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Chromosomal mosaicism (CM) is a common phenomenon in preimplantation genetic testing (PGT). In embryos with CM, genetic contents of trophoblastic ectodermal (TE) cells may be different from that of the inner cell mass (ICM) which will develop into the fetus. Embryos with low mosaic proportion could give rise to healthy live births after transplantation, but are accompanied with high pregnancy risks such as high abortion rate. In order to provide a more comprehensive understanding for CM embryos, this article has systematically summarized the recent progress of research on the definition, mechanism, classification, PGT techniques, self-correction mechanism, transplantation outcome and treatment principles for CM embryos.
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Pregnancy , Female , Humans , Preimplantation Diagnosis/methods , Mosaicism , Aneuploidy , Genetic Testing/methods , BlastocystABSTRACT
Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.
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Objective@#To investigate the potential application values of screening on breast cancer, using the single-nucleotide polymorphisms (SNPs) that were identified from the genome- wide association studies (GWASs).@*Methods@#Two million Chinese women aged 35-69 years were simulated, based on both age distributions, age-specific incidence rates of breast cancer and the distribution of known risk factors, in 2013. Twenty-three SNPs identified from GWAS were further simulated. Both genetic-related risks explained by each SNPs and the improvement on the risks under reclassification, were used to select SNPs for the prediction on breast cancer among the targeted high-risk population. Further analyses were conducted to investigate the following items as: improvements on detection rates of breast cancer among the high-risk populations, areas under the curve (AUC) and the odds ratio (OR) among women at high risk.@*Results@#A total of 12 SNPs were eligible for targeting the high-risk population of breast cancer. When high-risk populations were defined as women whose predicted risks were higher than the 95th predicted risk of the whole population, the detection rate (146.99/100 000) among high-risked women predicted by 12 SNPs would be significantly lower than 177.46/100 000, which was predicted by the known risk factors (P<0.001), among the high-risked women. Among those women at high risk, the detection rate (229.00/100 000) predicted by integrating known risk factors and 12 SNPs was significantly higher than that predicted by known risk factors (P<0.001). Also, the AUC increased from 64.4% to 67.8% (P<0.001), and the OR of increased from 3.32 to 4.33, predicted by integrating known risk factors and 12 SNPs, for women at high risk on breast cancer.@*Conclusion@#Targeted SNPs that were identified from genome- wide association studies could be used to improve the detection rates as well as the overall accuracy of risk prediction so as to identify the potential high-risk women on breast cancer before carrying on the screening program.
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Screening has been always considered as a double-edged sword. Cancer screening could save lives in some cases, however, in other cases, it might also turn people into overdiagnosis. Overdiagnosis is the diagnosis of cancer that will never cause symptoms or death during a patient's lifetime. Therefore, overdiagnosis might lead to unnecessary treatments and lifetime surveillance, and then increase economic burden and psychological burden. In this review, we focus on how to correctly evaluate the overdiagnosis rate, and how to avoid or reduce the harms caused by overdiagnosis in the future according to the reasons associated with overdiagnosis. After systematically reviewing the previous studies, we will try to identify the potential reasons associated with overdiagnosis in breast cancer screening with mammography, address how to correctly evaluate the overdiagnosis rate, and finally provide some suggestions to reduce the overdiagnosis.
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Screening has been always considered as a double-edged sword. Cancer screening could save lives in some cases, however, in other cases, it might also turn people into overdiagnosis. Overdiagnosis is the diagnosis of cancer that will never cause symptoms or death during a patient's lifetime. Therefore, overdiagnosis might lead to unnecessary treatments and lifetime surveillance, and then increase economic burden and psychological burden. In this review, we focus on how to correctly evaluate the overdiagnosis rate, and how to avoid or reduce the harms caused by overdiagnosis in the future according to the reasons associated with overdiagnosis. After systematically reviewing the previous studies, we will try to identify the potential reasons associated with overdiagnosis in breast cancer screening with mammography, address how to correctly evaluate the overdiagnosis rate, and finally provide some suggestions to reduce the overdiagnosis.
