Role of short-chain fatty acids in host physiology.

Short-chain fatty acids (SCFAs) are major metabolites produced by the gut microbiota through the fermentation of dietary fiber, and they have garnered significant attention due to their close association with host health. As important mediators between the gut microbiota and the host, SCFAs serve as energy substrates for intestinal epithelial cells and maintain homeostasis in host immune and energy metabolism by influencing host epigenetics, activating G protein-coupled receptors, and inhibiting pathogenic microbial infections. This review provides a comprehensive summary of SCFAs synthesis and metabolism and offering an overview of the latest research progress on their roles in protecting gut health, enhancing energy metabolism, mitigating diseases such as cancer, obesity, and diabetes, modulating the gut-brain axis and gut-lung axis, and promoting bone health.

Jatrophane diterpenoids with cytotoxic activity from the whole plant of Euphorbia heliosocpia L.

Eight undescribed jatrophane diterpenoids, euphohelinoids A-H, along with 11 known analogues were isolated from the whole plant of Euphorbia heliosocpia L. Among them, euphohelinoids A and B contain a rare type of jatrophane diterpenoid skeleton with a 7,8-seco scaffold. To the best of our knowledge, only two such jatrophane diterpenoids have been reported. In addition, euphohelinoids G and H belong to a rare class of jatrophane diterpene possessing a ß-hydroxy group at C-11. Structure elucidation of these undescribed diterpenoids was performed by spectroscopic analysis, including NMR, HRESIMS, IR, electronic circular dichroism (ECD) and DP4+ analysis. The cytotoxicity of 17 abundant jatrophane diterpenes was evaluated against HepG2, HeLa, HL-60, and SMMC-7721 cell lines. Seven compounds presented potent cytotoxicity against the four tested cell lines with IC50 values from 8.1 to 29.7 µM. Moreover, preliminary structure-activity relationships for these jatrophane diterpenoids were discussed.

Systemic Immune-Inflammation Index Is Superior to Neutrophil to Lymphocyte Ratio in Prognostic Assessment of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy.

RESULTS: SII, NLR, and PLR did not define patient groups with distinct clinicopathological characteristics. SII, NLR, and PLR cut-off values were 547, 2.13, and 88.23, as determined by ROC analysis; the corresponding areas under the curve (AUCs) were 0.625, 0.555, and 0.571, respectively. Cox regression models identified SII as independently associated with OS. Patients with low SII had prolonged OS (65 vs. 41 months, P = 0.017, HR: 3.24, 95% CI: 1.23-8.55). In the Z test, the difference in AUC between SII and NLR was statistically significant (Z = 2.721, 95% CI: 0.0194-0.119, P = 0.0065). CONCLUSION: Our study suggests that the pretreatment SII value is significantly correlated with OS in breast cancer patients undergoing NAC and that the prognostic utility of SII is superior to that of NLR and PLR.

Tailoring neoadjuvant chemotherapy for patients with breast cancer who have achieved pathologic complete response.

BACKGROUND: We retrospectively examined whether different cycles of chemotherapy affected the prognosis of patients who achieved a pathologic complete response (pCR). METHODS: We reviewed data from patients who achieved pCR after neoadjuvant chemotherapy (NACT) between 2008 and 2018. In total, 286 patients were divided into three groups: group one (n=148, 52%) completed standard chemotherapy cycles before surgery, group two (n=81, 28%) did not complete standard chemotherapy cycles before surgery or received chemotherapy after surgery, and group three (n=57, 20%) did not complete standard chemotherapy cycles before surgery but completed them after surgery. Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method, and differences between groups were evaluated by the log-rank test. Cox proportional hazards regression analysis was adjusted for different NACT groups, age, Ki-67 levels, and clinical stages. RESULTS: After a median follow-up of 26 months, there were no significant differences in RFS among the NACT groups (P=0.14). Multivariate analysis showed that Ki-67 ≥40% (P=0.03) and clinical stage (IIIB + IIIC) (P=0.002) might be risk factors for recurrence in patients with pCR. There were no significant differences in survival among subgroups according to Ki-67 levels and clinical stages. CONCLUSIONS: Our study suggests that, even with pCR, patients with baseline stage IIIB or IIIC or Ki-67 levels ≥40% may have an increased risk of recurrence. The RFS of patients with pCR was not associated with the completion of standard chemotherapy cycles, even in high-risk patients. Therefore, the prevention of excessive chemotherapeutic treatment by de-escalation is necessary for patients with pCR.

