Interpretations of the NCCN guidelines for breast cancer risk reduction (version 2023) / 中国胸心血管外科临床杂志

@#Breast cancer, the most common malignancy in the world, also causes the most death cases of women among malignancies. Breast cancer risk reduction guidelines (version 2023) was updated by National Comprehensive Cancer Network (NCCN). Based on high-level evidences from evidence-based medicine and the latest research progress, the guidelines provided standardized guidance for breast cancer risk assessment and risk reduction strategies for individuals without a history of invasive breast cancer or ductal carcinoma in situ, which has attracted widespread attention from clinicians worldwide. Breast cancer is also the most common malignancy in Chinese women, and the number of newly diagnosed breast cancer cases each year in China ranks first in the world due to the large population, so the breast cancer prevention has become a major public health challenge in China. Aimed to provide reference for breast cancer prevention in China, this article interpreted the guidelines (the new version) based on the characteristics of breast structure in Asian women and the epidemiological characteristics of breast cancer in China.

The effect of varied exercise intensity on antioxidant function, aortic endothelial function, and serum lipids in rats with non-alcoholic fatty liver disease / El efecto del ejercicio de intensidad variada sobre la función antioxidante, la función endotelial aórtica y los lípidos séricos en ratas con enfermedad del hígado graso no alcohólico

Abstract This study aimed to compare the effects of diet and exercise of different intensities on antioxidant function, aortic endothelial cell function and serum lipids in NAFLD (nonalcoholic fatty liver disease) rats. Fifty Sprague-Dawley (SD) rats (180-220g) were randomly divided into two experimental groups and fed either a standard rodent chow diet (CON; n=10) or a high-fat diet (HFD; n=40). After 16 weeks, the animals that received the HFD were randomly separated into a high-fat control group (HFC; n=10) or three exercise training groups: HFD and low-intensity exercise (LE; n=10), HFD and moderate-intensity exercise (ME; n=10), and HFD and incremental intensity exercise (IE; n=10). These experimental rats keep sedentary or trained for the next six weeks. A detection kit was used to detect nitric oxide synthase (NOs), nitric oxide (NO), malondialdehyde (MDA) and other markers of aortic oxidative stress. The expression levels of endothelial nitric oxide synthase (e-NOS) and endothelin-1 (ET-1) were detected by immunohistochemistry. TC, TG, and other lipid metabolism parameters were detected by an automatic analyzer. Exercise with different intensities could improve lipid metabolism, enhance antioxidant function, reduce MDA (P<0.01), increase NO (P<0.01), and improve the expression of e-NOS and ET-1 (P<0.01) protein levels in NAFLD rats. Decreased blood lipids were exhibited in all exercise groups. Notably, the moderate-intensity exercise demonstrated more effect on increasing glutathione (GSH) contents (P<0.01) and decreased the expression of ET-1 protein levels (P<0.01). The results showed that exercise at different intensities improved lipid metabolism and enhanced anti-oxidation function. Moderate exercise could improve the function of aortic endothelial cells.

Resumen Este estudio tuvo como objetivo comparar los efectos de la dieta y el ejercicio a diferentes intensidades sobre la función antioxidante, la función de las células endoteliales aórticas y los lípidos séricos en ratas NAFLD (con enfermedad del hígado graso no alcohólico) y alimentados con una dieta estándar para roedores (CON; n = 10) o con una dieta alta en grasas (HFD; n = 40). Después de 16 semanas, los animales que recibieron HFD se separaron aleatoriamente en un grupo de control alto en grasas (HFC; n=10) o tres grupos de entrenamiento físico: HFD y ejercicio de baja intensidad (LE; n=10), HFD y ejercicio de intensidad moderada (ME; n=10), y HFD y ejercicio de intensidad incremental (IE; n=10). Estas ratas experimentales se mantuvieron sedentarias o entrenadas durante las próximas seis semanas. Se utilizó un kit de detección para determinar óxido nítrico sintetasa (NO), óxido nítrico (NO), malondialdehído (MDA) y otros marcadores de estrés oxidativo aórtico. Los niveles de expresión de la óxido nítrico sintetasa endotelial (e-NOS) y endotelina-1 (ET-1) se detectaron mediante inmunohistoquímica. El analizador automático detectó TC, TG y otros parámetros del metabolismo de los lípidos. El ejercicio con diferente intensidad mejoró el metabolismo de los lípidos, mejoró la función antioxidante, redujo la MDA (P <0,01), aumentó el NO (P <0,01) y mejoró la expresión de los niveles de proteína e-NOS y ET-1 (P <0,01) en ratas NAFLD. Se observó una disminución de los lípidos en sangre en todos los grupos de ejercicio. En particular, el ejercicio de intensidad moderada demostró un mayor efecto en el aumento del contenido de glutatión (GSH) (P<0,01) y disminuyó la expresión de los niveles de proteína ET-1 (P<0,01). Los resultados mostraron que el ejercicio a diferentes intensidades mejoró el metabolismo de los lípidos y mejoró función antioxidante. El ejercicio moderado podría mejorar la función de las células endoteliales aórticas.

