Prevalence and risk factors of thyroid nodules in breast cancer women with different clinicopathological characteristics: a cross-sectional study.

BACKGROUND: Association between breast cancer (BC) and thyroid nodules (TNs) is still unclear. This research was to estimate the prevalence and risk factors of TN in Chinese BC women at initial diagnosis. METHODS: 1731 Chinese early-stage BC women at initial diagnosis underwent thyroid ultrasound and 1:1 age-matched Chinese healthy women underwent health examination in corresponding period were enrolled for analysis. RESULTS: Prevalence of TN and TI-RADS ≥ 4 TN in BC patients (56.27% and 9.76%) were higher than healthy people (46.04% and 5.49%), respectively, P < 0.001. Among BC patients, prevalence of TN and TI-RADS ≥ 4 TN in hormone receptor (HR)-positive patients (59.57% and 11.81%) were higher than HR-negative patients (48.77% and 5.10%), respectively, P < 0.001, while without difference between HR-negative patients and healthy people. After adjusting for age and BMI, HR-positive patients had higher risk of TN (OR = 1.546, 95%CI 1.251-1.910, P < 0.001) and TI-RADS ≥ 4 TN (OR = 3.024, 95%CI 1.943-4.708, P < 0.001) than HR-negative patients. Furthermore, the risk of TI-RADS ≥ 4 TN was higher in patients with estrogen receptor (ER) positive (OR = 2.933, 95%CI 1.902-4.524), progesterone receptor (PR) positive (OR = 1.973, 95%CI 1.378-2.826), Ki-67 < 20% (OR = 1.797, 95%CI 1.280-2.522), and tumor size < 2 cm (OR = 1.804, 95%CI 1.276-2.552), respectively, P < 0.001. CONCLUSIONS: Prevalence of TN, especially TI-RADS ≥ 4 TN, in Chinese early-stage BC women was higher than healthy people. HR-positive patients had higher prevalence and risk of TN, while without difference between HR-negative patients and healthy people. The increased risk of TN was correlated with ER-positive, PR-positive, lower Ki-67 expression, and smaller tumor size.

Systematic evaluation of the incidence of the knee donor area after autobone cartilage mosaic xentoplasty / 中国骨伤

OBJECTIVE@#To provide an overview of the incidence of knee donor -site morbidity after autologous osteochondral mosaicplasty.@*METHODS@#A comprehensive search was conducted in PubMed, EMbase, Wanfang Medical Network, and CNKI databases from January 2010 to April 20, 2021. Relevant literature was selected based on predefined inclusion and exclusion criteria, and data were evaluated and extracted. The correlation between the number and size of transplanted osteochondral columns and donor-site morbidity was analyzed.@*RESULTS@#A total of 13 literatures were included, comprising a total of 661 patients. Statistical analysis revealed an incidence of knee donor-site morbidity at 8.6% (57/661), with knee pain being the most common complaint, accounting for 4.2%(28/661). There was no significant correlation between the number of osteochondral columns and postoperative donor-site incidence (P=0.424, N=10), nor between the diameter size of osteochondral columns and postoperative donor-site incidence(P=0.699, N=7).@*CONCLUSION@#Autologous osteochondral mosaicplasty is associated with a considerable incidence of knee donor-site morbidity, with knee pain being the most frequent complaint. There is no apparent correlation between donor-site incidence and the number and size of transplanted osteochondral columns. Donors should be informed about the potential risks.

Decentralized Primal-Dual Proximal Operator Algorithm for Constrained Nonsmooth Composite Optimization Problems over Networks.

In this paper, we focus on the nonsmooth composite optimization problems over networks, which consist of a smooth term and a nonsmooth term. Both equality constraints and box constraints for the decision variables are also considered. Based on the multi-agent networks, the objective problems are split into a series of agents on which the problems can be solved in a decentralized manner. By establishing the Lagrange function of the problems, the first-order optimal condition is obtained in the primal-dual domain. Then, we propose a decentralized algorithm with the proximal operators. The proposed algorithm has uncoordinated stepsizes with respect to agents or edges, where no global parameters are involved. By constructing the compact form of the algorithm with operators, we complete the convergence analysis with the fixed-point theory. With the constrained quadratic programming problem, simulations verify the effectiveness of the proposed algorithm.

An Observational and Cross-Sectional Study of the Prevalence of Breast Lesions and Metabolic Dysfunction-Associated Fatty Liver Disease and their Relationship in China.