MR-guided percutaneous biopsy of solitary pulmonary lesions using a 1.0-T open high-field MRI scanner with respiratory gating.

OBJECTIVES: To prospectively evaluate the feasibility, safety and accuracy of MR-guided percutaneous biopsy of solitary pulmonary lesions using a 1.0-T open MR scanner with respiratory gating. METHODS: Sixty-five patients with 65 solitary pulmonary lesions underwent MR-guided percutaneous coaxial cutting needle biopsy using a 1.0-T open MR scanner with respiratory gating. Lesions were divided into two groups according to maximum lesion diameters: ≤2.0 cm (n = 31) and >2.0 cm (n = 34). The final diagnosis was established in surgery and subsequent histology. Diagnostic accuracy, sensitivity and specificity were compared between the groups using Fisher's exact test. RESULTS: Accuracy, sensitivity and specificity of MRI-guided percutaneous pulmonary biopsy in diagnosing malignancy were 96.9 %, 96.4 % and 100 %, respectively. Accuracy, sensitivity and specificity were 96.8 %, 96.3 % and 100 % for lesions 2.0 cm or smaller and 97.1 %, 96.4 % and 100 %, respectively, for lesions larger than 2.0 cm. There was no significant difference between the two groups (P > 0.05). Biopsy-induced complications encountered were pneumothorax in 12.3 % (8/65) and haemoptysis in 4.6 % (3/65). There were no serious complications. CONCLUSIONS: MRI-guided percutaneous biopsy using a 1.0-T open MR scanner with respiratory gating is an accurate and safe diagnostic technique in evaluation of pulmonary lesions. KEY POINTS: • MRI-guided percutaneous lung biopsy using a 1.0-T open MR scanner is feasibility. • 96.9 % differentiation accuracy of malignant and benign lung lesions is possible. • No serious complications occurred in MRI-guided lung biopsy.

Cystoid angiocentric glioma: A case report and literature review.

Angiocentric glioma is a rare subtype of neuroepithelial tumor that is associated with a history of epilepsy. We report a case of cystoid angiocentric glioma associated with an area of calcification. This 25 year old male patient presented with tonic clonic spasm. He underwent craniotomy with complete resection of the lesion. Pathologic specimen showed monomorphous bipolar cells with angiocentric growth pattern.

MRI-guided percutaneous transpedicular biopsy of thoracic and lumbar spine using a 0.23t scanner with optical instrument tracking.

PURPOSE: To prospectively evaluate the safety and accuracy of magnetic resonance imaging (MRI)-guided percutaneous transpedicular biopsy of thoracic and lumbar spine using 0.23T magnetic resonance imaging with optical tracking. MATERIALS AND METHODS: Sixty-seven thoracic and lumbar spine lesions in 67 patients underwent MRI-guided percutaneous transpedicular biopsy using 0.23T MRI with optical tracking. These lesions were divided into two groups according to the location: 16 lesions in the thoracic spine and 51 lesions in the lumbar spine. The diagnostic accuracy, sensitivity, and specificity were calculated, and comparison of the two groups was performed using Fisher's exact test. Each patient was monitored for complications. RESULTS: All specimens obtained were sufficient for diagnosis. Histological examination of MRI-guided percutaneous biopsy revealed 38 malignant and 29 benign lesions. The final diagnoses from surgery or clinical follow-up were 42 malignant lesions and 25 benign lesions. The combined diagnostic performance of MRI-guided percutaneous transpedicular thoracic and lumbar biopsy in diagnosing malignant tumors was as follows: accuracy, 94%; sensitivity, 89%; and specificity, 100%. There was no significant difference between the two groups (P = 1, Fisher's exact test). No serious complications occurred. CONCLUSION: MRI-guided percutaneous transpedicular biopsy is a safe and accurate diagnostic technique to evaluate thoracic and lumbar spine lesions.

