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Triple-negative breast cancer is estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 negative breast cancer. The lack of specific treatment targets, there are few effective therapy for advanced triple- negative breast cancer. This article will review the current progress in drug therapy for advanced triple-negative breast cancer, including chemotherapy, targeted therapy, endocrine therapy and immunotherapy, in order to provide reference for clinical treatment.
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Objective@#Positron emission tomography-computed tomography (PET-CT) has been used to quantify inflammatory response in the body. The aim of the present study was to explore the possibility of using this method to evaluate the stability of atherosclerotic plaques and the efficacy of atorvastatin in stabilizing atherosclerotic plaques.@*Methods@#Twenty New Zealand male white rabbits were included and divided into the atorvastatin intervention group and the control group, with 10 rabbits in each group. Rabbits in both groups were fed with a high fat diet for 20 weeks, and treated with thoracoabdominal aortic balloon-pulling to establish atherosclerosis model at the end of the 2nd week. Rabbits in atorvastatin intervention group was given atorvastatin intragastrically once a day. At the 8th week, thoracoabdominal aortic ultrasound was used to detect plaques in all rabbits. Blood was drawn at the 3rd and the 20th week, respectively, to measure blood lipids, high-sensitive C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9). At the end of experiment, survival animals were scanned by 18F-FDG PET-CT, and the average and maximum standard uptake values (SUVmean, SUVmax) of aortic segments were measured. Thereafter, the animals were sacrificed and aortic specimens of rabbits were taken and examined by immunohistochemistry. The pathological indexes were measured and compared.@*Results@#At the end of experiment, the total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), hs-CRP [ (4.58±0.51) ng/ml vs.(5.87±0.66) ng/ml, P<0.01], MMP-9[ (43.93±2.16) ng/ml vs. (50.77±2.32) ng/ml, P<0.01], SUVmean (0.59±0.15 vs. 0.68±0.20, P<0.05) , SUVmax (0.68±0.20 vs. 0.81±0.27, P<0.05) , plaque area [ (0.36±0.24) mm2 vs. (0.50±0.34) mm2, P<0.05) ] and density of macrophage[ (4.34±1.54) % vs. (5.65±1.89) %, P<0.01] in the atorvastatin intervention group were significantly lower than those in the control group. In contrast, fiber cap thickness of the plaque[ (4.12±0.66) μm vs. (2.96±0.37) μm, P<0.01] in the atorvastatin intervention group was higher than that of the control group, and the difference was statistically significant. The arterial plaque areas were positively correlated with SUVmean (r=0.27, P<0.05) and SUVmax (r=0.43, P<0.01) . Fiber cap thickness was negatively correlated with SUVmean (r=-0.38, P<0.05) and SUVmax (r=-0.47, P<0.01) . The density of macrophage were positively correlated with SUVmean (r=0.52, P<0.01) and SUVmax (r=0.51, P<0.01) .@*Conclusion@#18F-FDG PET/CT can be used to evaluate the efficacy of atorvastatin by the stability of atherosclerotic plaques.
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Objective To assess the impact of glycemic variability on left ventricular function in patients with acute ST-segment elevation myocardial infarction (STEMI) and type 2 diabetes.Methods Three hundred and three patients with type 2 diabetes and first STEMI between May 2014 and December 2016 in Beijing Anzhen Hospital,Capital Medical University were seclected continuously.All participants' continuous glucose monitoring system (CGMS) parameters,echocardiogram and biochemical characteristics were measured at baseline.According to the level of mean amplitude of glycemic excursion (MAGE) which is the gold indicator to present glycemic variability patients were classified into low MAGE group (n=182) and high MAGE group (n =117).Impact of glycemic variability on left ventricular function in patients with acute ST-segment elevation myocardial infarction and type 2 diabetes were analysed.Results (1) Cardiac function evaluation:The level of left ventricular ejection fraction (LVEF) were significantly lower in high MAGE group than in low MAGE group ((43.8± 7.2) vs.(52.3± 8.5) ％,t =4.912,P＜ 0.001).There were significant differences between the two groups in Killip classification (x2 =49.931,P＜ 0.001).(2) Pearson correlation analysis shows that LVEF negatively correlated with the levels of MAGE(r=-0.367,P＜0.001),postprandial glucose excursion (PPGE) (r=-0.274,P=0.003),Hemoglobin A1c(HbA1c) (r=-0.238,P =0.010),serum highsensitive C-reactive protein (hs-CRP) via logarithmic transformation (r =-0.245,P =0.008) and fasting plasma glucose (FPG) (r =-0.229,P =0.021).Killip classification positively correlated with the levels of MAGE (r =0.301,P ＜ 0.001),PPGE (r =0.228,P =0.022),hs-CRP via logarithmic transformation (r =0.234,P =0.019),H bA 1 c (r =0.195,P =0.041) and FPG (r =0.193,P =0.045).(3) Multiple stepwise regression analysis and multivariate Logistic regression analysis indicated that the level of MAGE was independent risk factor of LVEF (t =-2.279,P =0.005,95％ CI(-3.160 -0.219)) and the level of MAGE was an independent risk factor of Killip classification (Waldx2 =5.673,OR=1.665,95％CI(1.095-2.534),P=0.017).Conclusion Glycemic variability is associated with the presence and severity of left ventricular function in patients with STEMI and type 2 diabetes.