Interpretation of the global patterns of breast cancer incidence and mortality: A population-based cancer registry data analysis from 2000 to 2020 / 中国胸心血管外科临床杂志

@#Recently, the National Cancer Center analyzed the disease burden and epidemiological trend of breast cancer based on the global population registration data, providing important reference for the prevention and control of breast cancer and health decision-making. Based on the current situation of prevention and control of breast cancer in China, this paper briefly interpreted the key points of the disease burden and trend of breast cancer.

A brief introduction to the clinical pathway of the endoscopic-assisted immediate implant-based breast reconstruction after nipple sparing mastectomy for breast cancer patients in day surgery center of West China Hospital / 中国胸心血管外科临床杂志

@#The traditional view is that breast reconstruction is not an option for day surgery center. As a result, few hospitals in the world conduct this operation in day surgery center. Endoscopic breast reconstruction with liposuction and robot-assisted breast reconstruction are minimally invasive surgeries for breast cancer patients, but they cannot be carried out in the day surgery center due to long operation time. The novel endoscopic-assisted immediate implant-based breast reconstruction after nipple sparing mastectomy through a single axillary incision for breast cancer patients has been successfully conducted in the day surgery center in our hospital due to short operation time and small trauma. Standardized management of the complete process from the patient selection to follow-up after discharge brings rapid recovery and few complications. At the same time, the development of endoscopic surgery makes the breast almost scarless and improves aesthetic results. Therefore, the mode of endoscopic-assisted reconstruction in the day surgery center of our hospital is expected to be popularized in the whole country.

An innovative exploration of endoscopic nipple-sparing mastectomy combined with immediate pre-pectoral implant-based breast reconstruction with TiLoop Bra via single axillary incision for breast cancer patients / 中国胸心血管外科临床杂志

@#Objective    To explore the surgical technique and preliminary results of endoscopic nipple-sparing mastectomy (E-NSM) and immediate pre-pectoral implant-based breast reconstruction (BR) with titanium-coated polypropylene mesh (TiLoop Bra) via single axillary incision for breast cancer patients. Methods    The clinical data of 9 consecutive female patients who underwent E-NSM and immediate pre-pectoral implant-based BR with TiLoop Bra from  March to May 2021 were retrospectively analyzed. The mean age of patients was 40.6 (22-60) years. The operation time, early complications were collected, and the patients' social and mental health, breast satisfaction and chest function before and after the operation were assessed with the BREAST-Q questionnaire. Results    All the patients had unicentric tumor with a mean diameter of 2.4 (0.6-4.7) cm. The mean distance from the tumor to the nipple was 2.5 (2-4) cm. There were 2 patients with tumor stage 0 and 7 patients with stageⅠ. The mean operation time was 161.1 (125-201) min, the mean blood loss was 41.1 mL and the hospital stay time was 1.5 d. There were 5 patients in the day-care unit. All the patients were successfully followed up with a median follow-up time of 1 (1-2) month. One (11.1%) patient with depigmentation of the nipple-areola complex caused by mild ischemia. None of the patients had incision complications, subcutaneous emphysema, hematoma, infection, nipple-areola or skin flaps necrosis, implant loss. During the follow-up period, no local/regional recurrence or distant metastasis was found. Chest well-being was decreased in the first month after the surgery compared with preoperative status, and the difference was statistically significant (P=0.001). There was no statistical difference in the breast satisfaction or psychosocial function scores between pre- and post-operation (P>0.05). Conclusion    E-NSM and immediate pre-pectoral implant-based BR with TiLoop Bra via single axillary incision has minimal trauma, rapid postoperative recovery, short operation time, few early complications and good early cosmetic effect, and the short-term result is satisfactory.

