[Analysis of risk factors of axillary lymph node metastasis and prognosis in T1 breast cancer: a large-scale retrospective study based on the SEER database].

Objective: To analyze the clinicopathological characteristics of T1 breast cancer, the risk of lymph node metastasis and related prognostic factors. Methods: The National Cancer Institute Surveillance, Epidemiology and Results (SEER) database was utilized to search and screen out 73 421 female patients with T1 breast cancer from 2010 to 2015 for retrospective analysis. Logistic regression was used to assess the risk factors of lymph node metastasis. Kaplan-Meier survival analysis was used to analysis overall survival (OS) and breast cancer-specific survival (BCSS); Log-rank test and Cox risk model were used for prognostic analysis. Results: A total of 73 421 female patients were enrolled, including 61 955 (84.4%) N0 stage, 9 995 N1 stage (13.6%), 1 087 N2 stage (1.5%) and 384 N3 stage (0.5%). Patients with invasive cancer, histological grade 3, T1c stage, progesterone receptor (PR) positive and human epidermal growth factor receptor-2 (HER-2) positive were most likely to develop lymph node metastasis (all P<0.05). The median follow-up time was 55 months. The 5-year survival rate was 93.8%, and the 5-year BCSS rate was 98.2%. Cox regression analysis showed that T stage (HR=1.517, 95%CI: 1.382-1.666, P<0.01), N stage (HR=5.173, 95%CI: 4.424-6.049, P<0.01), estrogen receptor (ER) status (HR=0.774, 95%CI: 0.607-0.987, P=0.039), PR status (HR=0.745, 95%CI: 0.689-0.806, P<0.01) and subtype (HR=1.439, 95%CI: 1.078-1.478, P=0.011) were independent prognostic risk factors for the OS. Histological grade (HR=2.100, 95%CI: 1.766-2.483, P<0.01), T stage (HR=1.310, 95%CI: 1.193-1.439, P<0.01), N stage (HR=21.230, 95%CI: 17.980-25.060, P<0.01), PR status (HR=0.855, 95%CI: 0.791-0.925, P<0.01) were independent prognostic risk factors for the BCSS in T1 breast cancer. Conclusions: The lymph node metastasis rate of T1 breast cancer is low and the overall prognosis is good. Pathological type, histological grade, tumor size and subtype maybe helpful in predicting the lymph node metastasis of T1 breast cancer.

Comparison of three different PCR-based methods to predict the penicillin nonsusceptible Streptococcus pneumoniae isolates from China.

AIM: To find a quick and reliable diagnostic technique for penicillin nonsusceptible Streptococcus pneumoniae (PNSSP) from Nanjing, China. METHODS AND RESULTS: A total of 130 S. pneumoniae clinical isolates and 50 healthy carriers' isolates were collected from seven teaching hospitals in Nanjing between March 2005 and June 2007. Three different methods, PCR, seminested-PCR, and PCR-RFLP, were applied in detecting PNSSP. The prevalence of PNSSP was 73.9%, the penicillin-resistance rate of children's group and adults' group were 87.8% and 31.2%, respectively. The PCR method had difficulty in identifying intermediate-resistant and resistant isolates, the PCR-RFLP method could only be used for susceptible isolates and had poor sensitivity. Seminested-PCR was fast, sensitive for detection, and successfully differentiated between moderately and highly resistant S. pneumoniae; 96.1% of the PCR results were in agreement with the minimum inhibitory concentration (MIC) data. CONCLUSIONS: The penicillin resistance rate in isolates from children was much higher than of isolates from adults in China. Seminested-PCR for pbp1A was the best diagnostic method. SIGNIFICANCE AND IMPACT OF THE STUDY: We compared three different strategies for the first time in identification of PNSSP in China. In conclusion, seminested-PCR can be applied in clinical microbiology laboratories for detection of serious infections caused by S. pneumoniae.

Stress-induced cardioadaptation reveals a code linking hormone receptors and spatial redistribution of PKC isoforms.

