Massive malignant phyllodes tumor accompanied by anemia and ulceration in the breast: A case report.

Large malignant breast phyllodes tumors are uncommon in clinical settings. Here, we report such a case to provide a reference for clinical work. A 48-year-old woman identified a lump in her right breast, which eventually grew up to 25 cm × 10 cm and began to rapidly bleed and ulcerate within 3 months. The patient had visible signs of anemia and significant emaciation as a result of the tumor's wasting effect and the protracted course of the disease. The patient underwent a modified radical mastectomy on the right breast. The pathology results obtained after surgery revealed a malignant phyllodes tumor. No adjuvant therapy, such as chemotherapy or radiation, was administered. The patient had no symptoms of tumor recurrence and complications from the surgery after a follow-up of 9 months.

Manganese self-boosting hollow nanoenzymes with glutathione depletion for synergistic cancer chemo-chemodynamic therapy.

Chemodynamic therapy (CDT) has outstanding potential as a combination therapy to treat cancer. However, the effectiveness of CDT in the treatment of solid tumors is limited by the overexpression of glutathione (GSH) in the tumor microenvironment (TME). GSH overexpression diminishes oxidative stress and attenuates chemotherapeutic drug-induced apoptosis in cancer cells. To counter these effects, a synergistic CDT/chemotherapy cancer treatment, involving the use of a multifunctional bioreactor of hollow manganese dioxide (HMnO2) loaded with cisplatin (CDDP), was developed. Metal nanoenzymes that can auto-degrade to produce Mn2+ exhibit Fenton-like, GSH-peroxidase-like activity, which effectively depletes GSH in the TME to attenuate the tumor antioxidant capacity. In an acidic environment, Mn2+ catalyzed the decomposition of intra-tumor H2O2 into highly toxic ·OH as a CDT. HMnO2 with large pores, pore volume, and surface area exhibited a high CDDP loading capacity (>0.6 g-1). Treatment with CDDP-loaded HMnO2 increased the intratumor Pt-DNA content, leading to the up-regulation of γ-H2Aχ and an increase in tumor tissue damage. The decreased GSH triggered by HMnO2 auto-degradation protected Mn2+-generated ·OH from scavenging to amplify oxidative stress and enhance the efficacy of CDT. The nanoenzymes with encapsulated chemotherapeutic agents deplete GSH and remodel the TME. Thus, tumor CDT/chemotherapy combination therapy is an effective therapeutic strategy.

Analysis of the clinical efficacy of visualization of percutaneous endoscopic lumbar discectomy combined with annulus fibrosus suture in lumbar disc herniation.

The objective of this study is to compare the clinical effectiveness of visualization of percutaneous endoscopic lumbar discectomy (VPELD) combined with annulus fibrosus suture technique and simple percutaneous endoscopic lumbar discectomy (PELD) technique in the treatment of lumbar disc herniation. A retrospective analysis was conducted on 106 cases of lumbar disc herniation treated with foraminoscopic technique at our hospital from January 2020 to February 2022. Among them, 33 cases were treated with VPELD combined with annulus fibrosus suture in group A, and 73 cases were treated with PELD in group B. The preoperative and postoperative visual analogue scale (VAS), functional index (Oswestry Disability Index, ODI), healing of the annulus fibrosus, intervertebral space height, and postoperative recurrence were recorded and compared between the two groups. All patients underwent preoperative and postoperative MRI examinations, and the average follow-up period was 12 ± 2 months. Both groups showed significant improvements in postoperative VAS and ODI scores compared to the preoperative scores (P < 0.05), with no statistically significant difference between the groups during the same period (P > 0.05). There was no significant decrease in intervertebral space between the two groups after surgery (P > 0.05). Group A showed significantly lower postoperative recurrence rate and better annulus fibrosus healing compared to group B (P < 0.05). The VPELD combined with annulus fibrosus suture technique is a safe, feasible, and effective procedure for the treatment of lumbar disc herniation. When the indications are strictly adhered to, this technique can effectively reduce the postoperative recurrence rate and reoperation rate. It offers satisfactory clinical efficacy and can be considered as an alternative treatment option for eligible patients.

CircHSPB6 Promotes Tumor-Associated Macrophages M2 Polarization and Infiltration to Accelerate Cell Malignant Properties in Lung Adenocarcinoma by CCL2.

