The value of dynamic contrast-enhanced magnetic resonance imaging combined with apparent diffusion coefficient in the differentiation of benign and malignant diseases of the breast.

BACKGROUND: The value of combined dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and apparent diffusion coefficient (ADC) histogram analysis for the diagnosis of breast cancer has not been evaluated in previous studies. PURPOSE: To investigate the diagnostic value of DCE-MRI combined with ADC in benign and malignant breast lesions. MATERIAL AND METHODS: The clinicopathological imaging data included 168 patients (177 lesions) with breast lesions who underwent convention breast MRI, DCE-MRI, and diffusion-weighted imaging (DWI); they were divided into the benign lesion group (n = 39) and malignant lesion group (n = 129) based on pathology. RESULTS: Using the type III outflow curve as a diagnostic criterion for malignant breast lesions, the diagnostic sensitivity was 76.9%, the specificity was 80%, the correct rate was 72.2%, and its area under the curve (AUC) was 0.823. Using an enhancement ratio > 100% as a diagnostic criterion for malignant breast lesions, the sensitivity was 61.5%, specificity was 80%, and AUC was 0.723. Using > 3 ipsilateral vessels as a diagnostic criterion for malignant lesions in the breast resulted in a diagnostic sensitivity of 81.6%, a specificity of 80.8%, and an AUC of 0.805. CONCLUSION: The type of time intensity curve DCE-MRI, the early enhancement rate in the first phase, the number of ipsilateral vessels, and the ADC full volume histogram of the blood supply score and DWI are valuable in the diagnosis of benign and malignant breast lesions.

Association between the CYP1A1 A2455G polymorphism and risk of cancer: evidence from 272 case-control studies.

A2455G is a common polymorphism in CYP1A1, showing differences in its biological functions. Case-control studies have been performed to elucidate the role of A2455G in cancer; however, the results are conflicting and heterogeneous. Hence, we performed a meta-analysis to investigate the association between cancer susceptibility and A2455G (64,593 cases and 91,056 controls from 272 studies) polymorphism in different inheritance models. We used odds ratios with 95% confidence intervals to assess the strength of the association. Overall, significantly increased cancer risk was observed in any genetic model (dominant model, odds ration [OR] = 1.19, 95% confidence interval [CI] = 1.13-1.25; recessive model: OR = 1.41, 95% CI = 1.29-1.54; additive model: OR = 1.49, 95% CI = 1.35-1.65) when all eligible studies were pooled into the meta-analysis. In further stratified and sensitivity analyses, the elevated risk remained for subgroups of breast cancer, colorectal cancer, esophageal cancer, hepatocellular cancer, head and neck cancer, leukemia, lung cancer, and prostate cancer, but these associations vary in different ethnic populations. In summary, this meta-analysis suggests the participation of A2455G in the susceptibility for some cancers, such as breast cancer, colorectal cancer, lung cancer, and so on. Moreover, ethnicity, histological type of cancer, and smokers seem to contribute to varying expressions of the A2455G on some cancers risk. In addition, our work also points out the importance of new studies for A2455G polymorphism in some cancer types, such as gallbladder cancer, Indians of breast cancer, and Caucasians of ovarians, because these cancer types had high heterogeneity in this meta-analysis (I(2) > 75%).

Brain abscess due to Aggregatibacter aphrophilus in association with atrial septal defect：Case report and literature review.

