new thinking for the synthesis of efficient nitrogen-fixing photocatalysts.

Linking health to geology-a new assessment and zoning model based on the frame of medical geology.

With the growing concerns about the Earth's environment and human health, there has been a surge in research focused on the intersection of health and geology. This study quantitatively assesses the relationship between human health and geological factors using a new framework. The framework considers four key geological environment indicators related to health: soil, water, geological landform, and atmosphere. Results indicate that the atmospheric and water resource indicators in the study area were generally favorable, while the scores of geological landforms varied based on topography. The study also found that the selenium content in the soil greatly exceeded the local background value. Our research underscores the importance of geological factors on human health, establishes a new health-geological assessment model, and provides a scientific foundation for local spatial planning, water resource development, and land resource management. However, due to varying geological conditions worldwide, the framework and indicators for health geology may need to be adjusted accordingly.

Decomposition-Reassembly Synthesis of a Silverton-Type Polyoxometalate 3D Framework: Semiconducting Properties and Photocatalytic Applications.

Polyoxometalate-based all-inorganic three-dimensional (3D) frameworks have recently attracted attention as a unique class of materials due to their unique physicochemical properties and a wide field of application with excellent prospects. We herein synthesized a novel all-inorganic 3D framework material based on cobalt-substituted Silverton-type polyoxometalate, H6{Co6W10O42[Co(H2O)4]3}·2H2O (Co9W10), which was successfully constructed using Na12[WCo3II(H2O)2(CoIIW9O34)2]·46-48H2O (Co5W19) and Co(NO3)2·6H2O as starting materials in a hydrothermal reaction via a decomposition-reassembly route together with the rational adjustment of pH values. Co9W10 has been structurally characterized using single-crystal X-ray diffraction. Photocurrent response, band-gap (Eg) value, and the VB-XPS spectrum have been measured to reveal the semiconducting property of Co9W10. Furthermore, we synthesized x% PTh/Co9W10 composites (PTh = polythiophene, x = 0.5, 1, 2, 5) for photodegradation of tetracycline hydrochloride (TH) to evaluate the photocatalytic activities of title composites. Due to the optimal molar ratio of hybrids and matching energy levels, 2% PTh/Co9W10 composites show the best photocatalytic activities among these composites.

Exploring the Coordination Modes of a Keggin-Type [ZnW12O40]6- Anionic Cluster: Bonding Patterns, Crystal Structure, and Semiconducting Properties.

Polyoxometalate-based organic-inorganic hybrid compounds (POIHCs) have been greatly developed due to their wide application prospects, but the pursuit of their directed synthesis via molecular design still remains a challenge. Herein, we demonstrate that the coordination modes of the Keggin-type [ZnW12O40]6- anion can be tuned, which leads to different semiconductor characteristics. Using the same building block, ligand, and metal ion (ZnW12, phen, Cu2+), we synthesized three new POIHCs with different bonding patterns by means of different coordination modes of ZnW12. The three POIHCs (H2phen){ZnW12O40[Cu(phen)2]2}·3H2O (1), {ZnW12O40[Cu(phen)(H2O)2]2[Cu(phen)(H2O)]}n·3H2O (2), and (Me4N)2{ZnW12O40[Cu(phen)(H2O)]2}n·5H2O (3) (phen = 1,10-phenanthroline) have been structurally characterized by single-crystal X-ray diffraction. Compound 1 appears as a zero-dimensional coordination complex cluster, while compounds 2 and 3 are both 1D chain structures with different Cu2+ bridge linkages. Although these three POIHCs possess the same chemical components, their semiconductor properties are different, which is demonstrated by measurements of transient photocurrent and band gap (Eg) values. Furthermore, we carried out comparative experiments on the photoconductivity performance of compounds 1-3 and their photocatalytic reduction from O2 to H2O2, indicating the significant influence of the energy level matching on the photocatalytic activity.

A stepwise-targeting strategy for the treatment of cerebral ischemic stroke.