Circular RNAs (circRNAs) are reported to be involved in the tumorigenesis of lung adenocarcinoma (LUAD). Here, this study focused on studying the function and mechanism of circHSPB6 in LUAD progression. Levels of genes and proteins were tested using qRT-PCR and western blotting analyses. The 5-ethynyl-2'-deoxyuridine (EdU), colony formation, flow cytometry, and transwell assays were adopted for in vitro assays. In vivo assay was conducted using mouse xenograft models. The binding between let-7a-2-3p and circHSPB6 or CCL2 was validated using RIP and dual-luciferase reporter assays. The M2 polarization of tumor-associated macrophages (TAMs) was analyzed by flow cytometry. LUAD tissues and cells showed high circHSPB6 expression, knockdown of circHSPB6-suppressed LUAD cell proliferation, migration, invasion, and induced cell apoptosis in vitro, as well as hindered tumor growth in vivo. Mechanistically, circHSPB6/let-7a-2-3p/CCL2 forms a feedback loop. CircHSPB6 could regulate CCL2 expression via sponging let-7a-2-3p. Further rescue assays showed that the effects of circHSPB6 silencing on LUAD cells were reversed by let-7a-2-3p inhibition or CCL2 overexpression. Moreover, circHSPB6 promoted the M2 polarization and infiltration of TAMs by CCL2. Functionally, circHSPB6 knockdown in A549 and H1299 cells inhibited TAM M2 polarization and then suppressed cell proliferation, migration, invasion, and emergency medical technicians (EMT) progression, while these effects were reversed by CCL2 up-regulation CircHSPB6 induced TAM M2 polarization to promote LUAD cell proliferation, migration, invasion, and EMT progression through let-7a-2-3p/CCL2 axis.

Asthma aggravates alzheimer's disease by up-regulating NF- κB signaling pathway through LTD4.

Clinical studies have shown that asthma is a risk factor for dementia or Alzheimer's disease (AD). To investigate whether asthma aggravates AD in APP/PS1 mice and explore the potential mechanisms, an asthma model was established using six-month-old APP/PS1 mice, and montelukast was used as a therapeutic agent in APP/PS1 mice with asthma. The Morris water maze test showed that asthma aggravates spatial learning and memory abilities. Asthma also upregulates the NF-κB inflammatory pathway in APP/PS1 mice and promotes the expression of beta-site amyloid precursor protein cleaving enzyme 1 (BACE1), amyloid-ß (Aß) deposition, neuronal damage, synaptic plasticity deficiency, activation of microglia and astrocytes. The level of LTD4 and its receptor CysLT1R in the hippocampus of APP/PS1 mice after the asthma modeling was established was higher than that in APP/PS1 mice, suggesting that asthma may affect the pathology of AD through LTD4 and its receptor Cys-LT1R. Montelukast ameliorates these pathological changes and cognitive impairment. These results suggest that asthma aggravates AD pathology and cognitive impairment of APP/PS1 mice via upregulation of the NF-κB inflammatory pathway, and montelukast ameliorates these pathological changes.

[Clinical study of percutaneous double-segment lengthened sacroiliac screws internal fixation via three-dimensional navigation technology in treatment of Denis type â ¡ and â ¢ sacral fractures].