MRI-guided stereotactic aspiration of brain abscesses by use of an optical tracking navigation system.

BACKGROUND: Owing to the high risk of abscess drainage by craniotomy, imaging-guided stereotactic aspiration is considered an ideal choice in the management of brain abscesses. Interventional magnetic resonance imaging (MRI) represents a valuable technique for the treatment of brain abscess as a guiding modality. PURPOSE: To evaluate the safety and efficacy of an interventional MRI system in performing the procedure. MATERIAL AND METHODS: Thirteen brain abscesses in 11 patients were treated with percutaneous aspiration. All procedures were performed solely under the guidance of a 0.23-T open-configuration MRI scanner with optical tracking. Clinical and imaging follow-up was at 1 week, 1 month, 3 months, and 6 months. The changes of abscess, MRI features, and clinical symptoms were recorded. Procedure efficacy and safety were evaluated by success rate, procedure time, decrease of abscess, recovery rate, and complication. Descriptive statistical analysis was performed. RESULTS: MRI-guided stereotactic aspirations were performed successfully in 13/13 (100%) abscesses. The mean operating time was 70 min (range, 45-100 min). Follow-up MRI at 1 week after the procedure showed average reduction of abscesses by 60% (2.1/3.5). And the abscesses continued to get smaller by up to 89.7% (3.14/3.5) at 1-month follow-up. All cavities resolved at the end of the 6-month follow-up period. The recovery rate was 100% for fever, headache, vomiting, papilledema, meningismus, altered sensorium, 75% (3/4) for hemiparesis, and 83.3% (5/6) for epilepsy. There were no complications. CONCLUSION: Punctures of brain abscesses with subsequent aspiration can be performed safely and efficiently by monitoring the procedure using an open interventional MRI system.

Magnetic resonance imaging-guided percutaneous biopsy of mediastinal masses: diagnostic performance and safety.

OBJECTIVE: The objective of this study was to evaluate the diagnostic performance and safety of magnetic resonance (MR) imaging-guided percutaneous mediastinal biopsy procedures using a 0.23-T open MR system with optical tracking navigation. MATERIALS AND METHODS: A retrospective analysis of 59 participants (38 males and 21 females; mean age, 45 years; range, 16-73 years) who underwent MR imaging-guided percutaneous mediastinal biopsy procedures was performed. The access techniques included extrapleural (40 of 59; 67.8%) and transpulmonary (19 of 59; 32.2%) needle paths. Tissue sampling techniques included fine-needle aspiration (22 of 59; 37.3%) and core-needle biopsy (37 of 59; 62.7%). Histopathological analysis of surgical specimen and clinical and imaging follow-ups were used as the reference standard. The procedures were evaluated for technical success rate, number of biopsy passes, diagnostic performance, procedure time, and complications. RESULTS: Technical success was achieved in 57 of the 59 procedures (96.6%). For the fine-needle aspiration, a mean of 3 passes (range, 2-4 passes) was performed. For the core-needle biopsy, a mean of 4 passes (range, 3-6 passes) was performed. Pathological and cytological analysis of biopsy specimens showed 41 of 57 malignant lesions (71.9%) and 16 of 57 benign lesions (28.1%), with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 93.2% (41 of 44), 100% (13 of 13), 100% (41 of 41), 81.2% (13 of 16), and 94.7% (54 of 57), respectively. Procedure time was 30 minutes (range, 20-50 minutes). Mild hemoptysis occurred in 3 cases, and in 2 cases, a small pneumothorax occurred. CONCLUSIONS: Magnetic resonance imaging-guided biopsy of mediastinal masses has a high diagnostic performance and is safe for use in clinical practice.