BACKGROUND AND AIMS: Metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed to replace the concept of non-alcoholic fatty liver disease (NAFLD). The relationship between MAFLD and breast lesions has not been reported. Therefore, we aimed to explore their prevalence and relationship among general population. METHODS: This cross-sectional study was conducted in the First Affiliated Hospital of Chongqing Medical University. After considering the exclusion criteria, 46,547 consecutive women who synchronously accepted breast and abdominal ultrasonography during one physical check-up between January 2015 and September 2018 were enrolled in this study. Prevalence of breast masses (BM), BI-RADS categories breast lesions and MAFLD in general population were revealed and the association between MAFLD and breast mass, BI-RADS categories breast lesions was analyzed by conducting logistic regression models. RESULTS: Of 46,547 participants, 8,020 (17.23%) had BM, 6,345 (13.63%) had MAFLD. Women with MAFLD had a lower BM prevalence than those without MAFLD (11.87% vs.18.08%; p<0.001). Overall, women with MAFLD had a lower risk of BM compared to those without MAFLD (adjusted OR=0.849, 95%CI: 0.775-0.930, p<0.001). Analysis based on BI-RADS categories breast lesions demonstrated that MAFLD is negatively related to BI-RADS 2/3 categories breast lesions (BI-RADS 2 category adjusted OR=0.980, 95%CI: 0.906-1.061, p=0.626; BI-RADS 3 category adjusted OR=0.736, 95%CI: 0.641-0.845, p=0.001), while associated with higher risk of BI-RADS ≥4 categories breast lesions (adjusted OR=1.220, 95%CI: 1.005-1.480, p=0.044). Subgroup analysis across age (18-44, 45-54 and≥55 years old) and body mass index (<25 and ≥25kg/m2) demonstrated that MAFLD was negatively associated with BI-RADS 2/3 categories breast lesions in premenopausal and perimenopausal women, and positively associated with BI-RADS ≥4 categories breast lesions in postmenopausal women, whether in obese or not. CONCLUSIONS: MAFLD was inversely associated with BM and BI-RADS 2/3 categories breast lesions in premenopausal and perimenopausal women, irrespective of obesity presence; MAFLD increased the risk of BM and BI-RADS ≥4 categories breast lesions in postmenopausal women.

Effect of Danggui Buxuetang on Podocyte Pyroptosis in Diabetic Kidney Disease Rats： An Exploration Based on TXNIP/NLRP3/GSDMD Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo observe the effect of Danggui Buxuetang on podocyte pyroptosis in diabetic kidney disease （DKD） rats and to explore the possible mechanism of its prevention and treatment of DKD and podocyte pyroptosis. MethodEight of the 50 male SD rats were randomly classified into a normal group， and the remaining 42 were fed a high-glucose and high-fat diet for six weeks and then intraperitoneally injected with 35 mg·kg-1 streptozotocin （STZ） for inducing type 2 diabetes. After successful modeling， they were randomized into the model group， low- （0.72 g·kg-1） and high-dose （1.44 g·kg-1） Danggui Buxuetang group， and irbesartan （0.017 g·kg-1） group and gavaged with the corresponding drugs， while those in the normal group and model group with an equal volume of normal saline， once per day， for 20 weeks. During the medication， the fasting blood glucose （FBG） and 24 h urine protein （24 h-UTP） were measured regularly. After administration， the pathological changes in renal tissues were observed by periodic acid-silver metheramine （PASM） staining， followed by the observation of ultrastructural changes in podocytes under the transmission electron microscope （TEM）. Serum levels of interleukin-1β （IL-1β） and interleukin-18 （IL-18） were determined by enzyme-linked immunosorbent assay （ELISA）. The DNA damage in renal tissue cells of rats was detected by in situ nick end-labeling （TUNEL） assay. The protein expression levels of thioredoxin interacting protein （TXNIP）， cysteine-dependent aspartate-directed protease-1 （Caspase-1）， and gasdermin D （GSDMD） in renal tissues of rats were detected by immunohistochemistry （IHC）， the expression levels of nucleotide binding domain like receptor protein 3 （NLRP3） and Wilms tumor protein-1 （WT-1） in podocytes by immunofluorescent （IF） staining， and the expression levels of TXNIP/NLRP3/Caspase-1/GSDMD pathway proteins and Synaptopodin in renal podocytes by Western blot. ResultCompared with the normal group， the model group exhibited increased FBG and 24 h UTP， glomerular hypertrophy， mesangial hyperplasia， increased extracellular matrix， thickened basement membrane， K-W nodules， vacuolar degeneration in renal tubular epithelial cells， foot process fusion or loss， elevated serum IL-1β and IL-18 levels and TUNEL-positive cells in renal tissue， enhanced NLRP3 but diminished WT-1 expression in podocytes， down-regulated Synaptopodin protein expression， and up-regulated TXNIP/NLRP3/Caspase-1/GSDMD protein expression （P<0.01）. Compared with the model group， Danggui Buxuetang high-dose group remarkably lowered FBG， 24-h UTP， and TUNEL-positive cells in renal tissue， improved renal histopathology and podocyte injury and loss， down-regulated NLRP3 expression in podocytes and TXNIP/NLRP3/Caspase-1/GSDMD protein expression levels， and up-regulated WT-1 expression in podocytes and Synaptopodin protein expression （P<0.05， P<0.01）. ConclusionDanggui Buxuetang inhibits podocyte pyroptosis to reduce proteinuria and delays the development of DKD possibly by regulating the TXNIP/NLRP3/GSDMD signaling pathway.