Objective: To investigate the effectiveness of percutaneous double-segment lengthened sacroiliac screws internal fixation assisted by three-dimensional (3D) navigation technology in treatment of Denis type Ⅱ and Ⅲ sacral fractures. Methods: A clinical data of 45 patients with the Denis type Ⅱ and Ⅲ sacral fractures admitted between January 2017 and May 2020 was retrospectively analyzed. There were 31 males and 14 females, with an average age of 48.3 years (range, 30-65 years). The pelvic fractures were all high energy injuries. According to the Tile classification standard, there were 24 cases of type C1, 16 cases of type C2, and 5 cases of type C3. The sacral fractures were classified as Denis type Ⅱ in 31 cases and type Ⅲ in 14 cases. The interval between injury and operation was 5-12 days (mean, 7.5 days). The lengthened sacroiliac screws were implanted in S 1 and S 2 segments respectively under the assistance of 3D navigation technology. The implantation time of each screw, the intraoperative X-ray exposure time, and the occurrence of surgical complications were recorded. After operation, the imaging reexamination was used to evaluate the screw position according to Gras standard and the reduction quality of sacral fractures according to Matta standard. At last follow-up, the pelvic function was scored with Majeed scoring standard. Results: The 101 lengthened sacroiliac screws were implanted with the assisting of 3D navigation technology. The implantation time of each screw was 37.3 minutes on average (range, 30-45 minutes), and the X-ray exposure time was 46.2 seconds on average (range, 40-55 seconds). All patients had no neurovascular or organ injury. All incisions healed by first intention. The quality of fracture reduction was evaluated according to Matta standard as excellent in 22 cases, good in 18 cases, and fair in 5 cases, and the excellent and good rate was 88.89%. The screw position was evaluated according to Gras standard as excellent in 77 screws, good in 22 screws, and poor in 2 screws, and the excellent and good rate was 98.02%. All patients were followed up 12-24 months (mean, 14.6 months). All fractures healed and the healing time was 12-16 weeks (mean, 13.5 weeks). Pelvic function was evaluated according to Majeed scoring standard as excellent in 27 cases, good in 16 cases, fair in 2 cases, and the excellent and good rate was 95.56%. Conclusion: Percutaneous double-segment lengthened sacroiliac screws internal fixation for the treatment of Denis type Ⅱ and Ⅲ sacral fractures is minimally invasive and effective. With the assistance of 3D navigation technology, the screw implantation is accurate and safe.

Antioxidant Effects of Rhodoxanthin from Potamogeton crispus L. on H2 O2 -Induced RAW264.7 Macrophages Cells.

Potamogeton crispus L. (P. crispus) is the type of a widely distributed perennial herbs, which is rich in rhodoxanthin. In this research work, five antioxidant indexes in vitro were selected to study the antioxidant activity of rhodoxanthin from P. crispus (RPC). A model of hydrogen peroxide (H2 O2 ) -induced oxidative damage in RAW264.7 cells was established to analyze the antioxidant effect and potential mechanism of RPC. The levels of ROS, MDA and the activities of oxidation related enzymes by H2 O2 were determined by enzyme linked immunosorbent assay (ELISA). The mRNA expression of Nrf-2, HO-1, SOD1 and SOD2 was measured by qRT-PCR assay. According to the results, RPC had free radical scavenging ability for 2, 2-diphenyl-1-trinitrohydrazine (DPPH), 2,2'-azinobis(3-ethylbenzo-thiazoline-6-sulfonic acid radical ion) (ABTS), hydroxyl radical and superoxide anion. RPC significantly decreased the level of MDA and ROS and LDH activity, while increased GSH level and activities of SOD, GSH-Px and CAT. It was showed that RPC could increase the mRNA expression of Nrf-2, HO-1, SOD1 and SOD2 in RAW264.7 cells in a dose-dependently manner. In summary, RPC treatment could effectively attenuate the H2 O2 -induced cell damage rate, and the mechanism is related to the reduction of H2 O2 induced oxidative stress and the activation of Nrf-2 pathway.

Digital versus slit-beam marking for toric intraocular lenses in cataract surgery.

PURPOSE: To compare the visual outcomes of digital and slit-beam manual marking for toric intraocular lenses (IOL) in cataract surgery. SETTING: Single-center, Beijing Tongren Hospital, China. DESIGN: Retrospective study. METHODS: All patients with cataracts and regular corneal astigmatism greater than 0.75 diopters (D) underwent cataract surgery and astigmatism correction between June 2019 and June 2020. To mark the target axis of the toric IOL and the location of the incision, intraoperative digital marking was used by Callisto eye image-guided system in one group, while preoperative manual slit-beam marking was used in the other group. Uncorrected and best-corrected spectacle visual acuity, refraction, toric IOL axis, total higher order aberrations, coma, spherical aberration, and trefoil were evaluated at 1, 4, and 12 weeks postoperatively. RESULTS: Seventy-two eyes of 58 patients were included. At 3 months after surgery, the mean residual refractive cylinder was 0.42 ± 0.45D in the digital group and 0.39 ± 0.40D in the manual group (P = 0.844). There were no significant differences between groups in spherical equivalent refraction, uncorrected and best-corrected spectacle visual acuity, or the parameters of vector analysis. All toric IOL alignment errors were within 10° of the intended axis, and among them, about 42% of eyes in the digital group and 61% of eyes in the manual group had a rotation of 0-2° (P = 0.038). Trefoil in the manual group decreased postoperatively compared with the digital group (P = 0.012). Other aberration analyses did not reveal any statistical differences between groups. CONCLUSIONS: Accurate slit-beam manual marking and digital image-guided marking are equally effective for toric IOL alignment.