A multi-center survey of HPV knowledge and attitudes toward HPV vaccination among women, government officials, and medical personnel in China.

OBJECTIVES: To assess knowledge of HPV and attitudes towards HPV vaccination among the general female population, government officials, and healthcare providers in China to assist the development of an effective national HPV vaccination program. METHODS: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China using a short questionnaire. 763 government officials, 760 healthcare providers, and 11,681 women aged 15-59 years were included in the final analysis. Data were analyzed using standard descriptive statistics and logistic regression. RESULTS: Knowledge of HPV among the general female population was low; only 24% had heard of HPV. Less than 20% of healthcare providers recognized sexually naive women as the most appropriate population for HPV vaccination. There was high acceptance of the HPV vaccine for all categories of respondents. Only 6% of women were willing to pay more than US $300 for the vaccine. CONCLUSIONS: Aggressive education is necessary to increase knowledge of HPV and its vaccine. Further proof of vaccine safety and efficacy and government subsidies combined with increased awareness could facilitate development and implementation of HPV vaccination in China.

A multi-center survey of age of sexual debut and sexual behavior in Chinese women: suggestions for optimal age of human papillomavirus vaccination in China.

OBJECTIVE: Cervical cancer is the second most common cancer among women worldwide, and over 85% of cervical cancers occur in developing countries such as China. Lack of resources for nationwide cervical cancer screening in China makes vaccination against oncogenic strains of HPV particularly important. Knowledge of age at sexual debut and sexual behavior is essential prior to implementation of a national vaccination program. METHODS AND MATERIALS: A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China to assess age at sexual debut and sexual behavior. 98.6% of the 11,852 recruited women aged 15-59 years were included in the analysis. Data were collected using a short, nurse-administered questionnaire and analyzed using standard descriptive statistics and survival analysis. RESULTS: In urban areas, more than ten percent of the 15-19 year old age group were already sexually active at the time of interview; this number increased to nearly 44% in the 20-24 year old age group. Chinese young women with an occupation were more likely to be sexually active compared to female students of the same age, irrespective of area of residence. The crude median sexual debut age for the youngest age group was 17 years, earlier than the sexual debut age reported by older cohorts. Younger age cohorts had an earlier menarche age than older cohorts and were more likely to have more sexual partners than older women, and more likely to have partners with more than one female partner. CONCLUSION: There is a trend towards earlier sexual debut and riskier sexual behaviors in younger age groups of Chinese women. These findings suggest that HPV vaccination of women between the ages of 13 and 15 years, before the completion of national compulsory education, is likely to contribute to the prevention of HPV infection and cervical cancer in China.

MRI-guided biopsy and aspiration in the head and neck: evaluation of 77 patients.

OBJECTIVES: To evaluate the efficacy and safety of MRI-guided percutaneous biopsy procedures of head and neck lesions using 0.23T open MRI with optical tracking. METHODS: A retrospective analysis of 77 patients (51 male, 26 female; mean age, 43 years; range, 11-88 years) who underwent MRI-guided percutaneous biopsy of a head and neck lesion was performed. Mean lesion diameter was 3 cm (range, 1-7.8 cm). Rapid gradient echo sequences were used for image guidance. 23/77 lesions were biopsied after intravenous gadolinium. Tissue sampling techniques included needle aspiration (n = 19) and core needle biopsy (n = 58). Outcome variables included technical success, diagnostic accuracy, procedure time and complications. RESULTS: In all patients, a sufficient amount of tissue for pathological analysis was obtained. Pathological analysis diagnosed 41 malignant lesions and 36 benign lesions. In 42 cases, surgical correlation was available. In 35 cases, the final diagnosis was confirmed by imaging and clinical follow-up. MR-guided biopsy had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 93.2%, 100%, 100%, 91.7%, and 96%, respectively. Procedure time was 29 min (range, 15-47 min). No major complications occurred. CONCLUSIONS: MRI-guided biopsy of head and neck lesions has a high diagnostic performance and is safe in clinical practice. KEY POINTS: • MRI-guided biopsy helps clinicians to assess patients with head&neck masses. • Differention of malignant and benign lesions is possible with 96% accuracy. • The safety profile of MRI-guided biopsy of head&neck lesions is favorable. • MRI guidance enables accurate biopsy without the use of ionizing radiation.