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Objective To investigate the metabolic characteristics of chronic total occlusion (CTO) in different sex elderly patients. Methods A retrospective analysis was performed on three hundred and sixty-two cases from Beijing Anzhen Hospital with CTO,including 226 cases in the male group and 136 cases in the female group. The characteristics of metabolic risk factors were compared and analyzed between the two groups. Results (1)The level of the systolic blood pressure (SBP)((135. 62±19. 67)mmHg vs. (129. 08±14. 13)mmHg), total cholesterol (TC)((4. 39±0. 95) mmol/ L vs. (3. 91±0. 93) mmol/ L)、low density lipoprotein cholesterol (LDL-C)((2. 56±0. 80) mmol/ L vs. (2. 23±0. 70) mmol/ L) in the female group were significantly higher than those of the male group,the differences were statistically significant (t = -2. 594,P = 0. 010;t = -3. 341,P= 0. 001;t= -2. 893,P = 0. 004) . (2) The level of urea acid (UA) ((368. 95±75. 96) μmol/ L vs. (326. 20 ±83. 27)μmol/ L) and ratio of smoking ( 61. 95% ( 140/ 226) vs. 5. 88% ( 8/ 136)) in the male group were significantly higher than those in the female group(t= 3. 440,P= 0. 001;χ2 = 55. 211,P= 0. 000). Conclusion The higher levels of systolic pressure,total cholesterol and low density lipoprotein cholesterol are the metabolic clinical characteristics of elderly female CTO patients,and the elevated uric acid and smoking are metabolic clinical characteristics of elderly male CTO patients.
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Objective@#To compare the safety of continued warfarin therapy and bridging anticoagulation therapy during hospital stay in patients undergoing percutaneous coronary intervention (PCI). @*Methods@#We retrospectively analyzed patients on warfarin therapy referred for PCI in Beijing Anzhen Hospital from January 2008 to December 2016. The patients were divided into continued warfarin therapy (n=195) or bridging anticoagulation therapy (n=311) groups. After Propensity Score Matching, data from matched patients (n=123 in each group) were analyzed. Bleeding complications and major adverse cardiac events including death, myocardial infarction, target vessel revascularization, and stent thrombosis were assessed. @*Results@#There were no significant difference in the rate of death (2.4%(3/123) vs. 1.6%(2/123),P=0.54), acute myocardial infarction (4.1%(5/123) vs. 4.9%(6/123), P=0.78),re-revascularization (0.8%(1/123) vs. 1.6%(2/123),P=0.16), stent thrombosis (1.6%(2/123) vs. 1.6%(2/123),P=1.00) and stroke between the two groups. Prevalence of minor bleeding complications was significantly higher in the bridging therapy group (15.4%(19/123) vs. 9.8%(12/123),P=0.01). Rate of access-site complications (hematoma:4.1%(5/123) vs. 2.4%(3/123),P=0.20; pseudoaneurysm:2.4%(3/123) vs. 2.4%(3/123),P=1.00; arteriovenous fistula:0.8%(1/123) vs. 1.6%(2/123),P=0.09; and retroperitoneal hematoma:0(0/123) vs. 0.8%(1/123),P=0.23) were similar between the two groups. @*Conclusion@#For patients receiving chronic warfarin therapy, the uninterrupted oral anticoagulant treatment is as safe as bridging therapy in PCI patients.
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Purpose 18F-FDG PET/CT,pathological and immunohistochemical analysis are adopted to explore the value of PET/CT in the early-stage calcification examination of atherosclerosis in rabbits and effects of Pioglitazone in treating early-stage calcification.Material and Methods Sixteen New Zealand male rabbits were randomly divided into two groups:Pioglitazone group and control group,witheight rabbits in each group.Atherosclerosis model was established.Rabbits in Pioglitazone group received gavage with Pioglitazone and were raised with high-fat diet for 20 weeks.Blood was drawn to exam high sensitivity C-reactive protein and matrix metalloproteinase-9.PET/CT was used to measure mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax).Rabbit aorta received immunohistochemical,the plaque area,density of macrophage,percentage of calcification area and apoptosis index between the two groups were determined and compared.Results On 20 week,high sensitivity C-reactive protein in Pioglitazone group (4.27±0.43 vs.6.51 ±0.91,P＜0.01),matrix metalloproteinase-9 (41.52± 1.99 vs.62.21 ±3.60,P＜0.05),SUVmean (0.55±0.18 vs.0.68±0.21,P＜0.01)and SUVmax (0.70±0.19 vs.0.82±0.30,P＜0.05) were obviously lower than those in control group.Plaque area,density of macrophage,percentage of calcification area and apoptosis index in control group were obviously higher than those in Pioglitazone group.Plaque area of related artery section was positively correlated with SUVmean (r=0.28,P＜0.01) and SUVmax (r=0.25,P＜0.05).Density of macrophage was positively correlated with SUVmean (r=0.50,P＜0.01) and SUVmax (r=0.46,P＜0.01).Percentage of calcification area was positively correlated with SUVmean (r=0.50,P＜0.01) and SUVmax (r=0.47,P＜0.01).Apoptosis index was positively correlated with SUVmean (r=0.61,P＜0.01)and SUVmax (r=0.60,P＜0.01).Conclusion Inflammation and macrophage apoptosis are of great importance in the early-stage of atherosclerosis.18F-FDG PET/CT imaging can be used to assess minor calcification.Pioglitazone can reduce inflammatory level of atherosclerosis of the experimented animals,inhibiting early-stage calcification.