Effect of Danggui Buxuetang on Podocyte Injury in Diabetic Kidney Disease Rats： An Exploration Based on RIPK1/RIPK3/MLKL Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo observe the effect of Danggui Buxuetang on the podocyte injury and receptor-interacting protein kinase 1/receptor-interacting protein kinase3/mixed lineage kinase domain-like protein （RIPK1/RIPK3/MLKL） signaling pathway in diabetic kidney disease （DKD） ratsand to explore its possible mechanism against DKD. MethodEight of the 50 SD rats were randomly classified intoa normal group， and the remaining were fed a high-glucose and high-fat diet for six weeks and then intraperitoneally injected with 0.035 g·kg-1streptozotocin （STZ） for inducing type 2 diabetes. After successful modeling，they were randomized into the model group，high- and low-dose （1.44，0.72 g·kg-1） Danggui Buxuetang groups， and irbesartan （0.017 g·kg-1）group. After 20 weeks of drug intervention， the fasting blood glucose （FBG）， kidney index （KI），and urinary microalbumin-to-urine creatinine ratio （UACR）were detected in each group. The pathological changes in renal tissue were observed by hematoxylin-eosin （HE） staining， followed by the observation of ultrastructural changes in podocytes under the transmission electron microscope. The levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in renal tissue of rats were determined by enzyme-linked immunosorbent assay （ELISA）， and the protein expression levels of RIPK1， RIPK3， and MLKL in rat kidney tissue by immunohistochemistry. The apoptosis rate of podocytes was detected by in situ nick end-labeling （TUNEL） assay. The mRNA expression levels of RIPK1， RIPK3， and MLKL in kidney tissue of rats were measured by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and the protein expression levels of RIPK， RIPK3， and MLKL and podocyte marker Wilms tumor protein-1 （WT-1） in rat kidney tissue were assayed by Western blot. ResultCompared with the normal group， the model group exhibited elevated FBG， UACR， and KI （P<0.01）， glomerular hypertrophy， thickened basement membrane， increased extracellular matrix， mesangial hyperplasia， foot process fusion or loss， enhanced apoptosis in renal tissue， up-regulated TNF-α and IL-6 levels （P<0.01） and RIPK1/RIPK3/MLKL mRNA and protein expression （P<0.01）， and down-regulated WT-1 protein expression. Compared with the model group， Danggui Buxuetang high-dose group significantly reduced the levels of FBG， UACR， and KI， improved renal histopathology， podocyte loss， and apoptosis in renal tissue， down-regulated TNF-α and IL-6 levels and RIPK1/RIPK3/MLKL mRNA and protein expression （P<0.05， P<0.01）， and up-regulated WT-1 protein expression. ConclusionDanggui Buxuetang alleviates podocyte injury and delays the development of DKD possibly by regulating the RIPK1/RIPK3/MLKL signaling pathway.

