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BACKGROUND. Abbreviated protocols could allow wider adoption of MRI in patients undergoing breast cancer neoadjuvant chemotherapy (NAC). However, abbreviated MRI has been explored primarily in screening settings. OBJECTIVE. The purpose of this article was to compare diagnostic performance of abbreviated MRI and full-protocol MRI for evaluation of breast cancer NAC response, stratifying by radiologists' breast imaging expertise. METHODS. This retrospective study included 203 patients with breast cancer (mean age, 52.1 ± 11.2 [SD] years) from two hospitals who underwent MRI before NAC initiation and after NAC completion before surgical resection from March 2017 to April 2021. Abbreviated MRI was extracted from full-protocol MRI and included the axial T2-weighted sequence and precontrast and single early postcontrast T1-weighted sequences. Three general radiologists and three breast radiologists independently interpreted abbreviated and full-protocol MRI in separate sessions, identifying enhancing lesions to indicate residual tumor and measuring lesion size. The reference standard was presence and size of residual tumor on pathologic assessment of post-NAC surgical specimens. RESULTS. A total of 50 of 203 patients had pathologic complete response (pCR). Intraobserver and interobserver agreement for abbreviated and full-protocol MRI for general and breast radiologists ranged from substantial to nearly perfect (κ = 0.70-0.81). Abbreviated MRI compared with full-protocol MRI showed no significant difference for general radiologists in sensitivity (54.7% vs 57.3%, p > .99), specificity (92.8% vs 95.6%, p = .29), or accuracy (83.4% vs 86.2%, p = .30), nor for breast radiologists in sensitivity (60.0% vs 61.3%, p > .99), specificity (94.6% vs 97.4%, p = .22), or accuracy (86.0% vs 88.5%, p = .30). Sensitivity, specificity, and accuracy were not significantly different between protocols for any reader individually (p > .05). Mean difference in residual tumor size on MRI relative to pathology for abbreviated protocol ranged for general radiologists from -0.19 to 0.03 mm and for breast radiologists from -0.15 to -0.05 mm, and for full protocol ranged for general radiologists from 0.57 to 0.65 mm and for breast radiologists from 0.66 to 0.79 mm. CONCLUSION. Abbreviated compared with full-protocol MRI showed similar intraobserver and interobserver agreement and no significant difference in diagnostic performance. Full-protocol MRI but not abbreviated MRI slightly overestimated pathologic tumor sizes. CLINICAL IMPACT. Abbreviated protocols may facilitate use of MRI for post-NAC response assessment by general and breast radiologists.
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Neoplasias de la Mama , Humanos , Adulto , Persona de Mediana Edad , Femenino , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/cirugía , Estudios Retrospectivos , Terapia Neoadyuvante , Neoplasia Residual , Imagen por Resonancia Magnética/métodosRESUMEN
The purpose of this study was to determine whether there are dialectal and gender related differences in nasalance of main Mandarin vowels and three sentences in 400 Chinese normal adults. The mean nasalance score difference for dialect and gender was significant (p < .001) in all speech materials. For different dialects, the average nasalance scores show that Chongqing > Beijing > Shanghai > Guangzhou for the nasal sentence, oro-nasal sentence, /a/, /i/ and /u/. In addition, the average nasalance scores of females were higher than those of males for all speech materials in all dialects. The clinical significance of this study can be helpful in making nasalance clinical decisions for Chinese people with cleft palate, hearing disorders and dysarthria with resonance disorders. It also shows the theoretical and socio-cultural features for linguists considering dialects and gender.