Preoperative "second eye" ultrosound guided orientation in non-palpable breast lesions surgery / 中华内分泌外科杂志

Objective:To investigate clinical application of preoperative "second eye" ultrosound guided orientation in non-palpable breast lesions surgery.Methods:100 patients were involved in the present study, with 136 impalpable breast lesions. Patients were divided into treatment group and control group by using random number table method. Patients of the control group were operated according to the preoperative ultrasonic location alone, while lesions of patients from the treatment group were located not only by preoperative surface location, but also by the "second eye" ultrasonic examination performed by surgeons. Volume of resected specimen and the operation time and the average length of incision were observed and compared between the two groups.Results:All lesions were completely resected. The average operation time of the treatment and control groups was 20 minutes vs 28 minutes ( P<0.05) , the average volume of resected specimens was 3.0 ml vs 4.1 ml ( P<0.05) , and the average length of incision was 25 mm vs 30 mm ( P=0.21) . Conclusions:It is an accurate, safe and effective method to remove clinical non-palpable breast lesions by the "second eye" ultrasound operated immediately before the surgery. It can obviously shorten the operation time, precisely remove the specimen, and reduce damage to normal tissues. In clinical practice, breast ultrasonic characteristics are recommended to be mastered by surgeons so that it could be helpful to the surgery.

Ultrasonographic features and pathological diagnosis of breast disease with ultrasound classification as BI-RADS 4a / 中华内分泌外科杂志

Objective To summarize the characteristics of BI-RADS 4a breast diseases under ultrasonic examination referring to patients' clinical data and pathological reports.Methods 82 patients who were firstlydiagnosed and treated in the Affiliated Hospital of Jiangnan University were included.The ultrasonograms were retrospectively reviewed along with the correlated pathological and clinical findings.Results 48 (58.5％) cases were benign,among which fibroadenoma was the most common.34 cases (41.4％) were malignant,among which invasive ductal carcinoma was the most common.68 of the 82 cases were neoplastic disease (82.9％),6 (9.8％)were inflammatory disease,and 8(7.3％) were adenosis.Conclusions The patients who are graded BI-RADS 4a by ultrasonic examination may have completely different diseases.Beyond the most common benign diseases,few of them are malignancies with atypical,even ambiguous sonographic features.Therefore,in clinical practice,sonologists should set appropriate parameters of ultrasonic devices appropriately,and evaluate the sonographic features carefully,in order to make the correct grading and diagnosis.While for clinicians,it is necessary to learn to read the ultrasonographic features along with patients' manifestations,and finally reduce the misdiagosis and missed diagnosis of such diseases.

Effect of dopamine on hemodynamics and cerebral oxygen metabolism in the early stage of post-resuscitation in rabbit with cardiac arrest / 中华急诊医学杂志

