The Association between ER, PR, HER2, and ER-/PR+ Expression and Lung Cancer Subsequent in Breast Cancer Patients: A Retrospective Cohort Study Based on SEER Database.

Aims: The available research on the association between estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), ER-/PR+ status, and the occurrence of lung cancer subsequent to breast cancer in patients (referred to as BC-LuC) had been limited. Consequently, there is a need to examine whether ER, PR, HER2, and ER-/PR+ have independent correlations with the risk and outcomes of BC-LuC, while appropriately adjusting for other potential covariates. Methods: The present study employed a cohort design and utilized data from the Surveillance, Epidemiology, and End Results (SEER) program spanning from 2010 to 2015. The study population consisted of 683,336 individuals who were diagnosed with breast cancer (referred to as BC). Various covariates were assessed at baseline, including age, sex, race, marital status, CS tumor size, laterality, radiation, chemotherapy, months from diagnosis to treatment, breast subtype, AJCC 7th edition (2010-2015), and combined summary stage (2004+). The primary objective of this study was to investigate the association between ER, PR, HER2, ER-/PR+ status, and the risk of developing BC-LuC. Logistic regression analysis was employed to assess this association. Furthermore, multivariable Cox regression analyses were conducted to calculate adjusted hazard ratios (HRs) along with their respective 95% confidence intervals (CIs). Kaplan-Meier plots and log-rank tests were utilized to estimate the outcomes, specifically overall survival (OS), disease-specific survival (DSS), and metastasis. Results: The average age of 198,972 selected participants was 59.8 ± 13.1 years, and about 99.3% of them were female. Result of fully adjusted binary logistic regression showed PR+ and HER2+ were positively associated with lower risk BC-LuC after adjusting confounders (ORs = 0.84, 95% CI: 0.73-0.96, p = 0.011 and ORs = 0.83, 95% CI: 0.72-0.96, p = 0.012, respectively). ER+ and ER-/PR+ were detected no significant relationship with BC-LuC (ORs = 1.03, 95% CI: 0.87-1.22, p = 0.718 and ORs = 1.02, 95% CI: 0.61-1.72, p = 0.936, respectively). In subgroups analyses, the results remain stable. Multivariable Cox regression showed that BC-LuC patients with ER and PR were significantly associated with OS and DSS. However, ER, PR, HER2, and ER-/PR+ were significantly associated with OS and DSS in breast cancer patients. The relationship between ER, PR, HER2, and ER-/PR+ and metastasis in breast cancer patients was different. Conclusion: The results of this study indicated a potential correlation between PR- and HER2- status and a risk of developing BC-LuC. Furthermore, it appears that the prognosis of BC-LuC may be influenced by the presence of ER+ and PR+. Therefore, additional research is warranted to fully investigate and validate this association.

Differences of Structural Plasticity between Hemispheres during Rehabilitation for Subacute Stroke / 中国康复理论与实践

Objective:To explore the differences in plasticity mechanism of cortical structure between hemispheres during rehabilitation for stroke patients at subacute stage. Methods:From October 20, 2018 to February 1, 2020, 22 patients with first-onset subcortical ischemic stroke completed the assessments of MRI and clinical evaluation at admission, and after one and two months of rehabilitation. Cortical surface area, thickness, and volume were measured to evaluate cortical structure plasticity. Two-way repeated measures analyses of variance were implemented to estimate dynamic cortical morphology changes and differences between hemispheres. Results:A significant time effect occurred between admission and after one month of rehabilitation for both hemispheres. Cortical surface area, thickness and volume for most regions in both hemispheres gradually decreased, while parahippocampal gyrus thickness and volume increased. The surface area and volume of postcentral gyrus was significant between both hemispheres (F > 4.305, P < 0.05), in which ipsilesional hemisphere was lower than contralesional hemisphere. The reduction of the thickness (r = -0.474, P = 0.026) and volume (r = -0.432, P = 0.044) of postcentral gyrus in ipsilesional hemisphere was negatively correlated with the recovery rate of motor function. Conclusion:There are differences in cortical structure plasticity during stroke rehabilitation between hemispheres. Cortical morphology markedly changes in the first two months poststroke. The greater the reduction in thickness and volume of postcentral gyrus in ipsilesional hemisphere is, the worse the recovery of motor function may be.

Advance in Magnetic Resonance Imaging Research of Rehabilitation Therapy on Cerebral Network Remodeling of Motor Deficits after Stroke (review) / 中国康复理论与实践

With the development of rehabilitation researches for post-stroke motor dysfunction, functional magnetic resonance imaging (fMRI) on nerve injury has also attracted extensive attention. Subcortical lesions of stroke affect nearby or distal brain areas, leading to motor dysfunction. Mirror neuron system therapy, repetitive transcranial magnetic stimulation and transcranial electrical stimulation can activate relevant regions of cerebral cortex in a non-invasive way, and restore the balance between cerebral hemispheres, which can regulate the whole brain network circuit. However, there is a lack of grade A evidence for the effects of transcranial electrical stimulation. Although acupuncture and moxibustion can widely regulate the topological structure of the whole brain functional network nodes, it cannot fully explain the therapeutic mechanism of acupuncture and moxibustion due to the differences of acupuncture point selection, manipulation, time, and channels. The interactive application of rehabilitation therapy and neuroimaging is becoming a new direction of stroke treatment research.