A novel non-chemically amplified resist based on polystyrene-iodonium derivatives for electron beam lithography.

To break the resolution limitation of traditional resists, more work is needed on non-chemically amplified resists (non-CARs). Non-CARs based on iodonium salt modified polystyrene (PS-I) were prepared with controllable molecular weight and structure. The properties of the resist can be adjusted by the uploading of iodonium salts on the polymer chain, the materials with a higher proportion of iodonium salts show better lithography performance. By comparing contrast curves and quality of the lithographic patterns, the optimum developing condition of 4-methyl-2-pentanone and ethyl alcohol (v:v = 1:7) was selected. The high-resolution stripes of 15 nm half-pitch (HP) can be achieved by PS-I0.58in e-beam lithography (EBL). PS-I0.58shows the advanced lithography performance in the patterns of 16 nm HP and 18 nm HP stripes with low line edge roughness (3.0 nm and 2.4 nm). The resist shows excellent potential for further pattern transfer, the etch selectivity of resist PS-I0.58to the silicon was close to 12:1. The lithographic mechanism of PS-I was investigated by experimental and theoretical calculation, which indicates the polarity of materials changes results in the solubility switch. This work provides a new option and useful guidelines for the development of high-resolution resist.

Anti-reflux effects of a novel esophagogastric asymmetric anastomosis technique after laparoscopic proximal gastrectomy.

BACKGROUND: Reflux esophagitis is a common postoperative complication of proximal gastrectomy. There is an urgent need for a safer method of performing esophageal-gastric anastomosis that reduces the risk of reflux after proximal gastrectomy. We hypothesize that a novel technique termed esophagogastric asymmetric anastomosis (EGAA) can prevent postoperative reflux in a safe and feasible manner. AIM: To observe a novel method of EGAA to prevent postoperative reflux. METHODS: Initially, we employed a thermal stress computer to simulate and analyze gastric peristalsis at the site of an esophagogastric asymmetric anastomosis. This was done in order to better understand the anti-reflux function and mechanism. Next, we performed digestive tract reconstruction using the EGAA technique in 13 patients who had undergone laparoscopic proximal gastrectomy. Post-surgery, we monitored the structure and function of the reconstruction through imaging exams and gastroscopy. Finally, the patients were followed up to assess the efficacy of the anti-reflux effects. RESULTS: Our simulation experiments have demonstrated that the clockwise contraction caused by gastric peristalsis and the expansion of the gastric fundus caused by the increase of intragastric pressure could significantly tighten the anastomotic stoma, providing a means to prevent the reverse flow of gastric fluids. Thirteen patients with esophagogastric junction tumors underwent laparoscopic proximal gastrectomy, with a mean operation time of 304.2 ± 44.3 min. After the operation, the upper gastroenterography in supine/low head positions showed that eight patients exhibited no gastroesophageal reflux, three had mild reflux, and two had obvious reflux. The abdominal computed tomography examination showed a valve-like structure at the anastomosis. During follow-up, gastroscopy revealed a closed valve-like form at the anastomosis site without stenosis or signs of reflux esophagitis in 11 patients. Only two patients showed gastroesophageal reflux symptoms and mild reflux esophagitis and were treated with proton pump inhibitor therapy. CONCLUSION: EGAA is a feasible and safe surgical method, with an excellent anti-reflux effect after proximal gastrectomy.

Chemically Amplified Molecular Glass Photoresist Regulated by 2-Aminoanthracene Additive for Electron Beam Lithography and Extreme Ultraviolet Lithography.

2-Aminoanthracene was used as a nucleophilic additive in a molecular glass photoresist, bisphenol A derivative (BPA-6-epoxy), to improve advanced lithography performance. The effect of 2-aminoanthracene on BPA-6-epoxy was studied by electron beam lithography (EBL) and extreme ultraviolet lithography (EUVL). The result indicates that the additive can optimize the pattern outline by regulating epoxy cross-linking reaction, avoiding photoresist footing effectively in EBL. The EUVL result demonstrates that 2-aminoanthracene can significantly reduce line width roughness (LWR) for HP (Half-Pitch) 25 nm (from 4.9 to 3.8 nm) and HP 22 nm (from 6.9 to 3.0 nm). The power spectrum density (PSD) curve further confirms the reduction of roughness at medium and high frequency for HP 25 nm and the whole range of frequency for HP 22 nm, respectively. The study offers useful guidelines to improve the roughness of a chemically amplified molecular glass photoresist with epoxy groups for electron beam lithography and extreme ultraviolet lithography.