BACKGROUND: Effective amelioration of neuronal damages in the case of cerebral ischemic stroke (CIS) is essential for the protection of brain tissues and their functional recovery. However, most drugs can not penetrate the blood-brain barrier (BBB), resulting in the poor therapeutic outcomes. RESULTS: In this study, the derivatization and dual targeted delivery technologies were used to actively transport antioxidant melatonin (MLT) into the mitochondria of oxidative stress-damaged cells in brain tissues. A mitochondrial targeting molecule triphenylphosphine (TPP) was conjugated to melatonin (TPP-MLT) to increase the distribution of melatonin in intracellular mitochondria with the push of mitochondrial transmembrane potential. Then, TPP-MLT was encapsulated in dual targeted micelles mediated by TGN peptide (TGNYKALHPHNG) with high affinity for BBB and SHp peptide (CLEVSRKNG) for the glutamate receptor of oxidative stress-damaged neural cells.TGN/SHp/TPP-MLT micelles could effectively scavenge the overproduced ROS to protect neuronal cells from oxidative stress injury during CIS occurrence, as reflected by the improved infarct volume and neurological deficit in CIS model animals. CONCLUSIONS: These promising results showed this stepwise-targeting drug-loaded micelles potentially represent a significant advancement in the precise treatment of CIS.

HN1 promotes tumor associated lymphangiogenesis and lymph node metastasis via NF-κB signaling activation in cervical carcinoma.

Lymph node metastasis (LNM) is a critical cause for disease progression and treatment failure in cervical cancer. However, the mechanism underlying cervical cancer LNM remains unclear. In this study, HN1 was found to be dramatically upregulated in cervical cancer and patients with higher HN1 expression are more likely to exhibit a higher rate of LNM and lower survival rate. Univariate and multivariate Cox-regression analyses showed that HN1 is an independent prognostic factor in cervical cancer. Meanwhile, HN1 promotes lymphangiogenesis of cervical cancer in vitro. The in vivo experiment also indicates that HN1 enhances LNM in cervical cancer. Furthermore, we also found that HN1 activated the NF-κB signaling pathway to enhance the expression of downstream genes. Taken together, our study suggests that HN1 plays a crucial role in promoting LNM and acts as a prognostic biomarker in cervical cancer.

Hyaluronan-mediated motility receptor confers resistance to chemotherapy via TGFß/Smad2-induced epithelial-mesenchymal transition in gastric cancer.

Chemotherapy is one of the vital treatments for gastric cancer (GC) patients, especially those suffering advanced stages. Chemoresistance results in tumor relapse, leading to poor prognosis in GC patients; thus, identifying key regulators in this process might provide novel clues for GC therapy. Herein, we identify hyaluronan-mediated motility receptor (HMMR) as a key regulator of chemoresistance in GC. HMMR was found to be substantially up-regulated in 5-fluorouracil (5-Fu)-resistant GC biopsies and cell lines. High expression of HMMR significantly correlates with tumor relapse and predicts poorer prognosis in GC patients. Moreover, we observed that HMMR induced epithelial-mesenchymal transition and increased the cancer stem cell properties of GC, thus rendering resistance to chemotherapy. Importantly, silencing of HMMR effectively increased the susceptibility to 5-Fu therapy both in vitro and in vivo. Furthermore, we demonstrated that HMMR activates the TGF-ß/Smad2 signaling pathway, which was required for the HMMR-mediated oncogenic effects and exhibited significant clinical relevance with HMMR expression. These findings reveal a critical role for HMMR in the chemoresistance of GC and suggest that HMMR might be a potential prognostic marker or therapeutic target against the disease.-Zhang, H., Ren, L., Ding, Y., Li, F., Chen, X., Ouyang, Y., Zhang, Y., Zhang, D. Hyaluronan-mediated motility receptor confers resistance to chemotherapy via TGFß/Smad2-induced epithelial-mesenchymal transition in gastric cancer.

