RNADisease v4.0: an updated resource of RNA-associated diseases, providing RNA-disease analysis, enrichment and prediction.

Numerous studies have shown that RNA plays an important role in the occurrence and development of diseases, and RNA-disease associations are not limited to noncoding RNAs in mammals but also exist for protein-coding RNAs. Furthermore, RNA-associated diseases are found across species including plants and nonmammals. To better analyze diseases at the RNA level and facilitate researchers in exploring the pathogenic mechanism of diseases, we decided to update and change MNDR v3.0 to RNADisease v4.0, a repository for RNA-disease association (http://www.rnadisease.org/ or http://www.rna-society.org/mndr/). Compared to the previous version, new features include: (i) expanded data sources and categories of species, RNA types, and diseases; (ii) the addition of a comprehensive analysis of RNAs from thousands of high-throughput sequencing data of cancer samples and normal samples; (iii) the addition of an RNA-disease enrichment tool and (iv) the addition of four RNA-disease prediction tools. In summary, RNADisease v4.0 provides a comprehensive and concise data resource of RNA-disease associations which contains a total of 3 428 058 RNA-disease entries covering 18 RNA types, 117 species and 4090 diseases to meet the needs of biological research and lay the foundation for future therapeutic applications of diseases.

Tailored Polypyrrole Nanofibers as Ion-to-Electron Transduction Membranes for Wearable K+ Sensors.

Conductive polymers are recognized as ideal candidates for the development of noninvasive and wearable sensors for real-time monitoring of potassium ions (K+) in sweat to ensure the health of life. However, the low ion-to-electron transduction efficiency and limited active surface area hamper the development of high-performance sensors for low-concentration K+ detection in the sweat. Herein, a wearable K+ sensor is developed by tailoring the nanostructure of polypyrrole (PPy), serving as an ion-to-electron transduction layer, for accurately and stably tracing the K+ fluctuation in human sweat. The PPy nanostructures can be tailored from nanospheres to nanofibers by controlling the supramolecular assembly process during PPy polymerization. Resultantly, the ion-to-electron transduction efficiency (17-fold increase in conductivity) and active surface area (1.3-fold enhancement) are significantly enhanced, accompanied by minimized water layer formation. The optimal PPy nanofibers-based K+ sensor achieved a high sensitivity of 62 mV decade-1, good selectivity, and solid stability. After being integrated with a temperature sensor, the manufactured wearable sensor realized accurate monitoring of K+ fluctuation in the human sweat.

Affective or cognitive interpersonal emotion regulation in couples: an fNIRS hyperscanning study.

Sadness regulation is crucial for maintaining the romantic relationships of couples. Interpersonal emotion regulation, including affective engagement (AE) and cognitive engagement (CE), activates social brain networks. However, it is unclear how AE and CE regulate sadness in couples through affective bonds. We recruited 30 heterosexual couple dyads and 30 heterosexual stranger dyads and collected functional near-infrared spectroscopy hyperscanning data while each dyad watched sad or neutral videos and while the regulator regulated the target's sadness. Then, we characterized interbrain synchronization (IBS) and Granger causality (GC). The results indicated that AE and CE were more effective for couples than for strangers and that sadness evaluation of female targets was lower than that of male targets. CE-induced IBS at CH13 (BA10, right middle frontal gyrus) was lower for female targets than for male targets, while no gender difference in AE was detected. GC change at CH13 during CE was lower in the sad condition for male targets than for female targets, while no gender difference in AE was discovered. These observations suggest that AE and CE activate affective bonds but that CE was more effective for regulating sadness in female targets, revealing different neural patterns of cognitive and affective sadness regulation in couples.

Development and validation of an artificial intelligence model for predicting de novo distant bone metastasis in breast cancer: a dual-center study.

