Preliminary results for treatment of early stage breast cancer with endoscopic subcutaneous mastectomy combined with endoscopic sentinel lymph node biopsy in China.

BACKGROUND AND OBJECTIVES: To evaluate efficacy and aesthetic outcome for combined endoscopic subcutaneous mastectomy (E-SM) and endoscopic sentinel lymph node biopsy (E-SLNB) in early stage breast cancer patients. METHODS: Combined E-SM+E-SLNB was compared to modified radical resection in a cohort of Chinese patients (n = 49) with stages I and II breast cancer. Patient satisfaction with the aesthetic results was assessed 1 year after surgery with a 5-item-by-4-step scoring system for evaluating cosmetic outcomes. RESULTS: All patients were alive 1 year following surgery with no locoregional recurrence or distant metastases and without any critical complications. The average length of incision was less in patients receiving E-SM+E-SLNB (4.4 vs. 19.4 cm; P < 0.001), but time in surgery was longer (131.6 vs. 99.2 min; P = 0.024). After 1 year, nearly all E-SM+E-SLNB patients rated satisfaction with their appearance as excellent or good (23/24; 95.8% vs. 19/25; 76.0%; P < 0.001), and exhibited less disturbance of sensory (P < 0.001) and motor function (P = 0.014) relative to modified radical resection. CONCLUSIONS: E-SM+E-SLNB provides significant aesthetic and functional advantages for patients with early stage breast cancer without compromising medical efficacy as assessed at 16 months postsurgery. J. Surg. Oncol. 2016;113:616-620. © 2016 Wiley Periodicals, Inc.

The Balloon Catheter Method and the End-hole Catheter Method in the Measurement of Hepatic Venous Pressure Gradient: a Comparative Study.

OBJECTIVE: This study aims to evaluate the differences between The balloon catheter method and End-hole Catheter Method in measuring hepatic venous pressure gradient (HVPG) among cirrhosis patients. METHODS: From October 2017 to January 2024, patients who underwent HVPG measurements using both methods were consecutively included. HVPGs obtained from both methods were compared with the portal vein pressure gradient (PPG) obtained via transjugular intrahepatic portosystemic shunt (TIPS) using paired comparisons. Additionally, the consistency and predictive ability for bleeding risk of the two methods, as well as the impact of intrahepatic veno-venous shunt (IHVS), were analyzed. RESULTS: The study enrolled 145 patients, each of whom had HVPG measured by both methods. PPG was measured in 61 patients. There was a statistically significant difference between the PPGs and HVPGs measured by both the balloon catheter method and the end-hole catheter method (P < 0.001), with the HVPG mean values obtained by the end-hole catheter method being closer to the PPGs. In the non-IHVS group, no significant statistical difference was found between the two methods (P = 0.071). In contrast, the IHVS group showed a significant difference (P < 0.001), with a mean difference of 2.98 ± 4.03 mmHg. When IHVS was absent, the measurement results from the end-hole catheter method and the balloon catheter method were found to be highly correlated. The end-hole catheter method has a higher screening capability for patients at risk of bleeding compared to the balloon catheter method (75.90% vs. 72.86%). CONCLUSION: HVPG measurements using either the balloon catheter method or end-hole catheter method showed significant difference with the PPG. The end-hole catheter method has a higher screening capability for patients at risk of bleeding, and IHVS could lead to lower HVPG measurements with The balloon catheter method.

Effects of high-fat diet on folic acid-induced kidney injury in mice.

Obesity is recognized as a significant contributor to the onset of kidney disease. However, the key processes involved in the development of kidney disease in obese individuals are not well understood. Here, we investigated the effects of high-fat diet (HFD)-induced obesity on folic acid (FA)-induced kidney injury in mice. Mice were fed an HFD for 12 weeks to induce obesity, followed by an additional intraperitoneal injection of FA. The results showed that mice fed HFD developed higher levels of kidney damage than those in the chow group. In contrast, mice exposed to both HFD and FA showed less fibrosis and inflammatory responses compared to the FA only treated group. Furthermore, the HFD with FA group exhibited elevated lipid accumulation in the kidney and reduced expression of mitochondrial proteins compared to the FA-treated group. Under in vitro experimental conditions, we found that lipid accumulation induced by oleic acid treatment reduced inflammatory and fibrotic responses in both renal tubules and fibroblasts. Finally, RNA sequencing analysis revealed that the inflammasome and pyroptosis signaling pathways were significantly increased in the HFD group with FA injection. In summary, these findings suggest that obesity increases renal injury due to a lack of appropriate inflammatory, fibrotic, and metabolic responses and the activation of the inflammasome and pyroptosis signaling pathways.

The impact of medical service on the return behavior: A city-level study in China.

