What Is the Optimal Strategy for Drain Removal After Mastectomy and Axillary Surgery in Breast Cancer Patients? A Multicenter, Three-Arm Randomized Clinical Trial.

INTRODUCTION: The best strategy for drain removal after mastectomy and axillary surgery in breast cancer patients has remained controversial. We conducted a multicenter, three-arm randomized clinical trial to determine the optimal strategy. METHODS: A total of 187 eligible breast cancer patients who underwent mastectomy and axillary surgery were randomized into 10 mL (n = 62), 20 mL (n = 63), and 30 mL (n = 63) groups for drain removal on the first day when the output decreased to a corresponding volume in 24 h. The drain duration, total drain duration, incidence of seroma, quality of life, outpatient visit times, healthcare costs, and postoperative complications were evaluated. RESULTS: The median axillary drain durations and total drain durations were all significantly different between three groups (both P < 0.001). The incidences of seroma were 31.1%, 38.3%, and 52.1%, and the difference between the 30 mL and 10 mL groups was significant (RR = 2.41). The 20 mL group reported significantly better quality of life (QoL) in terms of physical functioning (PF) at the 2-week (30 mL versus 20 mL, HR:-14.18) and 3-week (20 mL versus 10 mL, HR: 11.65) follow-up and role functioning (RF) at the 2-week follow-up (20 mL versus 10 mL, HR: 18.15). No between-group differences were found in G-QoL, outpatient visits, costs, or complications. CONCLUSIONS: The 20 mL group had a moderate drain duration, total drain duration, and incidence of seroma but a significant advantage over the other two groups in terms of PF and RF, with relatively low outpatient costs and comparable postoperative complication rates. These findings could aid in clinical decision-making regarding drain removal timing (http://www.chictr.org.cn/: ChiCTR2000028729).

The Prognostic Value of Decreased KLF4 in Digestive System Cancers: A Meta-Analysis from 17 Studies.

BACKGROUND: The prognostic value of loss of Krüppel-like factor 4 (KLF4) expression in digestive system cancers has not reached a consensus. This study aimed for a comprehensive investigation of the internal associations between KLF4 expression loss and prognostic implications in patients with digestive system cancers. METHODS: We searched for all relevant literatures in the electronic databases until February 1, 2017. The degree of association between KLF4 and prognosis was evaluated by pooled hazard ratios (HRs) as well as relevant 95% confidence intervals (95% CIs). RESULTS: Seventeen eligible studies with 2118 patients revealed that loss of KLF4 expression was connected with poor prognosis, with the pooled HRs of 1.61 (95% CI: 1.17-2.20, P = 0.003) for the overall survival (OS) and 1.99 (95% CI: 1.12-3.52, P = 0.001) for the disease-free survival (DFS)/recurrence-free survival (RFS)/metastasis-free survival (MFS). Additionally, loss of KLF4 expression was also related to a worse disease-special survival (DSS) yielding a pooled HR of 1.73 (95% CI: 1.08-2.77, P = 0.022). CONCLUSION: Our findings suggest that loss of KLF4 expression is correlated with a bad outcome in most digestive system cancers, apart from esophagus squamous cell carcinoma (ESCC).

The prognostic value of decreased miR-101 in various cancers: a meta-analysis of 12 studies.

BACKGROUND: A consensus regarding the prognostic value of decreased miR-101 in human cancers has not been reached. This study aimed to comprehensively investigate the internal associations between loss of miR-101 expression and prognostic implications in patients with cancer. MATERIALS AND METHODS: All relevant literature in electronic databases, including PubMed, ISI Web of Science, and Embase, up to March 1, 2017 were searched. Correlations between decreased miR-101 and clinicopathological parameters were defined by odds ratios (ORs). The degree of association between reduced miR-101 and survival outcome was evaluated by pooled hazard ratios (HRs) and relevant 95% CIs. RESULTS: Twelve eligible studies with 2,088 patients were included in this meta-analysis. Decreased miR-101 expression was closely connected with poor overall survival, with a pooled HR of 2.15 (95% CI 1.71-2.7, P<0.001). This correlation was also revealed when stratified analysis was conducted with respect to ethnicity, cancer type, sample size, specimen source, and analysis model. However, decreased miR-101 was not associated with disease-free survival, recurrence-free survival, or progression-free survival, with a pooled HR of 1.59 (95% CI 0.83-3.03, P=0.128), despite a positive trend. In addition, reduced miR-101 was intimately related to poorer tumor differentiation (OR 2.17, 95% CI 1.14-4.13; P=0.019), advanced tumor classification (OR 5.25, 95% CI 3.39-8.12; P<0.001), and higher TNM stage (OR 6.18, 95% CI 3.79-10.09; P<0.001). CONCLUSION: Our findings suggest that loss of miR-101 expression is correlated with worse overall survival in a variety of cancers, and could serve as a predictive indicator for clinicopathological features. Furthermore, miR-101 may become a feasible therapeutic target in most human cancers.