Low Dimensional Nanostructure-Assisted Long-Range Surface Plasmon Resonance Sensors With High Figure of Merit.

Long-range surface plasmon resonance (LRSPR) sensors have been extensively studied by virtue of their extremely narrow full width at half maxima (FWHM) characteristics, but their low sensitivity remains an important factor limiting the figure of merit (FOM), making the sensors have difficulties in detecting small refractive index changes accurately. To address this problem, this paper proposes and demonstrates a low dimensional nanostructure (Au nanospheres, WS2) assisted LRSPR sensor to achieve an effective enhancement of the sensor interfaced electric field and thus improve the sensitivity. The performance parameters of the two sensors are compared with the LRSPR sensor by finite element method analysis, and the results showed that the assistance of the low dimensional nanostructure has a positive effect on the sensor. The first refractive index sensing experiment of the WS2-assisted LRSPR sensor was realized with a 25.47% increase in sensitivity and a 7.13% increase in FOM simultaneously, and the Au nanospheres-assisted LRSPR sensor with a 29.23% increase in sensitivity and a 15.95% increase in FOM simultaneously. The introduction of low dimensional nanostructures provides a flexible and effective means of sensitization for LRSPR sensors, making the plasmon resonance sensors combine high sensitivity, narrow FWHM and high FOM, which have promising applications in biochemical sensing.

Oral mycobiota and pancreatic ductal adenocarcinoma.

Early detection of pancreatic ductal adenocarcinoma (PDAC) is essential for survival. Preliminary research demonstrated significant associations between structural alternation of mycobiota and PDAC. In this study, we investigated the associations between oral mycobiota and PDAC. We further explored mycobiota biomarkers for PDAC detection. We enrolled 34 PDAC patients and 35 matched healthy controls from West China hospital in Southwest China. Demographic data, clinical information, and salivary samples were collected. Mycobiota characteristics were defined using Internal Transcribed Spacer (ITS) ribosomal RNA sequencing. We found that the PDAC patients had significant increase in fungal abundance (P < 0.001) and significant decrease in fungal diversity (P < 0.001) in comparison to the healthy controls. A higher abundance of Basidiomycota and Unclassifed_p_Ascomycota was associated with an increased risk of PDAC. With each increase of abundance of g__unclassified_k__Fungi and g__unclassified_p__Ascomycota in PDAC patients, the risk of pancreatic cancer increased by 1.359 odds and 1.260 odds, respectively. Aspergillus (AUC = 0.983, 95% CI 0.951-1.000) and Cladosporium (AUC = 0.969, 95% CI 0.921-1.000) achieved high classification powers to distinguish PDAC patients from the healthy controls. The rapid, inexpensive tests of ITS1 sequencing of mycobiota and PCR detection of potential fungal biomarkers make it promising for the clinical practice to use oral microbes for PDAC early detection and prevention. Results of our study provide evidence that salivary mycobiota may provide insights into cancer risk, prevention, and detection.

A Prediction Model for Peak Expiratory Flow Derived From Venous Blood Biomarkers and Clinical Factors in Amyotrophic Lateral Sclerosis.

Although peripheral venous blood biomarkers are related to respiratory function in Amyotrophic lateral sclerosis (ALS) patients, there are still few prediction models that predict pulmonary function. This study aimed to investigate the venous blood biomarkers associated with respiratory function in patients with ALS from southwest China and to create prediction models based on those clinical biomarkers using logistic regression. A total of 319 patients with ALS from the retrospective cohort and 97 patients with ALS from the prospective cohort were enrolled in this study. A multivariable prediction model for the correlation between peak expiratory flow (PEF) and hematologic, biochemical laboratory parameters, and clinical factors in patients with ALS was created. Along with female patients, bulbar-onset, lower body mass index (BMI), later age of onset, lower level of creatinine, uric acid, triglyceride, and a higher level of high-density lipoprotein cholesterol (HDL_C) were related to reduced PEF. The area under the receiver operating characteristics (ROC) curve is.802 for the test set and.775 for the validation set. The study constructed a multivariable prediction model for PEF in patients with ALS. The results can be helpful for clinical practice to predict respiratory impairment.