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Acústica del Lenguaje , Medición de la Producción del Habla/métodos , Calidad de la Voz , Adolescente , China , Femenino , Humanos , Lenguaje , Masculino , Caracteres Sexuales , Adulto JovenRESUMEN
PURPOSE: Previous studies have suggested a potential association between gut microbiota and neurological and psychiatric disorders. However, the causal relationship between gut microbiota and cognitive performance remains uncertain. METHODS: A two-sample Mendelian randomization (MR) study used SNPs linked to gut microbiota (n = 18,340) and cognitive performance (n = 257,841) from recent GWAS data. Inverse-variance weighted (IVW), MR Egger, weighted median, simple mode, and weighted mode were employed. Heterogeneity was assessed via Cochran's Q test for IVW. Results were shown with funnel plots. Outliers were detected through leave-one-out method. MR-PRESSO and MR-Egger intercept tests were conducted to address horizontal pleiotropy influence. LIMITATIONS: Limited to European populations, generic level, and potential confounding factors. RESULTS: IVW analysis revealed detrimental effects on cognitive perfmance associated with the presence of genus Blautia (P = 0.013, 0.966[0.940-0.993]), Catenibacterium (P = 0.035, 0.977[0.956-0.998]), Oxalobacter (P = 0.043, 0.979[0.960-0.999]). Roseburia (P < 0.001, 0.935[0.906-0.965]), in particular, remained strongly negatively associated with cognitive performance after Bonferroni correction. Conversely, families including Bacteroidaceae (P = 0.043, 1.040[1.001-1.081]), Rikenellaceae (P = 0.047, 1.026[1.000-1.053]), along with genera including Paraprevotella (P = 0.044, 1.020[1.001-1.039]), Ruminococcus torques group (P = 0.016, 1.062[1.011-1.115]), Bacteroides (P = 0.043, 1.040[1.001-1.081]), Dialister (P = 0.027, 1.039[1.004-1.074]), Paraprevotella (P = 0.044, 1.020[1.001-1.039]) and Ruminococcaceae UCG003 (P = 0.007, 1.040[1.011-1.070]) had a protective effect on cognitive performance. CONCLUSIONS: Our results suggest that interventions targeting specific gut microbiota may offer a promising avenue for improving cognitive function in diseased populations. The practical application of these findings has the potential to enhance cognitive performance, thereby improving overall quality of life.
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Microbioma Gastrointestinal , Trastornos Mentales , Humanos , Microbioma Gastrointestinal/genética , Análisis de la Aleatorización Mendeliana , Calidad de Vida , CogniciónRESUMEN
Blood-brain barrier (BBB) disruption is increasingly recognized as an early contributor to the pathophysiology of cerebral ischemia/reperfusion (I/R) injury, and is also a key event in triggering secondary damage to the central nervous system. Recently, long non-coding RNA (lncRNA) have been found to be associated with ischemic stroke. However, the roles of lncRNA in BBB homeostasis remain largely unknown. Here, we report that long intergenic non-coding RNA-p21 (lincRNA-p21) was the most significantly down-regulated lncRNA in human brain microvascular endothelial cells (HBMECs) after oxygen and glucose deprivation/reoxygenation (OGD/R) treatment among candidate lncRNA, which were both sensitive to hypoxia and involved in atherosclerosis. Exogenous brain-endothelium-specific overexpression of lincRNA-p21 could alleviate BBB disruption, diminish infarction volume and attenuate motor function deficits in middle cerebral artery occlusion/reperfusion (MCAO/R) mice. Further results showed that lincRNA-p21 was critical to maintain BBB integrity by inhibiting the degradation of junction proteins under MCAO/R and OGD/R conditions. Specifically, lincRNA-p21 could inhibit autophagy-dependent degradation of occludin by activating PI3K/AKT/mTOR signaling pathway. Besides, lincRNA-p21 could inhibit VE-cadherin degradation by binding with miR-101-3p. Together, we identify that lincRNA-p21 is critical for BBB integrity maintenance, and endothelial lincRNA-p21 overexpression could alleviate cerebral I/R injury in mice, pointing to a potential strategy to treat cerebral I/R injury.