OBJECTIVE: Breast cancer has become the most prevalent malignant tumor in women, and the occurrence of distant metastasis signifies a poor prognosis. Utilizing predictive models to forecast distant metastasis in breast cancer presents a novel approach. This study aims to utilize readily available clinical data and advanced machine learning algorithms to establish an accurate clinical prediction model. The overall objective is to provide effective decision support for clinicians. METHODS: Data from 239 patients from two centers were analyzed, focusing on clinical blood biomarkers (tumor markers, liver and kidney function, lipid profile, cardiovascular markers). Spearman correlation and the least absolute shrinkage and selection operator regression were employed for feature dimension reduction. A predictive model was built using LightGBM and validated in training, testing, and external validation cohorts. Feature importance correlation analysis was conducted on the clinical model and the comprehensive model, followed by univariate and multivariate regression analysis of these features. RESULTS: Through internal and external validation, we constructed a LightGBM model to predict de novo bone metastasis in newly diagnosed breast cancer patients. The area under the receiver operating characteristic curve values of this model in the training, internal validation test, and external validation test1 cohorts were 0.945, 0.892, and 0.908, respectively. Our validation results indicate that the model exhibits high sensitivity, specificity, and accuracy, making it the most accurate model for predicting bone metastasis in breast cancer patients. Carcinoembryonic Antigen, creatine kinase, albumin-globulin ratio, Apolipoprotein B, and Cancer Antigen 153 (CA153) play crucial roles in the model's predictions. Lipoprotein a, CA153, gamma-glutamyl transferase, α-Hydroxybutyrate dehydrogenase, alkaline phosphatase, and creatine kinase are positively correlated with breast cancer bone metastasis, while white blood cell ratio and total cholesterol are negatively correlated. CONCLUSION: This study successfully utilized clinical blood biomarkers to construct an artificial intelligence model for predicting distant metastasis in breast cancer, demonstrating high accuracy. This suggests potential clinical utility in predicting and identifying distant metastasis in breast cancer. These findings underscore the potential prospect of developing economically efficient and readily accessible predictive tools in clinical oncology.

Automatic Positive and Negative Emotion Regulation in Adolescents with Major Depressive Disorder.

INTRODUCTION: Adolescents with major depressive disorder (MDD) exhibit hypoactivity to positive stimuli and hyperactivity to negative stimuli in terms of neural responses. Automatic emotion regulation (AER) activates triple networks (i.e., the central control network, default mode network, and salience network). Based on previous studies, we hypothesized that adolescents with MDD exhibit dissociable spatiotemporal deficits during positive and negative AER. METHODS: We first collected EEG data from 32 adolescents with MDD and 35 healthy adolescents while they performed an implicit emotional Go/NoGo task. Then, we characterized the spatiotemporal dynamics of cortical activity during AER. RESULTS: In Go trials, MDD adolescents exhibited reduced N2 amplitudes, enhanced theta power for positive pictures, and stronger bottom-up information flow from the left orbitofrontal cortex (OFC) to the right superior frontal gyrus compared to top-down information flow than the controls. In contrast, in NoGo trials, MDD adolescents exhibited elevated P3 amplitudes, enhanced theta power, and stronger top-down information flows from the right middle frontal gyrus to the right OFC and the left insula than the controls. CONCLUSION: Overall, adolescents with MDD exhibited impaired automatic attention to positive emotions and impaired automatic response inhibition. These findings have potential implications for the clinical treatment of adolescents with MDD.

Lack of Interaction Motivation in Older Adults Automatically Reduces Cognitive Empathy.