Comparison of Visual Outcomes Between Toric Intraocular Lenses and Clear Corneal Incisions to Correct Astigmatism in Image-Guided Cataract Surgery.

Purpose: To compare the astigmatism correction effects of toric intraocular lenses (IOL) and clear corneal incisions during image-guided cataract surgery. Methods: All patients with regular corneal astigmatism of 0.75-1.5 D underwent cataract surgery and astigmatism correction using the Callisto eye image-guided system. One group had implantation of an AcrySof toric IOL. Another group had implantation of aspheric IOL with 3.0 mm single clear corneal incision (SCCI) on the steep axis. Uncorrected and best-corrected spectacle visual acuity, refraction, and toric IOL axis were evaluated at 1, 4, and 12 weeks postoperatively. Results: Sixty-eight eyes of 68 patients were included. The mean residual refractive cylinder was 0.34 ± 0.40 D in the toric group and 0.64 ± 0.57 D in the SCCI group. There were no significant differences in residual refractive cylinder, spherical equivalent, uncorrected distance visual acuity (UDVA), and best-corrected spectacle visual acuity (BCSVA) between groups. The percentage of the residual cylinder within ± 0.50 D was 75 and 56% for toric and SCCI cases, respectively (p > 0.1). The mean surgical induced astigmatism vector was 0.61 ± 0.29 D in the SCCI group and 1.04 ± 0.38 D in the toric group. The mean magnitude of error was negative (-0.54 ± 0.48 D) and the correction index was <1.0 (p < 0.05) in SCCI group. At 3 months, all toric IOL alignment errors were within 5 degrees from the intended axis. Conclusions: Both toric IOL and SCCI can correct low and medium astigmatism effectively with the help of a precise image-guided system.

Multi-ligand modified PC@DOX-PA/EGCG micelles effectively inhibit the growth of ER+, PR+ or HER2+ breast cancer.

Breast cancer is one of the most common cancers in the world with tumor heterogeneity. Currently, cancer treatment mainly relies on surgical intervention, chemotherapy, and radiotherapy, for which the side effects, drug resistance and cost need to be resolved. In this study, we develop a natural medicine targeted therapy system. Phosphatidylcholine (PC), doxorubicin (DOX), procyanidin (PA), and epigallocatechin gallate (EGCG) are assembled and PC@DOX-PA/EGCG nanoparticles (NPs) are obtained. In addition, the HER2, ER and PR ligands were grafted on the surface of the NPs to acquire the targeted nanoparticles NP-ER, NP-ER-HER2, and NP-ER-HER2-PR. The physicochemical properties of the nanoparticles were detected and it was found that the nanoparticles are spherical and less than 200 nm in diameter. Furthermore, in vitro and in vivo results indicate that the nanoparticles can target BT-474, MCF-7, EMT-6, and MDA-MB-231 breast cancer cells, effectively inhibiting the growth of the breast cancer cells. In short, this research will provide some strategies for the treatment of heterogeneous breast cancer.

Construction and Evaluation of a High-Frequency Hearing Loss Screening Tool for Community Residents.

Early screening and detection of individuals at high risk of high-frequency hearing loss and identification of risk factors are critical to reduce the prevalence at community level. However, unlike those for individuals facing occupational auditory hazards, a limited number of hearing loss screening models have been developed for community residents. Therefore, this study used lasso regression with 10-fold cross-validation for feature selection and model construction on 38 questionnaire-based variables of 4010 subjects and applied the model to training and testing cohorts to obtain a risk score. The model achieved an area under the curve (AUC) of 0.844 in the model validation stage and individuals' risk scores were subsequently stratified into low-, medium-, and high-risk categories. A total of 92.79% (1094/1179) of subjects in the high-risk category were confirmed to have hearing loss by audiometry test, which was 3.7 times higher than that in the low-risk group (25.18%, 457/1815). Half of the key indicators were related to modifiable contexts, and they were identified as significantly associated with the incident hearing loss. These results demonstrated that the developed model would be feasible to identify residents at high risk of hearing loss via regular community-level health examinations and detecting individualized risk factors, and eventually provide precision interventions.