Objective To observe the effects of dopamine in different doses on hemodynamics and cerebral oxygen metabolism in the early stage of post-resuscitation in rabbit with cardiac arrest.Methods Healthy adult rabbits were randomly(random number) divided into 4 groups according to the different doses of dopamine administration:control group (CG),low dose group (LG),medium dose group (MG),high dose group (HG),(n=15 in each group).Ventricular fibrillation (VF) was induced by electricity and cardiopulmonary resuscitation (CPR) was performed subsequently as the experiment designed.When 10 rabbits with restoration of spontaneous circulation (ROSC) were got each group,it was enough for experiment carried out.Cardiac output (CO),mean arterial pressure (MAP),heart rate (HR),systemic vascular resistance index (SVRI) and the cerebral local tissue blood oxygen saturation (TOI) were observed at 0 min,15 min,30 min,60 min,120 min after ROSC.The animals were sacrificed at 120 min after ROSC,brain tissues were harvested for study by using HE staining.Repeated measure analysis of variance was used to determine the statistical significance among the four groups at different intervals.Multi-group quantitative data was analyzed by one way ANOVA and then further by LSD test for multiple comparisons.Chi-square test or Fisher's exact probabilities was applied for multi-group binomial classification variable.Log-rank test was used for comparisons of survival curves in four groups.A twotailed value of P＜0.05 was considered statistically significant.Results There were no differences in the rate of ROSC among groups.Compared with CG and LG,ROSC time was shorter in MG (277±15 vs.190±12,P＜0.01;252±16 vs.190±12,P=0.016) with higher 120 min survival rate (20％ vs.90％,x2=9.899,P=0.005;30％ vs.90％,x2=7.5,P=0.02).CO was higher in MG than that in other groups at all given intervals in the early stage of post-resuscitation(P＜0.05).MAP levels were significantly higher in MG and HG compared with CG and LG at given intervals 15 min after ROSC (P＜0.05).SVRI was significantly higher in HG than that in other groups at all given intervals after ROSC (P＜0.05).Compared with other groups,the TOI levels in MG were significantly higher than that in other groups at 15 min and 30 min after ROSC (P＜0.05).The median survival time in MG and HG was significantly longer than that in CG and LG.The number of cellular necrosis in MG (28.4±1.0) was significantly fewer than that in other groups (CG 41.2±1.5;LG 41.0±2.0;HG 39.6±1.9) (P＜0.01).Conclusion The moderate dose of dopamine might maintain MAP and CO at a higher level meeting the cerebral oxygen metabolism in the early stage of post-resuscitation from cardiac arrest in rabbits.

A retrieval method of drug molecules based on graph collapsing / 北京大学学报(医学版)

OBJECTIVE@#To establish a compact and efficient hypergraph representation and a graph-similarity-based retrieval method of molecules to achieve effective and efficient medicine information retrieval.@*METHODS@#Chemical structural formula (CSF) was a primary search target as a unique and precise identifier for each compound at the molecular level in the research field of medicine information retrieval. To retrieve medicine information effectively and efficiently, a complete workflow of the graph-based CSF retrieval system was introduced. This system accepted the photos taken from smartphones and the sketches drawn on tablet personal computers as CSF inputs, and formalized the CSFs with the corresponding graphs. Then this paper proposed a compact and efficient hypergraph representation for molecules on the basis of analyzing factors that directly affected the efficiency of graph matching. According to the characteristics of CSFs, a hierarchical collapsing method combining graph isomorphism and frequent subgraph mining was adopted. There was yet a fundamental challenge, subgraph overlapping during the collapsing procedure, which hindered the method from establishing the correct compact hypergraph of an original CSF graph. Therefore, a graph-isomorphism-based algorithm was proposed to select dominant acyclic subgraphs on the basis of overlapping analysis. Finally, the spatial similarity among graphical CSFs was evaluated by multi-dimensional measures of similarity.@*RESULTS@#To evaluate the performance of the proposed method, the proposed system was firstly compared with Wikipedia Chemical Structure Explorer (WCSE), the state-of-the-art system that allowed CSF similarity searching within Wikipedia molecules dataset, on retrieval accuracy. The system achieved higher values on mean average precision, discounted cumulative gain, rank-biased precision, and expected reciprocal rank than WCSE from the top-2 to the top-10 retrieved results. Specifically, the system achieved 10%, 1.41, 6.42%, and 1.32% higher than WCSE on these metrics for top-10 retrieval results, respectively. Moreover, several retrieval cases were presented to intuitively compare with WCSE. The results of the above comparative study demonstrated that the proposed method outperformed the existing method with regard to accuracy and effectiveness.@*CONCLUSION@#This paper proposes a graph-similarity-based retrieval approach for medicine information. To obtain satisfactory retrieval results, an isomorphism-based algorithm is proposed for dominant subgraph selection based on the subgraph overlapping analysis, as well as an effective and efficient hypergraph representation of molecules. Experiment results demonstrate the effectiveness of the proposed approach.