Danggui Buxuetang Alleviates Oxidative Stress and Inflammation in Diabetic Kidney Disease Rats by Improving Mitochondrial Dysfunction of Podocytes / 中国实验方剂学杂志

ObjectiveTo investigate the intervention effect of Danggui Buxuetang on oxidative stress and inflammatory response in diabetic kidney disease （DKD） rats from its improvement of podocyte mitochondrial dysfunction. MethodSD rats were randomly divided into the control group and modeling group， and the ones in the latter group rats were fed a high-glucose and high-fat diet and then intraperitoneally injected with a small dose of streptozotocin （STZ） for inducing type 2 diabetes. The successfully modeled rats were randomized into the model group， high- and low-dose （1.44 and 0.72 g·kg-1） Danggui Buxuetang groups， and irbesartan （0.017 g·kg-1）group and gavaged with the corresponding drugs， while those in the normal and model groups with an equal volume of normal saline. After 20 weeks of drug intervention， the urinary microalbumin-to-urine creatinine ratio （UACR） and serum malondialdehyde （MDA） content and manganese superoxide dismutase （MnSOD） activity in each group were measured. The pathological changes in renal tissue were observed by Masson trichrome staining， and periodic acid-silver metheramine （PASM） staining， followed by the observation of ultrastructural changes in podocytes under the transmission electron microscope （TEM）. The expression level of reactive oxygen species （ROS） in rat kidney tissue was detected using a fluorescent probe dihydroethidium （DHE）. The protein expression levels of peroxisome proliferator-activated receptor γ -coactivator -1α （PGC-1α）， nucleotide-binding domain like receptor protein 3 （NLRP3）， and Wilms tumor protein-1 （WT-1） were measured by immunohistochemistry （IHC）， and the expression levels of NLRP3， interleukin-1β （IL-1β），and WT-1 in podocytes by immunofluorescence （IF） assay. The mRNA expression levels of PGC-1α and NLRP3 in the renal tissues were determined by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and the protein expression levels of PGC-1α， MnSOD， NLRP3， and IL-1β were assayed by Western blot. ResultCompared with the normal group， the model group exhibited elevated UACR and MDA content， weakened MnSOD activity （P<0.01）， glomerular hypertrophy， thickened basement membrane， mesangial hyperplasia， increased extracellular matrix， K-W nodules， podocyte mitochondrial swelling， disordered mitochondrial cristae， foot process fusion or loss， vacuolization， increased ROS （P<0.01）， enhanced NLRP3 and IL-1β but diminished WT-1 expression in podocytes， down-regulated PGC-1α mRNA expression （P<0.01） and PGC-1α and MnSOD protein expression （P<0.01）， and up-regulated NLRP3 mRNA expression and NLRP3 and IL-1β protein expression （P<0.01）. Compared with the model group， Danggui Buxuetang high-dose group significantly decreased UACR and MDA， enhanced MnSOD activity （P<0.05， P<0.01）， improved renal histopathology and podocyte mitochondrial ultrastructure， decreased ROS （P<0.05， P<0.01） and NLRP3 and IL-1β expression in podocytes， enhanced WT-1 expression in podocytes， up-regulated the mRNA and protein levels of PGC-1α and MnSOD， and down-regulated the mRNA and protein levels of NLRP3 and IL-1β （P<0.05， P<0.01）. ConclusionDanggui Buxuetang alleviates oxidative stress， reduces inflammatory response， protects kidney， and delays the progression of DKD possibly by improving the mitochondrial dysfunction in podocytes of DKD rats.

Clinical effects of arthroscopy-assisted anterior cruciate ligament tibial eminence avulsion fracture compared with traditional open surgery:a Meta-analysis / 中国骨伤

OBJECTIVE@#To systematically evaluate the clinical efficacy of arthroscopy and traditional incision in the treatment of tibial avulsion fracture of anterior cruciate ligament (ACL).@*METHODS@#From July 2010 to July 2020, clinical comparative trial about arthroscopy and traditional incision in the treatment of ACL tibial avulsion fracture was conducted by using computer-based databases, including Embase, Pubmed, Central, Cinahl, PQDT, CNKI, Weipu, Wanfang, Cochrane Library, CBM. Literature screening and data extraction were carried out according to the inclusion and exclusion criteria, and the quality of the included literature was evaluated by improved Jadad score and Ottawa Newcastle scale (NOS). The operation time, hospital stay, fracture healing time, knee range of motion, postoperative excellent and good rate, complication rate, Lysholm score, International Knee Documentation Committee (IKDC) score and Tegner score were statistically analyzed by Review Manager 5.3 software.@*RESULTS@#Finally, 16 literatures were included, including 1 randomized controlled trial and 15 non randomized controlled trials, with a total of 822 patients (405 in arthroscopy group and 417 in traditional incision group). Meta analysis showed that the operation time [MD=-9.03, 95% CI(-14.36, -3.70), P<0.001], hospital stay [MD=-5.81, 95%CI(-9.32, -2.31), P=0.001] and fracture healing time [MD=-14.61, 95% CI(-17.93, -11.28), P<0.001] in the arthroscopy group were better than those in the traditional incision group. The incidence of complications in arthroscopy group was lower than that in traditional incision group[OR=0.15, 95%CI(0.07, 0.33), P<0.001]. The postoperative excellent and good rate[OR=4.39, 95%CI (1.96, 9.82), P<0.001], knee mobility[MD=6.78, 95%CI(2.79, 10.77), P<0.001], Lysholm score[MD=11.63, 95%CI(4.91, 18.36), P<0.001], IKDC score[MD=7.83, 95%CI(6.09, 9.57), P<0.001] and Tegner score[MD=0.60, 95%CI(0.31, 0.89), P<0.001] in the arthroscopic group were higher than those in the traditional incision group.@*CONCLUSION@#Compared with the traditional open reduction and internal fixation, arthroscopic surgery in patients with ACL tibial avulsion fracture can shorten the operation time, hospital stay and fracture healing time, reduce the incidence of postoperative complications, and obtain good postoperative knee function. It can be recommended as one of the first choice for patients with ACL tibial avulsion fracture.