Empathy, the ability to understand and respond to the experiences of others, is an important skill for maintaining good relationships throughout one's life. Previous research indicated that emotional empathy remained stable or even increased in older adults compared to younger adults, while cognitive empathy showed age-related deficits. Based on the selective engagement hypothesis, this deficit was not caused by a decline in cognitive functioning, but by a lack of willingness to judge the target person's emotions more precisely, that is, by a lack of interaction motivation. In order to provide more evidence on the causes of empathic aging in older adults, the current study investigated the influence of interaction motivation on empathy in older adults in an Eastern cultural context (China) based on the selective engagement hypothesis. This study used older adults and younger adults as subjects. Through two experiments, empathy was measured by the multiple empathy test (Experiment 1) and film tasks (Experiment 2); at the same time, use accountability instructions (Experiment 1), the age-related events (Experiment 2) to manipulate interaction motivation. The results showed that emotional empathy was significantly higher in older adults than in younger adults, regardless of whether interaction motivation was elicited. In terms of cognitive empathy, when there is no motivation, the cognitive empathy of older adults is significantly lower than that of younger adults. When the interaction motivation is stimulated, the cognitive empathy of older adults is no less than that of younger adults. This suggested that empathic aging in older adults was not a permanent decline in cognitive empathy, but rather a decline in interaction motivation, supporting the selective engagement hypothesis.

Laponite/lactoferrin hydrogel loaded with eugenol for methicillin-resistant Staphylococcus aureus-infected chronic skin wound healing.

Severe bacterial infections can give rise to protracted wound healing processes, thereby posing a significant risk to a patient's well-being. Consequently, the development of a versatile hydrogel dressing possessing robust bioactivity becomes imperative, as it holds the potential to expedite wound healing and yield enhanced clinical therapeutic outcomes. In this context, the present study involves the formulation of an injectable multifunctional hydrogel utilizing laponite (LAP) and lactoferrin (LF) as foundational components and loaded with eugenol (EG). This hydrogel is fabricated employing a straightforward one-pot mixing approach that leverages the principle of electrostatic interaction. The resulting LAP/LF/EG2% composite hydrogel can be conveniently injected to address irregular wound geometries effectively. Once administered, the hydrogel continually releases lactoferrin and eugenol, mitigating unwarranted oxidative stress and eradicating bacterial infections. This orchestrated action culminates in the acceleration of wound healing specifically in the context of MRSA-infected wounds. Importantly, the LAP/LF/EG2% hydrogel exhibits commendable qualities including exceptional injectability, potent antioxidant attributes, and proficient hemostatic functionality. Furthermore, the hydrogel composition notably encourages cellular migration while maintaining favorable cytocompatibility. Additionally, the hydrogel manifests noteworthy bactericidal efficacy against the formidable multidrug-resistant MRSA bacterium. Most significantly, this hydrogel formulation distinctly expedites the healing of MRSA-infected wounds by promptly inducing hemostasis, curbing bacterial proliferation, and fostering angiogenesis, collagen deposition, and re-epithelialization processes. As such, the innovative hydrogel material introduced in this investigation emerges as a promising dressing for the facilitation of bacterial-infected wound healing and consequent tissue regeneration.

Membranes based on Covalent Organic Frameworks through Green and Scalable Interfacial Polymerization using Ionic Liquids for Antibiotic Desalination.

Covalent organic framework (COF) membranes featuring uniform topological structures and devisable functions, show huge potential in water purification and molecular separation. Nevertheless, the inability of uniform COF membranes to be produced on an industrial scale and their nonenvironmentally friendly fabrication method are the bottleneck preventing their industrial applications. Herein, we report a new green and industrially adaptable scraping-assisted interfacial polymerization (SAIP) technique to fabricate scalable and uniform TpPa COF membranes. The process used non-toxic and low-volatility ionic liquids (ILs) as organic phase instead of conventional organic solvents for interfacial synthesis of TpPa COF layer on a support membrane, which can simultaneously achieve the purposes of (i) improving the greenness of membrane-forming process and (ii) fabricating a robust membrane that can function beyond the conventional membranes. This approach yields a large-area, continuous COF membrane (19×25 cm2 ) with a thickness of 78 nm within a brief period of 2 minutes. The resulting membrane exhibited an unprecedented combination of high permeance (48.09 L m-2 h-1 bar-1 ) and antibiotic desalination efficiency (e.g., NaCl/adriamycin separation factor of 41.8), which is superior to the commercial benchmarking membranes.