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Objective To evaluate the efficacy of ultrasound-guided continuous brachial plexus block for analgesia after fixation of upper extremity fractures in the pediatric patients.Methods Sixty American Society of Anesthesiologists physical status Ⅰ pediatric patients of both sexes,aged 3-10 yr,weighing 13-46 kg,with body height of 97-152 cm,scheduled for open reduction and internal fixation of distal humeral fractures,were selected and divided into 2 groups (n =30 each) using a random number table:intravenous analgesia group (group Ⅴ) and continuous brachial plexus block group (group B).Surgery was completed under brachial plexus block combined with general anesthesia in the two groups.At the end of surgery,patient-controlled intravenous analgesia was used in group Ⅴ,and continuous brachial plexus block was performed with 0.1％ ropivacaine 250 ml (background infusion 0.1 ml · kg-1 · h-1,bolus dose 0.2 ml/kg,lockout interval 30 min) in group B.Tramadol was given as rescue analgesic when necessary.Ramsay sedation scores were assessed and recorded at 2,4,8,12,24,36 and 48 h after surgery,and the development of over-sedation was recorded.The require,nent for rescue analgesics and development of respiratory depression,dizziness,nausea and vomiting,pruritus and urinary retention during analgesia were recorded.The development of adverse reactions such as vascular and nerve injury,local hematoma and pneumothorax was recorded in group B.Family's satisfaction with analgesia was assessed and scored.Results Compared with group Ⅴ,Ramsay sedation scores at 2-12 h after surgery,the incidence of oversedation,nausea and dizziness and requirement for tramadol were significantly decreased (P＜0.05),and no significant change was found in the degree of family's satisfaction with analgesia in group B (P＞ 0.05).The adverse reactions such as vascular and nerve injury,local hematoma or pneumothorax were not found in group B.Conclusion Ultrasound-guided continuous brachial plexus block can be safely and effectively used for analgesia after fixation of upper extremity fractures in the pediatric patients.
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Objective To investigate the expression of Vav1 in gastric cancer(GC), and analyze its potential relevance to clinicopathological characteristics and prognostic significance in GC patients. Methods The mRNA expression level of Vav1 was detected by real-time quantitative PCR in GC cell lines (HGC-27,SGC7901 and MGC803) and normal gastric mucosa cell line (GES-1). In addition, the protein expression of Vav1 was analyzed by immunohistochemistry in formalin-fixed samples from 105 GC patients. The associations between clinical pathological features and Vav1 protein expression were evaluated in GC patients. Kaplan-Meier method and Cox regression analysis were used to analyze the related factors influencing the prognosis of GC. Results The mRNA expression levels of Vav1 were significantly higher in GC cell lines (HGC-27, SGC7901, MGC803) than those in normal gastric mucosa cell line (GES-1, P<0.05). The positive expression of Vav1 in GC tissues was correlated with diameter of tumor and lymph node metastasis (P<0.05). The univariate analysis showed that size of tumor, degree of differentiation, serosal invasion, lymph node metastasis and Vav1 expression were significantly related with prognosis of GC (P<0.05). Results of Cox regression showed that tumor invasion depth (HR=2.764, 95%CI 1.316-5.817, P=0.007), lymph node metastasis (HR=1.298, 95%CI 1.098-1.534, P=0.002) and Vav1 expression (HR=2.577, 95%CI 1.066-3.946, P=0.006) were the risk factors affecting prognosis of patients with gastric cancer. Conclusion Vav1 performs important role in the aggressiveness of GC, and Vav1 may serve as a novel prognostic factor in GC.