[Determination of Aromatic Compounds Metabolites in Human Urine by Solid Phase Extraction-liquid Chromatography-Tandem Mass Spectrometry].

OBJECTIVE: To establish the method based on high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) with solid phase extraction (SPE) for simultaneous determination of the biological metabolites of aromatic compounds, including N-acetyl-S-phenyl-L-cysteine (SPMA), N-acetyl-S-benzyl-cysteine (SBMA), p-nitrophenol (PNP), methylhippuric acids (MHA), p-Aminophenol (PAP), mandelic acid (MA), phenylglyoxylic acid (PGA) and 1-hydroxypyrene (1-OHP) in urine. METHODS: After adding 20 µL of ß-glucuronidase and 1 mL ammonium acetate buffer solution in 1 mL of urine, the sample was digested in a 37 ℃ incubator for 20 h. After digestion, the enzymatic hydrolysate was purified by PRIME HLB solid phase extraction column. The target compounds were eluted with 4 mL of acetonitrile and blown to dryness with nitrogen, reconstituted with 0.20 mL of methanol. Injected the sample solution into LC-MS/MS system for analysis after filtering with 0.22 µm filter membrane. LC separation was carried out on a reversed-phase C18 column (2.1 mm×150 mm, 3.5 µm); gradient eluting was performed at a flow rate of 0.2 mL/min. The water containing 0.1% formic acid was used as mobile phase A and methanol was used as mobile phase B. The mass spectrometry was performed with multiple reaction monitoring (MRM) mode, using alternating positive and negative ions, and internal standard curves were used for quantification. RESULTS: The eight metabolites showed good linearity within the range of 1-100 ng/mL, with a correlation coefficients greater than 0.995, and the relative precision deviation (RSDs) was 0.050%-9.95%. The method detection limits (MDLs) of the eight target metabolites were 0.041-0.12 ng/mL. The proposed method was used for urine sample analysis and the spiked recoveries were 80.1%-114.0%. CONCLUSION: The established method is quick, sensitive and accurate; it meets the requirementof the biological monitoring of aromatic compounds for the general population and occupational population.

Alkaline aided thermophiles pretreatment of waste activated sludge to increase short chain fatty acids production: Microbial community evolution by alkaline on hydrolysis and fermentation.

Adding alkaline into an anaerobic waste activated sludge (WAS) fermentation with thermophilic bacteria pretreatment could efficiently improve short-chain fatty acids (SCFAs) accumulation to 3550 ± 120 mg COD/L. The acidification rate in combined test was 21.2%, while that was 15.6% and 10.7% in sole thermophilic bacteria pretreatment and control tests respectively. Four distinct groups of microbes could be identified with noticeable shifts using the combined pretreatments, and tremendous effects were analyzed on organic content especially of the soluble proteins and SCFAs concentrations. Particularly, alkaline addition would significantly change the functional microbial structures, including the decrease of Caloramator with the function of thermophilic proteolytic and the increase of Acidobacteria TM7 and Petrimonas sp. The results above suggested that alkaline addition could decrease the hydrolytic substances consume by thermotolerance bacteria and final improve SCFAs accumulation in fermentation process.

TiO2@UiO-68-CIL: A Metal-Organic-Framework-Based Bifunctional Composite Catalyst for a One-Pot Sequential Asymmetric Morita-Baylis-Hillman Reaction.

A chiral ionic liquid (CIL) moiety of a l-pyrrolidin-2-ylimidazole-decorated homochiral UiO-68-type metal-organic framework, UiO-68-CIL (1), was successfully prepared by the combination of a new premodified chiral CIL ligand (H2L-CIL) and ZrCl4 via a solvothermal method. The TiO2-loaded TiO2@UiO-68-CIL (2) was prepared by impregnating 1 in a toluene solution of Ti(OPri)4 and sequential in situ hydrolysis. The obtained 2 can be a bifunctional asymmetric heterogeneous catalyst to successfully promote the one-pot Morita-Baylis-Hillman reaction starting from aromatic alcohols in a tandem way.