Due to the constraints of the rural-urban household registration systems, the migrants of China currently receive varying degrees of medical services. The fact that many migrants choose to return to their hometowns due to the inequality in medical care has been a social phenomenon. Using data from the 2017 China Migrant Dynamic Survey (CMDS), this paper explores the effect of medical services on population migration. Probit regression analysis method was utilized to examine the relationship between medical service level (MSL) and medical service improvement (MSI) and return behavior (RB), as well as the interaction effect between MSL and MSI, and the moderating effect of health status (HS) and health education (HE). Multiple heterogeneity tests were performed. Grouping regressions were conducted using rural household registration (RHR), grouping regressions were conducted using new rural cooperative medical system (NRCMS), and multinomial Probit regressions were conducted using migration distance and age factors. The following findings were obtained. First, when MSL is low but MSI is high in the locality of household registration, the return probability of migrants will increase. MSL also has a positive interaction effect with MSI, and they jointly increase the return probability of migrants; Second, HS and HE have a positive moderating effect on the relationships between MSL and RB and between MSI and RB; Third, heterogeneity analysis indicates that the migrants with RHR or the migrants not covered by the NRCMS are more prone to return due to the reason of medical service. In addition, the analysis also shows that middle-aged and older people who return across provinces have the highest tendency to return due to medical services and young people have the lowest propensity to return across and within provinces. The study could help local governments change their public medical care policies and close the gap between medical services in different areas. As a result, it is necessary to understand population migration trends and promote New Urbanization Strategies.

[System construction of early warning for ecological security at cultural and natural heritage mixed sites and its application: a case study of Wuyishan Scenery District].

This paper proposed a new concept of ecological security for protection by a comprehensive analysis of the contents and standards of world heritage sites. A frame concept model named "Pressure-State-Control" for early warning of ecological security at world heritage mixed sites was constructed and evaluation indicators of this frame were also selected. Wuyishan Scenery District was chosen for a case study, which has been severely disturbed by natural and artificial factors. Based on the frame model of "Pressure-State-Control" and by employing extension analysis, the matter-element model was established to assess the ecological security status of this cultural and natural world heritage mixed site. The results showed that the accuracy of ecological security early warning reached 84%. Early warning rank was I level (no alert status) in 1997 and 2009, but that in 2009 had a higher possibility to convert into II level. Likewise, the early-warning indices of sensitive ranks were different between 1997 and 2009. Population density, population growth rate, area index for tea garden, cultivated land owned per capita, level of drought, and investment for ecological and environmental construction were the main limiting factors to hinder the development of ecological security from 2009 to future. In general, the status of Wuyishan Scenery District ecological security was relatively good and considered as no alert level, while risk conditions also existed in terms of a few early-warning indicators. We still need to pay more attention to serious alert indicators and adopt effective prevention and control measures to maintain a good ecological security status of this heritage site.

Therapeutic effect of transarterial chemoembolization combined with apatinib on patients with advanced hepatocellular carcinoma / 中国肿瘤临床

Objective: To evaluate the therapeutic effect of transarterial chemoembolization (TACE) combined with apatinib on pa-tients with advanced hepatocellular carcinoma (HCC). Methods:Twenty-one patients were treated with TACE combined with 250 mg of apatinib once a day. Disease classification was assessed by investigators using the modified Response Evaluation Criteria in Solid Tu-mors (mRECIST). The evaluation period was 28 days. Results:The therapeutic effects were classified as follows:3 patients (14.3%) had complete response, 6 patients (28.6%) had partial response, 5 patients (23.8%) had stable disease, and 2 patients (9.5%) had progres-sive disease. The disease control rate was 61.9%, and the objective response rate was 38.1%. In patients, the most frequent adverse events were fatigue (94.4%), anorexia (23.8%), diarrhea (19.0%), hypertension (19.0%), and hand-foot syndrome (19.0%). Conclusion:The short-term therapeutic effect revealed that the combination of TACE and apatinib could be a promising treatment for patients with advanced HCC. Adverse events should be closely monitored and provided with active management.

Therapeutic effect of transarterial chemoembolization combined with apatinib on patients with advanced hepatocellular carcinoma / 中国肿瘤临床

Objective: To evaluate the therapeutic effect of transarterial chemoembolization (TACE) combined with apatinib on pa-tients with advanced hepatocellular carcinoma (HCC). Methods:Twenty-one patients were treated with TACE combined with 250 mg of apatinib once a day. Disease classification was assessed by investigators using the modified Response Evaluation Criteria in Solid Tu-mors (mRECIST). The evaluation period was 28 days. Results:The therapeutic effects were classified as follows:3 patients (14.3%) had complete response, 6 patients (28.6%) had partial response, 5 patients (23.8%) had stable disease, and 2 patients (9.5%) had progres-sive disease. The disease control rate was 61.9%, and the objective response rate was 38.1%. In patients, the most frequent adverse events were fatigue (94.4%), anorexia (23.8%), diarrhea (19.0%), hypertension (19.0%), and hand-foot syndrome (19.0%). Conclusion:The short-term therapeutic effect revealed that the combination of TACE and apatinib could be a promising treatment for patients with advanced HCC. Adverse events should be closely monitored and provided with active management.