Quantitative evaluation of cardiovascular function in patients with subclinical atherosclerosis by ultrasonography / 中华超声影像学杂志

Objective To evaluate the carotid and left ventricular function changes in patients with subclinical atherosclerosis (SA) using echo-tracking (ET) and three-dimensional speckle tracking echocardiography (3D-STE).Methods Eighty patients with SA were divided into low-risk group (27 cases),middle-risk group (26 cases) and high-risk group (27 cases) according to the Framingham risk score (FRS).Each of them was examined by echocardiography and carotid ultrasound to obtain the parameters including carotid intima-media thickness (cIMT),stiffness parameter (β),Pressure-strain elastic modulus (Ep),pulse wave conducting velocity(PWVβ),LV peak systolic global longitudinal strain (GLS),LV peak systolic global circumferential strain (GCS),myocardial wall stress (MWS) and left ventricular ejection fraction(LVEF) for analysis.The study got approval from the Ethics Committee of Tongji Medical College,Huazhong University of Science and Technology (NO:IORG00371).Results Ep,left atrial volume (LAV) and MWS had significantly differences among the three groups (all P ＜0.05).Compared with low-risk group,cIMT,β,PWVβ were higher and GLS was lower in high-risk group (all P ＜0.05).There were no statistical difference in LVEF and GCS among the three groups (all P ＞ 0.05).β was positively correlated with age and FRS,and negatively correlated with GLS (all P ＜ 0.05).LAV was positively correlated with age and E/e (all P ＜0.05).GLS was negatively correlated with FRS and β (all P ＜ 0.05).MWS was positively correlated with β and SBP,and negatively correlated with LVEF (all P ＜0.01).Conclusions ET combined with 3D-STE could be applied to evaluate the carotid and left ventricular function accurately in patients with subclinical atherosclerosis,and provide scientific bases for establishing intervention strategy.

Theories and clinical applications of biochemotherapy for malignant carcinomas / 中国肿瘤临床

Chemoimmunotherapy or biochemotherapy, the combination of chemotherapy with immunotherapy, is a novel compre-hensive treatment model for malignant carcinoma. In recent years, many clinical trials have shown that biochemotherapy is associated with an improved response rate. Such biological agents include tumor vaccines, monoclonal antibodies, cytokines, and immunocompe-tent cells. In this article, we review the theories, sort the clinical applications of novel treatments, and discuss some of the problems existing in this field.

Left ventricular systolic intraventricular flow field assessment in hyperthyroidism patients using vector flow mapping / 华中科技大学学报（医学）（英德文版）

Intraventricular hydrodynamics is considered an important component of cardiac function assessment. Vector flow mapping (VFM) is a novel flow visualization method to describe cardiac pathophysiological condition. This study examined use of new VFM and flow field for assessment of left ventricular (LV) systolic hemodynamics in patients with simple hyperthyroidism (HT). Thirty-seven simple HT patients were enrolled as HT group, and 38 gender- and age-matched healthy volunteers as control group. VFM model was used to analyze LV flow field at LV apical long-axis view. The following flow parameters were measured, including peak systolic velocity (Vs), peak systolic flow (Fs), total systolic negative flow (SQ) in LV basal, middle and apical level, velocity gradient from the apex to the aortic valve (ΔV), and velocity according to half distance (V1/2). The velocity vector in the LV cavity, stream line and vortex distribution in the two groups were observed. The results showed that there were no significant differences in the conventional parameters such as left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and left atrium diameter (LAD) between HT group and control group (P>0.05). Compared with the control group, a brighter flow and more vortexes were detected in HT group. Non-uniform distribution occurred in the LV flow field, and the stream lines were discontinuous in HT group. The values of Vs and Fs in three levels, SQ in middle and basal levels, ΔV and V1/2 were higher in HT group than in control group (P<0.01). ΔV was positively correlated with serum free thyroxin (FT4) (r=0.48, P<0.01). Stepwise multiple regression analysis showed that LVEDD, FT4, and body surface area (BSA) were the influence factors of ΔV. The unstable left ventricular systolic hydrodynamics increased in a compensatory manner in simple HT patients. The present study indicated that VFM may be used for early detection of abnormal ventricle contraction in clinical settings.

