Clinicopathological Features and Long-Term Prognostic Role of Human Epidermal Growth Factor Receptor-2 Low Expression in Chinese Patients with Early Breast Cancer: A Single-Institution Study.

Objective: This study aimed to comprehensively analyze and compare the clinicopathological features and prognosis of Chinese patients with human epidermal growth factor receptor 2 (HER2)-low early breast cancer (BC) and HER2-IHC0 BC. Methods: Patients diagnosed with HER2-negative BC ( N = 999) at our institution between January 2011 and December 2015 formed our study population. Clinicopathological characteristics, association between estrogen receptor (ER) expression and HER2-low, and evolution of HER2 immunohistochemical (IHC) score were assessed. Kaplan-Meier method and log-rank test were used to compare the long-term survival outcomes (5-year follow-up) between the HER2-IHC0 and HER2-low groups. Results: HER2-low BC group tended to demonstrate high expression of ER and more progesterone receptor (PgR) positivity than HER2-IHC0 BC group ( P < 0.001). The rate of HER2-low status increased with increasing ER expression levels (Mantel-Haenszel χ 2 test, P < 0.001, Pearson's R = 0.159, P < 0.001). Survival analysis revealed a significantly longer overall survival (OS) in HER2-low BC group than in HER2-IHC0 group ( P = 0.007) in the whole cohort and the hormone receptor (HR)-negative group. There were no significant differences between the two groups in terms of disease-free survival (DFS). The discordance rate of HER2 IHC scores between primary and metastatic sites was 36.84%. Conclusion: HER2-low BC may not be regarded as a unique BC group in this population-based study due to similar clinicopathological features and prognostic roles.

Chinese pediatric Tuina can prevent premature infant feeding intolerance and is conducive to weight gain: a prospective randomized controlled study.

Objective: Preterm birth is one of the most important health problems in the world. Feeding intolerance is one of the most common and serious complications of premature infant. The purpose of this study was to explore the effect of Chinese pediatric Tuina on the prevention of feeding intolerance in favour of weight gain in premature infants. Methods: A prospective randomized controlled study was conducted in the Department of Neonatology in our hospital. Premature infants were recruited and randomly assigned to an intervention group or a control group. Premature infants in the intervention group received a Chinese pediatric Tuina intervention by professional chiropractors, while premature infants in the control group received standard care. The incidence of feeding intolerance and weight gain situation were compared between the two groups. Result: After 1 week of intervention, the body weight (2.5±0.5 vs 2.0±0.4, p=0.038), head circumference (32.8±1.7 vs 29.9±1.4, p=0.041), albumin (34.6±5.8 vs 28.4±6.1, p-0.026) and prealbumin (155.8±35.2 vs 113.6±36.8, p=0.021) of preterm infants in the intervention group were significantly better than those in the control group. The incidence of feeding intolerance (7 vs 15, p=0.032) in the intervention group was significantly lower than that in the control group. Although there were no statistically significant differences (P>0.05), the incidences of gastrointestinal bleeding, necrotizing enterocolitis, and liver insufficiency were lower in the intervention group than in the control group. Conclusion: Chinese pediatric Tuina can effectively prevent the occurrence of feeding intolerance in premature infants and be conducive to the weight gain and improving nutritional status of premature infants.

Temporal retinal thinning might be an early diagnostic indicator in male pediatric X-linked Alport syndrome.

AIM: To evaluate temporal retinal thinning changes in retinal layers using spectral-domain optical coherence tomography (SD-OCT) in pediatric X-linked Alport syndrome (XLAS) patients. METHODS: A retrospective case-control study. SD-OCT scans of pediatric patients diagnosed with XLAS and age- and sex-matched healthy control participants were reviewed. Automated segmentation of SD-OCT scans was induced to analyze the retinal thickness (RT) of different layers. The temporal thinning index (TTI) was calculated for each layer and compared between the patients and the control group. RESULTS: Forty-three pediatric XLAS patients and 60 healthy controls were included. Temporal retinal thinning was present in 33 patients (76.74%), while 28 patients (65.11%) had severe pathological temporal retinal thinning and 5 patients (11.63%) had moderate thinning. The temporal inner sector RT (P<0.0001), the temporal outer sector RT (P<0.0001), and the nasal outer sector RT (P=0.0211) were significantly thinner in the XLAS male patients. The TTI of the total retina was significantly higher in the XLAS group than in the control group (P<0.0001). The TTI of the inner retina layers (P<0.0001), ganglion cell layer (P<0.0001), inner plexiform layer (P<0.0001), inner nuclear layer (P<0.0001), and outer nuclear layer (P<0.0001) were significantly higher in the XLAS group. The central RT of the XLAS group was significantly thinner than that of the control group (P<0.0001). CONCLUSION: Temporal retinal thinning appears early in XLAS patients, especially in male patients. The thinning is mainly caused by structural abnormalities of the inner retina. This suggests that temporal retinal thinning could be helpful for the early diagnosis and follow-up of XLAS with noninvasive SD-OCT examination.