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Objective To identify snoRNA, which may be related to prognosis of gastric cancer. Methods Ninetygastric cancer patients who diagnosed at Tianjin Medical University Cancer Institute and Hospital were randomly collected in this study, and their clinical data were followed up. A total of 405 snoRNA expression profiles were analyzed in 90 gastric cancer patients. Patients were classified aslow expressiongroup orhigh expressiongroup according to the median expression of each snoRNA expression, which was calculated by univariate and multivariate survival analysis. We also screened out the snoRNAs, in which patients were survived differently. Patients were classified as high, middle, or low risk groups based on the snoRNA risk score. Values of age, gender, smoking, drinking, histological differentiation (well, moderately-differentiated and poorly differentiated), clinical stage (Ⅰ+Ⅱstage andⅢ+Ⅳstage), tumor size (<5 cm and≥5 cm), tumor location (upper 1/3 and others) and snoRNA risk score (high, middle, and low risk group) were assessed by multivariate Cox analysis. Results There were significant differences in overall survival and (or) progression-free survival rates in 19 patients with high and low snoRNAs expressions (P<0.05). Results of multivariate Cox analysis showed that patients with high expression of ACA61,ACA27 and U36A showed a higher overall survival and progression-free survival rates, while patients with high expression of ENSG00000206898 showed a lower overall survival and progression-free survival survival rates (P<0.01). SnoRNA risk score is an independent prognostic factor for patients with gastric cancer. Compared with low risk group, patients in middle risk group and in high risk group showed a shorter overall survival and progression-free survival rates (P<0.001). Conclusion The expressions of ACA61, ACA27, U36A and ENSG00000206898 are independent prognostic factors of gastric cancer. Low expressions of the first three indexes and high expressions of the last one predict a bad prognosis.
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Breast cancer has become the most common malignant tumor and the major cause of cancer-related death for women around the world. The number of patients shows an increasing trend recently. Breast cancer is a big threaten to wom?en’s health and quality of life. With the development of molecular biology, molecular biomarkers have been found assiciated with prognosis in patients with breast cancer, which makes it possible to predict cancer patient survival precisely and practi?cally. This review summarized those new developments of biomarkers on the prognosis of breast cancer.
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Objective This meta-analysis was conducted to quantitatively estimate the associations between sleep duration and weight gain or obesity in adults according to the literature retrieval results of related prospective cohort studies published before October 2014.Methods The literature retrieval was conducted by using PubMed,Embase,Cochrane Library and Chinese databases,including CNKI,VIP and Wan Fang.The pooled relative risk (RR) and 95％ confidence intervals (CI) were estimated,and the tests of the publication bias and the heterogeneity were also performed.Results Sixteen literatures met the inclusion criteria were selected for analysis.In 285 452 adults surveyed in these studies,both short sleep duration and long sleep duration significantly increased the risk of weight gain (RR=1.26,95％CI:1.12-1.42;RR=1.12,95％CI:1.04-1.20),and short sleep duration also increased the risk of obesity (RR=1.35,95％CI:1.22-1.50,P＜0.001),but long sleep duration was not associated with obesity.In subgroup analysis,the associations were stronger in the studies with higher quality and using ＜6 h and ≥8 h as the criteria to identify short and long sleep durations.Conclusion The meta-analysis indicated that both short and long sleep durations were associated with weight gain,and short sleep duration could also increase the risk of obesity.Therefore,public health efforts in promoting sufficient sleep may be important in the prevention of obesity.
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It has been demonstrated that astrocyte elevated gene 1 ( AEG-1 ) can promote tumor initia-tion and progression .Over expression of AEG -1 is correlated with tumor angiogenesis ,metastasis and chemother-apy resistance of tumor cells of different origins .The present article is a review on the mechanism of AEG -1 me-diated drug resistance .Studies have shown that AEG -1 participates in carcinogenesis through Ha -ras,myc,NF-κB and PI3K/Akt signalling pathways .AEG-1 can also promote autophagy through activating AMP Kinase . Other researchers demonstrate that AEG -1 promotes MDR1 protein translation by up-regulating MDR1 mRNA expression ,and thus increases polyribosome .It is testified that AEG-1 can influence drug susceptibility and ex-pression of MDR gene as a RNA binding protein .Multiple functions of AEG -1 in drug resistance in multiple cancers demonstrate that AEG -1 can be used as a novel target for antitumor drugs .