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OBJECTIVES: To study the effects of total flavones of Rhododendra simsii Planch flower (TFR) on hypoxia/reoxygenation (H/R) injury in rat hippocampal neurons and its underlying mechanism. METHOD: Model of H/R was established in newborn rat primary cultured hippocampal neuron. Lactate dehydrogenase (LDH) and neuron-specific enolase (NSE) activity as well as malondialdehyde (MDA) content in cultured supernatants of the neurons were examined. Methyl thiazolyl tetrazolium assay and Hoechst33258 staining were, respectively, used to detect cell viability and apoptosis of neurons. Protein expression and current of BKCa channel were assessed by using Western blotting and whole-cell patch-clamp methods, respectively. KEY FINDINGS: In the ranges of 3.7-300 mg/l, TFR significantly inhibited H/R-induced decrease of neuronal viability and increases of LDH, NSE and MDA in the supernatants as well as apoptosis; TFR 33.3, 100 and 300 mg/l markedly increased current of BKCa channel rather than the BKCa channel protein expression in the neurons. CONCLUSIONS: Total flavones of R. simsii Planch flower had a protective effect against H/R injury in rat hippocampal neuron, and activation of BKCa channel may contribute to the neuroprotection.
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Flavonas/farmacología , Flores , Hipocampo/efectos de los fármacos , Hipoxia Encefálica/tratamiento farmacológico , Subunidades alfa de los Canales de Potasio de Gran Conductancia Activados por Calcio/agonistas , Neuronas/efectos de los fármacos , Fármacos Neuroprotectores/farmacología , Extractos Vegetales/farmacología , Daño por Reperfusión/prevención & control , Rhododendron , Animales , Animales Recién Nacidos , Apoptosis/efectos de los fármacos , Células Cultivadas , Flavonas/aislamiento & purificación , Flores/química , Hipocampo/metabolismo , Hipocampo/patología , Hipoxia Encefálica/metabolismo , Hipoxia Encefálica/patología , Subunidades alfa de los Canales de Potasio de Gran Conductancia Activados por Calcio/metabolismo , Neuronas/metabolismo , Neuronas/patología , Fármacos Neuroprotectores/aislamiento & purificación , Extractos Vegetales/aislamiento & purificación , Ratas Sprague-Dawley , Daño por Reperfusión/metabolismo , Daño por Reperfusión/patología , Rhododendron/química , Transducción de SeñalRESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: Qizhiweitong particles (QZWT) which is derived from the Sinisan decoction in Shang Han Za Bing Lun, composed of Bupleurum chinenis, Paeonia obovata, Citrus aurantium L., Glycyrrhiza uralensis Fisch., Cyperus rotundus and Rhizoma Corydalis is a traditional Chinese medicine (TCM) treating gastrointestinal diseases. It have been used in clinical for years. It have been used in clinical for years. According to previous research, Bupleurum chinenis, Citrus aurantium, Cyperus rotundus in QZWT play the role of promoting gastric peristalsis, which consist of complex chemical constituents. The aim of this study is to probe the multiple effective components with gastrointestinal prokinetic efficacy in QZWT and investigate the multitarget integrated adjustment mechanism of QZWT curing atropine-induced gastrointestinal motility dysfunction mice. MATERIALS AND METHODS: One hundred and thirty two male mice were randomly divided into 11 groups, including control group, model group, Domperidone group, Mosapride group, QZWT group and six components groups. With gastric retention rate, rate of small intestine propulsion, serum content of GAS and MTL as indexes to evaluate the curing effect on gastrointestinal movement disorders caused by atropine in mice. A serum metabonomics method based on the ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) had been established to investigate the mechanism of QZWT and these components, and PCA and PLS-DA have been used to distinguish different groups and found potential biomarkers. RESULTS: Four components from six present good prokinetic effects, including Bupleurum Polysaccharide, Citrus aurantium flavonoid, Citrus aurantium essential oil and Cyperus rotundus flavonoids. These components and QZWT regulate 5 potential biomarkers in the body, and primarily involved in 5 metabolic pathways. These potential biomarkers possess direct or indirect connections, each biomarker regulated by multiple components, each component adjusting multiple targets, and QZWT is nearly the sum of its components. CONCLUSIONS: This experiment deepened our understanding of insufficient gastrointestinal dynamics, confirmed that QZWT treating gastrointestinal disorders was through multicomponent, multitarget ways. These results fully reflect the multiple targets synergy characteristics of TCM.