The over-expression of Pim-2 promote the tumorigenesis of prostatic carcinoma through phosphorylating eIF4B.

BACKGROUND: Cell experiments have found Pim-2 may take part in the tumorigenesis of prostatic carcinoma (PCA). More direct evidences are needed, and the detailed anti-apoptotic mechanism of Pim-2 in PCA cells is still unknown. METHODS: Pim-2 expression levels were compared between benign prostatic hyperplasia (BPH) tissues and PCA tissues using real time PCR and Western blot, respectively. Then Pim-2 expression levels were detected in PCA cell lines DU-145 and LNCaP, as well as in nontumorous prostatic epithelial cell lines RWPE-1 and PNT1a, using real time PCR and Western blot, respectively. The co-expression of Pim-2 and eukaryotic initiation factor 4B (eIF4B) was examined by immunofluorescence cytochemistry using laser scanning confocal microscope. Finally, Pim-2 SiRNA was transfected into DU-145 cells and Pim-2 was transfected into RWPE-1 cells, and the level of Pim-2 and phosphorylated eukaryotic initiation factor 4B (p-eIF4B) were detected, as well as the apoptosis rate. RESULTS: The Pim-2 mRNA and protein level were significantly higher in PCA tissues than those in BPH tissues. The Pim-2 mRNA and protein level in DU-145 and LNCaP cells were significantly higher than those in RWPE-1 and PNT1a cells. Pim-2 and eIF4B could co-express in DU-145 cells. Pim-2 level determined the phosphorylation level of eIF4B and the apoptosis rate of prostatic cells. The higher Pim-2 expressed, the more eIF4B phosphorylated, then the less cell got apoptosis, and vice versa. CONCLUSION: Pim-2 was over-expressed in PCA cell lines and tissues. It may inhibit the apoptosis of PCA cells through phosphorylating eIF4B, thus promote the tumorigenesis of PCA.

Assessment of sperm antigen specific T regulatory cells in women with recurrent miscarriage.

BACKGROUND AND AIMS: The prevalence of recurrent miscarriage (RM) is about 1-3% of women; the pathogenesis of RM is not fully understood yet. This study aims to assess the sperm antigen specific regulatory T cells (Treg) in women with RM. METHODS: A group of women with RM was recruited into this study. The sperm antigen was extracted from the semen samples of each woman's husband. The sperm antigen specific T cell response was assessed by flow cytometry. RESULTS: Low frequency of sperm specific Tregs and high frequency of T helper (Th)1 cells were detected in RM women as compared with women without RM. The sperm specific Tregs in RM women expressed less Ubc13. Knockdown of Ubc13 from Tregs converted the Tregs to effector T cells. CONCLUSIONS: Immune deregulation may play an important role in RM.

Clinical significance and expression of PAF and TNF-alpha in seminal plasma of leukocytospermic patients.

OBJECTIVE: Discuss the changes and roles of PAF in the reproductive tract infection by observing the expression of platelet activating factor (PAF) and tumor necrosis factor α (TNF-α) in seminal plasma of patients with leukocytospermia. METHODS: The seminal plasma was obtained from 22 cases of leukocytospermia and 15 cases of normal males; the peroxidase dyeing method was adopted for seminal plasma white blood count; the ELISA was adopted to test PAF and TNF-α concentration in seminal plasma. RESULT: PAF concentration (2.14 ± 0.43 ng/mL) of leukocytospermia group was significantly lower than the normal group (6.21 ± 1.38 ng/mL, P < 0.01) while TNF-α (5.51 ± 1.46 ng/mL) was significantly higher than that of normal group (3.48 ± 1.08 ng/mL). There was negative correlation between PAF and TNF-α , (r = -0.68, P < 0.01); the same situation existed in PAF and WBC (r = -0.62, P < 0.01); but TNF-α was positively correlated to WBC (r = 0.77, P < 0.01). CONCLUSION: (1) Low expression of PAF and high expression of TNF-α in leukocytospermia affect the sperm motility, which is one of the reasons that leads to infertility. (2) Lower expression of PAF has its particularity during the reproductive tract infection.