MicroRNA­93 knockdown inhibits acute myeloid leukemia cell growth via inactivating the PI3K/AKT pathway by upregulating DAB2.

Acute myeloid leukemia (AML) is associated with a poor prognosis in elderly adults and currently lacks optimal treatment strategies. MicroRNAs (miRNAs or miRs) have increasingly been reported to be associated with AML progression; however, the mechanisms of action of miR­93 in AML with the involvement of disabled 2 (DAB2) are currently unknown. In the present study, miR­93 expression was assessed in patients with AML and in AML cell lines. The association between miR­93 expression and the pathological characteristics of patients with AML was analyzed. AML cells were then transfected to knockdown or overexpress miR­93 in order to elucidate its function in AML progression. The target gene of miR­93 was assessed using a dual­luciferase reporter gene assay. The expression levels of miR­93, DAB2 and phosphatidylinositol 3­kinase (PI3K)/protein kinase B (AKT) pathway­related proteins were measured and in vivo experiments were conducted to confirm the results. It was observed that miR­93 was highly expressed in patients with AML and in AML cells. The knockdown of miR­93 in HL­60 cells inhibited AML cell proliferation and resistance to apoptosis, while the overexpression of miR­93 in THP­1 cells led to contrasting results. Moreover, miR­93 targeted DAB2 to inactivate the PI3K/AKT pathway, and the overexpression of DAB2 reversed the effects of miR­93 on THP­1 cell growth. Tumor volume, tumor weight, and the positive expression of Ki67, survivin and p53 were increased in THP­1 cells overexpressing miR­93. On the whole, the present study demonstrates that miR­93 is highly expressed in AML cells, and that the suppression of miR­93 inhibits AML cell growth by targeting DAB2 and inhibiting the PI3K/AKT pathway.

Definitive Simultaneous Integrated Boost Versus Conventional-Fractionated Intensity Modulated Radiotherapy for Patients With Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Analysis.

BACKGROUND: The aim of this study was to compare the effects of simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) and conventional fractionated-IMRT (CF-IMRT) for patients with esophageal squamous cell carcinoma (ESCC). METHODS: The data of 1173 patients treated with either CF-IMRT or SIB-IMRT for a curative intent from 2005 to 2016 were retrospectively reviewed. Propensity score matching (PSM) was used to create a well-balanced cohort of 687 patients at 1:2 ratio (237 patients in SIB-IMRT group and 450 patients in CF-IMRT group). Overall survival (OS), progression-free survival (PFS), recurrence pattern, and toxicity profiles were evaluated and compared between the two groups after PSM. RESULTS: After a median follow-up time of 42.3 months (range, 3.0-153.2 months) for surviving patients, survival results were comparable in the two groups. After PSM, the 1-year, 2-year and 4-year OS rates in the SIB-IMRT and CF-IMRT groups were 70.0% vs. 66.4%, 41.9% vs. 41.7% and 30.2% vs. 27.6%, respectively (p = 0.87). The 1-year, 2-year and 4-year PFS rates were 48.4% vs. 49.1%, 31.2% vs. 29.4%, and 26.1% vs. 17.9%, respectively (p = 0.64). Locoregional recurrence (p = 0.32) and distant metastasis (p = 0.54) rates were also comparable between two groups. The toxicity profile was similar in the two groups. Multivariate analyses in the matched samples showed that female, concurrent chemotherapy and earlier clinical stage were independently associated with longer OS and PFS. CONCLUSIONS: SIB-IMRT appears to be equivalent to CF-IMRT in treatment efficacy and safety, and could become an alternative option for definitive radiotherapy of ESCC.

MiR-335-3p inhibits cell proliferation and induces cell cycle arrest and apoptosis in acute myeloid leukemia by targeting EIF3E.