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Atropina , Medicamentos Herbarios Chinos/farmacología , Fármacos Gastrointestinales/farmacología , Enfermedades Gastrointestinales/tratamiento farmacológico , Motilidad Gastrointestinal/efectos de los fármacos , Metabolómica , Biología de Sistemas , Animales , Benzamidas/farmacología , Biomarcadores/sangre , Cromatografía Líquida de Alta Presión , Cromatografía Liquida , Modelos Animales de Enfermedad , Domperidona/farmacología , Medicamentos Herbarios Chinos/química , Medicamentos Herbarios Chinos/aislamiento & purificación , Fármacos Gastrointestinales/química , Fármacos Gastrointestinales/aislamiento & purificación , Enfermedades Gastrointestinales/sangre , Enfermedades Gastrointestinales/inducido químicamente , Enfermedades Gastrointestinales/fisiopatología , Análisis de los Mínimos Cuadrados , Masculino , Metabolómica/métodos , Ratones Endogámicos ICR , Terapia Molecular Dirigida , Morfolinas/farmacología , Análisis Multivariante , Fitoterapia , Plantas Medicinales , Análisis de Componente Principal , Transducción de Señal/efectos de los fármacos , Espectrometría de Masas en TándemRESUMEN
OBJECTIVE: To investigate the reliability, practicability and limitations of cytopathological scrape method in the diagnosis of superficial lesions of skin and mucosal membrane. METHODS: The quantity of cells harvested by different collecting methods were compared in 18 cases of malignant tumors of the skin and mucosal membrane. The scrape method was performed in 456 cases, of which 148 cases had corresponding histological specimens. RESULTS: Glass slide scraping provides the most satisfactory cell numbers from the lesions of skin and mucosal membrane. The specificity for diagnosing benign lesion in 37 patients was 100% and that for diagnosing malignant tumors in 111 patients was 92.8% (103). The overall diagnostic accuracy was 94.6% (140/148). The false negative rate, false positive rate and the overall misdiagnostic rates were 7.2% (8/111) , 0, and 5.4% (8/148) respectively. CONCLUSIONS: For cytopathological examination of superficial skin and mucosal membrane lesions, the glass slide scraping methodprovides broad applications with high diagnostic accuracy and advantages of simplicity, safety and efficiency. Certain limitations do exist, but can be resolved by histological examination of the lesion.
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Técnicas de Preparación Histocitológica/métodos , Neoplasias/patología , Neoplasias Cutáneas/patología , Biopsia con Aguja , Neoplasias de la Mama/patología , Carcinoma Basocelular/patología , Carcinoma de Células Escamosas/patología , Citodiagnóstico , Femenino , Humanos , Neoplasias de los Labios/patología , Masculino , Mucosa Bucal/patología , Neoplasias de la Boca/patología , Enfermedad de Paget Mamaria/patología , Neoplasias de la Lengua/patologíaRESUMEN
Primary breast lymphomas are uncommon. All reported primary breast lymphomas were in the breast parenchyma. Here we reported the first case of primary nipple lymphoma in a 76-year-old woman initially diagnosed using a modified fine-needle aspiration method. The aspirated material by this method had yielded adequate material for both cytomorphologic and flowcytometric analysis, as well as for molecular analysis of light chain rearrangement. In smears the atypical lymphocytes were predominantly middle-sized with irregular nuclei. Scattered large centroblast or immunoblast-like cells, a few reactive lymphocytes,histocytes, and few plasma cells were also observed. These findings suggested a low-grade lymphoma that was further confirmed by flow cytometry (CD19+/CD3-, positive for cytoplasmic kappa light chain but negative for lambda light chain) and molecular analysis (monoclonal rearrangement of immunoglobulin kappa chain). Immunohistochemical stains performed on the excised specimen showed that the tumor cells were positive forCD20 and CD79a but negative for cytokeratin, CD3, CD5,CD10, CD23, CD43, CD45RO, bcl-6, and cyclin-D1. The Ki-67 proliferation index was less than 20%. Taking these together, the case was diagnosed as a primary MALT lymphoma of the nipple.FNA usually provides a better cell morphology than tissue sections, but pathologists have to face the sampling error and lack of immunophenotype information when subtyping lymphoma issues using FNA. With the help of flow cytometry and molecular analysis, more and more trials have proved the accuracy of FNA in diagnosis of lymphomas. Therefore, FNA could play an informative and diagnostic role in diagnosis of lymphoma