Efficient visible-light-driven photocatalytic hydrogen production over a direct Z-scheme system of TaON/Cd0.5Zn0.5S with a NiS cocatalyst.

In this work, a series of samples of Cd0.5Zn0.5S (ZCS) nanoparticles decorated with porous TaON were successfully prepared as a direct Z-scheme system. The photocatalytic evolution of H2 with a high efficiency was explored using NiS decorated with TaON sensitized ZCS nanocomposites (NiS-TaON/ZCS) and Na2SO3/Na2S as sacrificial reagents. The results showed that 0.5 wt% NiS deposited on the surface of 4 wt% TaON-ZCS nanocomposites could reach the highest photocatalytic H2 evolution rate of 34.8 mmol h-1 g-1 with a maximum quantum yield of about 25.5% under 420 nm monochromatic light. The activity of the TaON-ZCS photocatalyst for photocatalytic H2 evolution is higher than that of either pure ZCS or TaON. This high photocatalytic performance is ascribed firstly to the hierarchical structure of the coupled semiconductor system and secondly to the efficient transfer and separation of photogenerated charge carriers with NiS as a cocatalyst, which could serve as an electron collector.

Histological Tumor Type is Associated with One-Year Cause-Specific Survival in Women with Stage III-IV Epithelial Ovarian Cancer: A Surveillance, Epidemiology, and End Results (SEER) Database Population Study, 2004-2014.

BACKGROUND The prognosis of epithelial ovarian cancer (EOC) remains poor. Cause-specific survival (CSS) is an overall survival measure of cancer survival that excludes other causes of death. This retrospective population study used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate prognostic factors associated with one-year CSS in women with stage III-IV EOC between 2004-2014. MATERIAL AND METHODS Data from the SEER program included a cohort of patients with stage III-IV EOC between 2004-2014. Binomial logistic regression analysis, Kaplan-Meier survival curves, and multivariate Cox proportional hazards models were used for analysis of patient outcome, including the one-year CSS. RESULTS There were 14,798 patients with stage III-IV EOC identified from SEER between 2004-2014, including 13,134 (88.8%), 892 (6.0%), 448 (3.0%), and 324 (2.2%) patients with serous, endometrioid, clear cell, and mucinous ovarian cancer, respectively. The overall one-year CSS was 91.2%. One-year CSS was 92.5%, 92.2%, 74.0%, and 62.5% in patients with serous, endometrioid, clear cell, and mucinous ovarian cancer, respectively (P<0.001). Histological tumor type was an independent prognostic factor of one-year CSS. Patients with mucinous EOC (HR, 8.807; 95% CI, 6.563-9.965; P<0.001) and clear cell EOC (HR, 4.581; 95% CI, 3.774-5.560; P<0.001) had a significantly lower one-year CSS compared with patients with endometrioid and serous EOC who had comparable one-year CSS (HR, 1.247; 95% CI, 0.978-1.590; P=0.075). CONCLUSIONS A retrospective population study of the SEER database between 2004-2014 identified that histological tumor type was associated with one-year CSS in women with stage III-IV EOC.

Dual modification of TiO2 nanorod arrays with SiW11Co and Ag nanoparticles for enhanced photocatalytic activity under simulated sunlight.

Well-organized TiO2 nanorod arrays (TNRs) have increasingly attracted our attention in recent years due to their excellent photocatalytic properties. However, it is of great importance to prepare more efficient photocatalysts using a facile method towards their more widespread use. In this work, K6SiW11O39Co(ii)(H2O) (SiW11Co) and Ag nanoparticles were introduced into TNRs using spin-coating and chemical bath deposition methods. It was found that TNRs/SiW11Co/Ag composite films with an active area of only 1 cm2 exhibit highly efficient and sustainable properties for the photodegradation of NO2 and display a significant enhancement compared with P25 and pure TNRs. Photocatalytic measurements demonstrated that both SiW11Co and Ag synergistically improve the light absorption and charge separation efficiency, thus obtaining the most efficient photocatalytic performance. In addition, the probable photocatalytic mechanism and the dominating active species for NO2 photodegradation were also proposed, in order to testify the effectively enhanced photocatalytic ability of the TNRs/SiW11Co/Ag composite. Hence, the design of these polyoxometalate and metal particle co-modified TNRs may provide a new tactic for developing promising materials for photocatalytic degradation.