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ObjectiveTo explore the imaging of the thrombosis after pharmacological triggering of plaque rupture in atherosclerotic rabbit model by using 3.0 T high-resolution magnetic resonance imaging.MethodsTwenty male New Zealand white rabbits were divided into an experimental group (n = 16) and a control group (n = 4).The aortic wall injuries were induced by an intravascular balloon in experimental group rabbits after high cholesterol diet.The pharmacological triggering with Russell's viper venom and histamine was performed after 3 months of establishment of model.All of the animals underwent pre-trigger and post-trigger MR examinations including 3D time of fight (3D TOF),T1 WI,T2WI and post contrast T1 WI.Euthanasia was performed in all rabbits and gross anatomy and histological specimen of aorta were obtained.Comparing the location and length of the thrombus between MRI images and histopathology was used Pearson test.Comparing the calculated indexes of abdominal aorta between rabbits with and without thrombosis was used AVONA test and LSD-t test.Results After triggering,8 in 14 survived rabbits developed thrombosis in experimental group,meanwhile,no thrombus was found in control group.The accuracy of multi-sequences MRI for detecting of thrombus was 87.1％ (27/31).MRI data correlated with the histopathology regarding thrombus length ( r = 0.85,P ＜ 0.01 ) and thrombus location ( r = 0.94,P＜0.01 ).Compared with rabbits without thrombosis,the rabbits with thrombosis had narrower lumen of abdominal aorta in the pre-triggered MR images [ ( 5.71 ± 2.38 )mm2 vs.( 8.93 ± 5.36) mm2,P ＜ 0.01 ].ConclusionMRI is useful tool to determine the thrombosis and plaque rupture in atherosclerotic rabbit model.
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Objective To study the feasibility of noninvasive detection of unstable plaques with ~(18)F-Fluorodeoxyglu-cose (~(18)F-FDG) PET/CT imaging. Methods Atherosclerotic plaques were induced in male New Zealand white rabbits. Animals were injected with FDG labeled with ~(18)F, then examined with PET/CT. Aorta was explanted for photography with digital camera, and ~(18)F-FDG uptake analysis. Thirty unstable plaques and 30 stable plaques were choosed so as to compare the quantitativly ~(18)F-FDG uptake. The number of macrophages and smooth muscle cells was detected by immunohistochemical technique. Results Experimental group showed inconsistent uptake of ~(18)F-FDG in the abdominal aorta. The results were confirmed in the ex vivo digital photo of the explanted aorta. The target to non target ratio (T/NT) and macrophages of unstable plaques were higher than stable plaques (P<0.01) , but smooth muscle cells obviously reduced (P <0. 01). Correlation analysis showed that there was a positive correlation between T/NT and macrophage content (r=0. 815,P<0. 01), and a negative correlation between T/NT and SMC content(r=-0. 684,P <0. 01). Conclusion ~(18)F-FDG PET/CT can constitute an attractive imaging method for the noninvasive detection of experimental unstable plaques.
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Objective To study the feasibility of noninvasive detection of unstable plaques with 18F-Fluorodeoxyglucose (18F-FDG) PET/CT imaging. Methods Atherosclerotic plaques were induced in male New Zealand white rabbits. Animals were injected with FDG labeled with 18F,then examined with PET/CT. Aorta was explanted for photography with digital camera,and 18F-FDG uptake analysis. Thirty unstable plaques and 30 stable plaques were choosed so as to compare the quantitativly 18F-FDG uptake.The number of macrophages and smooth muscle cells was detected by immunohistochemical technique. Results Experimental group showed inconsistent uptake of 18F-FDG in the abdominal aorta. The results were confirmed in the ex vivo digital photo of the explanted aorta. The target to non target ratio(T/NT) and macrophages of unstable plaques were higher than stable plaques(P
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Objective To evaluate the feasibility, safty and methology of transradial coronary angiography Methods Transradial coronary angiography was carried out in 304 patients Results Transradial coronary angiography and ventriculography were successful in 291 patients (95 7%) Conclusion Radial artery seems to be both feasible and safe for coronary angiography, with a very low risk of local complication and more comfort for patients