Relationship between the Metabolic Associated Fatty Liver Disease and Endometrial Thickness in Postmenopausal Women: A Cross-sectional Study in China.

Objectives: To determine the relationship between the endometrial thickness (ET) and metabolic associated fatty liver disease (MAFLD) in the postmenopausal women who have a comprehensive health examination. Methods: This was a population-based, retrospective observational study of the prevalence of MAFLD in 8594 postmenopausal women with different ET in the Quality Control Center of Health Examination in Chongqing, China. Binary and multivariable logistic regression analyses were used to obtain odds ratios and 95% confidence intervals for patients of different ET with MAFLD after adjusting for age. Results: The incidences of MAFLD were 28.6% (1352), 30.3% (1058), 34.9% (133) in postmenopausal women with ET of < 3 mm, 3 mm ≤ & < 5 mm, and ≥ 5 mm, respectively. Compared with a baseline ET of less than 5.0 mm, the risk of MAFLD in patients with ET of ≥5.0 mm is higher (OR=1.291, 95% CI: 1.041-1.603, P<0.05). After adjustment for age, a statistically significant positive correlation was still observed. The increased prevalence of MAFLD in patients with ET of 3 mm ≤ &<5 mm (OR=1.110, 95% CI: 1.008-1.223) and ≥5 mm (OR=1.383, 95% CI: 1.109-1.724) achieved statistical significance, respectively. In addition, multiple logistic analyses controlling for age also confirmed the finding of positive correlation among body mass index (BMI) and ET. Conclusion: Our results suggest that there is a positive correlation between MAFLD and ET in postmenopausal women. In addition, increased BMI is also associated with an increased risk of thickened endometrium.

Prevalence of and risk factors for metabolic associated fatty liver disease in an urban population in China: a cross-sectional comparative study.

BACKGROUND: Metabolic associated fatty liver disease (MAFLD) is a new definition for liver disease associated with known metabolic dysfunction. Based on new diagnostic criteria, we aimed to investigate its prevalence and risk factors in Chinese population. METHODS: We conducted this study in a health examination population who underwent abdominal ultrasonography in China. The diagnosis of MAFLD was based on the new diagnostic criteria. The characteristics of the MAFLD population, as well as the associations between MAFLD and metabolic abnormalities, were explored. Mann-Whitney U test and chi-square test were performed to compare different variables. Binary logistic regression was used to determine the risk factors for MAFLD. RESULTS: Among 139,170 subjects, the prevalence of MAFLD was 26.1% (males: 35.4%; females: 14.1%). The prevalence based on female menopausal status, that is, premenopausal, perimenopausal, and postmenopausal, was 6.1%, 16.8%, and 30.2%, respectively. In different BMI groups (underweight, normal, overweight and obese), the prevalence was 0.1%, 4.0%, 27.4% and 59.8%, respectively. The proportions of abnormal metabolic features in the MAFLD group were significantly higher than those in the non-MAFLD group, as was the proportion of elevated alanine aminotransferase (ALT) (42.5% vs. 11%, P < 0.001). In nonobese individuals with MAFLD, the proportions of abnormal metabolic features were also all significantly higher than those in nonobese individuals without MAFLD. The prevalence of metabolic syndrome (MS), dyslipidaemia, and hyperuricaemia, respectively, in the MAFLD group (53.2%, 80.0%, and 45.0%) was significantly higher than that in the non-MAFLD group (10.1%, 41.7%, and 16.8%). Logistic regression revealed that age, BMI, waist circumference, ALT, triglycerides, fasting glucose, uric acid and platelet count were associated with MAFLD. CONCLUSIONS: MAFLD is prevalent in China and varies considerably among different age, sex, BMI, and female menopausal status groups. MAFLD is related to metabolic disorders, especially obesity, while metabolic disorders also play important roles in the occurrence of MAFLD in nonobese individuals. MAFLD patients exhibit a high prevalence of MS, dyslipidaemia, hyperuricaemia, and elevated liver enzymes. MAFLD tends to coexist with systemic metabolic disorders, and a deep inner relationship may exist between MAFLD and MS. Metabolic disorders should be considered to improve the management of MAFLD.