Efficacy and safety comparison of everolimus and fulvestrant in patients with estrogen receptor-positive advanced breast cancer progressed after endocrine therapy / 实用医学杂志

Objective To compare the efficacy and safety of everolimus combined with endocrine therapy and fulvestrant in patients with estrogen receptor-positive advanced breast cancer progressed after endocrine thera-py. Methods Ninety-three breast cancer patients were selected from January 2014 to February 2017. The primary end points were progression-free survival and clinical benefit rate and the secondary end points was tolerability. Re-sults The progression-free survival in fulvestrant group was slightly higher than that in the everolimus group(13.4 months vs 12.2 months,P = 0.297). The clinical benefit rates were 46.15% and 31.71% in fulvestrant group and everolimus group,respectively. Patients treated with fewer than 2 lines and endocrine resistant patients benefited more from fulvestrant but without statistical difference. The main adverse events related to everolimus were stomati-tis,with a prevalence rate of about 26% and a localized pneumonia with a prevalence rate of about 10%. The main adverse reaction of fulvestrant was the injection site reaction. Conclusions The efficacy of everolimus in combina-tion with endocrine therapy is not superior to that of fulvestrant for the treatment of advanced breast cancer pro-gressed after endocrine therapy. After weighing the clinical benefits and quality of life,fulvestrant may be better for patients treated with fewer than 2 lines and endocrine resistance.

Smart pH-Responsive Polymer-Tethered and Pd NP-Loaded NMOF as the Pickering Interfacial Catalyst for One-Pot Cascade Biphasic Reaction.

A Pd nano particle (NP)-loaded and nano metal-organic framework (NMOF)-based Pickering emulsifier is reported. The poly[2-(diethylamino)ethyl methacrylate)] (PDEAEMA) chains were grafted onto UiO-66-type NPs via a postsynthetic approach to generate PDEAEMA-g-UiO-66 NMOF (termed as MOF-3). The Pd NPs-loaded Pd@MOF-3 was synthesized via solution impregnation. Stable toluene-in-water Pickering emulsion was prepared with emulsifier Pd@MOF-3. Notably, the obtained Pd@MOF-3 is pH-responsive, and it is able to trigger the emulsification (at neutral condition) and demulsification (at acidic condition) of toluene droplets. Furthermore, it can be a highly active interfacial catalyst to effectively promote one-pot Knoevenagel condensation-hydrogenation cascade reaction at ambient conditions. The pH-responsive property allowed it to be in situ separated and recycled by demulsifying via simply tuning the pH value at the end of the reaction. This smart Pickering emulsion catalytic system is robust, and it can be recycled at least five times without loss of its catalytic activity.

Long-term Results for Sudden Cardiac Death Prevention of Implantable Cardioverter-defibrillator in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy / 中国循环杂志

Objective:Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited cardiomyopathy,which may cause frequent ventricular arrhythmia or even sudden cardiac death (SCD).We observed the long-term follow-up result of high risk ARVC patients received an implantable cardioverter-defibrillator(ICD).Methods:We retrospectively collected ARVC patients with ICD who were treated in our hospital from 1996-12 to 2015-09 for their in-hospital and clinical records and conducted follow-up study.Results:A total of 39 ARVC patients were enrolled including 32 (82.1％) males,the mean age at diagnosis was (42.1±14.8) years and 33 (84.6％) patients suffered from persistent ventricular tachycardia (VT) or ventricular fibrillation (VF) prior to ICD therapy.The median follow-up time was 48.6 (32.3-73.3) months and 7 (7.7％) patients died during that period including 1 sudden death,1 heart failure and 1 cerebral infarction.28 (71.8％) patients received 540 appropriate ICD interventions,5 (12.8％) of them received the first appropriate ICD intervention more than 2 years after initial implantation procedure.12 (30.8％) patients experienced electrical storm and 7 (17.9％) of them with electrical storm more than 2 years after initial implantation procedure.The patients without broad precordial T wave inversion (TWI ≥V1～3) had a shorter eventfree survival period (HR=0.39,95％ CI 0.16-0.96).The application rates of antiarrhythmic drugs and radiofrequency catheter ablation before ICD therapy were similar in patients with or without appropriate ICD intervention,P＞0.05.Conclusion:High risk ARVC patients have frequent ventricular arrhythmia,ICD therapy could effectively stop VT/VF,which was the most reliable method to prevent sudden cardiac death.