Magnetic resonance imaging-guided biopsy of musculoskeletal lesions using open low-field systems.

With the development of open-configuration magnetic resonance imaging (MRI) systems, magnetic resonance-compatible navigational tools, and fast pulse sequences, MRI-guided biopsy of musculoskeletal lesions has evolved into an effective and safe, minimally invasive technique. Magnetic resonance-guided percutaneous biopsy of musculoskeletal lesions is especially suited for lesions that are detectable only with MRI, lesions that require double-angulated needle paths, and for patients in which radiation exposure needs to be avoided. In this article, we review pertinent principles, techniques, and clinical applications of low-field MRI for biopsy procedures in the musculoskeletal system.

[Development of the system of quality of life instruments for cancer patients: colorectal cancer (QLICP-CR)].

BACKGROUND & OBJECTIVE: Based on the development of the general module of the system of quality of life instruments for cancer patients (QLICP-GM), this study was to develop and evaluate a quality of life scale for patients with colorectal cancer (QLICP-CR). METHODS: A quality of life scale for colorectal cancer patients that associated with Chinese cultural background was developed. The data from 110 patients with colorectal cancer were analyzed using statistical description, Pearson Correlation, Cluster analysis, and paired t-student test to assess the instrument. RESULTS: The test-retest reliability for the scale and 5 domains were all above 0.78. Internal consistency alpha for each domain was higher than 0.85 except for the social domain (0.66) and the symptom and side effect domain (0.63). Most of the correlation coefficients between each item and its domains were above 0.6. The differences in the scores of overall scale, general module, special domain, psychological domain, and symptom and side effect domain between pre-treatment and post-treatment were significant. CONCLUSION: The QLICP-CR is reasonably valid, reliable, and responsible, and can be used to assess quality of life for the patients with colorectal cancer.

Development and validation of the general module of the system of quality of life instruments for cancer patients.

Based on World Health Organization (WHO)'s definition of Quality of Life (QOL) and programmed decision procedures, we developed a general module of the System of Quality of Life Instruments for Cancer Patients (QLICP-GM) utilizing focus group discussions, pilot tests of 448 cases and field tests of 600 cases of 5 different cancer patients. The number of items in the final version was reduced to 32 from a 78-item pool. The psychometric properties of the scale were evaluated by indicators such as validity and reliability coefficients, SRM, and statistical methods of correlational analysis, t tests, and structural equation modeling. Correlational and structural equation model analyses indicate good construct validity with RMSEA 0.086, NNFI 0.947 and CFI 0.961. Good criterion-related validity was found when FACT-G was used as the criterion. The test-retest reliability for all domains and the overall scale is above 0.85; the internal consistency alpha for each domain is higher than 0.70 except of the social function; alpha and the split-half reliability of the overall scale is 0.88 and 0.93, respectively. The pre-post changes of QOL scores are of statistical significances in 3 domains of physical function, psychological function, common symptoms and side effects, and the overall instrument, with standardized response mean ranging from 0.16 to 0.67. Equivalence tests showed nonequivalence on quality of life score changes of these domains and the overall instrument. Our study shows that the QLICP-GM has good validity, reliability, responsiveness, and can be used as the general module for cancer patients in China.

Development and validation of the system of quality of life instruments for cancer patients: lung cancer (QLICP-LU).