Avoiding high ozone pollution in Delhi, India.

Surface ozone is a major pollutant threatening public health, agricultural production and natural ecosystems. While measures to improve air quality in megacities such as Delhi are typically aimed at reducing levels of particulate matter (PM), ozone could become a greater threat if these measures focus on PM alone, as some air pollution mitigation steps can actually lead to an increase in surface ozone. A better understanding of the factors controlling ozone production in Delhi and the impact that PM mitigation measures have on ozone is therefore critical for improving air quality. Here, we combine in situ observations and model analysis to investigate the impact of PM reduction on the non-linear relationship between volatile organic compounds (VOC), nitrogen oxides (NOx) and ozone. In situ measurements of NOx, VOC, and ozone were conducted in Delhi during the APHH-India programme in summer (June) and winter (November) 2018. We observed hourly averaged ozone concentrations in the city of up to 100 ppbv in both seasons. We performed sensitivity simulations with a chemical box model to explore the impacts of PM on the non-linear VOC-NOx-ozone relationship in each season through its effect on aerosol optical depth (AOD). We find that ozone production is limited by VOC in both seasons, and is particularly sensitive to solar radiation in winter. Reducing NOx alone increases ozone, such that a 50% reduction in NOx emissions leads to 10-50% increase in surface ozone. In contrast, reducing VOC emissions can reduce ozone efficiently, such that a 50% reduction in VOC emissions leads to ∼60% reduction in ozone. Reducing PM alone also increases ozone, especially in winter, by reducing its dimming effects on photolysis, such that a 50% reduction in AOD can increase ozone by 25% and it also enhances VOC-limitation. Our results highlight the importance of reducing VOC emissions alongside PM to limit ozone pollution, as well as benefitting control of PM pollution through reducing secondary organic aerosol. This will greatly benefit the health of citizens and the local ecosystem in Delhi, and could have broader application for other megacities characterized by severe PM pollution and VOC-limited ozone production.

Association between ovarian and breast masses among Chinese women in Chongqing based on ultrasonography screening: A cross-sectional study.

OBJECTIVE: To explore associations between breast and ovarian tumors among the general healthcare population. METHODS: We conducted a cross-sectional retrospective study that enrolled 47 951 consecutive Chinese women who took health check-ups between January 2015 and July 2018 and accepted both breast and gynecologic ultrasound scans during one healthcare examination in The Quality Control Center of Health Examination in Chongqing (China). Prevalence of breast and ovarian tumors was addressed. Multivariable logistic regressions were applied to assess the association between breast and ovarian lesions after adjusting for age, height, and body mass index, using ultrasonographic reports. RESULTS: Among participants, 8481 (17.7%) had breast masses (BM), and 2994 (6.2%) had ovarian masses (OM). After adjusting for age, height and body mass index (BMI), women with OM had an increased risk of BM (odds ratio [OR] 1.139, 95% confidence interval [CI] 1.040-1.249, P = 0.005) than those without OM. Furthermore, subgroup analysis based on menopausal status revealed a positive association between the occurrence of OM and BM in premenopausal women (adjusted OR 1.155, 95% CI 1.052-1.269, P = 0.012) but this was not significant in perimenopausal or postmenopausal women. In subgroup analysis on BMI, positive correlations between OM and BM were found in women with an underweight BMI (OR 1.433, 95% CI 1.048-1.960, P = 0.024) and with a normal BMI (OR 1.130, 95% CI 1.018-1.253, P = 0.021), but this was not significant in overweight or obese cohorts. CONCLUSION: A high prevalence of ultrasound-revealed breast and ovarian tumors were found in Chinese women. Women with OM or BM have an increased prevalence of BM or OM, particularly among younger women and women with a lower BMI.