Fabrication of Coffee-Ring Nanostructured Membranes for Organic Solvent Nanofiltration.

Organic solvent nanofiltration (OSN) plays important roles in pharmaceutical ingredients purification and solvent recovery. However, the low organic solvent permeance under cross-flow operation of OSN membrane hampers their industrial applications. Herein, we report the construction of coffee-ring structured membrane featuring high OSN permeance. A water-insoluble crystal monomer that dissolved in EtOH/H2O mixed solvent was designed to react with trimesoyl chloride via interfacial polymerization. Owing to the diffusion of EtOH to n-hexane, coffee-ring nanostructure on the support membrane appeared, which served as the template for construction of coffee-ring structured membrane. The optimal nanostructured membrane demonstrated 2.6-fold enhancement in the effective surface area with reduced membrane thickness. Resultantly, the membrane afforded a 2.7-fold enhancement in organic solvent permeance, e.g., ~13 LMH/bar for MeOH, without sacrificing the rejection ability. Moreover, due to the rigid monomer structure, the fabricated membrane shows distinctive running stability in active pharmaceutical ingredients purification and the ability for concentration of medicines.

Micro/Nano-Fabrication of Flexible Poly(3,4-Ethylenedioxythiophene)-Based Conductive Films for High-Performance Microdevices.

With the increasing demands for novel flexible organic electronic devices, conductive polymers are now becoming the rising star for reaching such targets, which has witnessed significant breakthroughs in the fields of thermoelectric devices, solar cells, sensors, and hydrogels during the past decade due to their outstanding conductivity, solution-processing ability, as well as tailorability. However, the commercialization of those devices still lags markedly behind the corresponding research advances, arising from the not high enough performance and limited manufacturing techniques. The conductivity and micro/nano-structure of conductive polymer films are two critical factors for achieving high-performance microdevices. In this review, the state-of-the-art technologies for developing organic devices by using conductive polymers are comprehensively summarized, which will begin with a description of the commonly used synthesis methods and mechanisms for conductive polymers. Next, the current techniques for the fabrication of conductive polymer films will be proffered and discussed. Subsequently, approaches for tailoring the nanostructures and microstructures of conductive polymer films are summarized and discussed. Then, the applications of micro/nano-fabricated conductive films-based devices in various fields are given and the role of the micro/nano-structures on the device performances is highlighted. Finally, the perspectives on future directions in this exciting field are presented.

Impact of the COVID-19 on the vertical distributions of major pollutants from a tower in the Pearl River Delta.

The outbreak of the 2019 novel coronavirus (COVID-19) had a large impact on human health and socio-economics worldwide. The lockdown implemented in China beginning from January 23, 2020 led to sharp reductions in human activities and associated emissions. The declines in primary pollution provided a unique opportunity to examine the relationship between anthropogenic emissions and air quality. This study reports on air pollutant and meteorological measurements at different heights from a tall tower in the Pearl River Delta. These measurements were used to investigate the vertical scale response of pollutants to understand reductions in human activities. Compared to that in the pre-lockdown period (from December 16, 2019), the concentrations of surface layer nitric oxide (NOx), fine particulate matter (PM2.5), and daily maximum 8 h average ozone (MDA8O3) declined significantly during the lockdown by 76.8%, 49.4%, and 18.6%, respectively. Although the vertical profiles of NOx and O3 changed during the lockdown period, those of PM2.5 remained the same. During the lockdown period, there were statistically significant correlations between PM2.5 and O3 but not between PM2.5 and NOx at four heights, indicating that the main composition of PM2.5 have dramatically changed, during which the impact of NOx on PM2.5 became insignificant. Additionally, O3 concentrations were also insensitive to NOx concentrations during the lockdown, implying that O3 levels were more of a representative of regional background level. In this case, local photochemical formation is no longer a significant ozone source. This evidence suggests that it is possible to mitigation of PM2.5 and O3 levels simultaneously by significant reductions in anthropogenic emissions.