Overexpression of CDCA7 predicts poor prognosis and induces EZH2-mediated progression of triple-negative breast cancer.

Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer with high proliferative and metastatic phenotypes. CDCA7, a new member of the cell division cycle associated family of genes, is involved in embryonic development and dysregulated in various types of human cancer. However, the biological role and molecular mechanism of CDCA7 in TNBC have not been defined. Herein, we found that CDCA7 was preferentially and markedly expressed in TNBC cell lines and tissues. High expression of CDCA7 was associated with metastatic relapse status and predicted poorer disease-free survival in patients with TNBC. We observed that CDCA7 silencing in TNBC cell lines effectively impaired cell proliferation, invasion and migration in vitro. Importantly, depletion of CDCA7 strongly reduced the tumorigenicity and distant colonization capacities of TNBC cells in vivo. Furthermore, CDCA7 increased the expression of EZH2, a marker of aggressive breast cancer that is involved in tumor progression, by enhancing the transcriptional activity of its promoter. This increase in EZH2 expression was essential for the CDCA7-mediated effects on TNBC progression. Finally, our immunohistochemical analysis revealed that the CDCA7/EZH2 axis was clinical relevant. These findings suggest CDCA7 plays a crucial role in TNBC progression by transcriptionally upregulating EZH2 and might be a potential prognostic factor and therapeutic target in TNBC.

TiO2 seeded on nitrogen-doped porous carbon nanofibers for superior electrochemical performance as freestanding anodes of lithium-ion batteries.

Fibrous mats piled by nitrogen-doped porous carbon nanofibers with seeded TiO2 are fabricated and punched directly into circles as lithium-ion battery anodes. The seeding structure is composed of semi-wrapped TiO2 nanoparticles on carbon nanofibers (CNFs) coated with a thin layer of carbon. Synchronously, pores with various widths are formed on CNFs. As a freestanding anode, an initial discharge capacity of 615 mAh g-1 with a coulombic efficiency of 56% is reached, and 322 mAh g-1 is obtained after 100 cycles at a current density of 100 mA g-1. This is assigned to the increasing number of active sites for the lithium ion from pores with various widths and improved conductivity originating from nitrogen doping. Superior rate performance (179 mAh g-1 at the current density of 2000 mA g-1) under various current densities compared with that of other counterparts is attributed to the structural stability originating from the seeding structure with the help of the C-O-Ti bond. An additional 800 cycles are displayed at the current density of 2000 mA g-1, and superior stability is also exhibited.

Tubular carcinomas of the breast: an epidemiologic study.

AIM: We explored the clinicopathologic characteristics, prognostic factors and outcomes in tubular carcinoma (TC) of the breast. METHODS: We retrospectively assessed 8091 TC patients using the SEER database from 2000 to 2013. RESULTS: Most patients were non-Hispanic white, well-differentiated disease, tumor size ≤2 cm, node-negative, nonmetastatic, hormone receptor-positive and HER2-negative status. The 10-year breast cancer-specific survival and overall survival were 98.1 and 82.0%, respectively. Multivariate analysis indicated that age, ethnicity, surgery procedures, radiotherapy and chemotherapy were independent predictors affecting survival outcomes. There was comparable breast cancer-specific survival between surgery and nonsurgery groups. CONCLUSION: The patients with TC has excellent survival outcomes, which may in part be due to the favorable tumor characteristics.

Lymph node ratio has prognostic value related to the number of positive lymph nodes in patients with vulvar cancer.