Laser-induced interstitial thermotherapy via a single-needle delivery system: Optimal conditions of ablation, pathological and ultrasonic changes / 华中科技大学学报（医学）（英德文版）

This study aimed to examine the optimal conditions of laser-induced interstitial thermotherapy (LITT) via a single-needle delivery system, and the ablation-related pathological and ultrasonic changes. Ultrasound (US)-guided LITT (EchoLaser system) was performed at the output power of 2-4 Wattage (W) for 1-10 min in ex vivo bovine liver. Based on the results of the ex vivo study, the output power of 3 and 4 W with different durations was applied to in vivo rabbit livers (n=24), and VX2 tumors implanted in the hind limbs of rabbits (n=24). The ablation area was histologically determined by hematoxylin-eosin (HE) staining. Traditional US and contrast enhanced ultrasound (CEUS) were used to evaluate the treatment outcomes. The results showed: (1) In the bovine liver, ablation disruption was grossly seen, including a strip-like ablation crater, a carbonization zone anteriorly along the fiber tip, and a surrounding gray-white coagulation zone. The coagulation area, 1.2 cm in length and 1.0 cm in width, was formed in the bovine liver subjected to the ablation at 3 W for 5 min and 4 W for 4 min, and it extended slightly with the ablation time. (2) In the rabbit liver, after LITT at 3 W for 3 min and more, the coagulation area with length greater than or equal to 1.2 cm, and width greater than or equal to 1.0 cm, was found. Similar coagulation area was seen in the implanted VX2 carcinoma at 3 W for 5 min. (3) Gross examination of the liver and carcinoma showed three distinct regions: ablation crater/carbonization, coagulation and congestion distributed from the center outwards. (4) Microscopy revealed four zones after LITT, including ablation crater/carbonization, coagulation, edema and congestion from the center outwards. A large area with coagulative necrosis was observed around a vessel in the peripheral area with edema and hyperemia. (5) The size of coagulation was consistent well to the CEUS findings. It was concluded that EchoLaser system at low power can produce a coagulation area larger than 1.0 cm×1.0 cm during a short time period. The real-time US imaging can be used to effectively guide and assess the treatment.

Systematic review of dynamic hip plate and proximal femoral intramedullary nail fixation for intertrochanteric fracture in adults / 中国组织工程研究

BACKGROUND:Intertrochanteric fractures are often treated with extramedulary fixation and intramedulary fixation. Which internal fixation can better repair intertrochanteric fractures remains controversial. OBJECTIVE: To compare the efficacy and safety of dynamic hip plate and proximal femoral intramedulary nail fixation in treatment of intertrochanteric fracture in adults. METHODS: Al randomized clinical trials relevant to comparing proximal femoral intramedulary nail fixation with dynamic hip plate for intertrochanteric fracture in adults from 1966 to 2013 were identified. The quality of the trials was assessed. The outcomes included length of surgery, operative blood loss, postoperative femoral shaft fracture, cut-out of the implant from the femoral head, non-union of the fracture, reoperation rate, wound infection, postoperative hip pain (hip joint pain and thigh pain), which were extracted and reviewed systematicaly. RESULTS AND CONCLUSION:4 757 trial participants with 4 748 fractures were included in the 31 published trials. There was no significant difference in the length of surgery, reoperation rate, cut-out of the implant from the femoral head, non-union of the fracture, wound infection and postoperative hip pain between the two groups (P > 0.05) between dynamic hip plate and proximal femoral intramedulary nail fixation. Compared with dynamic hip plate fixation, proximal femoral intramedulary nail fixation had less blood loss and significantly higher rate of femoral shaft fractures (P=0.003). Experimental findings show that, in treatment of intertrochanteric fracture, intramedulary nail fixation is associated with significantly lower blood loss. However, the risk of femoral shaft fracture is increased compared with dynamic plate fixation. There were no differences in length of surgery, cut-out of the implant from the femoral head, non-union of the fracture, reoperation rate, wound infection and postoperative hip pain. The results of this systematic review should be explained prudently because of some limitations of included trials. To obtain more reliable conclusions, large-scale randomized controled trials of strict design, uniform index and long-term folow-up are needed.

Preparation technology of propolis extract / 中草药

Objective: To establish the preparation technology of propolis extract. Methods: With the contents of total flavonoids, chrysin, pinocembrin, and galangin and extract yield as evaluation indexes, the extraction methods, extraction solvent, extraction times, extraction time, and amount of solvent extraction were optimized with single factor test and orthogonal design to investigate the effect on the preparation technology of propolis extract. Results: The optimal extraction technology was that propolis was refrigerated, grinded, soaked with 95% five times the amount of ethanol, shaked, then extracted for 4 h, filtrated, concentrated, and dried after ethanol recovery. Conclusion: The optimial extracting technology of propolis is stable and feasible, and suitable for further application.