Transplantation of endothelial progenitor cells transfected with VEGF165 to restore erectile function in diabetic rats.

The present study investigated the effect of transplanting endothelial progenitor cells (EPCs) transfected with the vascular endothelial growth factor gene (VEGF165) into the corpora cavernosa of rats with diabetic erectile dysfunction (ED). A rat model of diabetic ED was constructed via intraperitoneal injection of streptozotocin. After streptozotocin treatment, pre-treated EPCs from each of three groups of rats were transplanted into their corpora cavernosa. Our results, following intracavernosal pressure (ICP) monitoring, showed that ICP increased significantly among rats in the trial group when compared to the results from rats in the blank-plasmid and control groups during basal conditions and electrical stimulation (P<0.01 for both comparisons). Histological examination revealed extensive neovascularisation in the corpora cavernosa of rats in the trial group. Fluorescence microscopy indicated that many of the transplanted EPCs in the trial group survived, differentiated into endothelial cells and integrated into the sites of neovascularisation. Based on the results of this study, we conclude that transplantation of VEGF165-transfected EPCs into the corpora cavernosa of rats with diabetic ED restores erectile function.

[Clinical observation on therapeutic effect of electroacupuncture on chronic prostatitis and detection of urethral sphincter EMG].

OBJECTIVE: To observe the clinical therapeutic effect of electroacupuncture for chronic prostatitis and investigate its mechanism. METHODS: Forty-eight cases were randomly divided into an electroacupuncture group and a western medicine group, 24 cases in each group. The electroacupuncture group was treated by electroacupuncture and Guanyuan (CV 4), Zhongji (CV 3). Ciliao (BL 32) and Huiyang (BL 35) were selected as main acupoints. The western medicine group was treated by oral administration of Sparfloxacin tablets and Prostat tablets. The scores of NIH-CPSI, changes in uroflow rate-urethral sphincter EMG and their therapeutic effects were observed. RESULTS: The total effective rate was 87.5 % in the electroacupuncture group which, was better than 62. 5% in the western medicine group (P(<0. 05). There were significant differences in the scores of NIH-CPSI and Q(max), Q(ave), TL value before and after treatment in the electroacupuncture group (all P<0.05), and with a significant difference in the scores of NIH-CPSI and Q(max). Q(ave), TL value after treatment between the two groups (all P<0.05). CONCLUSION: Electroacupuncture based on syndrome differentiation has better therapeutic effect on chronic prostatitis than that of routine clinical medicine.

[Effect of eucommia ulmoides oliv on SOD activity and alpha-actin expression in the penile tissues of diabetic rats].

OBJECTIVE: To study the effect of aqueous abstract from eucommia ulmoides oliv on the activity of superoxide dismutase (SOD) and alpha-actin expression in the penile tissues of rats with diabetes mellitus (DM) in vitro. METHODS: A diabetes model was established by administration of alloxun twice to Sprague Dawley (SD) rats. Ten diabetic and 10 normal rats were randomly selected and the penile strips of each rat were divided into four equal shares and cultured in two groups, a eucommia ulmoides oliv coculture group (Group A, further dicided into 1 microg/ml, 10 microg/ml and 100 microg/ml subgroups) and a control group (Group B). Seven days later, the activity of SOD in the culture medium was detected by spectrophotometry, and the levels of micro-actin expression in the penile tissues were examined with the immunohistochemical method. RESULTS: Compared with Group B, the activity of SOD in the culture medium in athe 10 and 100 microg/ml subgroups was notably elevated (P < 0.01), and the numbers of immunoreactive positive cells of alpha-actin in the penile tissues remarkably increased (P < 0.01). CONCLUSION: The activity of SOD and alpha-actin expression in the penile tissues of diabetic rats in vitro can be increased by eucommia ulmioides oliv.