AIM: We investigated the value of the number of positive lymph nodes (PLNs) and lymph node ratio (LNR) on survival of vulvar cancer patients. METHODS: A total of 2332 patients with vulvar squamous cell carcinoma were included from the SEER program. RESULTS: In multivariate analysis, the number of PLNs and LNR were independent prognostic indictors of survival outcomes, a higher number of PLNs and a higher LNR had poorer survival outcomes. An LNR >0.2 was associated with poor survival outcomes according to the number of PLNs. CONCLUSION: The LNR has prognostic value related to the number of PLNs and may allow a more accurate determination of the lymph node status of vulvar cancer patients.

Widowed status increases the risk of death in vulvar cancer.

AIM: To evaluate the effect of marital status on survival of patients with vulvar cancer. MATERIALS & METHODS: A total of 4001 patients with vulvar cancer were included from the SEER database. Statistical analyses were performed using χ2 test, Kaplan-Meier method, Cox regression proportional hazards and a 1:1 propensity score-matching. RESULTS: The 8-year vulvar cancer-related survival in married, divorced, single and widowed patients were 78.6, 82.2, 78.9 and 61.6%, respectively (p < 0.001). In multivariate analysis, widows patients had significantly worse vulvar cancer survival than the nonwidowed counterparts in unmatched and matched populations. CONCLUSION: Being widowed is associated with greater risk of vulvar cancer mortality than the nonwidowed counterparts.

[Identification of pathogenic mutation in a Chinese pedigree affected with split hand/split foot malformation].

OBJECTIVE: To detect potential mutation in a Chinese pedigree affected with split hand/split foot malformation (SHFM). METHODS: The patients were screened for genome-wide copy number variations with single nucleotide polymorphism (SNP) microarray. Copy number variations were verified by real-time fluorescence quantitative PCR. RESULTS: There were 3 SHFM patients from three generations, which conformed to an autosomal dominant inheritance. SNP microarray assay revealed that all patients have carried a 0.34 Mb duplication in 10q24.31-q24.32 (102 993 649-103 333 271) encompassing the BTRC and DPCD genes. The result was verified by real-time fluorescence quantitative PCR, confirming that the duplication has co-segregated with the SHFM phenotype in the pedigree. CONCLUSION: The 10q24.31-q24.32 duplication probably underlies the pathogenesis of SHFM in this pedigree. Tiny copy number variations can result in diseases featuring autosomal dominant inheritance.

The effect of distant metastases sites on survival in de novo stage-IV breast cancer: A SEER database analysis.

To investigate the effect of distant metastases sites on survival in patients with de novo stage-IV breast cancer. From 2010 to 2013, patients with a diagnosis of de novo stage-IV breast cancer were identified using the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were performed to analyze the effect of distant metastases sites on breast cancer-specific survival and overall survival. A total of 7575 patients were identified. The most common metastatic sites were bone, followed by lung, liver, and brain. Patients with hormone receptor+/human epidermal growth factor receptor 2- and hormone receptor+/human epidermal growth factor receptor 2+ status were more prone to bone metastases. Lung and brain metastases were common in hormone receptor-/human epidermal growth factor receptor 2+ and hormone receptor-/human epidermal growth factor receptor 2- subtypes, and patients with hormone receptor+/ human epidermal growth factor receptor 2+ and hormone receptor-/human epidermal growth factor receptor 2+ subtypes were more prone to liver metastases. Patients with liver and brain metastases had unfavorable prognosis for breast cancer-specific survival and overall survival, whereas bone and lung metastases had no effect on patient survival in multivariate analyses. The hormone receptor-/human epidermal growth factor receptor 2- subtype conferred a significantly poorer outcome in terms of breast cancer-specific survival and overall survival. hormone receptor+/human epidermal growth factor receptor 2+ disease was associated with the best prognosis in terms of breast cancer-specific survival and overall survival. Patients with liver and brain metastases were more likely to experience poor prognosis for breast cancer-specific survival and overall survival by various breast cancer subtypes. Distant metastases sites have differential impact on clinical outcomes in stage-IV breast cancer. Follow-up screening for brain and liver metastases might be effective in improving breast cancer-specific survival and overall survival.