Efficacy and Safety Profile of Combining Sorafenib with Chemotherapy in Patients with HER2-Negative Advanced Breast Cancer: A Meta-analysis / 한국유방암학회지

PURPOSE: The aim of the study was to evaluate the efficacy and safety of combining sorafenib with chemotherapy in patients with human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, American Society for Clinical Oncology abstracts, and European Society for Medical Oncology abstracts were searched. Randomized clinical trials that compared the efficacy and safety of sorafenib plus chemotherapy in patients with HER2-negative advanced breast cancer with placebo plus chemotherapy were eligible. The endpoints were progression-free survival (PFS), overall survival (OS), time to progression (TTP), duration of response (DOR), overall response rate (ORR), clinical benefits, and adverse effects. The meta-analysis was performed using Review Manager 5.2.6 (The Nordic Cochrane Centre), and the fixed-effect model weighted by the Mantel-Haenszel method was used. When considerable heterogeneity was found (p<0.1), further analysis (subgroup analysis, sensitivity analysis, or random-effect model) was performed to identify the potential cause. The results are expressed as hazard ratios or risk ratios, with their corresponding 95% confidence intervals. RESULTS: The final analysis included four trials comprising 844 patients. The results revealed longer PFS and TTP, and higher ORR and clinical benefit rates in patients receiving sorafenib combined with chemotherapy compared to those receiving chemotherapy and placebo. OS and DOR were similar in the two groups. Meanwhile, the incidence of some adverse effects, including hand-foot skin reaction/hand-foot syndrome, diarrhea, rash, and hypertension, were significantly higher in the sorafenib arm. CONCLUSION: Sorafenib combined with chemotherapy may prolong PFS and TTP. This treatment was associated with manageable toxicities, but frequent dose interruptions and reductions were required.

Left ventricle geometry remolding after heart transplantation: A two-dimensional ultrasound study / 华中科技大学学报（医学）（英德文版）

The function of the transplanted heart will be affected by acute allograft rejection, chronic rejection, high blood pressure and so on, which may induce the reconstruction of the left ventricle and the increase of left ventricular mass (LVM), and eventually lead to left ventricular hypertrophy that will significantly affect the prognosis of heart transplantation (HT). The purpose of this study was to dynamically monitor the changes of left ventricular geometric patterns after HT using two-dimensional echocardiography and to understand the remodeling process and its possible influencing factors. The left ventricular internal diameter, interventricular septal wall thickness, posterior wall thickness at end diastole were measured and the relative wall thickness (RWT), left ventricular mass, left ventricular mass index were calculated respectively in 34 HT patients and 34 healthy volunteers by two-dimensional echocardiography. The type of left ventricular geometry was identified based on the echocardiographic determination of LVM index (LVMI) and RWT. The HT patients were divided into three groups according to the time length after surgery: A (3 months postoperatively), B (6 months postoperatively) and C (12 months postoperatively). We compared the parameters of left ventricle between HT group and normal control group, and explored the risk factors causing the increase of LVM. The results showed that 4 patients (16%) in group A had concentric remodeling. Nine patients (34.62%) in group B had reconstruction, including 5 cases of concentric remodeling, 2 cases of concentric hypertrophy and 2 cases of eccentric hypertrophy. The hypertrophy incidence rate was 15.4% in group B. 15 patients (62.5%) had reconstruction in group C, including 9 cases of concentric remodeling, 5 cases of concentric hypertrophy, and 1 case of eccentric hypertrophy. The prevalence of hypertrophy was 25%. Multivariate analysis showed that hypertension and acute rejection history were the risk factors that resulted in left ventricular hypertrophy. It is concluded that the left ventricular remodeling occurs following cardiac transplantation at an early stage and the incidence of left ventricular hypertrophy increases with survival time. In this study, the one-year prevalence of left ventricular hypertrophy was 25% after surgery. Hypertension and acute rejection history are risk factors that can predict the left ventricular hypertrophy.