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<p><b>OBJECTIVE</b>To investigate the current status of smoking and passive smoking among Chinese females to provide evidence for related strategy development.</p><p><b>METHODS</b>Data from 32 720 women aged 45-65 years old who participated in the 2008 to 2010 Chinese Multi-center Women Breast Cancer Screening Project, were used to analyze the prevalence rates of smoking/heavy smoking, daily smoking, smoking cessation, successful smoking cessation, passive smoking, etc.</p><p><b>RESULTS</b>A total of 913 females, accounted for 2.8% of all the women in the study, had reported the history of smoking. There were significant differences seen regarding the prevalence rates of smoking in different regions (Beijing, 2.8%; Tianjin, 5.9%; Nanchang, 1.7%; Feicheng, 0.9%; Shenyang, 1.8%). The prevalence rates of current smoking, daily smoking, and heavy smoking were 1.8%, 1.0% and 0.2%, respectively. The prevalence rates of smoking and current smoking increased with age but not the prevalence rates of daily smoking and heavy smoking. Among the smokers, the median initiation age of smoking, the median daily cigarette per day, and median year of smoking were 30 years old, 10 cigarette, and 16 years, respectively. And the prevalence rates of smoking cessation and successful smoking cessation were 19.1% and 8.2%. The prevalence rate of passive smoking was 45.7% (12 730/27 874). After combing the number of smokers and the number of passive smokers, the total exposure rate to tobacco was 41.8% (13 670/32 720).</p><p><b>CONCLUSION</b>There was a relatively low level of smoking among Chinese females, so as the rate of smoking cessation. However, passive smoking presented a relatively high level among Chinese females.</p>
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Aged , Female , Humans , Middle Aged , China , Epidemiology , Prevalence , Smoking , Epidemiology , Tobacco Smoke PollutionABSTRACT
Objective:This work aims determine the expression of the neurotensin (NTS) gene in hepatocellular carcinoma (HCC) subgrouping using immunohistochemical staining (IHC) as well as to evaluate the correlation between the activation of NTS/IL-8 pathway in HCC and inflammatory response in microenvironment and epithelial mesenchymal transition (EMT) in cancer and in the prognosis of patients. Methods:Tumor tissues and corresponding adjacent normal tissue were collected from 64 cases of HCC patients. The expression levels of NTS protein and multiple inflammation and EMT-related proteins, including IL-8, VEGF, MMP9, CD68, E-Cadherin,β-Catenin, and Vimentin, were examined in 64 cases of paraffin-embedded HCC tissues using the immunohistochemistry (IHC) staining method. The clinical outcome and overall survival (OS) among 64 cases of HCC patients were compared. Results:We found that the frequency of NTS-expressing tissues among all HCC samples was 17.19%(11/64). Significantly increased IL-8 protein was confirmed in 90.91%of NTS+HCC samples and was positively correlated with the levels of NTS protein in cancer tissues (P=0.036), which implied the dysfunctional activation of NTS/IL-8 pathway in HCC. The levels of VEGF and MMP9 were significantly correlated with the co-expression of NTS and IL-8 in HCC. Evident features of EMT, including decreased membrane expression of E-Cadherin and increased accumulation of cytoplasmicβ-Catemin and Vimentin, were found in NTS+IL-8+samples. The co-expression of NTS and IL-8 in cancer was significantly correlated with the clinical outcomes of patients, as the mortality rate of NTS+IL-8+HCC patients is 2.5-fold higher than that of others after surgery (P=0.022).Accordingly, the OS of NTS+IL-8+HCC patients significantly decreased (24.65±4.45 m vs. 75.79±16.32 m, P=0.013), and these patients are at a higher risk of death at an expected hazard ratio (HR) of 3.457. Conclusion:The NTS/IL-8 pathway is dysfunctionally activated in a subgroup of HCC samples. Highly expressed NTS is associated with increased inflammatory response in microenvironment, enhanced EMT in cancer, and worse prognosis in HCC patients.