Here, we aimed to investigate the biological roles and the regulatory mechanisms of miR-335-3p in acute myeloid leukemia (AML). We first found miR-335-3p was significantly downregulated in blood samples from leukemia patients and cell lines using reverse transcription quantitative polymerase chain reaction. Through CCK-8 assay and flow cytometry, we observed that miR-335-3p overexpression significantly inhibited cell proliferation and induced cell cycle G0/G1 arrest and apoptosis in AML cell lines (THP-1 and U937). Moreover, miR-335-3p directly targets EIF3E and negatively regulated its expression. More importantly, EIF3E overexpression reversed the effects of miR-335-3p on cell proliferation, G1/S transition, and apoptosis. Furthermore, miR-335-3p overexpression obviously downregulated the expression of CDK4, Cyclin D1, and Bcl-2, while upregulated the expression of p21 and Bad, which were significantly rescued by the cotransfection of pcDNA3.1-EIF3E. Collectively, our study proposes that miR-335-3p/EIF3E axis could be a promising therapeutic target to mitigate the progression of AML.

Concurrent chemoradiotherapy versus radiotherapy alone for patients with locally advanced esophageal squamous cell carcinoma in the era of intensity modulated radiotherapy: a propensity score-matched analysis.

BACKGROUND: To investigate the survival benefit of concurrent chemoradiotherapy (CCRT) for patients with locally advanced esophageal squamous cell carcinoma (ESCC) during the years of intensity-modulated radiotherapy (IMRT). METHODS: Medical records of 1089 patients with ESCC who received IMRT from January 2005 to December 2017 were retrospectively reviewed. A total of 617 patients received CCRT, 472 patients received radiotherapy (RT) alone. Propensity score matching (PSM) method was used to eliminate baseline differences between the two groups. Survival and toxicity profile were evaluated afterward. RESULTS: After a median follow-up time of 47.9 months (3.2-149.8 months), both overall survival (OS) and progression-free survival (PFS) of the CCRT group were better than those of the RT alone group, either before or after PSM. After PSM, the 1-, 3-, and 5-year OS of RT alone and CCRT groups were 59.0% versus 70.2%, 27.7% versus 40.5% and 20.3% versus 33.1%, respectively (p < 0.001). The 1-, 3-, and 5-year PFS were 39.4% versus 49.0%, 18.3% versus 30.4% and 10.5% versus 25.0%, respectively (p < 0.001). The rates of ≥ grade 3 leukopenia and radiation esophagitis in the CCRT group were higher than that of RT alone group (p < 0.05). There was no significant difference in the probability of radiation pneumonitis between the two groups (p = 0.167). Multivariate Cox analysis indicated that female, EQD2 ≥60 Gy and concurrent chemotherapy were favorable prognostic factors for both OS and PFS. CONCLUSIONS: Concurrent chemotherapy can bring survival benefits to patients with locally advanced ESCC receiving IMRT. For patients who cannot tolerate concurrent chemotherapy, RT alone is an effective alternative with promising results.

The Clinical and Molecular Characteristics of Sex-Determining Region Y-Box 2 and its Prognostic Value in Breast Cancer: A Systematic Meta-Analysis.

OBJECTIVE: Transcription factor SOX2 (sex-determining region Y-box 2) has a crucial role in the maintenance of the stem cell state. However, current evidence regarding the role of SOX2 in breast cancer is conflicting. We conducted this meta-analysis to clarify the association of SOX2 expression with clinical and molecular features and its prognostic effect on breast cancer. METHODS: All relevant articles were searched using electronic databases. The pooled odds ratios (ORs) or hazard ratios (HRs: multivariate Cox survival analysis) with their 95% confidence intervals (CIs) were calculated. RESULTS: A final total of 18 studies containing 3,080 patients with breast cancer were included. SOX2 protein expression was not related to age, menopausal status, lymph node metastasis, lymphovascular invasion, molecular estrogen receptor status, progesterone receptor status, triple-negative status, and the overall survival in breast cancer, but was closely associated with advanced tumor grade (grade 3 vs. grade 1-2: OR = 2.74, 95% CI = 1.85-4.06, p < 0.001), clinical stage (stage 3-4 vs. stage 0-2: OR = 2.46, 95% CI = 1.37-4.40, p = 0.002), pT stage (T stage 2-4 vs. T stage 1: OR = 1.52, 95% CI = 1.07-2.17, p = 0.019), molecular human epidermal growth factor receptor 2 (HER2) status (positive vs. negative: OR = 1.61, 95% CI = 1.21-2.14, p = 0.001), epidermal growth factor receptor (EGFR) status (positive vs. negative: OR = 2.21, 95% CI = 1.13-4.33, p = 0.021), and worse disease-free survival (DFS) (HR = 2.66, 95% CI = 1.20-5.91, p = 0.016) of breast cancer. CONCLUSIONS: SOX2 expression is correlated with breast cancer progression, HER2 status, and EGFR status, and may be an independent prognostic marker for predicting poor DFS.