Using the structured group methods (nominal and focus group) and the theory in instrument development, the quality of life instrument for lung cancer (QLICP-LU) with Chinese cultural background was developed, and evaluated based on the data from a sample of 85 in-patients of lung cancer. Statistical methods used were correlation analysis, factor analysis and paired t-test, etc. The results showed that test-retest reliability of the overall scale was 0.78, and test-retest reliability and internal consistency alpha for most domains were higher than 0.70; correlation and factor analysis demonstrated good construct validity; criterion-related validity were confirmed given FACT-L and QLQ-LC43 (QLQ-C30 plus QLQ-LC13) as the criterions; statistically significant changes were found for each domain and the overall scale with standardized response mean SRM being greater than 0.80 except for the social function domain. We conclude that the QLICP-LU can be used to measure QOL for patients with lung cancer with better validity, reliability and responsiveness in China.

[Development of the general module of the system of quality of life instruments for cancer patients: responsiveness analysis].

BACKGROUND & OBJECTIVE: The general module of the system of quality of life instruments for cancer patients, QLICP-GM, has been developed and its reliability and validity has been evaluated by us. This study was to analyze its responsiveness. METHODS: The quality of life of 600 patients with 5 kinds of cancer was measured using QLICP-GM before and after treatment. Traditional significance tests with some indices, such as effect size, standardized response mean and equivalence, were applied to evaluate responsiveness. RESULTS: The quality of life score changed significantly after treatment on 3 domains: physical function, psychologic function, and general symptoms and side effects. The standardized response mean of the overall instrument ranged from 0.16 to 0.67. Equivalence test showed no equivalence on quality of life score changes of these domains and the overall instrument. CONCLUSION: QLICP-GM possesses reasonable responsiveness and can be used in clinical measurement of quality of life for cancer patients.

[Development of the general module of the system of quality of life instruments for cancer patients: reliability and validity analysis].

BACKGROUND & OBJECTIVE: The general module of the system of quality of life instruments for cancer patients (QLICP-GM) has been developed by us, but its psychologic properties need to be evaluated. This study was to evaluate the reliability and validity of QLICP-GM. METHODS: The QOL data of 600 patients with lung cancer, breast cancer, colorectal cancer, gastric cancer, and head and neck cancer were analyzed by paired t-tests, correlation analysis, equivalence tests, and structural equation models to evaluate QLICP-GM. RESULTS: The test-retest reliability for all domains and the overall scale was above 0.85. Internal consistency alpha values for all domains except social function domain were above 0.70. The alpha value and split-half reliability of the overall scale were 0.88 and 0.93, respectively. Correlation analyses and structural equation models displayed good construction validity of the scale. It also showed good criterion-related validity when FACT-G was used as the criterion. CONCLUSION: QLICP-GM can be used to measure QOL for cancer patients with good reliability and validity.

[Development of the general module of the system of quality of life instruments for cancer patients: item selection and structure of the general module].

BACKGROUND & OBJECTIVE: The researches on quality of life (QOL) of cancer patients are concerned worldwide. Two QOL instrument systems for cancer patients, Functional Assessment of Cancer Therapy (FACT) and Quality of Life Questionnaires (QLQ), have been developed and used widely in the US and Europe, but no one has been developed in China. This study was to develop the general module of the system of quality of life instruments for cancer patients (QLICP-GM) used in China. METHODS: The structured group (nominal group and focus group) methods and the qualitative combined quantitative theory and methodology was used to develop rating scales. The items were preliminarily screened, evaluated, and modified. The QOL data of 448 cancer patients were analyzed by the methods of coefficient of variation, factor analysis, clustering analysis, and correlation analysis. RESULTS: QLICP-GM was developed and evaluated. The module, including 32 items, was consisted of 4 domains: physical function, psychologic function, social function, and general symptoms and side effects. CONCLUSION: QLICP-GM possesses a reasonable content validity because it reflects the WHO definition and connotation of QOL, and common issues of cancer patients as well.