Sources of black carbon during severe haze events in the Beijing-Tianjin-Hebei region using the adjoint method.

The Beijing-Tianjin-Hebei (BTH) region in China has been frequently suffering from severe haze events (observed daily mean surface fine particulate matter PM2.5 concentrations larger than 150 µg m-3) partially caused by certain types of large-scale synoptic patterns. Black carbon (BC), as an important PM2.5 component and a primarily emitted species, is a good tracer for investigating sources and formation mechanisms leading to severe haze pollutions. We apply GEOS-Chem model and its adjoint to quantify the source contributions to BC concentrations at the surface and at the top of the planetary boundary layer (PBL) during typical types of severe haze events for April 2013-2017 in BTH. Four types of severe haze events, mainly occurred in December-January-February (DJF, 62.3%) and in September-October-November (SON, 26.3%), are classified based on the associated synoptic weather patterns using principal component analysis. Model results reasonably capture the daily variations of BC measurements at three ground sites in BTH. The adjoint method attributes BC concentrations to emissions from different source sectors and from local versus regional transport at the model spatial and temporal resolutions. By source sectors, the adjoint method attributes the daily BC concentrations during typical severe haze events (in winter heating season) in Beijing largely to residential emissions (48.1-62.0%), followed by transportation (16.8-25.9%) and industry (19.1-29.5%) sectors. In terms of regionally aggregated source influences, local emissions in Beijing (59.6-79.5%) predominate the daily surface BC concentrations, while contributions of emissions from Beijing, Hebei, and outside BTH regions are comparable to the daily BC concentrations at the top of PBL (~200-400 m). Our adjoint analyses would provide a scientific support for joint regional and targeted control policies on effectively mitigating the particulate pollutions when the dominant synoptic weather patterns are predicted.

Association Between Breast and Thyroid Lesions: A Cross-Sectional Study Based on Ultrasonography Screening in China.

Introduction: Prior research has shown an association between breast and thyroid cancers, although their relationship is unclear. In China, asymptomatic women undergoing regular health checkups usually undergo breast and thyroid ultrasonography screening. The present cross-sectional ultrasound-based study estimated the prevalence of breast masses (BM) and thyroid nodules (TN) and their relationship among a population-based cohort of Chinese women. Methods: This study included 34,184 consecutive asymptomatic Chinese women who underwent both breast and thyroid ultrasound evaluation during one health care examination. Detected lesions were assigned into categories of different malignant risks according to the Breast and Thyroid Imaging Reporting and Data System (BI-/TI-RADS). Binomial logistic regression was used to determine the association between occurrence of BM and TN, and multinomial logistic regression was used to analyze the correlation of BM and TN in different BI-/TI-RADS categories. Associations between BM and TN, as well as anthropometric and biochemical markers, were also explored. Results: Of those enrolled, 6371 (18.6%) had BM, 12,153 (35.6%) had TN, and 2279 (6.7%) had both. After adjusting for age, body mass index (BMI), and height, females with TN had a higher risk of BM (odds ratio [OR] = 1.151, 95% confidence interval [CI 1.081-1.225], p < 0.0001) than those with normal thyroids, and females with BM had a higher risk of TN (OR = 1.165 [CI 1.096-1.238], p < 0.0001) than those without BM. Women with a TN >10 mm (OR = 1.249 [CI 1.104-1.413], p = 0.0004) and those with a TN ≤10 mm (OR = 1.134 [CI 1.062-1.211], p = 0.0002) were at higher risk of BM compared with those with normal thyroids. As RADS categories increased, so did the correlation between BM and TN. The increased risk of TN was associated with a higher BMI, height, systolic blood pressure, and a lower plasma albumin level. The increased risk of BM was associated with a lower BMI, plasma albumin levels, and higher height. Conclusions: A high prevalence of BM and TN was detected by ultrasonography screening in this cohort of Chinese women. These lesions occurred frequently and simultaneously, particularly in women with lesions in higher RADS categories.

A population-based study of the relationship between endometrial thickness and prevalence of breast mass in postmenopausal women.