BACKGROUND: Aggregatibacter aphrophilus（A. aphrophilus）is one of the organisms of the HACEK group. Previously reported cases of brain abscesses caused by A. aphrophilus infection have occurred in children with a basis for congenital heart disease, or in adults with a basis for dental disease. Rare cases of brain abscess caused by A. aphrophilus have been reported in adults with congenital heart disease or in patients without dental disease history. Herein we present a rare case of brain abscess caused by A. aphrophilus, who was in association with atrial septal defect for more than 20 years, and had no dental disease and did not develop infective endocarditis. CASE PRESENTATION: A 51-year-old female was admitted due to progressively worsening headache and left limb weakness for more than 10 days. She denied the history of chronic diseases such as hypertension and diabetes, and no periodontal disease. While she had a history of atrial septal defect, a form of congenital heart disease with severe pulmonary hypertension for more than 20 years. After admission, echocardiographic illustrated congenital heart disease with severe pulmonary hypertension. CT and MRI showed brain abscess. Cerebrospinal fluid (CSF) results also confirmed the presence of intracranial infection. Empirical therapy with vancomycin 1.0 g i.v q12h and meropenem 2.0 g i.v q8h was initiated from the day of admission. On the fourth day after admission, brain abscess resection and decompressive craniectomy were performed, and the pus drained on operation were cultured and Gram-negative bacilli grew, which was identified as A.aphrophilus. Vancomycin was discontinued and meropenem was continued（2.0 g i.v q8h）for 5 weeks, followed by oral levofloxacin 0.5 qd for 4 weeks of out-patient antibiotics. The patient recovered fully within 9 weeks of treatment. CONCLUSIONS: This is the first case of A. aphrophilus to cause brain abscess in adult with a history of congenital heart disease for more than 20 years, who had no dental disease and did not develop infective endocarditis. We also highlight the value of bacterial 16 S rDNA PCR amplification and sequencing in identifying bacteria in abscesses which are culture-negative, and prompt surgical treatment，choosing effective antibiotics and appropriate course of treatment will get better clinical effect.

Nuclear-targeted p53 and DOX co-delivery of chitosan derivatives for cancer therapy in vitro and in vivo.

The nucleus is one of the most important cellular organelles. Chitosan-grafted poly-(N-3-carbobenzyloxy-lysine) (CCL) decorated with human immunodeficiency virus-1 transactivator of transcription (TAT) can co-deliver p53 and doxorubicin into the nucleus simultaneously, such that their antitumor functions are exerted. However, TAT-CCL has been shown to have an anti-tumor effect only in vitro; the effect in vivo was unsatisfactory. Here, a unique nucleus-targeted delivery system based on amidized TAT (aTAT)-CCL with aTAT functional on the surface was designed to achieve a highly efficient nucleus-targeting gene and drug delivery system for effective cancer cell elimination in vitro and in vivo. In this delivery system, TAT is amidized to inhibit its nonspecific interactions. Confocal laser scanning microscopy observations revealed that if aTAT-CCL was incubated in pH 5.0 acetate buffer solution for 24 h before use (named aTAT-CCL-HB), more aTAT-CCL-HB entered the nucleus compared with aTAT-CCL or CCL. aTAT-CCL-HB can also achieve high gene transfection and drug delivery efficiencies and low viability in HepG2 cells. However, only aTAT-CCL achieved extensive circulation in the blood compartment and high antitumor activity in vivo. Amidization of TAT in vectors may become a promising strategy for nucleus-targeted delivery systems, especially in in vivo applications.

Hypoxia-inducible factor-1α rs11549465 C>T and rs11549467 G>A gene polymorphisms are associated with an increased risk of digestive cancers in Asians.

OBJECTIVE: We used a meta-analysis framework to examine the correlation between HIF-1α gene polymorphisms and the susceptibility to digestive cancers. METHODS: Cochrane Library Database, EMBASE, MEDLINE, Pubmed, CINAHL, Chinese Biomedical Database and Web of Science were searched without language restrictions to identify relevant case-control studies reporting data on HIF-1α gene polymorphisms in digestive cancers. Data was extracted from the selected studies and meta-analysis was carried out using STATA 12.0 and Comprehensive Meta-analysis 2.0 softwares. Relative risk (RR) and its 95% confidence interval (95%CI) were calculated. A total of 8 eligible case-control studies were included. These 8 studies contained a combined total of 1,276 patients diagnosed with various digestive cancers and 3,392 healthy controls. Two functional HIF-1α polymorphisms (rs11549465 C>T and rs11549467 G>A) were examined in these 8 studies. RESULTS: Our findings demonstrated that both rs11549465 C>T and rs11549467 G>A HIF-1α polymorphisms conferred significantly increased risk of digestive cancers. However, ethnicity-stratified analysis revealed that HIF-1α rs11549465 C>T and rs11549467 G>A polymorphisms were associated with an elevated risk of digestive cancer in Asians, but not in Caucasians. These two polymorphisms also conferred different degrees of susceptibility to various digestive cancer types. CONCLUSION: Our meta-analysis suggests that HIF-1α rs11549465 C>T and rs11549467 G>A polymorphisms influence the pathogenesis of digestive cancers in Asians.