Cooperation with partners of differing social experience: An fNIRS-based hyperscanning study.

Previous studies have shown the brain synchronization of all team members while completing a collaborative task. Moreover, this effect is influenced by a team's compositional elements, such as gender (opposite or same) or relationships (i.e., friends, lovers, or strangers) among team members. However, whether interpersonal brain synchronization (IBS) is affected by team members' experience, as well as the temporal dynamics of such brain synchronization, remains to be investigated. In the current study, we combined behavioral methods and functional near-infrared spectroscopy-based hyperscanning to examine the effect of member experience on team cooperation by an adopted continuous joint drawing task with 21 student-student dyads (S-S dyads) and 22 teacher-student dyads (T-S dyads). The results revealed that team members with differing experiences (T-S dyads) perform better than those with similar ones (S-S dyads). Moreover, we observed IBS in the left frontopolar region (channel 11). However, we did not observe significant changes of the task-related IBS across time. Besides, IBS was negatively correlated with the participants' behavioral performance. Our findings demonstrate the importance of social experience in teamwork in the real world and suggest a possible mechanism for cooperation from a temporal and spatial perspective.

Mobile LiDAR Scanning System Combined with Canopy Morphology Extracting Methods for Tree Crown Parameters Evaluation in Orchards.

To meet the demand for canopy morphological parameter measurements in orchards, a mobile scanning system is designed based on the 3D Simultaneous Localization and Mapping (SLAM) algorithm. The system uses a lightweight LiDAR-Inertial Measurement Unit (LiDAR-IMU) state estimator and a rotation-constrained optimization algorithm to reconstruct a point cloud map of the orchard. Then, Statistical Outlier Removal (SOR) filtering and European clustering algorithms are used to segment the orchard point cloud from which the ground information has been separated, and the k-nearest neighbour (KNN) search algorithm is used to restore the filtered point cloud. Finally, the height of the fruit trees and the volume of the canopy are obtained by the point cloud statistical method and the 3D alpha-shape algorithm. To verify the algorithm, tracked robots equipped with LIDAR and an IMU are used in a standardized orchard. Experiments show that the system in this paper can reconstruct the orchard point cloud environment with high accuracy and can obtain the point cloud information of all fruit trees in the orchard environment. The accuracy of point cloud-based segmentation of fruit trees in the orchard is 95.4%. The R2 and Root Mean Square Error (RMSE) values of crown height are 0.93682 and 0.04337, respectively, and the corresponding values of canopy volume are 0.8406 and 1.5738, respectively. In summary, this system achieves a good evaluation result of orchard crown information and has important application value in the intelligent measurement of fruit trees.

Behavioral and brain synchronization differences between expert and novice teachers when collaborating with students.

Differences in behavior and neural mechanisms between expert and novice teachers when collaborating with students are poorly understood. This study investigated whether expert teachers do better in collaborating with students than novice teachers and explored the neural basis of such differences. Novice teacher and student (NT-S) dyads and expert teacher and student (ET-S) dyads were recruited to complete an interactive task consisting of a cooperation and an independent condition. During the experiment, neural activity in the prefrontal cortex of the participants was recorded with functional near-infrared spectroscopy. The results show higher accuracy for the ET-S dyads than the NT-S dyads in the cooperation condition; however, no difference was found in the independent condition. Increased interpersonal brain synchronization (IBS) was detected in the left dorsolateral prefrontal cortex of participants in ET-S dyads, but not in NT-S dyads in the cooperation condition. Moreover, an interaction effect of dyad type and conditions on IBS was observed, revealing IBS was stronger in ET-S dyads than in NT-S dyads. In ET-S dyads, IBS was positively correlated with the teachers' perspective-taking ability and accuracy. These findings suggest that expert teachers collaborate better with students than novice teachers, and IBS might be the neural marker for this difference.