Long-term Results for Sudden Cardiac Death Prevention of Implantable Cardioverter-defibrillator in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy / 中国循环杂志

Objective:Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited cardiomyopathy,which may cause frequent ventricular arrhythmia or even sudden cardiac death (SCD).We observed the long-term follow-up result of high risk ARVC patients received an implantable cardioverter-defibrillator(ICD).Methods:We retrospectively collected ARVC patients with ICD who were treated in our hospital from 1996-12 to 2015-09 for their in-hospital and clinical records and conducted follow-up study.Results:A total of 39 ARVC patients were enrolled including 32 (82.1％) males,the mean age at diagnosis was (42.1±14.8) years and 33 (84.6％) patients suffered from persistent ventricular tachycardia (VT) or ventricular fibrillation (VF) prior to ICD therapy.The median follow-up time was 48.6 (32.3-73.3) months and 7 (7.7％) patients died during that period including 1 sudden death,1 heart failure and 1 cerebral infarction.28 (71.8％) patients received 540 appropriate ICD interventions,5 (12.8％) of them received the first appropriate ICD intervention more than 2 years after initial implantation procedure.12 (30.8％) patients experienced electrical storm and 7 (17.9％) of them with electrical storm more than 2 years after initial implantation procedure.The patients without broad precordial T wave inversion (TWI ≥V1～3) had a shorter eventfree survival period (HR=0.39,95％ CI 0.16-0.96).The application rates of antiarrhythmic drugs and radiofrequency catheter ablation before ICD therapy were similar in patients with or without appropriate ICD intervention,P＞0.05.Conclusion:High risk ARVC patients have frequent ventricular arrhythmia,ICD therapy could effectively stop VT/VF,which was the most reliable method to prevent sudden cardiac death.

Predictor Analysis for Super-response to Cardiac Resynchronization Therapy / 中国循环杂志

To analyze the predictors and prognosis for super-response to cardiac resynchronization therapy (CRT) in patients with different etiology. Methods: A total of 181 patients received CRT in our hospital from 2012-01 to 2016-01 were enrolled. The patients were divided into 3 groups: Non-response group, n=63, Response group, n=62 and Super-response group, n=56. The patients were followed-up at 6 months after CRT. Results: There were 30.9% (56/181) patients having super-response. Compared with the other 2 groups, Super-response group had more patients with NYHA II-III and less NYHA IV, the patients were with the smaller LAD, LVESD, LVEDD andless patients had CRT-D implantation. The baseline cardiac function was obviously improved at 6 months after CRT in all 3 groups. The basic LVEDD, LVESD, CRT-D implantation, non-ischemic cardiomyopathy (NICM) and NYHA IV were the independent predictors for super-response occurrence. In addition, compared with ischemic cardiomyopathy (ICM), NICM patients had the higher ratio for super-response occurrence (37.6% vs 7.5%), P<0.001. Survival analysis indicated that NICM patients had the lower risk of all cause mortality (HR=0.31, 95% CI 0.14-0.80), cardiac death (HR=0.27, 95% CI 0.09-0.48) and combined endpoints (HR=0.36, 95% CI 0.27-0.78). Conclusion: At baseline condition, the patients with less degree of left ventricular reconstruction, CRT-D implantation, NICM and NYHA IV had more chance to suffer from super-response after CRT. NICM patients had the better response and prognosis to CRT.

Clinical Features and Outcomes of Cardiac Resynchronization Therapy in 16 Patients With Dilated-phase Hypertrophic Cardiomyopathy / 中国循环杂志

Objective: To analyze the clinical features and outcomes of cardiac resynchronization therapy (CRT) in patients with dilated-phase hypertrophic cardiomyopathy (DHCM). Methods: A total of 16 DHCM patients received CRT in our hospital from 2007-03 to 2016-01 were retrospectively studied to analyze their clinical features and outcomes. Results: There were 12 male and 4 female patients at the mean age of (53.3±13.5) years. Pre-operative QRS duration of ECG was (158.7±32.2) ms, left ventricular ejection fraction (LVEF) was (33.6±6.3) %, the patient with NYHA class I, II, III and IV were 1, 5, 8 and 2 respectively. 13 patients received new CRT device, 3 received upgraded device and 8 (50%) combining atrial fibrillation (AF). The patients were followed-up for (2.56±2.13) years, 5 of them died including 3 of heart failure, 1 of sudden death and 1 of stroke. At 6 months follow-up time, 7 patients had the response to CRT which was defined by the improvement of NYHA class≥1 and the absolute elevation of LVEF≥5%; NYHA class improved from (2.69±0.79) to (2.38±0.89), P=0.02; LVEF increased from (33.6±6.3) % to (40.03±9.83) %, P=0.01. Conclusion: DHCM patients with CRT indication had the higher incidence to suffer from AF, those were more in patients with traditional pacemaker or ICD upgrading. DHCM patients with CRT had the poor general prognosis, while there was still certain proportion of patients had the response to CRT.