Ultrasound-assisted Percutaneous Vertebroplasty in Upper and Mid-thoracic Osteoporotic Fracture.

Osteoporotic vertebral compression fracture (OVCF) is a common disease among the elderly individuals. With the aging of the population development, the incidence of OVCF is increasing. Cementation of vertebral body like percutaneous vertebroplasty (PVP) is a minimally invasive and effective treatment. However, the application in upper and mid-thoracic vertebrae is rare for poor fluoroscopy view caused by osteopenia vertebral body itself and scapula, sternum block. Inaccurate puncture and high radiation exposure of PVP in upper and mid-thoracic vertebrae still challenge surgeons. Owing to the ability of musculoskeletal ultrasound in revealing the clear real-time view of soft tissues and skeleton, the authors use intraoperative ultrasound-guided PVP to treat eight patients with upper or mid-thoracic vertebra body OVCFs, which has been tested to be a safe, feasible and satisfied technique after the operation and follow-up. To the authors' knowledge, this technique has not been reported elsewhere.   Key Words: Ultrasound, Percutaneous vertebroplasty, Osteoporotic vertebral compression fracture, Upper and mid-thoracic vertebra body.

Choline phosphate lipid insertion and rigidification of cell membranes for targeted cancer chemo-immunotherapy.

To prevent tumor reproduction and metastasis, a method to modify the membranes of cancer cells was designed to suppress their vitality. A phosphatidyl choline reversed choline phosphate lipid (CP-Lip) was synthesized and modified with a PD-L1 antibody (CP-αPDL). Drug-loaded nanoparticles of CP-Lip/CP-αPDL (Dox@tCP-Lipos) could be selectively attached to melanoma cells, thus causing CP-Lip to be inserted and to interact strongly with the cell membrane, which largely reduced the fluidity and functionality of the membrane. As a result, the metabolism, reproduction, and migration of melanoma cells were proved to be weakened by CP-Lip and the tumor was 100% suppressed after treatment with Dox@tCP-Lipos.

Engineering Cu2-xS-conjugated upconverting nanocomposites for NIR-II light-induced enhanced chemodynamic/photothermal therapy of cancer.

The integration of chemodynamic therapy (CDT) and photothermal therapy (PTT) has played a huge role in improved anticancer treatments. Here, a novel multifunctional nanoplatform based on Cu2-xS conjugated NaYF4:Yb/Er@NaYF4:Yb upconversion nanoparticles (UCNPs) was proposed and designed. In the UCNPs-Cu2-xS nanocomposites, UCNPs with excellent luminescent properties and a high X-ray attenuation coefficient can serve as an upconversion luminescence (UCL) and computer tomography (CT) imaging contrast agent; meanwhile, Cu(II) in the Cu2-xS nanodots enables the nanocomposites to have a magnetic resonance imaging (MRI) ability owing to the presence of unpaired electrons. Moreover, the Cu2-xS nanodots with a strong absorbance in the NIR II biowindow not only could be employed as a stable photothermal agent under NIR laser irradiation, but also could be used as a photothermal-enhanced Fenton nanocatalyst to respond to over-expressed H2O2 in the tumor microenvironment (TME) and generate toxic hydroxyl radicals (˙OH) to effectively kill cancer cells. Furthermore, the UCNPs-Cu2-xS nanocomposites possess negligible cytotoxicity and a high photothermal conversion efficiency (43.8%) in the NIR-II biowindow (1064 nm), indicating that they possess great potential for the UCL/CT/MR multi-modal imaging guided synergistic enhanced CDT/PTT of cancer.