Dynamic Reconfiguration of Functional Topology in Human Brain Networks: From Resting to Task States.

Task demands evoke an intrinsic functional network and flexibly engage multiple distributed networks. However, it is unclear how functional topologies dynamically reconfigure during task performance. Here, we selected the resting- and task-state (emotion and working-memory) functional connectivity data of 81 health subjects from the high-quality HCP data. We used the network-based statistic (NBS) toolbox and the Brain Connectivity Toolbox (BCT) to compute the topological features of functional networks for the resting and task states. Graph-theoretic analysis indicated that under high threshold, a small number of long-distance connections dominated functional networks of emotion and working memory that exhibit distinct long connectivity patterns. Correspondently, task-relevant functional nodes shifted their roles from within-module to between-module: the number of connector hubs (mainly in emotional networks) and kinless hubs (mainly in working-memory networks) increased while provincial hubs disappeared. Moreover, the global properties of assortativity, global efficiency, and transitivity decreased, suggesting that task demands break the intrinsic balance between local and global couplings among brain regions and cause functional networks which tend to be more separated than the resting state. These results characterize dynamic reconfiguration of large-scale distributed networks from resting state to task state and provide evidence for the understanding of the organization principle behind the functional architecture of task-state networks.

Adolescents Exhibit Late Maturation of Long-Range Beta Coherences in Affective Processing.

We investigated whether intra-/interhemispheric long-range beta coherences mirror developmental changes in affective functional integration during adolescence. Electroencephalogram data were gathered from 15 young adolescents, 16 old adolescents, and 16 young adults during viewing affective pictures. The results indicated that both positive and negative pictures induced greater intra- and interhemispheric long-distance beta coherences than neutral pictures. However, opposite results were observed between young and old adolescents in terms of negative phase differences. Old adolescents exhibited greater beta coherences for positive and negative pictures than both young adolescents and young adults, but there was no difference between the groups for neutral pictures. These observations suggest that long-range beta coherence might reflect the late maturation of affective functional integration in adolescents.

Down-regulation of lncRNA-ATB inhibits epithelial-mesenchymal transition of breast cancer cells by increasing miR-141-3p expression.

Long noncoding RNA activated by transforming growth factor-beta (lnc-ATB) is abnormally expressed in a number of tumor types. The aim of this study was to investigate the expression of lnc-ATB and miR-141-3p, and to determine whether lnc-ATB can regulate epithelial-mesenchymal transition (EMT) by miR-141-3p in breast cancer. Here, we found that lnc-ATB was highly expressed, whereas there was low expression of miR-141-3p in breast cancer tissues and cells. Knockdown of lnc-ATB in two breast cancer cell lines (MDA-MB-231 and BT549) significantly increased miR-141-3p expression. Down-regulation of lnc-ATB resulted in a morphological change of breast cancer cells from spindle-like to a round shape, and in a remarkable inhibition of cell migration and invasion, which were reversed by miR-141-3p inhibitor. Furthermore, we demonstrated that lnc-ATB knockdown decreased ZEB1, ZEB2, N-cadherin, and vimentin expression, and promoted E-cadherin expression, while miR-141-3p inhibitor could reverse those effects. Moreover, we proved that miR-141-3p directly bound to the 3' untranslated region (UTR) of ZEB1 and ZEB2 and negatively regulated ZEB1 and ZEB2 expression. Taken together, our results show that knockdown of lnc-ATB significantly inhibits the EMT process of breast cancer cells by increasing the expression of miR-141-3p, indicating that lnc-ATB might serve as a novel therapeutic target for breast cancer.

Breath-focused mindfulness alters early and late components during emotion regulation.