Left ventricle geometry remolding after heart transplantation: a two-dimensional ultrasound study / 华中科技大学学报（医学）（英德文版）

The function of the transplanted heart will be affected by acute allograft rejection, chronic rejection, high blood pressure and so on, which may induce the reconstruction of the left ventricle and the increase of left ventricular mass (LVM), and eventually lead to left ventricular hypertrophy that will significantly affect the prognosis of heart transplantation (HT). The purpose of this study was to dynamically monitor the changes of left ventricular geometric patterns after HT using two-dimensional echocardiography and to understand the remodeling process and its possible influencing factors. The left ventricular internal diameter, interventricular septal wall thickness, posterior wall thickness at end diastole were measured and the relative wall thickness (RWT), left ventricular mass, left ventricular mass index were calculated respectively in 34 HT patients and 34 healthy volunteers by two-dimensional echocardiography. The type of left ventricular geometry was identified based on the echocardiographic determination of LVM index (LVMI) and RWT. The HT patients were divided into three groups according to the time length after surgery: A (3 months postoperatively), B (6 months postoperatively) and C (12 months postoperatively). We compared the parameters of left ventricle between HT group and normal control group, and explored the risk factors causing the increase of LVM. The results showed that 4 patients (16%) in group A had concentric remodeling. Nine patients (34.62%) in group B had reconstruction, including 5 cases of concentric remodeling, 2 cases of concentric hypertrophy and 2 cases of eccentric hypertrophy. The hypertrophy incidence rate was 15.4% in group B. 15 patients (62.5%) had reconstruction in group C, including 9 cases of concentric remodeling, 5 cases of concentric hypertrophy, and 1 case of eccentric hypertrophy. The prevalence of hypertrophy was 25%. Multivariate analysis showed that hypertension and acute rejection history were the risk factors that resulted in left ventricular hypertrophy. It is concluded that the left ventricular remodeling occurs following cardiac transplantation at an early stage and the incidence of left ventricular hypertrophy increases with survival time. In this study, the one-year prevalence of left ventricular hypertrophy was 25% after surgery. Hypertension and acute rejection history are risk factors that can predict the left ventricular hypertrophy.

STAT3, a Poor Survival Predicator, Is Associated with Lymph Node Metastasis from Breast Cancer / 한국유방암학회지

PURPOSE: The aim of this study is to explore signal transducer and activator of transcription 3 (STAT3) expression in breast cancer and to analyze the detailed mechanism that STAT3 contributes to the progression of breast cancer. METHODS: We retrospectively analyzed the clinicopathologic characteristics and overall survival (OS) of 140 breast cancer patients after curative surgery, and detected STAT3 expression, phosphorylated STAT3 (pSTAT3) expression, Ki-67 expression, vascular endothelial growth factor (VEGF)-C and -D expression in breast cancer tissues, and adjacent nontumor tissues. Survival analysis and relationship analysis were adopted for demonstrated the important mechanism of STAT3 contribution to progression of breast cancer. RESULTS: STAT3 expression, pSTAT3 expression, Ki-67 expression, VEGF-C expression, and VEGF-D expression in breast cancer tissues were significantly higher than those in adjacent nontumor tissues, respectively. With survival analysis, only number of lymph node metastasis (N stage) was identified as the independent predictors of the OS of breast cancer patients. Besides, we demonstrated there was the most prominent correlation between STAT3 expression and lymph node metastasis in breast cancer tissues by using the multinominal regression method. CONCLUSION: STAT3, a poor survival biomarker potential association with lymph node metastasis, was suitable for predication the OS of breast cancer patients after curative resection.

Isolation and sequence analysis on virus of HFMD with encephalitis in Yantal city / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To learn about the pathogen spectrum and genetic characterization of HFMD with encephalitis in Yantai city.</p><p><b>METHODS</b>Stool samples and cerebrospinal fluids (CSF) collected from HFMD with encephalitis cases in Yantai. Virus were isolated from stool samples and identified by fluorescence reverse transcription-polymerase chain reaction. The VPl region was amplified and sequenced from positive specimens. Genetic characterization was identified by sequence analysis.</p><p><b>RESULTS</b>Getting 3 virus strains from 10 stool specimens and all of them belong to EV71. The nucleotide and amino acid homogeneity with the representative isolates of C4a were 98%-99% and 98.90%-99.45% respectively.</p><p><b>CONCLUSION</b>The pathogen of HFMD with encephalitis in Yantai city were mainly EV71 wich belong to subgenogroup C4 cluster C4a.</p>