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Objective To conduct a descriptive epidemiological study on thyroid cancer incidence in the urbanarea of Tianjin during 2002 - 2006 and to analyze the secular trend of incidences based on previous data of 26 years and those from Shanghai and the United States. Methods Annual percent change (APC%) of thyroid cancer incidence and the rank of all-site cancer profiles were estimated. The secular trend of different histological incidences and the proportion changes were analyzed. Results The incidence of female thyroid cancer was 6. 55/100000 in 2006, ranking the eighth in the female cancer profile. The incidence of thyroid cancer showed an increased secular trend in recent 26 years, especially a 5.7-fold increase in the papillary thyroid cancer (PTC). The incidence for female increased by 267% in 2006 compared to that in 1981, APC% was 3. 1%. The variation ranked second among all the female tumors. The incidences of thyroid cancer in Shanghai and the United States also elevated with time.Conclusions Thyroid cancer has been one of female common tumors from a once less common tumor,especially the proportion of PTC is expanding. It suggests that further study on the risk factors and preventive efforts should be made.
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Objective To study the value of breast imaging reporting and data system (BI-RADS)in Chinese breast cancer screening. Methods A total number of 3483 women participated in breast cancer screening with mammography in Hexi district in Tianjin from August to December 2009, which was organized by ministry of public health. BI-RADS assessment categories and recommendations were compared with histological findings. The precision, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results Among 3483 screening mammography cases, 267 were almost entirely fat breast, 1245 were scauered fibroglandular, 1890 were dense and 81 extremely dense.There were 1011 patients(29.0%) with category 1, 1741 (50.0%) with category 2, 383 (11.0%) with category 3, 59 patients(1. 7%) with category 4 and 16 (0. 5%) with category 5 according to BI-RADS assessment categories. Totally, 71 women with 77 lesions were confirmed by histological examinations. There were 29 malignant and 48 benign lesions. The diagnostic precision, sensitivity, specificity of BI-RADS were 63. 6% (49/77) , 93. 1% (27/29) and 45.8% (22/48) . The general PPV of BI-RADS was 50. 9%(27/53). The PPV of categories 0, 4, 5 were 25.0% (1/4), 36. 4% (12/33) and 87. 5% (14/16). The NPV of categories 2 and3 were90.9% (10/11), 100.0% (12/12). Conclusions B1-RADS is of much value in assessing the breast malignancy. It is applicable in Chinese breast cancer screening.
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Objective To investigate the trends in incidence and mortality of esophageal cancer from 1981 to 2002 in Tianjin,China and to predict future trends and facilitate future prevention.Methods All new cancer cases registered in the Tianjin Cancer Registry between 1981 and 2002 were reviewed.Yearly age-specific,crude and age-adjusted incidence rates were calculated for males and females.Secular trends of incidence and mortality were indicated by the estimated annual percentage change(EAPC).Results A total of 8206 cases of esophageal cancer were reported in Tianjin form 1981 to 2002,with 5533 males and before 45 years,but increased rapidly after 45 years.The median age of esophageal cancer cases was 69 years,with quartile range from 62 to 75 years.The peak for age specific incidence in females was 75-80 years,which was earlier than that in males(aged 80-85).But recent data indicated that the peak age in females had increased and became similar to that of the males.The crude and age-standardized incidence rates(ASIR)of esophageal cancer decreased in last 22 years.For male and female,crude incidence decreased by 2.22% and 3.56% per year and ASIR decreased by 5.18% and 6.56% per year.The mortality of esophageal cancer decreased in the last 22 years.Conclusion The incidence of esophageal cancer decreased in the last 22 years in Tianjin,but there is little overall improvement in survival.
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<p><b>OBJECTIVE</b>To observe the trend in the change of incidence and mortality of female breast cancer in Tianjin and evaluate its effect of prevention.</p><p><b>METHODS</b>Method of descriptive epidemiology was used to study the epidemic situation of female breast cancer in Tianjin.</p><p><b>RESULTS</b>The incidence of breast cancer in Tianjin had increased by 39.7% from 1981 to 1997, as compared with the other cities in China. Especially, compared with the developed countries the world over, the incidence of breast cancer in Tianjin is much lower. The mortality rate of breast cancer had lowered by 31.0% from 1981 to 1997 and the 3-year and 5-year survival rates increased to various degrees.</p><p><b>CONCLUSION</b>Early detection and diagnosis of breast cancer are very important to both increase of survival and lowering of mortality of breast cancer. Preventive efforts should be made to the high risk people of breast cancer.</p>