Effect of Cardiac Resynchronization Therapy in Patients With Dispersion of Re-polarization and Ventricular Arrhythmia / 中国循环杂志

Objective: To explore the effects of cardiac resynchronization therapy (CRT) in patients with dispersion of re-polarization and ventricular arrhythmia. Methods: A total of 86 consecutive patents with CRT implantation were enrolled. According to weather absolute value of LVEF increased≥10% from baseline at 6 months after CRT implantation, the patients were divided into 2 groups: Response group and Non-response group,n=43 in each group. Dispersion of re-polarization indexes as QRS duration, QTc interval, TpTe interval and the events of ventricular arrhythmia were compared between 2 groups at different time points after CRT. Results:①In Response group, compared with pre-operation, QRS duration and TpTe interval were shorter at 1 year and within 24h after CRT implantation, allP0.05.②During 1 year after CRT implantation, the incidences of PVCs and PVC runs in Response group were much less than those in Non-response group, for lgPVCs: (1.78 ± 0.77) vs (2.73 ± 0.61), for lgPVC runs: (0.64 ± 0.48) vs (1.98 ± 0.72),P Conclusion: CRT ventricular reverse remodeling may reduce dispersion of re-polarization and the risk of ventricular arrhythmia, therefore improve the prognosis in relevant patients; TpTe interval within 24h after CRT had the predictive value for ventricular arrhythmia.

Acute and Chronic Changes and Predictive Value of Tpeak-Tend for Ventricular Arrhythmia Risk in Cardiac Resynchronization Therapy Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Prolongation of the Tpeak-Tend (TpTe) interval as a measurement of transmural dispersion of repolarization (TDR) is an independent risk factor for chronic heart failure mortality. However, the cardiac resynchronization therapy's (CRT) effect on TDR is controversial. Therefore, this study aimed to evaluate CRTs acute and chronic effects on repolarization dispersion. Furthermore, we aimed to investigate the relationship between TpTe changes and ventricular arrhythmia.</p><p><b>METHODS</b>The study group consisted of 101 patients treated with CRT-defibrillator (CRT-D). According to whether TpTe was shortened, patients were grouped at immediate and 1-year follow-up after CRT, respectively. The echocardiogram index and ventricular arrhythmia were observed and compared in these subgroups.</p><p><b>RESULTS</b>For all patients, TpTe slightly increased immediately after CRT-D implantation, and then decreased at the 1-year follow-up (from 107 ± 23 to 110 ± 21 ms within 24 h, to 94 ± 24 ms at 1-year follow-up, F = 19.366,P< 0.001). No significant difference in the left ventricular reverse remodeling and ventricular tachycardia/ventricular fibrillation (VT/VF) episodes between the TpTe immediately shortened and TpTe immediately nonshortened groups. However, patients in the TpTe at 1-year shorten had a higher rate of the left ventricular (LV) reverse remodeling (65% vs. 44%, χ2 = 4.495, P = 0.038) and less VT/VF episodes (log-rank test, χ2 = 10.207, P = 0.001) compared with TpTe 1-year nonshortened group. TpTe immediately after CRT-D independently predicted VT/VF episodes at 1-year follow-up (hazard ratio [HR], 1.030; P = 0.001).</p><p><b>CONCLUSIONS</b>Patients with TpTe shortened at 1-year after CRT had a higher rate of LV reverse remodeling and less VT/VF episodes. The acute changes of TpTe after CRT have minimal value on mechanical reverse remodeling and ventricular arrhythmia.</p>

Operable Breast Cancer of the Inner Hemisphere Is Associated with Poor Survival / 한국유방암학회지