OBJECTIVES: To determine the relationship between endometrial thickness and the prevalence of breast mass in postmenopausal women. METHODS: The prevalence of breast mass was investigated in 6759 postmenopausal women (≥60 years) with different endometrial thicknesses who underwent breast and transvaginal ultrasonography from January 2015 to June 2017. Multivariable logistic regression analysis was used to obtain odds ratios and 95% confidence intervals for breast mass in postmenopausal women with increased endometrial thickness after adjusting for age, height, and body mass index. RESULTS: Compared with a baseline endometrial thickness of less than 3 mm, the prevalence of breast mass increased in patients with endometrial thickness ≥3-4.9 mm (OR 1.077; 95% CI, 0.868-1.338), ≥5-9.9 mm (OR 1.910; 95% CI, 1.189-3.067), and ≥10 mm (OR 3.546; 95% CI, 1.458-8.620) (Ptrend =0.0026). In subgroup analysis, correlations between endometrial thickness and prevalence of breast mass with malignant possibility (BI-RADS ≥3) were similar and remained significant (Ptrend =0.035). CONCLUSION: Postmenopausal women with endometrial thickness greater than or equal to 5 mm have a significantly increased prevalence of breast mass and breast mass with malignant possibility (BI-RADS ≥3). Breast cancer screening for postmenopausal women with increased endometrial thickness should be given greater attention.

Neoadjuvant chemotherapy reduces the expression rates of ER, PR, HER2, Ki67, and P53 of invasive ductal carcinoma.

To analyze whether neoadjuvant chemotherapy (NAC) changes the expression rates of invasive ductal carcinoma (IDC) markers: estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), Ki67, and P53.This was a retrospective study of 112 IDC patients who underwent NAC (docetaxel+epirubicin/pirarubicin+cyclophosphamide) but without pathological complete response (pCR) in 2012 to 2013 at the First Affiliated Hospital of Chongqing Medical University. The IDC subtypes and tumor protein markers were analyzed by immunohistochemistry (IHC). Specific changes in tumor protein markers before/after NAC were compared.The decrease in the positive rate of Ki-67 was the most significant, from 75.9% before NAC to 41.1% after NAC (P < .001). The positive rate of HER2 decreased from 42.0% before NAC to 32.1% after NAC (P = .04). The positive rate of ER decreased from 66.1% before NAC to 56.2% after NAC (P = .04). Increased number of metastatic lymph nodes (P = .006) and body mass index (BMI) (P = .028) seemed to be related to conversion of PR (positive to negative). There was statistical association between the Ki-67 (positive to negative) with the age greater or equal to 50 (P = .015). The BMI greater or equal to 24 (P = .021), age greater or equal to 50 (P = .047), and blood type A (P = .038) were independently associated with conversion of P53 (positive to negative). The BMI greater or equal to 24 (P = .004), number of metastatic lymph nodes greater or equal to 1 (P = .029) and TNM stages I-II (P = .008) were statistically associated with change of HER2 (positive to negative).In patients without pCR, NAC leads to changes in Ki-67, HER2, and hormone receptor (HR) expression. Age, BMI, number of metastatic lymph nodes, and TNM stage are associated with some changes of markers.

Hypoxia-Inducible Factor 1α Regulates the Transforming Growth Factor ß1/SMAD Family Member 3 Pathway to Promote Breast Cancer Progression.

PURPOSE: The transforming growth factor ß1 (TGF-ß1)/SMAD family member 3 (SMAD3) pathway, and hypoxia-inducible factor 1α (HIF-1α) are two key players in various types of malignancies including breast cancer. The TGF-ß1/SMAD3 pathway can interact with HIF-1α in some diseases; however, their interaction in breast cancer is still unknown. Therefore, our study aimed to investigate the interactions between the TGF-ß1/SMAD3 pathway and HIF-1α in breast cancer. METHODS: Expression of HIF-1α in serum of breast cancer patients and healthy controls was detected by quantitative reverse transcription polymerase chain reaction, and the diagnostic value of HIF-1α for breast cancer was evaluated by receiver operating characteristic curve analysis. Breast cancer cell lines overexpressing SMAD3 and HIF-1α were established. Cell apoptosis and proliferation following different treatments were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, and cell counting kit-8, respectively. Expression of related proteins was detected by western blot. RESULTS: Serum levels of HIF-1α were higher in breast cancer patients than in normal controls. Both SMAD3 and HIF-1α overexpression inhibited cell apoptosis and promoted cell proliferation. Treatment with inhibitors of HIF-1α and SMAD3 promoted apoptosis in breast cancer cells and inhibited their proliferation. Overexpression of HIF-1α promoted the expression of TGF-ß1 and SMAD3, while SMAD3 overexpression did not significantly affect expression of HIF-1α or TGF-ß1. CONCLUSION: HIF-1α serves as an upstream regulator of the TGF-ß1/SMAD3 pathway and promotes the growth of breast cancer.