Nobiletin Inhibits Hypoxia-Induced Placental Damage via Modulating P53 Signaling Pathway.

In this study, we aimed to evaluate the effect of Nobiletin (NOB) on the placenta of Sprague-Dawley (SD) rats that had undergone reduced uterine perfusion pressure (RUPP) surgery and to evaluate the safety of NOB intervention during pregnancy. The results showed that NOB alleviated placental hypoxia, attenuated placental cell apoptosis, and inhibited placental damage in RUPP rats. No side effect of NOB intervention during pregnancy was observed. BeWo cell lines with P53 knockdown were then constructed using lentiviral transfection, and the P53 signaling pathway was found to be essential for NOB to reduce hypoxia-induced apoptosis of the BeWo cell lines. In summary, NOB attenuated hypoxia-induced placental damage by regulating the P53 signaling pathway, and those findings may contribute some insights into the role of NOB in placental development and the prevention of placental-related diseases.

Ultrasound Features Improve Diagnostic Performance of Ovarian Cancer Predictors in Distinguishing Benign and Malignant Ovarian Tumors.

To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors, we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from September 2014 to November 2016. Age, menopausal status, histopathology, the International Federation of Gynecology and Obstetrics (FIGO) stages, tumor biomarker levels, and detailed ultrasound reports of patients were collected. The area under the curve (AUC), sensitivity, and specificity of the bellow-mentioned predictors were analyzed using the receiver operating characteristic curve. Of the 719 patients, 531 had benign lesions, 119 had epithelial ovarian cancers (EOC), 44 had borderline ovarian tumors (BOT), and 25 had non-EOC. AUCs and the sensitivity of cancer antigen 125 (CA125), human epididymis-specific protein 4 (HE4), Risk of Ovarian Malignancy Algorithm (ROMA), Risk of Malignancy Index (RMI1), HE4 model, and Rajavithi-Ovarian Cancer Predictive Score (R-OPS) in the overall population were 0.792, 0.854, 0.856, 0.872, 0.893, 0.852, and 70.2%, 56.9%, 69.1%, 60.6%, 77.1%, 71.3%, respectively. For distinguishing EOC from benign tumors, the AUCs and sensitivity of the above mentioned predictors were 0.888, 0.946, 0.947, 0.949, 0.967, 0.966, and 84.0%, 79.8%, 87.4%, 84.9%, 90.8%, 89.1%, respectively. Their specificity in predicting benign diseases was 72.9%, 94.4%, 87.6%, 95.9%, 86.3%, 90.8%, respectively. Therefore, we consider biomarkers in combination with ultrasound features may improve the diagnostic performance in distinguishing malignant from benign ovarian tumors.

Sparing the pronator quadratus for volar plating of distal radius fractures: a comparative study of two methods.

OBJECTIVES: The objective of this study was to compare the results of two methods for sparing the pronator quadratus in volar plating of distal radius fractures. METHODS: A total of 110 patients were randomized to volar plating with sparing of the pronator quadratus either by a transverse incision along the distal border of the pronator quadratus (Group A, 55 people) or by the brachioradialis splitting method (Group B, 55 people). The operative and radiation time, range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, Visual Analog Scale (VAS) scores, and complications were recorded. RESULTS: There were no significant differences in the mean operative time, radiation time, mean bone union time, or total complication rate between the groups. We found no significant differences in range of motion, grip strength, VAS scores, and DASH scores at any of the study intervals between the groups. Although neurapraxia of the superficial branch of the radial nerve was more common in Group B than in Group A (6.7% vs. 0%), the difference was not significant. CONCLUSIONS: Both methods were efficient approaches for sparing the pronator quadratus and had similar clinical outcomes, but they had different indications.

Backflow Effect Enabling Fast Response and Low Driving Voltage of Electrophoretic E-ink Dispersion by Liquid Crystal Additives.

Electrophoretic display encountered several challenges towards high frame rate applications, such as long response time and high driving voltage. In this study, liquid crystal additive doping can simultaneously increase the response speed by 2.8 times and reduce the driving voltage to half of the initial value of electrophoretic dispersion. The backflow effect of liquid crystal, which induces an inversely electrorheological effect and facilitates the reverse micelles' dielectrophoretic separation, was suggested to be the main reason for the performance improvement. The proposed method is facile and effective which shows promising potential for fast response and low power consumption e-paper applications.

Structure characterization and immunological activity of a ß-glucan from White H. marmoreus and its silver nanoparticle derivatives.