Breath-focused mindfulness (BFM), which induces changes in brain structure and function, is applied in the clinical treatment of mental disorders as a method to regulate one's emotions. However, whether BFM works through a top-down emotional regulation strategy to alter brain dynamics and its relationship with individual differences in trait mindfulness are unclear. Event-related potentials (ERPs) of 20 healthy BFM-naïve undergraduates were recorded when they conducted BFM/viewing tasks while viewing affective pictures. Participants completed the Attentional Control Scale (ACS) and the Mindful Attention Awareness Scale (MAAS). The results indicated that under the viewing condition, positive and negative pictures elicited greater P1, N2, and late positive potential (LPP) amplitudes than did neutral pictures. However, BFM attenuated P1, N2, and LPP amplitudes for positive and negative pictures but not for neutral pictures. P1 amplitudes for emotional minus neutral pictures correlated with individual differences in focus attention measured by the ACS, while N2 amplitudes for emotional minus neutral pictures correlated with individual differences in trait mindfulness measured by the MAAS. These observations suggest that, consistent with the dual-process model, BFM is an effective emotion regulation strategy and might activate the dorsal top-down prefrontal system to alter early and late neural dynamics of affective processing.

The inhibition mechanism of ϵ-polylysine against Bacillus cereus emerging in surimi gel during refrigerated storage.

BACKGROUND: Refrigeration is commonly used in the processing and storage of surimi products. However, refrigerated surimi products are susceptible to microbial contamination, which leads to deterioration of the products and shortens their shelf life. The aims of the present study were therefore to evaluate the effects of ϵ-polylysine (ϵ-PL) on spoilage bacteria in surimi products, and to investigate the antibacterial mechanism of Bacillus cereus, which is the dominant spoilage bacterium. RESULTS: ϵ-Polylysine with a high degree of polymerization (20-30K) proved able to decrease the total number of colonies in surimi products and showed an obvious antibacterial effect against B. cereus. After ϵ-PL treatments, the distinct broken areas on the bacterial surfaces and the aggregations of cells were observed by scanning electron microscope (SEM). The intracellular materials, such as small molecules, soluble proteins, and deoxyribonucleic acids in the cells were analyzed, which revealed the destructive effects of ϵ-PL on bacterial cells. Experiments with propidium iodide (PI) infiltration experiments verified that the permeability of cell membranes was enhanced by ϵ-PL treatment. CONCLUSION: These results indicated that ϵ-PL could destroy the cell membranes and change the permeability of B. cereus, and subsequently the cell contents leaked out to achieve antibacterial effects. © 2018 Society of Chemical Industry.

Diagnostic value of endoscopic appearance during ductoscopy in patients with pathological nipple discharge.

BACKGROUND: To explore the features of ductoscopic appearance that may be diagnostic in patients with pathologic nipple discharge (PND) and to discuss the diagnostic criteria for intraductal tumors. METHODS: We reviewed 247 patients with PND but without a palpable mass who were evaluated using either surgical biopsy or excision. Data concerning patient age, duration of discharge, discharge color, and the details of endoscopic appearance were analyzed according to the pathological results. RESULTS: The postoperative diagnosis in 61 patients (24.70%) was a nonmass lesion, and 186 patients (76.52%) had an intraductal tumor. Among those with intraductal lesions, 10 patients (4.05%) had a malignant tumor, including 4 (1.62%) with ductal carcinoma in situ and 6 (2.43%) with invasive ductal carcinoma. On univariate analysis, patients of older age with spontaneous and bloody discharge were more likely to suffer from intraductal lesions. On logistic regression analysis, bloody nipple discharge, morphology, and a broad lesion base revealed by ductoscopy showed a statistically significant correlation with malignancy (p = 0.001, p < 0.001, p = 0.022, respectively). CONCLUSIONS: Both clinical features and endoscopic appearance are significant for the precise diagnosis of an intraductal lesion seen on ductoscopy. The endoscopic features of bloody discharge, morphology, and a broad lesion base are independent risk factors for malignancy and represent new criteria for the diagnosis of patients with PND.