PURPOSE: This study investigated the clinicopathological features of operable breast cancer lesions located in different hemispheres of the breast and determined related survival outcomes. METHODS: Data from 5,330 patients with invasive ductal carcinoma were retrospectively analyzed based on tumor location. RESULTS: The median follow-up time was 68 months (range, 18-176 months). Patients with breast cancer located in the outer hemisphere of the breast had lesions with more advanced nodal stages and more frequently received adjuvant chemotherapy than patients with breast cancer in the inner hemisphere. The 5-year disease-free survival (DFS) rates of patients with tumors located in outer versus inner hemispheres were 81.5% and 77.0%, respectively (p=0.004); the overall survival (OS) rates were 90.7% and 88.8%, respectively (p<0.001). The association between tumor location and the 5-year DFS rate was most apparent in node-positive patients (73.1% vs. 65.8% for outer vs. inner hemisphere lesions, p<0.001) and in patients with primary tumors greater than 2 cm in diameter (78.2% vs. 72.3%, p=0.002). Multivariate analysis showed that tumor location was an independent predictor of DFS (hazard ratio [HR], 1.23; p=0.002) and OS (HR, 1.28; p=0.006). There were no significant differences in 5-year DFS or OS rates between patients with outer versus inner hemisphere tumors when internal mammary node irradiation was performed. CONCLUSION: This study demonstrated that tumor location was an independent prognostic factor for operable breast cancer. Internal mammary node irradiation is recommended for patients with breast cancer of the inner hemisphere and positive axillary lymph nodes or large primary tumors.

Multiple oncogenic mutations related to targeted therapy in nasopharyngeal carcinoma / 癌症

<p><b>INTRODUCTION</b>An increasing number of targeted drugs have been tested for the treatment of nasopharyngeal carcinoma (NPC). However, targeted therapy-related oncogenic mutations have not been fully evaluated. This study aimed to detect targeted therapy-related oncogenic mutations in NPC and to determine which targeted therapy might be potentially effective in treating NPC.</p><p><b>METHODS</b>By using the SNaPshot assay, a rapid detection method, 19 mutation hotspots in 6 targeted therapy-related oncogenes were examined in 70 NPC patients. The associations between oncogenic mutations and clinicopathologic factors were analyzed.</p><p><b>RESULTS</b>Among 70 patients, 12 (17.1%) had mutations in 5 oncogenes: 7 (10.0%) had v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog (KIT) mutation, 2 (2.8%) had epidermal growth factor receptor (EGFR) mutation, 1 (1.4%) had phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA) mutation, 1 (1.4%) had Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation, and 1 (1.4%) had simultaneous EGFR and v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) mutations. No significant differences were observed between oncogenic mutations and clinicopathologic characteristics. Additionally, these oncogenic mutations were not associated with tumor recurrence and metastasis.</p><p><b>CONCLUSIONS</b>Oncogenic mutations are present in NPC patients. The efficacy of targeted drugs on patients with the related oncogenic mutations requires further validation.</p>

The impact of both platinum-based chemotherapy and EGFR-TKIs on overall survival of patients with advanced non-small cell lung cancer / 癌症

Both platinum-based doublet chemotherapy (PBC) and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) prolong the survival of patients with advanced non-small cell lung cancer (NSCLC). In early studies, most patients underwent PBC as first-line treatment, but not all patients could afford EGFR-TKIs as second-line treatment. To understand the impact of PBC and EGFR-TKIs on NSCLC prognosis, we evaluated the association between the receipt of both regimens and overall survival (OS). Using MEDLINE and EMBASE, we identified prospective, randomized, controlled phase III clinical trials in advanced NSCLC that met the inclusion criteria: in general population with advanced NSCLC, the percentage of patients treated with both PBC and EGFR-TKIs was available in the trial and OS was reported. After collecting data from the selected trials, we correlated the percentage of patients treated with both PBC and EGFR-TKIs with the reported OS, using a weighted analysis. Fifteen phase III clinical trials--involving 11,456 adult patients in 32 arms--were included in the analysis, including 6 trials in Asian populations and 9 in non-Asian (predominantly Caucasian) populations. The OS was positively correlated with the percentage of patients treated with both PBC and EGFR-TKIs (r = 0.797, P < 0.001). The correlation was obvious in the trials in Asian populations (r = 0.936, P < 0.001) but was not statistically significant in the trials in predominantly Caucasian populations (r = 0.116, P = 0.588). These results suggest that treatment with PBC and EGFR-TKIs may provide a survival benefit to patients with advanced NSCLC, highlighting the importance of having both modalities available for therapy.