White H. marmoreus is widely used as an ingredient of traditional Chinese dishes. In this study, a ß-glucan noted as WHP was isolated from alkaline extract of white H. marmoreus. The structure of WHP was investigated by FT-IR, NMR, methylation and partial acid hydrolysis. The results showed that the main chain of WHP was composed of (1→3)-ß-D-Glcp, with an average of three to four residues of O-6 linked with 1-ß-D-Glcp. Moreover, a nanoderivative (AgNPs) of WHP was prepared. The most AgNPs were synthesized when the concentration ratio of AgNO3 to WHP was 0.25. Immunological activity tests indicated that WHP had superior cell proliferation activity and its maximum proliferation index was 1.62. AgNPs could also stimulate the proliferation of macrophage RAW264.7. WHPS could better increase the phagocytosis, immunological activity of macrophage RAW264.7. The difference in immunological activity between WHP, AgNPs and WHPS evidently resulted from their structural distinction.

Removal of broken reamer stuck into femoral shaft in implanting PFNA: a case report.

Femoral intertrochanteric fracture is very common in elderly population. The usual treatment for these patients is intra-extramedullary fixation. In normal situations, expand medullary cavity is needed, in order to implant various intramedullary implants. On rare occasion, which will in turn lead to the reamer is stuck into the medullary cavity of femoral shaft. Open or closed technique for moving of the broken nails had been reported before. We firstly report a novel technique by using handy tool which included in orthopaedic instrument set to remove the broken reamer stuck into femoral cavity when implanting a PFNA.

[Analysis of the Temporal and Spatial Distribution of the Diversity of the Denitrifying Anaerobic Methane-Oxidizing Bacterial Community in the Sediments of the Hunhe River and Its Relationship with Environmental Factors].

16S rRNA and pmoA functional genes were used as biomarker genes to investigate the temporal and spatial distribution of community diversity of Candidatus Methylomirabilis oxyfera (M. oxyfera) in the sediments of the Hunhe River by clone library technology. The dependence relationship between the physicochemical property of water and sediment samples and the diversity characteristics of the M. oxyfera community were analyzed by multivariate direct gradient analysis. Among the examples collected in September 2014, the OTU number of the 16S rRNA gene of M. oxyfera was 2-5, the Shannon-Wiener diversity index was 0.21-1.4, and the distribution characteristics in the middle reaches > upstream > downstream were presented. The OTU number and Shannon-Wiener diversity index of the pmoA functional gene in upstream samples are significantly higher than those in the middle and lower reach samples, and the Shannon-Wiener diversity indices in the upstream samples are 3.5 times and 2.3 times higher than that of the middle and the downstream samples, respectively. The community diversity of M. oxyfera showed a distinct regional distribution. Samples were collected at 3 sampling points in March 2015. The OTU values of 16S rRNA and pmoA for M. oxyfera are 6 and 5 respectively, which were obviously higher than those in September 2014. The Shannon-Wiener index is also higher than that in September 2014 (1.4>0.68; 57>0.00). The community diversity of M. oxyfera showed obvious seasonal distribution characteristics. Multivariate direct gradient analysis results showed that the concentration of DOC in water, sediment conductivity, TOC concentration, and nitrite concentration in the sediment are the main environmental factors affecting the community diversity of M. oxyfera.

[Diagnostic value of CA125, HE4 and Copenhagen Index in differentiating benign from malignant epithelial ovarian tumors].

OBJECTIVE: To analyze diagnostic value of Copenhagen Index based on pretreatment serum CA125, HE4 and age in differentiating benign and malignant epithelial ovarian tumors. METHODS: The clinical data were analyzed for 208 consecutive patients with epithelial ovarian tumors (including 100 with malignant and 108 with benign tumors) treated in our department between September, 2014 and September, 2016. The receiver-operating characteristic curve was drawn based on the golden standard of pathological diagnosis for calculation of the diagnostic sensitivity and specificity of CA125, HE4 and the Copenhagen Index. RESULTS: In the overall cases, early stage cases and advanced stage cases, the prediction probabilities of CA125, HE4 and Copenhagen Index were all significantly higher for malignant than in benign tumors (P<0.001). The sensitivities of CA125, HE4, Copenhagen Index for differentiating benign and malignant tumors were 81.0%, 86.0% and 91.0% in the overall cases, 64.0%, 68.0% and 72.0% in early stage cases, and 86.7%, 92.0% and 97.3% in advanced stage cases, and their diagnostic specificities were 88.0%, 93.5% and 96.3%, respectively. Copenhagen Index had the highest diagnostic sensitivity (but not in early stage cases) and specificity followed by HE4 and then by CA125 (P<0.001) (P>0.05). CONCLUSION: Copenhagen Index combined with CA125, HE4 and age hase better diagnostic value than HE4 or CA125 alone for differentiation between benign and malignant epithelial ovarian tumors, and can be used clinically to improve the early diagnostic rate of epithelial ovarian cancer.