Extracellular agents, including growth factors, cytokines and hormones, transmit their information into cells utilizing a balanced mosaic of intracellular phosphatases and kinases. How do these agonists select the correct substrates and modify them in order to produce defined physiological responses? Our studies have centered on the mechanisms of stress-induced cardioprotection (preconditioning) against postischemic dysfunction. In several species, the ischemia-reperfusion resistant phenotype appears to be induced by metabotropic-receptor pathways linked to PKC. Our results on the isolated rat heart show that each protective stimulus involves a characteristic mosaic of PKC isoforms, translocating into distinct cellular compartments. The distinct receptor-stimulated PKC isoform profile engaged by each extracellular metabotropic agent could allow the heart several overlapping modes of phenotypic adaptation to ischemia.

Involvement of pressure-related mechanism in activation of inducible nitric oxide synthase.

The goal of this study was to clarify the relationship between blood pressure and inducible nitric oxide synthase (iNOS) activity. Different levels of blood pressure were obtained by long-term (six days) intravenous infusion of different concentrations (0.3%-8%) of NaCl solution to normal SD rats. iNOS activity assay and measurement of urinary nitrate/nitrite (UNOx), an index of NO production of the whole body, were carried out by isotope-labeled L-arginine conversion rate measurement and Greiss Reaction respectively. Groups of normotensive and hypertensive rats including normal Wistar rats, normal Sprague-Dawley (SD) rats, high NaCl-induced hypertensive rats (NaHR) and spontaneously hypertensive rats (SHR) were used to detect the changes in iNOS protein under normotension and hypertension by Western blotting. iNOS activity of aorta and kidney tissues and UNOx increased more significantly in hypertensive animals than in the normotensive control ones. Accordingly, iNOS protein in the aortas of NaHR and SHR increased by 149% and 261% respectively. It is suggested that in addition to cytokine and bacterial products etc, blood pressure is also an effective regulatory factor involved in iNOS activation and expression.

Therapeutic effects of intravenous infusion of hyperoxygenated solution on acute haemorrhagic shock in rabbits.

Tissue anoxia is the main mechanism of the shock reaction. Here, the effect of hyperoxygenated solution (HOS) on acute haemorrhagic shock was studied in rabbits. At 60 min after shock, rabbits were infused intravenously with hyperoxygenated solution at 10 (HOS1 group) or 20 ml/kg (HOS2 group) or with Ringer's solution at 10 ml/kg (RS group). Compared with values before shock, values after shock were lower for mean arterial pressure (MAP), more negative for base excess (BE) and higher for blood lactate (BL) and blood viscosity. After infusion, MAP declined more slowly in the HOS1 and HOS2 groups than in the RS group. At 30 and 60 min after infusion, arterial partial pressure of oxygen (PaO(2)) and oxygen saturation (SaO(2)) were higher and BE was less negative in the HOS1 and HOS2 groups than in the RS group, BL was lower in the HOS1 and HOS2 groups than in the RS group, and PaO(2) and SaO(2) were higher in the HOS2 group than in the HOS1 group. It was concluded that HOS infusion can rectify changes in vital signs more effectively than Ringer's solution after acute haemorrhagic shock in rabbits.

Glutathione peroxidase deficiency and childhood seizures.

4 children with intractable seizures, repeated infections, and intolerance to anticonvulsants had evidence of glutathione peroxidase deficiency. 2 had low intracellular enzyme activity but normal blood selenium and high plasma glutathione peroxidase concentrations. The other 2 had low intracellular glutathione peroxidase activity with low circulating glutathione peroxidase and selenium concentrations. The clinical state of the children improved after discontinuation of anticonvulsant medication and selenium substitution.

Clinical application of angiography of oral and maxillofacial hemangiomas. Clinical analysis of seventy cases.

Angiographic findings in seventy cases of maxillofacial hemangioma are reported. The tumors have been divided into four types: (1) plexiform hemangioma, (2) cavernous hemangioma with venous drainage, (3) cavernous hemangioma without venous drainage, and (4) the so-called "diffuse type" of cavernous hemangioma. The angiographic features of the four types are described, and clinical application is evaluated. The angiograms demonstrate the location, extent, blood supply, and drainage of the tumors and show whether they communicate intracranially, thus providing valuable criteria for planning and determining the mode of treatment.